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  1. Extended Criteria Donors in Liver Transplantation.

    PubMed

    Vodkin, Irine; Kuo, Alexander

    2017-05-01

    Mortality rates on the liver transplant waiting list are increasing. The shortage of organs has resulted in higher utilization of extended criteria donors (ECDs), with centers pushing the limits of what is acceptable for transplantation. Donor quality is more appropriately represented as a continuum of risk, and careful selection and matching of ECD grafts with recipients may lead to excellent outcomes. Although there is no precise definition for what constitutes an ECD liver, this review focuses on frequently cited characteristics, including donor age, steatosis, donation after cardiac death, and donors with increased risk of disease transmission.

  2. Endocrine Disrupting Chemicals (EDCs)

    MedlinePlus

    ... Center Pacientes y Cuidadores Hormones and Health The Endocrine System Hormones Endocrine Disrupting Chemicals (EDCs) Steroid and Hormone ... Hormones and Health › Endocrine Disrupting Chemicals (EDCs) The Endocrine System Hormones Endocrine Disrupting Chemicals (EDCs) EDCs Myth vs. ...

  3. Criteria for selecting organ donors and recipients.

    PubMed

    Michielsen, P

    1990-11-01

    As there is a world-wide shortage of organs for transplantation, the selection of the patients is more defined by the availability of transplantable organs than by the medical condition of the potential recipient. This shortage of cadaveric organs is mainly responsible for the use of living donors. With HLA identical sibling donors the results are better than with cadaveric organs, but the ethical problems are usually underestimated. For the parent-to-child donation, the HLA compatibility is less than what could be achieved with well-matched cadaveric donors. The use of genetically unrelated donors is unacceptable from the ethical as well as from the medical point of view. The short- and long-term risk of donation has been insufficiently documented. The experience with the introduction of an opting-out legislation in Belgium in 1987 demonstrates that the shortage of cadaveric organs can be overcome. Harmonization of the legislation is, however, necessary so as to achieve comparable organ retrieval rates between countries participating in organ-exchange organisations.

  4. Comparative study between kidney transplantation with deceased donor expanded criteria and donor standard criteria in a single center in Brazil.

    PubMed

    Mota, Luana Soriano; Oliveira, Claudia Maria Costa de; Pinheiro, Francisco Martho Leal; Santos, Larissa Costa de Oliveira; Nóbrega, Danilo Gonçalves; Fernandes, Paula Fbc; Costa, Alda Angélica de Melo; Silva, Sônia Leite da

    2016-01-01

    Kidney transplants with expanded criteria donor have been associated with improved patient survival compared to those who remain on dialysis. To compare renal function and survival of the kidney graft of deceased donor with expanded criteria and standard criteria over a year in a single transplant center. 255 kidney transplant recipients with deceased donor were included in the study between the years 2011 to 2013 and they were separated into two groups according to the type of donor (expanded criteria donor - ECD - and standard criteria donor - SCD). 231 deceased donor transplants (90.6%) were performed with standard criteria donor (SCD) and 24 (9.4%) with expanded criteria donor (ECD). There was no difference in the prevalence of delayed graft function - DGF - (62.9% vs. 70.8%; p = 0.44). Expanded criteria donor group had lower glomerular filtration rate (GFR) at the end of the 1st year (56.8 ± 26.9 vs. 76.9 ± 23.7; p = 0.001). Patient survival was significantly lower in the ECD group, but the graft survival was not different after death-censored analysis. The ECD group was associated with significantly lower levels of GFR during the first year of transplant and a lower patient survival at the 1st year when compared to the SCD. A aceitação dos rins com critério expandido de doação tem sido associada com melhor sobrevida do paciente em comparação àqueles que permanecem em terapia dialítica. Comparar a função renal e a sobrevida do enxerto renal de doador falecido critério expandido com os de doador falecido critério padrão ao longo de um ano em um único centro de transplantes. Foram incluídos 255 receptores de transplante renal com doador falecido, realizados entre os anos de 2011 a 2013, sendo divididos em dois grupos segundo o tipo de doador (critério expandido - DCE - ou padrão -DCP). Foram avaliados 231 receptores com doador critério ideal (90,6%) e 24 com doador critério expandido (9,4%). Não houve diferença na prevalência de fun

  5. Deceased donor organ transplantation with expanded criteria donors: a single-center experience from India.

    PubMed

    Goplani, K R; Firoz, A; Ramakrishana, P; Shah, P R; Gumber, M R; Patel, H V; Vanikar, A V; Trivedi, H L

    2010-01-01

    Deceased donor organ transplantation (DDOT) accounts for <4% of renal transplants in India. Many volunteers come forth for organ donation with increasing awareness; unfortunately, the majority are marginal donors, but their rejection would hamper the DDOT program. Judicious use of marginal organs is a challenge for developing countries. We performed 29 renal transplants from 21 expanded criteria donors (ECD) out of 115 DDOT between January 2006 to April 2009-10 dual (DKT) and 19 single (SKT). Fourteen donors had hypertension, a cerebrovascular accident as the cause of death, 9 had both, and 4 had diabetes. Mean donor age was 70.3 +/- 8.9 years. Decisions on the procedure were based upon frozen section biopsy in 13 of 21 donors. Mean DKT donor age was 76 +/- 9.7 years versu 64 +/- 5.7 years of SKT donors. The native kidney diseases were chronic glomerulonephritis (n = 14), diabetic nephropathy (n = 7), tubulointerstitial nephritis (n = 4) and polycystic kidney disease, focal segmental glomerulosclerosis, lupus nephritis and patchy cortical necrosis, (n = 1 each). Mean recipient age of DKT versus SKT was 43.5 versus 42.3 years. All recipients received rabbit anti-thymocyte globulin, followed by steroid, mycophenolate mofetil/calcinueurin inhibitor. Over a mean follow-up of 341 days, the mean serum creatinine (SCr) of 25/29 patients was 1.60 mg/dL (range, 1.0-2.6). The mean SCr of SKT patients was 1.59 +/- 0.63 mg/dL and of DKT, 1.62 +/- 0.48 mg/dL. Ten patients had delayed graft function and 11 had biopsy proven acute tubular necrosis. Seven (24%) patients had rejection (grade 3 Banff update '05, type IA; 4, type 2A); 6 responded to antirejection; 1 graft was lost at 7 months due to chronic rejection. Three (10.3%) patients were lost, 1 each due to AMI, sepsis, and CMV disease. In the circumstances of organ shortage, DDOT with expanded criteria donor is a feasible option.

  6. Utilization of kidneys with similar kidney donor risk index values from standard versus expanded criteria donors.

    PubMed

    Woodside, K J; Merion, R M; Leichtman, A B; de los Santos, R; Arrington, C J; Rao, P S; Sung, R S

    2012-08-01

    With the shortage of standard criteria donor (SCD) kidneys, efficient expanded criteria donor (ECD) kidney utilization has become more vital. We investigated the effects of the ECD label on kidney recovery, utilization and outcomes. Using data from the Scientific Registry of Transplant Recipients from November 2002 to May 2010, we determined recovery and transplant rates, and modeled discard risk, for kidneys within a range of kidney donor risk index (KDRI) 1.4-2.1 that included both SCD and ECD kidneys. To further compare similar quality kidneys, these kidneys were again divided into three KDRI intervals. Overall, ECD kidneys had higher recovery rates, but lower transplant rates. However, within each KDRI interval, SCD and ECD kidneys were transplanted at similar rates. Overall, there was increased risk for discard for biopsied kidneys. SCD kidneys in the lower two KDRI intervals had the highest risk of discard if biopsied. Pumped kidneys had a lower risk of discard, which was modulated by KDRI for SCD kidneys but not ECD kidneys. Although overall ECD graft survival was worse than SCD, there were no differences within individual KDRI intervals. Thus, ECD designation adversely affects neither utilization nor outcomes beyond that predicted by KDRI.

  7. Can living donor liver transplantation offer similar outcomes to deceased donor liver transplantation using expanded selection criteria for hepatocellular carcinoma?

    PubMed

    Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin

    2015-01-01

    To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria.

  8. Criteria for initiation and evaluation of minority donor programs and application to the example of donors of Turkish descent in Germany.

    PubMed

    Schmidt, A H; Solloch, U V; Baier, D; Yazici, B; Ozcan, M; Stahr, A; Schumacher, S; Ehninger, G; Rutt, C

    2009-10-01

    Minority donor programs aim to improve access to unrelated hematopoietic SCT for specific ethnic groups through directed donor recruitment. We have developed criteria for initiation and evaluation of such programs and applied them to the situation of donors of Turkish descent in Germany, as well as a program by DKMS German Bone Marrow Center that targets this group. Criteria for program initiation include the number of accessible minority donors, potential impact on the chances of finding matching donors, and general access to unrelated transplantation for patients of the targeted group. Success criteria comprise number and availability of recruited donors, the effect of these donors on the HLA phenotype distribution of a donor file, and the number of donations resulting from the program. More than 40 000 donors of Turkish descent have been recruited within the analyzed program to date. Recruited minority donors show more favorable demographic characteristics but lower availability rates than do German donors. Although HLA haplotype distributions of Turkish and German donors differ considerably, patients with common Turkish HLA phenotypes should benefit from the German donor pool even without a specific minority program. The analysis of donations from minority donors, however, shows specific benefits for patients with rare HLA phenotypes.

  9. Assessment of Graft Selection Criteria in Living-Donor Liver Transplantation: The Jikei Experience.

    PubMed

    Shiba, Hiroaki; Wakiyama, Shigeki; Futagawa, Yasuro; Iida, Tomonori; Matsumoto, Michinori; Haruki, Koichiro; Ishida, Yuichi; Misawa, Takeyuki; Yanaga, Katsuhiko

    2015-07-01

    In living-donor liver transplantation, graft selection is especially important for the safety of the live donor and an acceptable outcome for the recipient. The essential medical requirements for living liver donation at Jikei University Hospital are as follows: an adult aged 65 years or younger, in good general condition, with partial liver volume of more than 35% of the standard liver volume (SLV) for the recipient, and without severe liver steatosis. Based on our criteria, we performed 13 living-donor liver transplantations between 2007 and 2013, including 1 retransplantation. Three cases were outside our standard donor criteria, including age (18 and 66 years) and 33% graft volume (GV) to SLV ratio for the recipient on preoperative volumetry using computed tomography. In 2 cases, the actual GV to SLV ratio at transplantation was less than 35%. Median postoperative hospital stay was 11 days for the donors, and 29 days for the recipients. All donors returned to their preoperative status, and all recipients were discharged in good condition. Our medical requirements for living liver donation seem to be acceptable because of the good outcome.

  10. Epidemiology of Kidney Discard from Expanded Criteria Donors Undergoing Donation after Circulatory Death

    PubMed Central

    Singh, Sunita K.

    2016-01-01

    Background and objectives The broader use of combined expanded criteria donor and donation after circulatory death (ECD/DCD) kidneys may help expand the deceased donor pool. The purpose of our study was to evaluate discard rates of kidneys from ECD/DCD donors and factors associated with discard. Design, setting, participants, & measurements ECD/DCD donors and kidneys were evaluated from January 1, 2000 to March 31, 2011 using data from the Scientific Registry of Transplant Recipients. The kidney donor risk index was calculated for all ECD/DCD kidneys. Multivariable logistic regression models were used to determine risk factors for discarding both donor kidneys. The Kaplan–Meier product limit method and the log-rank statistic were used to assess the cumulative probability of graft failure for transplants from ECD/DCD donors where the mate kidney was discarded versus both kidneys were used. Results There were 896 ECD/DCD donors comprising 1792 kidneys. Both kidneys were discarded in 44.5% of donors, whereas 51.0% of all available kidneys were discarded. The kidney donor risk index scores were higher among donors of discarded versus transplanted kidneys (median, 1.82; interquartile range, 1.60, 2.07 versus median, 1.67; interquartile range, 1.49, 1.87, respectively; P<0.001); however, the distributions showed considerable overlap. The adjusted odds ratios for discard were higher among donors who were older, diabetic, AB blood type, and hepatitis C positive. The cumulative probabilities of total graft failure at 1, 3, and 5 years were 17.3%, 36.5%, and 55.4% versus 13.8%, 24.7%, and 40.5% among kidneys from donors where only one versus both kidneys were transplanted, respectively (log rank P=0.04). Conclusions Our study shows a significantly higher discard rate for ECD/DCD kidneys versus prior reports. Some discarded ECD/DCD kidneys may be acceptable for transplantation. Additional studies are needed to evaluate the factors that influence decision making around the

  11. Epidemiology of Kidney Discard from Expanded Criteria Donors Undergoing Donation after Circulatory Death.

    PubMed

    Singh, Sunita K; Kim, S Joseph

    2016-02-05

    The broader use of combined expanded criteria donor and donation after circulatory death (ECD/DCD) kidneys may help expand the deceased donor pool. The purpose of our study was to evaluate discard rates of kidneys from ECD/DCD donors and factors associated with discard. ECD/DCD donors and kidneys were evaluated from January 1, 2000 to March 31, 2011 using data from the Scientific Registry of Transplant Recipients. The kidney donor risk index was calculated for all ECD/DCD kidneys. Multivariable logistic regression models were used to determine risk factors for discarding both donor kidneys. The Kaplan-Meier product limit method and the log-rank statistic were used to assess the cumulative probability of graft failure for transplants from ECD/DCD donors where the mate kidney was discarded versus both kidneys were used. There were 896 ECD/DCD donors comprising 1792 kidneys. Both kidneys were discarded in 44.5% of donors, whereas 51.0% of all available kidneys were discarded. The kidney donor risk index scores were higher among donors of discarded versus transplanted kidneys (median, 1.82; interquartile range, 1.60, 2.07 versus median, 1.67; interquartile range, 1.49, 1.87, respectively; P<0.001); however, the distributions showed considerable overlap. The adjusted odds ratios for discard were higher among donors who were older, diabetic, AB blood type, and hepatitis C positive. The cumulative probabilities of total graft failure at 1, 3, and 5 years were 17.3%, 36.5%, and 55.4% versus 13.8%, 24.7%, and 40.5% among kidneys from donors where only one versus both kidneys were transplanted, respectively (log rank P=0.04). Our study shows a significantly higher discard rate for ECD/DCD kidneys versus prior reports. Some discarded ECD/DCD kidneys may be acceptable for transplantation. Additional studies are needed to evaluate the factors that influence decision making around the use of ECD/DCD kidneys. Copyright © 2016 by the American Society of Nephrology.

  12. United Network for Organ Sharing's expanded criteria donors: is stratification useful?

    PubMed

    Baskin-Bey, Edwina S; Kremers, Walter; Stegall, Mark D; Nyberg, Scott L

    2005-06-01

    The United Network for Organ Sharing (UNOS) Expanded Criteria Donor (ECD) system utilizes pre-transplant variables to identify deceased donor kidneys with an increased risk of graft loss. The aim of this study was to compare the ECD system with a quantitative approach, the deceased donor score (DDS), in predicting outcome after kidney transplantation. We retrospectively reviewed 49 111 deceased donor renal transplants from the UNOS database between 1984 and 2002. DDS: 0-39 points; >or=20 points defined as marginal. Recipient outcome variables were analyzed by ANOVA or Kaplan-Meier method. There was a 90% agreement between the DDS and ECD systems as predictors of renal function and graft survival. However, DDS identified ECD- kidneys (10.7%) with a significantly poorer outcome than expected (DDS 20-29 points, n = 5,252). Stratification of ECD+ kidneys identified a group with the poorest outcome (DDS >or=30 points). Predictability of early post-transplant events (i.e. need for hemodialysis, decline of serum creatinine and length of hospital stay) was also improved by DDS. DDS predicted outcome of deceased donor renal transplantation better than the ECD system. Knowledge obtained by stratification of deceased donor kidneys can allow for improved utilization of marginal kidneys which is not achieved by the UNOS ECD definition alone.

  13. Donor selection criteria for liver transplantation in Argentina: are current standards too rigorous?

    PubMed

    Dirchwolf, Melisa; Ruf, Andrés E; Biggins, Scott W; Bisigniano, Liliana; Hansen Krogh, Daniela; Villamil, Federico G

    2015-02-01

    Organ shortage is the major limitation for the growth of deceased donor liver transplant worldwide. One strategy to ameliorate this problem is to maximize the liver utilization rate. To assess predictors of liver utilization in Argentina. The national database was used to analyze transplant activity in 2010. Donor, recipient, and transplant variables were evaluated as predictors of graft utilization of number of rejected donor offers before grafting and with the occurrence of primary nonfunction (PNF) or early post-transplant mortality (EM). Of the 582 deceased donors, 293 (50.3%) were recovered for liver transplant. Variables associated with the nonrecovery of the liver were age ≥46 years, umbilical perimeter ≥92 cm, organ procurement outside Gran Buenos Aires, AST ≥42 U/l and ALT ≥29 U/l. The median number of rejected offers before grafting was 4, and in 71 patients (25%), there were ≥13. The only independent predictor for the occurrence of PNF (3.4%) or EM (5.2%) was the recipient's emergency status. During 2010 in Argentina, the liver was recovered in only half of donors. The low incidence of PNF and EM and the characteristics of the nonrecovered liver donors suggest that organ acceptance criteria should be less rigorous. © 2014 Steunstichting ESOT.

  14. Extended criteria donor lungs and clinical outcome: results of an alternative allocation algorithm.

    PubMed

    Sommer, Wiebke; Kühn, Christian; Tudorache, Igor; Avsar, Murat; Gottlieb, Jens; Boethig, Dietmar; Haverich, Axel; Warnecke, Gregor

    2013-11-01

    Despite the scarcity of donor lungs, most potential donor organs are not offered by organ procurement organizations or are turned down by transplant centers because no suitable recipient is found according to regular allocation. Although extended criteria donors (ECDs) have recently been considered by many programs, the lung utilization rate remains < 30% in most countries. The allocation policy of Eurotransplant for donor lungs that have been turned down for donor-related medical reasons by 3 centers is to attempt a rescue offer, for which centers choose the recipients themselves. At Hannover Medical School we systematically divert these organs to more stable recipients to avoid adverse transplant outcomes. We follow up on these transplants and compare them with those following regular allocation. This study is an analysis of all organ offers and corresponding recipients at our center during the period from January 2010 to August 2011. A total of 183 lung transplantations were performed, 111 regular donor lung offers were accepted for their intended recipient, whereas a total of 72 rescue lung offers, including all extended criteria donors, were accepted for recipients selected by our center. Donor characteristics differed between the 2 groups accordingly. Median age of ECD organ donors was significantly higher than that of regular donors (46.0 [IQR 21] vs 40.0 [IQR 22] years, p = 0.02). Donor mechanical ventilation time did not differ (3.5 ± 4.8 vs 3.0 ± 4.0 days, p = 0.33, not statistically significant [NS]). Donor oxygenation ratio (PaO2:FIO2) at time of organ offer was significantly lower (398.3 ± 110.3 vs 423.0 ± 97.6 mm Hg, p = 0.02). Recipients of rescue allocation organs were older than regularly selected recipients (53.7 ± 11.7 vs 46.7 ± 15.4 years, p = 0.0003), needed a shorter time for mechanical ventilation post-operatively (19.5 ± 306.6 vs 68.5 ± 718.8 hours, p = 0.02), and had shorter hospital stays (24.0 ± 23.4 vs 47.0 ± 43.4 days, p > 0

  15. Extended criteria donors in liver transplantation Part I: reviewing the impact of determining factors.

    PubMed

    Nemes, Balázs; Gámán, György; Polak, Wojciech G; Gelley, Fanni; Hara, Takanobu; Ono, Shinichiro; Baimakhanov, Zhassulan; Piros, Laszlo; Eguchi, Susumu

    2016-07-01

    The definition and factors of extended criteria donors have already been set; however, details of the various opinions still differ in many respects. In this review, we summarize the impact of these factors and their clinical relevance. Elderly livers must not be allocated for hepatitis C virus (HCV) positives, or patients with acute liver failure. In cases of markedly increased serum transaminases, donor hemodynamics is an essential consideration. A prolonged hypotension of the donor does not always lead to an increase in post-transplantation graft loss if post-OLT care is proper. Hypernatremia of less than 160 mEq/L is not an absolute contraindication to accept a liver graft per se. The presence of steatosis is an independent and determinant risk factor for the outcome. The gold standard of the diagnosis is the biopsy. This is recommended in all doubtful cases. The use of HCV+ grafts for HCV+ recipients is comparable in outcome. The leading risk factor for HCV recurrence is the actual RNA positivity of the donor. The presence of a proper anti-HBs level seems to protect from de novo HBV infection. A favourable outcome can be expected if a donation after cardiac death liver is transplanted in a favourable condition, meaning, a warm ischemia time < 30 minutes, cold ischemia time < 8-10 hours, and donor age 50-60 years. The pathway of organ quality assessment is to obtain the most relevant information (e.g. biopsy), consider the co-existing donor risk factors and the reserve capacity of the recipient, and avoid further technical issues.

  16. Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression?

    PubMed Central

    Filiopoulos, Vassilis; Boletis, John N

    2016-01-01

    The growing gap between demand and supply for kidney transplants has led to renewed interest in the use of expanded criteria donor (ECD) kidneys in an effort to increase the donor pool. Although most studies of ECD kidney transplantation confirm lower allograft survival rates and, generally, worse outcomes than standard criteria donor kidneys, recipients of ECD kidneys generally have improved survival compared with wait-listed dialysis patients, thus encouraging the pursuit of this type of kidney transplantation. The relative benefits of transplantation using kidneys from ECDs are dependent on patient characteristics and the waiting time on dialysis. Because of the increased risk of poor graft function, calcineurin inhibitor (CNI)-induced nephrotoxicity, increased incidence of infections, cardiovascular risk, and malignancies, elderly recipients of an ECD kidney transplant are a special population that requires a tailored immunosuppressive regimen. Recipients of ECD kidneys often are excluded from transplant trials and, therefore, the optimal induction and maintenance immunosuppressive regimen for them is not known. Approaches are largely center specific and based upon expert opinion. Some data suggest that antithymocyte globulin might be the preferred induction agent for elderly recipients of ECD kidneys. Maintenance regimens that spare CNIs have been advocated, especially for older recipients of ECD kidneys. CNI-free regimens are not universally accepted due to occasionally high rejection rates. However, reduced CNI exposure and CNI-free regimens based on mammalian target of rapamycin inhibitors have shown acceptable outcomes in appropriately selected ECD transplant recipients. PMID:27011908

  17. Increasing Use of the Expanded Criteria for Living Kidney Donation and Good Outcomes of Living Kidney Donors in Korea.

    PubMed

    Lim, H J; Jambaldorj, E; Lee, Y; Kang, S S; Koo, T Y; Ahn, C; Yang, J

    2016-09-01

    Donor shortage for kidney transplantation may increase the number of expanded-criteria living donors (ECLDs). We investigated recent trends for ECLD use and the long-term outcomes of living kidney donors. We retrospectively analyzed medical records of 1,144 living kidney donors who donated at the Seoul National University Hospital from 1993 to 2015. The expanded criteria for living donation allow the following: age ≥60 years, body mass index >30 kg/m(2), history of hypertension, estimated glomerular filtration rate <80 mL/min, proteinuria or microscopic hematuria, and fasting glucose >100 mg/dL. The mean age of donors was 40.7 ± 10.8 years, and there were 600 women (52.4%). A total of 466 donors (40.7%) met the ECLD criteria, and the proportion of ECLDs increased over time. Only 5 donors died after donation over a median follow-up of 7 years. No donor developed end-stage renal disease (ESRD). A urine protein-creatinine ratio ≥0.3 g/gCr was found in 14 patients and was more common in the ECLDs than in the standard-criteria living donors. The follow-up loss rate of donors was 59.3% at 5 years. Both mortality and ESRD were very rare in carefully selected living kidney donors. However, living donors should be followed more carefully, because the follow-up loss rate was very high and ECLDs are increasingly used. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Criteria for Viability Assessment of Discarded Human Donor Livers during Ex Vivo Normothermic Machine Perfusion

    PubMed Central

    Karimian, Negin; Weeder, Pepijn D.; de Boer, Marieke T.; Wiersema-Buist, Janneke; Gouw, Annette S. H.; Leuvenink, Henri G. D.; Lisman, Ton; Porte, Robert J.

    2014-01-01

    Although normothermic machine perfusion of donor livers may allow assessment of graft viability prior to transplantation, there are currently no data on what would be a good parameter of graft viability. To determine whether bile production is a suitable biomarker that can be used to discriminate viable from non-viable livers we have studied functional performance as well as biochemical and histological evidence of hepatobiliary injury during ex vivo normothermic machine perfusion of human donor livers. After a median duration of cold storage of 6.5 h, twelve extended criteria human donor livers that were declined for transplantation were ex vivo perfused for 6 h at 37°C with an oxygenated solution based on red blood cells and plasma, using pressure controlled pulsatile perfusion of the hepatic artery and continuous portal perfusion. During perfusion, two patterns of bile flow were identified: (1) steadily increasing bile production, resulting in a cumulative output of ≥30 g after 6 h (high bile output group), and (2) a cumulative bile production <20 g in 6 h (low bile output group). Concentrations of transaminases and potassium in the perfusion fluid were significantly higher in the low bile output group, compared to the high bile output group. Biliary concentrations of bilirubin and bicarbonate were respectively 4 times and 2 times higher in the high bile output group. Livers in the low bile output group displayed more signs of hepatic necrosis and venous congestion, compared to the high bile output group. In conclusion, bile production could be an easily assessable biomarker of hepatic viability during ex vivo machine perfusion of human donor livers. It could potentially be used to identify extended criteria livers that are suitable for transplantation. These ex vivo findings need to be confirmed in a transplant experiment or a clinical trial. PMID:25369327

  19. Criteria for viability assessment of discarded human donor livers during ex vivo normothermic machine perfusion.

    PubMed

    Sutton, Michael E; op den Dries, Sanna; Karimian, Negin; Weeder, Pepijn D; de Boer, Marieke T; Wiersema-Buist, Janneke; Gouw, Annette S H; Leuvenink, Henri G D; Lisman, Ton; Porte, Robert J

    2014-01-01

    Although normothermic machine perfusion of donor livers may allow assessment of graft viability prior to transplantation, there are currently no data on what would be a good parameter of graft viability. To determine whether bile production is a suitable biomarker that can be used to discriminate viable from non-viable livers we have studied functional performance as well as biochemical and histological evidence of hepatobiliary injury during ex vivo normothermic machine perfusion of human donor livers. After a median duration of cold storage of 6.5 h, twelve extended criteria human donor livers that were declined for transplantation were ex vivo perfused for 6 h at 37 °C with an oxygenated solution based on red blood cells and plasma, using pressure controlled pulsatile perfusion of the hepatic artery and continuous portal perfusion. During perfusion, two patterns of bile flow were identified: (1) steadily increasing bile production, resulting in a cumulative output of ≥ 30 g after 6 h (high bile output group), and (2) a cumulative bile production <20 g in 6 h (low bile output group). Concentrations of transaminases and potassium in the perfusion fluid were significantly higher in the low bile output group, compared to the high bile output group. Biliary concentrations of bilirubin and bicarbonate were respectively 4 times and 2 times higher in the high bile output group. Livers in the low bile output group displayed more signs of hepatic necrosis and venous congestion, compared to the high bile output group. In conclusion, bile production could be an easily assessable biomarker of hepatic viability during ex vivo machine perfusion of human donor livers. It could potentially be used to identify extended criteria livers that are suitable for transplantation. These ex vivo findings need to be confirmed in a transplant experiment or a clinical trial.

  20. Medium-term outcome of recipients of marginal donor hearts selected with new stress-echocardiographic techniques over standard criteria

    PubMed Central

    2014-01-01

    Background Heart transplantation is limited by severe donor organ shortage. Regardless of the changes made in the acceptance of marginal donors, any such mechanism cannot be considered successful unless recipient graft survival rates remain acceptable. A stress echo-driven selection of donors has proven successful in older donors with normal left ventricular resting function and in standard donors with reversible resting left ventricular dysfunction acutely improving during stress, or slowly improving (over hours) during intensive hormonal treatment. Aim of this study is to assess the medium-term outcome of recipients of marginal donor hearts selected with new echocardiographic techniques over standard criteria. Methods and results We enrolled 43 recipients of marginal donor hearts: age > 55 years, or < 55 years but with concomitant risk factors, n = 32; acutely improving during stress, n = 3; or slowly improving during hormonal treatment, n = 8. At follow-up (median, 30 months; interquartile range, 21–52 months), 37 of the recipients were still alive. One-year survival was 93%. Conclusion The strict use of new stress-echocardiographic techniques over standard criteria of marginal donor management, together with comprehensive monitoring of the donor, has the potential to substantially increase the number of donor hearts without adverse effects on recipient medium-term outcome. PMID:24935114

  1. Organ donation in Switzerland: a survey on marginal or extended criteria donors (ECD) from 1998 to 2009.

    PubMed

    Otth, M; Rödder, S; Immer, F F; Marti, H P

    2011-07-30

    The widening gap between the numbers of patients on the waiting list for organ transplantation and the insufficient numbers of organ donors results in the use of "critical" donors, so-called marginal donors or extended criteria donors. Data concerning the evaluation of extended criteria donors (ECD) in Switzerland are sparse. All organ donors in Switzerland between 1.1.1998 and 30.6.2009 have been evaluated for special criteria. ECD were defined on the basis of at least one of seven criteria: six DOPKI criteria (ECD-DOPKI) and/or age ≥60 yr (ECD-Age). Once included in the study, special features, short time follow-up (first 7 days after transplantation) and the cold ischaemia time of all the transplanted organs were evaluated. During the period 1.1.1998 to 30.6.2009, a total of 408 organ donors were classified as ECD, reflecting 39% of all organ donors in this time period. Despite the fact that all organ donors in this study fulfilled at least one inclusion criterion, the number of recipients with satisfactory primary organ function was always higher than the respective number with a negative primary outcome within the first seven days after transplantation. A longer cold ischaemia time was associated with organs showing insufficient primary organ function compared to organs with satisfactory primary function. A relevant causal relationship cannot be investigated on the basis of our limited data. In addition, a longer observation period would be necessary to draw a more precise conclusion. ECD as defined by DOPKI and/or age represent a high proportion of all organ donors in Switzerland but show a remarkably good outcome.

  2. Who should donate blood? Policy decisions on donor deferral criteria should protect recipients and be fair to donors.

    PubMed

    Brailsford, S R; Kelly, D; Kohli, H; Slowther, A; Watkins, N A

    2015-08-01

    An important element in the development of voluntary blood donation schemes throughout the world has been the attention given to minimising the risk to recipients of donated blood, primarily the risk of transfusion transmitted infections. In response to the appearance of human immunodeficiency virus (HIV) in the 1980s a range of national policies emerged that excluded populations at high risk of contracting HIV from donating blood, with a particular focus on men who have sex with men (MSM), the primary reason being the protection of recipients of donated blood. Recently some countries, including the UK, have revised their policies, informed by advances in screening tests, epidemiological evidence of transmission rates and an increasing concern about unfair discrimination of specific groups in society. Policy makers face a difficult task of balancing safety of recipients; an adequate blood supply for those who require transfusion; and societal/legal obligations to treat everyone fairly. Given that no transfusion is risk free, the question is what degree of risk is acceptable in order to meet the needs of recipients and society. Decisions about acceptance of risk are complex and policy makers who set acceptable risk levels must provide ethically justifiable reasons for their decisions. We suggest it is possible to provide a set of reasons that stakeholders could agree are relevant based on careful evaluation of the evidence of all relevant risks and explicit acknowledgement of other morally relevant values. We describe using such a process in the Safety of Blood Tissue and Organs (SaBTO) review of donor deferral criteria related to sexual behaviour. © 2015 British Blood Transfusion Society.

  3. Section 4. Further expanding the criteria for HCC in living donor liver transplantation: the Tokyo University experience.

    PubMed

    Tamura, Sumihito; Sugawara, Yasuhiko; Kokudo, Norihiro

    2014-04-27

    In Asia, evidence-based guidelines for the management of hepatocellular carcinoma (HCC) have evolved, including the option of liver transplantation. Because of the continuing serious organ shortage, however, living donor liver transplantation (LDLT) remains the mainstream in Japan. Unlike deceased donor transplantation, living donor transplantation is not always limited by the restrictions imposed by the nationwide organ allocation system. The decision for transplantation may depend on institutional or case-by-case considerations, balancing the will of the donor, the operative risk, and the overall survival benefit. Cumulative data from the Japanese national multicenter registry analysis as well as individual center experiences suggest further expanding the criteria for LDLT for HCC from the Milan criteria is feasible with acceptable outcomes.

  4. Combined predictive value of the expanded donor criteria for long-term graft survival of kidneys from donors after cardiac death: A single-center experience over three decades.

    PubMed

    Kusaka, Mamoru; Kubota, Yusuke; Sasaki, Hitomi; Fukami, Naohiko; Fujita, Tamio; Hirose, Yuichi; Takahashi, Hiroshi; Kenmochi, Takashi; Shiroki, Ryoichi; Hoshinaga, Kiyotaka

    2016-04-01

    Kidneys procured from the deceased hold great potential for expanding the donor pool. The aims of the present study were to investigate the post-transplant outcomes of renal allografts recovered from donors after cardiac death, to identify risk factors affecting the renal prognosis and to compare the long-term survival from donors after cardiac death according to the number of risk factors shown by expanded criteria donors. A total of 443 grafts recovered using an in situ regional cooling technique from 1983 to 2011 were assessed. To assess the combined predictive value of the significant expanded criteria donor risk criteria, the patients were divided into three groups: those with no expanded criteria donor risk factors (no risk), one expanded criteria donor risk factor (single-risk) and two or more expanded criteria donor risk factors (multiple-risk). Among the donor factors, age ≥50 years, hypertension, maximum serum creatinine level ≥1.5 mg/dL and a warm ischemia time ≥30 min were identified as independent predictors of long-term graft failure on multivariate analysis. Regarding the expanded criteria donors criteria for marginal donors, cerebrovascular disease, hypertension and maximum serum creatinine level ≥1.5 mg/dL were identified as significant predictors on univariate analysis. The single- and multiple-risk groups showed 2.01- and 2.40-fold higher risks of graft loss, respectively. Renal grafts recovered from donors after cardiac death donors have a good renal function with an excellent long-term graft survival. However, an increased number of expanded criteria donors risk factors increase the risk of graft loss. © 2016 The Japanese Urological Association.

  5. Surveillance Registry of Sirolimus Use in Recipients of Kidney Allografts From Expanded Criteria Donors.

    PubMed

    Laham, G; Scuteri, R; Cornicelli, P; Arriola, M; Raffaele, P M; Davalos Michel, M; Imperiali, N; Fortunato, R M; Maggiora, E C; Sal, M V; Soler Pujol, G

    2016-10-01

    The use of expanded criteria donor (ECD) kidneys has increased the overall availability of renal transplants. This study assessed the use of sirolimus in patients receiving Argentina-ECD kidneys. This observational, open-label, 1-arm, prospective, longitudinal pilot study was conducted at 8 transplant centers in Argentina. Adults receiving kidney transplants (without pancreas) from ECDs were eligible if they were converted to sirolimus 1 to 36 months' posttransplantation, with sirolimus becoming base therapy within 1 month after conversion. Patients were followed up for 1 year. Outcomes included reasons for conversion, acute rejection, patient and graft survival, graft status, and safety. The intention-to-treat population included 52 patients (mean age, 48.7 years). Calcineurin inhibitor nephropathy (40%) and chronic allograft nephropathy (25%) were the most frequent reasons for conversion. Two acute rejections occurred during follow-up, but no patients experienced graft loss. One patient died during follow-up, and 3 patients died within 1 month of the last sirolimus dose. Levels of serum creatinine and creatinine clearance remained stable from baseline to week 52/53. Mean proteinuria measured in a subset of patients was 0.2 ± 0.2 g/24 hours before conversion and increased to 0.6 ± 1.2 g/24 hours at week 24/25 and 0.5 ± 0.6 g/24 hours at week 52/53. Adverse events were consistent with those in previous conversion trials; the most common were infections and infestations (54%). This pilot study illustrates the potential benefits of sirolimus in recipients of ECD kidneys in Argentina. Larger, randomized controlled trials are needed to confirm these findings and to clarify the long-term benefits of sirolimus in this patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Long-term exposure to belatacept in recipients of extended criteria donor kidneys.

    PubMed

    Charpentier, B; Medina Pestana, J O; Del C Rial, M; Rostaing, L; Grinyó, J; Vanrenterghem, Y; Matas, A; Zhang, R; Mühlbacher, F; Pupim, L; Florman, S

    2013-11-01

    Patients in the BENEFIT-EXT study received extended criteria donor kidneys and a more intensive (MI) or less intensive (LI) belatacept immunosuppression regimen, or cyclosporine A (CsA). Patients who remained on assigned therapy through year 3 were eligible to enter a long-term extension (LTE) study. Three hundred four patients entered the LTE (n = 104 MI; n = 113 LI; n = 87 CsA), and 260 continued treatment through year 5 (n = 91 MI; n = 100 LI; n = 69 CsA). Twenty patients died during the LTE (n = 5 MI; n = 9 LI; n = 6 CsA), and eight experienced graft loss (n = 2 MI; n = 1 LI; n = 5 CsA). Three patients experienced an acute rejection episode (n = 2 MI; n = 1 LI). The incidence rate of serious adverse events, viral infections and fungal infections was similar across groups during the LTE. There were four cases of posttransplant lymphoproliferative disorder (PTLD) from the beginning of the LTE to year 5 (n = 3 LI; n = 1 CsA); two of three PTLD cases in the LI group were in patients who were seronegative for Epstein-Barr virus (EBV(-)) at transplantation. Mean ± SD calculated GFR at year 5 was 55.9 ± 17.5 (MI), 59.0 ± 29.1 (LI) and 44.6 ± 16.4 (CsA) mL/min/1.73 m(2) . Continued treatment with belatacept was associated with a consistent safety profile and sustained improvement in renal function versus CsA over time.

  7. Risk Assessment and Management for Medically Complex Potential Living Kidney Donors: A Few Deontological Criteria and Ethical Values

    PubMed Central

    Petrini, Carlo

    2011-01-01

    A sound evaluation of every bioethical problem should be predicated on a careful analysis of at least two basic elements: (i) reliable scientific information and (ii) the ethical principles and values at stake. A thorough evaluation of both elements also calls for a careful examination of statements by authoritative institutions. Unfortunately, in the case of medically complex living donors neither element gives clear-cut answers to the ethical problems raised. Likewise, institutionary documents frequently offer only general criteria, which are not very helpful when making practical choices. This paper first introduces a brief overview of scientific information, ethical values, and institutionary documents; the notions of “acceptable risk” and “minimal risk” are then briefly examined, with reference to the problem of medically complex living donors. The so-called precautionary principle and the value of solidarity are then discussed as offering a possible approach to the ethical problem of medically complex living donors. PMID:22174982

  8. Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria for the Allocation of Dual Kidneys in Adults.

    PubMed

    Johnson, Adam P; Price, Thea P; Lieby, Benjamin; Doria, Cataldo

    2016-09-08

    BACKGROUND Dual kidney transplantation (DKT) of expanded-criteria donors is a cost-intensive procedure that aims to increase the pool of available deceased organ donors and has demonstrated equivalent outcomes to expanded-criteria single kidney transplantation (eSKT). The objective of this study was to develop an allocation score based on predicted graft survival from historical dual and single kidney donors. MATERIAL AND METHODS We analyzed United Network for Organ Sharing (UNOS) data for 1547 DKT and 26 381 eSKT performed between January 1994 and September 2013. We utilized multivariable Cox regression to identify variables independently associated with graft survival in dual and single kidney transplantations. We then derived a weighted multivariable product score from calculated hazard ratios to model the benefit of transplantation as dual kidneys. RESULTS Of 36 donor variables known at the time of listing, 13 were significantly associated with graft survival. The derived dual allocation score demonstrated good internal validity with strong correlation to improved survival in dual kidney transplants. Donors with scores less than 2.1 transplanted as dual kidneys had a worsened median survival of 594 days (24%, p-value 0.031) and donors with scores greater than 3.9 had improved median survival of 1107 days (71%, p-value 0.002). There were 17 733 eSKT (67%) and 1051 DKT (67%) with scores in between these values and no differences in survival (p-values 0.676 and 0.185). CONCLUSIONS We have derived a dual kidney allocation score (DKAS) with good internal validity. Future prospective studies will be required to demonstrate external validity, but this score may help to standardize organ allocation for dual kidney transplantation.

  9. Feasibility of renal transplantation after unroofing of a large renal cyst in an expanded criteria donor

    PubMed Central

    Kanagarajah, Prashanth; Ekwenna, Obi; Ayyathurai, Rajinikanth; Burk, George W.; Ciancio, Gaetano

    2013-01-01

    We present a case in which a deceased donor kidney with a large simple cyst was successfully unroofed and transplanted to a 61-year-old male. The donor was a 62-year-old male with a history of hypertension for 2 years; cerebral vascular accident was the cause of death. A large 8-cm cyst distorting the renal hilum was identified upon the procurement of the deceased donor kidney. Prior to transplantation, the large cyst was unroofed from the allograft; the frozen section confirmed a benign cyst and the transplant was performed. Postoperatively, the serum creatinine level was 1.4 mg/ml at 22-month follow-up and the patient was normotensive. Deceased donor kidneys with giant cysts distorting the renal hilum can be effectively transplanted. PMID:24049388

  10. Trends in Usage and Outcomes for Expanded Criteria Donor Kidney Transplantation in the United States Characterized by Kidney Donor Profile Index

    PubMed Central

    Rege, Aparna; Irish, Bill; Castleberry, Anthony; Vikraman, Deepak; Sanoff, Scott; Ravindra, Kadiyala; Sudan, Debra

    2016-01-01

    There has been increasing concern in the kidney transplant community about the declining use of expanded criteria donors (ECD) despite improvement in survival and quality of life. The recent introduction of the Kidney Donor Profile Index (KDPI), which provides a more granular characterization of donor quality, was expected to increase utilization of marginal kidneys and decrease the discard rates. However, trends and practice patterns of ECD kidney utilization on a national level based on donor organ quality as per KDPI are not well known. We, therefore, performed a trend analysis of all ECD recipients in the United Network for Organ Sharing (UNOS) registry between 2002 and 2012, after calculating the corresponding KDPI, to enable understanding the trends of usage and outcomes based on the KDPI characterization. High-risk recipient characteristics (diabetes, body mass index ≥30 kg/m2, hypertension, and age ≥60 years) increased over the period of the study (trend test p<0.001 for all). The proportion of ECD transplants increased from 18% in 2003 to a peak of 20.4% in 2008 and then declined thereafter to 17.3% in 2012. Using the KDPI >85% definition, the proportion increased from 9.4% in 2003 to a peak of 12.1% in 2008 and declined to 9.7% in 2012. Overall, although this represents a significant utilization of kidneys with KDPI >85% over time (p<0.001), recent years have seen a decline in usage, probably related to regulations imposed by Centers for Medicare & Medicaid Services (CMS). When comparing the hazards of graft failure by KDPI, ECD kidneys with KDPI >85% have a slightly lower risk of graft failure compared to standard criteria donor (SCD) kidneys with KDPI >85%, with a hazard ratio (HR) of 0.95, a confidence interval (CI) of 0.94-0.96, and statistical significance of p<0.001. This indicates that some SCD kidneys may actually have a lower estimated quality, with a higher Kidney Donor Risk Index (KDRI), than some ECDs. The incidence of

  11. The need for vigilance in extended criteria donors with a past history of malignancy: a case report and review of literature.

    PubMed

    Nickkholgh, Arash; Frey, Erich; Krenzel, Christoph; Lauchart, Werner; Flechtenmacher, Christa; Schmidt, Jan; Schemmer, Peter

    2011-01-01

    Organ shortage has prompted many transplant centers to extend their criteria for organ acceptance including the history of a variety of co-morbidities in donors. The use of organs from donors with a past medical history of malignancy in order to reduce the waiting list mortalities remains a dilemma. Herein we report a 62-year-old female donor with a history of a presumably cured serous adenocarcinoma of the ovary and underscore the need for vigilance in the search of an active site of cancer while assessing these donors for organ recovery. In order to minimize the risk of donor tumor transmission, especially in the donors with a past medical history of cancer, extensive evaluation of the donor including the surgical exploration of all body cavities is absolutely necessary. Any suspicious lesion should prompt a frozen section biopsy. In this regard, an on-call pathologist to do the frozen section should be an integral part of the transplant team.

  12. Living donor liver transplantation for hepatocellular carcinoma: results of prospective patient selection by Kyushu University Criteria in 7 years.

    PubMed

    Uchiyama, Hideaki; Itoh, Shinji; Yoshizumi, Tomoharu; Ikegami, Toru; Harimoto, Norifumi; Soejima, Yuji; Harada, Noboru; Morita, Kazutoyo; Toshima, Takeo; Motomura, Takashi; Maehara, Yoshihiko

    2017-09-07

    Expanding patient selection beyond the Milan criteria in living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) has long been a matter for debate. We have used the Kyushu University Criteria - maximum tumor diameter <5 cm or des-γ-carboxy prothrombin <300 mAU/ml - in LDLT for HCC since June 2007. The aim of the present study was to present the results of our prospective patient selection by Kyushu University Criteria and to confirm whether or not our criteria were justified. The entire study period was divided into the pre-Kyushu era (July 1999-May 2007) and the Kyushu era (June 2007-November 2014). Eighty-nine and 90 patients underwent LDLT for HCC in the pre-Kyushu era and the Kyushu era, respectively. In the pre-Kyushu era, there were significant differences in recurrence-free and disease-specific survival between the beyond-Milan and the within-Milan patients. In the Kyushu era, however, the differences in recurrence-free and disease-specific survival between the beyond-Milan and the within-Milan patients disappeared. The 5-year overall patient survival in the Kyushu era was 89.4%. Our selection criteria enabled a considerable number of beyond-Milan patients to undergo LDLT without jeopardizing the recurrence-free, and disease-specific, and overall patient survival. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  13. Lung transplantation in the elderly: Influence of age, comorbidities, underlying disease, and extended criteria donor lungs.

    PubMed

    Ehrsam, Jonas P; Benden, Christian; Seifert, Burkhardt; Opitz, Isabelle; Schneiter, Didier; Weder, Walter; Inci, Ilhan

    2017-07-29

    As large registries show an increased risk for lung transplant recipients aged 60 years or more, few single centers report favorable outcomes for carefully selected older recipients without providing essential details. The purpose of our study was to determine variables that influence survival in the elderly. All adult bilateral first lung transplants between January 2000 and December 2014 were divided in 2 groups: those aged less than 60 years (N = 223) and those aged 60 years or more (N = 83). The Charlson-Deyo Index determined recipient comorbidities. The Oto Donor Score assessed donor lung quality. Recipients aged 60 years or more had a significant lower median survival compared with their younger counterparts (48 vs 112 months, respectively, P < .001). Recipient age was as an exponentially increasing univariate risk factor for mortality. By adjusting for variables in multivariate analysis, this trend was nonsignificant. The displacing variables were idiopathic pulmonary fibrosis (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.0-2.2), Charlson-Deyo Index 2 or greater (HR, 1.3; 95% CI, 1.0-1.8), systemic hypertension (HR, 1.7; 95% CI, 1.2-2.6), gastroesophageal reflux (HR, 1.9; 95% CI, 1.1-3.1), diverticulosis (HR, 1.7; 95% CI, 1.0-2.7), and an Oto Donor Score 8 or greater (HR, 1.5; 95% CI, 1.1-2.0). All of these risk factors were significantly more likely to occur in recipients aged 60 years or more, except for a tendency for high Charlson-Deyo Index. The comorbidity profile, underlying disease, and donor lung quality appear to be more important than age in reducing long-term survival. Older age serves as a marker for a complex constellation of factors that might be considered the relative or absolute contraindication to lung transplantation rather than age, per se. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  14. Transplanting hearts after death measured by cardiac criteria: the challenge to the dead donor rule.

    PubMed

    Veatch, Robert M

    2010-06-01

    The current definition of death used for donation after cardiac death relies on a determination of the irreversible cessation of the cardiac function. Although this criterion can be compatible with transplantation of most organs, it is not compatible with heart transplantation since heart transplants by definition involve the resuscitation of the supposedly "irreversibly" stopped heart. Subsequently, the definition of "irreversible" has been altered so as to permit heart transplantation in some circumstances, but this is unsatisfactory. There are three available strategies for solving this "irreversibility problem": altering the definition of death so as to rely on circulatory irreversibility, rather than cardiac; defining death strictly on the basis of brain death (either whole-brain or more pragmatically some higher brain criteria); or redefining death in traditional terms and simultaneously legalizing some limited instances of medical killing to procure viable hearts. The first two strategies are the most ethically justifiable and practical.

  15. EDC RESEARCH AT EPA ATLANTIC ECOLOGY DIVISION: DO ENVIRONMENTAL EDCS IMPACT FISH POPULATIONS

    EPA Science Inventory

    The Atlantic Ecology Division, Office of Research and Development, EP A is a marine laboratory situated on Narragansett Bay, Rhode Island. Researchers at AED are investigating the effects endocrine disrupting chemicals (EDCs) in the aquatic environment might have on reproductive ...

  16. A comparison of two questionnaires on Informed Consent for extended criteria liver donors.

    PubMed

    Bruzzone, Paolo; Giannarelli, Diana

    2015-01-01

    Un questionario riguardante il consenso informato del ricevente per i cosiddetti donatori marginali di fegato (“extended criteria donors”-ECD) è stato inviato, previa approvazione del Comitato Etico, via e-mail ai membri di 2 società scientifiche, ELPAT(Ethical,Legal and Psychologic Aspects of Organ Transplantation) ed ELITA (European Liver and Intestine Transplant Association)-ELTR(European Liver Transplant Registry). I risultati sono stati pubblicati in diversi lavori apparsi su Transplantation Proceedings. Analizzando statisticamente le tabelle negli articoli 2011 ELPAT e 2013 ELITA, nel lavoro più recente meno Centri Trapianto di fegato (LTC) hanno considerato l’età fino a 80 anni (p<.002) e SGOT>90 IU (p<.02), o tutti i criteri insieme (p<.0001), come indicatori di donatore marginale. Ciò potrebbe riflettere il fatto che nel tempo i LTC sono divenuti meno selettivi, a causa della crescente mortalità dei pazienti in lista di attesa. Considerando che in tutti i nostri studi abbiamo riscontrato un notevole ricorso agli ECD, è necessario che i pazienti ricevano tutte le informazioni che vogliano richiedere sia al momento dell’iscrizione in lista di attesa, sia quando il fegato di un donatore venga effettivamente loro proposto. E’ anche possibile creare una lista di attesa separata, per pazienti che non accettano ECD: tale scelta però ritarda in modo inevitabile il trapianto e quindi, potenzialmente, aumenta la mortalità in lista di attesa.

  17. Results of a newborn liver transplant program in the era of piggyback technique and extended donor criteria in Italy.

    PubMed

    Ettorre, Giuseppe Maria; Santoro, Roberto; Vennarecci, Giovanni; Lepiane, Pasquale; Antonini, Mario; Santoro, Eugenio

    2011-09-01

    The aim of this study was to critically analyze the early and long-term results of a newborn liver transplantation (LTx) centre using piggyback technique (PT) without venovenous bypass and portocaval shunt in the era of extended criteria donors (ECDs). Between 2002 and 2010, a total of 229 LTx were performed in 225 patients, with the shortest as possible cold ischemia time (CIT) policy. The charts of the donors and recipients and the intraoperative data were retrospectively reviewed in order to define the feasibility of PT and surgical outcome, and long-term graft and patient survival. PT feasibility rate was 100%, with a median duration of surgery of 390 min (range 210-630) and median unit of packed RBC transfused intraoperatively of 1 U (range 1-10). Median CIT was 400 min (range 130-870), and median AST peak was 403 mmol/L (range 48-16,900). ECDs graft rate was 85%. Over all primary dysfunction and non-function (PNF) rates were 7.4 and 2.2%, respectively and increased with graft steatosis >30% (P < 0.004). Mortality, morbidity, re-operation and re-LTx rates were 4.4, 25, 6.1 and 1.3%, respectively, and median hospital stay was 18 days (range 8-150). On the long term, graft and patient 5-year overall survival were 72 and 74%, respectively, and re-LTx rate was 0.4%. Survival was significantly affected by recipient HCV-Ab seropositive status (67 vs. 85%, P = 0.023). Liver transplantation can be performed with low morbidity and mortality rates, despite ECDs. PT is a safe and effective procedure that, combined with short CIT, entailed prompt early functional recovery of the grafts and positive long-term results.

  18. The benefits of pulsatile machine perfusion of standard criteria deceased donor kidneys at a geographically remote transplant center.

    PubMed

    Chueh, Shih-Chieh Jeff; Sankari, Bashir R; Lipscomb, Lorie; Modak, Asmita; Castello, Michael G; Avallone, Edwin J

    2014-01-01

    Benefits of pulsatile machine perfusion (pumping) of standard criteria donor (SCD) kidneys are unclear. Our center is located 4½ hours from our Organ Procurement Organization. We evaluated outcomes of pumping SCD kidneys under such circumstances by conducting a retrospective examination of all SCD kidneys transplanted between January 2007 and March 2012, comparing kidneys pumped (28 [group 1]) versus standard cold storage (77 [group 2]). Group 1 had fewer delayed graft function (DGF, 3.57% vs. 23.38%, p = 0.02) and slow graft function (SGF, 7.14% vs. 24.68%; p = 0.047) and faster serum creatinine recovery curve (p < 0.001) than group 2. Having a kidney pumped decreases the incidence (odds ratio [OR], 0.059) of DGF, SGF, or primary nonfunction. Group 1 were quicker to reach an estimated glomerular filtration rate (eGFR) >30 ml/min (OR, 4.186; confidence interval [CI], [2.448-7.157]) or an eGFR >60 ml/min (OR, 2.669; CI [1.255-5.679]). Pumping the SCD kidneys in a geographically remote transplant center tended to be better than those preserved in cold storage. However, except recovery curve of serum creatinine during the first postoperative month, other parameters failed to reach statistical significance in the post hoc examination of the contemporary groups. Prospective paired kidney study is required to scrutinize this finding.

  19. Variability of Criteria for Pasteurized Donor Human Milk Use: A Survey of U.S. Neonatal Intensive Care Unit Medical Directors.

    PubMed

    Hagadorn, James I; Brownell, Elizabeth A; Lussier, Mary M; Parker, Margaret G K; Herson, Victor C

    2016-03-01

    Use of donor human milk (DHM) is increasing, but criteria for its use are not well defined. We conducted a 34-question Internet-based survey of medical directors of U.S. level 3 and level 4 neonatal intensive care units (NICUs), with the goal of describing specifics of policies developed to guide DHM use in U.S. NICUs. Respondents reported NICU characteristics and details of policies concerning DHM use. Policy-specified criteria for DHM use, if any, were described. Bivariate and multivariate analyses were used to identify NICU characteristics associated with DHM use. Respondents returned 153 (33%) surveys, with use of DHM reported by 91 (59%). Donor human milk use was more likely with more than 100 annual admissions <1500 g at birth (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.1-4.7) and with Vermont-Oxford Network participants (OR, 4.6; 95% CI, 1.8-11.6). Among 72 NICUs reporting a written policy, criteria for providing DHM required birth weights varying from <1000 to <1800 g and/or gestational ages from <28 to <34 completed weeks, but criteria were reportedly waived in many circumstances. Policies regarding duration of DHM therapy were similarly varied. Criteria for initiating and continuing DHM vary widely among U.S. level 3 and level 4 NICUs. Donor human milk use is more frequent in NICUs with many very low-birth-weight admissions and among Vermont-Oxford Network participants. Further research is needed to define short- and long-term outcomes and cost benefits of DHM use in subgroups of NICU patients, particularly for uses other than necrotizing enterocolitis prevention. © 2014 American Society for Parenteral and Enteral Nutrition.

  20. Impact of Early Low-Grade Proteinuria and Allograft Dysfunction on Survival in Expanded Criteria Donor Kidney Transplant Recipients.

    PubMed

    López, V; Cabello, M; Ruíz-Esteban, P; Sola, E; Gutiérrez, C; Jironda, C; Burgos, D; González-Molina, M; Hernández, D

    2015-11-01

    Recent studies have demonstrated a relationship between low-grade proteinuria and worse graft survival, but this has not been fully studied in expanded criteria donor (ECD) kidney transplant recipients. The aim of this study was to assess whether the combination of early low-grade proteinuria (<1 g/d) and allograft dysfunction at the third month post-transplantation predicts outcomes in terms of survival in ECD kidney transplant recipients. We studied a cohort of 269 ECD kidney transplant recipients subdivided into 4 groups according to clinically relevant proteinuria (300 mg/d) and median creatinine (Cr; 1.7 mg/dL; interquartile range, 1.4-2.1 mg/dL) at the third month post-transplantation: Group A (Cr <1.7 mg/dL and proteinuria <300 mg/24 h; n = 97), Group B (Cr <1.7 mg/dL and proteinuria ≥300 mg/24 h; n = 38), Group C (Cr ≥1.7 mg/dL and proteinuria <300 mg/24 h; n = 79), and Group D (Cr ≥1.7 mg/dL and proteinuria ≥300 mg/24 h; n = 55). Death-censored graft survival was significantly lower in Group D compared with the rest (P < .007). Multivariate Cox regression analysis using fixed covariates showed that the combination of low-grade proteinuria and a lower estimated glomerular filtration rate (eGFR) as associated with graft failure (hazard rate [HR] 2.5, 95% confidence interval [CI], 1.09-5.97; P = .03). The early association of low-grade proteinuria and allograft dysfunction represents an important risk factor for graft loss in ECD kidney transplant recipients. Strategies to optimize renal function could improve the outcome in this specific population. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. EDC-37 Deflagration Rates at Elevated Pressures

    SciTech Connect

    Maienschein, J L; Koerner, J G

    2008-01-31

    We report deflagration rates on EDC-37 at high pressures. Experiments are conducted using the Lawrence Livermore National Laboratory High Pressure Strand Burner (HPSB) apparatus. The HPSB contains a deflagrating sample in a small volume, high pressure chamber. The sample consists of nine, 6.35 mm diameter, 6.35 mm length cylinders stacked on end, with burn wires placed between cylinders. Sample deflagration is limited to the cross-sectional surface of the cylinder by coating the cylindrical surface of the tower with Halthane 88-2 epoxy. Sample deflagration is initiated on one end of the tower by a B/KNO{sub 3} and HNS igniter train. Simultaneous temporal pressure history and burn front time of arrival measurements yield the laminar deflagration rate for a range of pressures and provide insight into deflagration uniformity. These measurements are one indicator of overall thermal explosion violence. Specific details of the experiment and the apparatus can be found in the literature.

  2. Expanding the criteria of organ procurement from donors with prostate cancer: the application of the new Italian guidelines.

    PubMed

    D'Errico-Grigioni, A; Fiorentino, M; Vasuri, F; Corti, B; Ridolfi, L; Grigioni, W F; Bagni, Alberto; Pirini, Maria Giulia; Malvi, Deborah; Fabbrizio, Benedetta; Caprara, Giacomo; Alvaro, Nicola

    2010-08-01

    Prostate cancer (CaP) represents the most prevalent malignancy in men more than 60-year-old, posing a problem in organ procurement from elderly subjects. However, most of the currently diagnosed CaP are low-grade and intraprostatic, with low metastatic risk, and there is recent evidence that most patients are overdiagnosed. The Italian National guidelines about organ acceptance from neoplastic donors changed in March 2005, extending the pool of potential candidates with CaP and introducing the function of a second opinion expert. Between 2001 and February 2005, 40 candidate donors with total PSA>/=10 and/or positive digital rectal examination underwent histopathological analysis of the prostate: 15 (37.5%) donors harboured CaP, and 25 (62%) were judged at 'standard risk'. After the introduction of the new guidelines in 2005, the second opinion expert judged at 'standard risk' 48 of 65 donors, while 17 of 65 needed histopathological analysis. Four (6.2%) donors harboured CaP, and 61 (94%) where judged at 'standard risk', with a significant increase of donated and actually transplanted organs. The application of the new guidelines and the introduction of a second opinion expert allowed a significant extension of the 'standard risk' category also to CaP patients, decreasing the histopathological examinations and expanding the donor pool.

  3. Evaluation of eligibility criteria in living donor liver transplantation for hepatocellular carcinoma by α-SMA-positive cancer-associated fibroblasts.

    PubMed

    Takamura, Hiroyuki; Nakanuma, Shinichi; Hayashi, Hironori; Tajima, Hidehiro; Kakinoki, Kaheita; Sakai, Seisyo; Makino, Isamu; Nakagawara, Hisatoshi; Miyashita, Tomoharu; Okamoto, Koichi; Nakamura, Keishi; Oyama, Katunobu; Inokuchi, Masashi; Ninomiya, Itasu; Kitagawa, Hirohisa; Fushida, Sachio; Fujimura, Takashi; Ohnishi, Ichiro; Kayahara, Masato; Tani, Takashi; Arai, Kuniaki; Yamashita, Taro; Yamashita, Tatsuya; Kitamura, Hoshiko; Ikeda, Hiroko; Kaneko, Shuichi; Nakanuma, Yasuni; Matsui, Osamu; Ohta, Tetsuo

    2013-10-01

    The eligibility criteria of liver transplantation (LT) for hepatocellular carcinoma (HCC) must clearly confirm the prognosis not only from pathological diagnosis but also from pre-operative imaging diagnosis. In the present study, we evaluated published eligibility criteria for LT based on both pre-operative imaging diagnosis and pathological diagnosis using living donor liver transplantation (LDLT) recipients at our hospital by α-smooth muscle actin (SMA)-positive cancer-associated fibroblasts (CAFs) in HCC. The Up-to-seven (Up-to-7), Asan and Tokyo criteria were evaluated, in both overall survival and HCC disease-free survival, to be statistically significantly beneficial criteria to define post-LDLT prognosis. Recipients only within Up-to-7 criteria based on both pre-operative imaging diagnosis and pathological diagnosis survived without HCC recurrence. Recipients with proliferation of α-SMA-positive CAFs in HCC had significantly poorer prognosis. All survival recipients without HCC recurrence, who were above the Up-to-7 criteria in pathological diagnosis, had no proliferation of α-SMA-positive CAFs. As a result of multivariate analysis, the significant independent factors defining prognosis of recipients after LDLT for HCC were Up-to-7 criteria and proliferation of α-SMA-positive CAFs. The ideal eligibility criteria for LDLT with HCC is Up-to-7 criteria and α-SMA-positive CAFs was considered to be an important factor in HCC recurrence. LDLT should be limited to recipients within Up-to-7 criteria or without proliferation of α-SMA-positive CAFs.

  4. Evaluation of surfactant flushing for remediating EDC-tar contamination

    NASA Astrophysics Data System (ADS)

    Liang, Chenju; Hsieh, Cheng-Lin

    2015-06-01

    Ethylene dichloride tar (EDC-tar) is a dense non-aqueous phase liquid (DNAPL) waste originated from the process of vinyl chloride production, with major constituents including chlorinated aliphatic and aromatic hydrocarbons. This study investigated the feasibility of Surfactant Enhanced Aquifer Remediation (SEAR) for treating EDC-tar contaminated aquifers. Initial experiments explored the potential to enhance the apparent solubility of EDC-tar using single or mixed surfactants. The results showed that an aqueous solution mixed anionic and non-ionic surfactants (i.e., SDS/Tween 80) exhibited higher EDC-tar apparent solubility and lower surface tension than other surfactant systems tested. Additionally, alkaline pH aids in increasing the EDC-tar apparent solubility. In column flushing experiments, it was seen that the alkaline mixed SDS/Tween 80 solution showed better removal of pure EDC-tar from silica sand porous media. Furthermore, separation of EDC-tar in the surfactant solution was conducted employing a salting-out effect. Significant separation of DNAPL was observed when 13 wt.% or more NaCl was added to the solution. Overall, this study evaluates the feasibility of using SEAR for remediating EDC-tar contaminated subsurface soil and groundwater.

  5. Evaluation of surfactant flushing for remediating EDC-tar contamination.

    PubMed

    Liang, Chenju; Hsieh, Cheng-Lin

    2015-01-01

    Ethylene dichloride tar (EDC-tar) is a dense non-aqueous phase liquid (DNAPL) waste originated from the process of vinyl chloride production, with major constituents including chlorinated aliphatic and aromatic hydrocarbons. This study investigated the feasibility of Surfactant Enhanced Aquifer Remediation (SEAR) for treating EDC-tar contaminated aquifers. Initial experiments explored the potential to enhance the apparent solubility of EDC-tar using single or mixed surfactants. The results showed that an aqueous solution mixed anionic and non-ionic surfactants (i.e., SDS/Tween 80) exhibited higher EDC-tar apparent solubility and lower surface tension than other surfactant systems tested. Additionally, alkaline pH aids in increasing the EDC-tar apparent solubility. In column flushing experiments, it was seen that the alkaline mixed SDS/Tween 80 solution showed better removal of pure EDC-tar from silica sand porous media. Furthermore, separation of EDC-tar in the surfactant solution was conducted employing a salting-out effect. Significant separation of DNAPL was observed when 13 wt.% or more NaCl was added to the solution. Overall, this study evaluates the feasibility of using SEAR for remediating EDC-tar contaminated subsurface soil and groundwater. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. The Molecular Revolution in Cutaneous Biology: EDC and Locus Control.

    PubMed

    Oh, Inez Y; de Guzman Strong, Cristina

    2017-05-01

    The epidermal differentiation complex (EDC) locus consists of a cluster of genes important for the terminal differentiation of the epidermis. While early studies identified the functional importance of individual EDC genes, the recognition of the EDC genes as a cluster with its shared biology, homology, and physical linkage was pivotal to later studies that investigated the transcriptional regulation of the locus. Evolutionary conservation of the EDC and the transcriptional activation during epidermal differentiation suggested a cis-regulatory mechanism via conserved noncoding elements or enhancers. This line of pursuit led to the identification of CNE 923, an epidermal-specific enhancer that was found to mediate chromatin remodeling of the EDC in an AP-1 dependent manner. These genomic studies, as well as the advent of high-throughput sequencing and genome engineering techniques, have paved the way for future investigation into enhancer-mediated regulatory networks in cutaneous biology. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Added-value from a multi-criteria selection of donor catchments in the prediction of continuous streamflow series at ungauged pollution control-sites

    NASA Astrophysics Data System (ADS)

    Drogue, Gilles; Ben Khediri, Wiem; Conan, Céline

    2016-05-01

    We explore the potential of a multi-criteria selection of donor catchments in the prediction of continuous streamflow series by the spatial proximity method. Three criteria have been used: (1) spatial proximity; (2) physical similarity; (3) stream gauging network topology. An extensive assessment of our spatial proximity method variant is made on a 149 catchment-data set located in the Rhine-Meuse catchment. The competitiveness of the method is evaluated against spatial interpolation of catchment model parameters with ordinary kriging. We found that the spatial proximity approach is more efficient than ordinary kriging. When distance to upstream/downstream stream gauge stations is considered as a second order criterion in the selection of donor catchments, an unprecedented level of efficiency is reached for nested catchments. Nevertheless, the spatial proximity method does not take advantage from physical similarity between donor catchments and receiver catchments because catchments that are the most hydrologically similar to each catchment poorly match with the catchments that are the most physically similar to each catchment.

  8. The classic EDCs, phthalate esters and organochlorines, in relation to abnormal sperm quality: a systematic review with meta-analysis

    NASA Astrophysics Data System (ADS)

    Wang, Chao; Yang, Lu; Wang, Shu; Zhang, Zhan; Yu, Yongquan; Wang, Meilin; Cromie, Meghan; Gao, Weimin; Wang, Shou-Lin

    2016-01-01

    The association between endocrine disrupting chemicals (EDCs) and human sperm quality is controversial due to the inconsistent literature findings, therefore, a systematic review with meta-analysis was performed. Through the literature search and selection based on inclusion criteria, a total of 9 studies (7 cross-sectional, 1 case-control, and 1 pilot study) were analyzed for classic EDCs (5 studies for phthalate esters and 4 studies for organochlorines). Funnel plots revealed a symmetrical distribution with no evidence of publication bias (Begg’s test: intercept = 0.40 p = 0.692). The summary odds ratios (OR) of human sperm quality associated with the classic EDCs was 1.67 (95% CI: 1.31–2.02). After stratification by specific chemical class, consistent increases in the risk of abnormal sperm quality were found in phthalate ester group (OR = 1.52 95% CI: 1.09–1.95) and organochlorine group (OR = 1.98 95% CI: 1.34–2.62). Additionally, identification of official data, and a comprehensive review of the mechanisms were performed, and better elucidated the increased risk of these classic EDCs on abnormal sperm quality. The present systematic review and meta-analysis helps to identify the impact of classic EDCs on human sperm quality. However, it still highlights the need for additional epidemiological studies in a larger variety of geographic locations.

  9. The classic EDCs, phthalate esters and organochlorines, in relation to abnormal sperm quality: a systematic review with meta-analysis.

    PubMed

    Wang, Chao; Yang, Lu; Wang, Shu; Zhang, Zhan; Yu, Yongquan; Wang, Meilin; Cromie, Meghan; Gao, Weimin; Wang, Shou-Lin

    2016-01-25

    The association between endocrine disrupting chemicals (EDCs) and human sperm quality is controversial due to the inconsistent literature findings, therefore, a systematic review with meta-analysis was performed. Through the literature search and selection based on inclusion criteria, a total of 9 studies (7 cross-sectional, 1 case-control, and 1 pilot study) were analyzed for classic EDCs (5 studies for phthalate esters and 4 studies for organochlorines). Funnel plots revealed a symmetrical distribution with no evidence of publication bias (Begg's test: intercept = 0.40; p = 0.692). The summary odds ratios (OR) of human sperm quality associated with the classic EDCs was 1.67 (95% CI: 1.31-2.02). After stratification by specific chemical class, consistent increases in the risk of abnormal sperm quality were found in phthalate ester group (OR = 1.52; 95% CI: 1.09-1.95) and organochlorine group (OR = 1.98; 95% CI: 1.34-2.62). Additionally, identification of official data, and a comprehensive review of the mechanisms were performed, and better elucidated the increased risk of these classic EDCs on abnormal sperm quality. The present systematic review and meta-analysis helps to identify the impact of classic EDCs on human sperm quality. However, it still highlights the need for additional epidemiological studies in a larger variety of geographic locations.

  10. The classic EDCs, phthalate esters and organochlorines, in relation to abnormal sperm quality: a systematic review with meta-analysis

    PubMed Central

    Wang, Chao; Yang, Lu; Wang, Shu; Zhang, Zhan; Yu, Yongquan; Wang, Meilin; Cromie, Meghan; Gao, Weimin; Wang, Shou-Lin

    2016-01-01

    The association between endocrine disrupting chemicals (EDCs) and human sperm quality is controversial due to the inconsistent literature findings, therefore, a systematic review with meta-analysis was performed. Through the literature search and selection based on inclusion criteria, a total of 9 studies (7 cross-sectional, 1 case-control, and 1 pilot study) were analyzed for classic EDCs (5 studies for phthalate esters and 4 studies for organochlorines). Funnel plots revealed a symmetrical distribution with no evidence of publication bias (Begg’s test: intercept = 0.40; p = 0.692). The summary odds ratios (OR) of human sperm quality associated with the classic EDCs was 1.67 (95% CI: 1.31–2.02). After stratification by specific chemical class, consistent increases in the risk of abnormal sperm quality were found in phthalate ester group (OR = 1.52; 95% CI: 1.09–1.95) and organochlorine group (OR = 1.98; 95% CI: 1.34–2.62). Additionally, identification of official data, and a comprehensive review of the mechanisms were performed, and better elucidated the increased risk of these classic EDCs on abnormal sperm quality. The present systematic review and meta-analysis helps to identify the impact of classic EDCs on human sperm quality. However, it still highlights the need for additional epidemiological studies in a larger variety of geographic locations. PMID:26804707

  11. EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals.

    PubMed

    Gore, A C; Chappell, V A; Fenton, S E; Flaws, J A; Nadal, A; Prins, G S; Toppari, J; Zoeller, R T

    2015-12-01

    The Endocrine Society's first Scientific Statement in 2009 provided a wake-up call to the scientific community about how environmental endocrine-disrupting chemicals (EDCs) affect health and disease. Five years later, a substantially larger body of literature has solidified our understanding of plausible mechanisms underlying EDC actions and how exposures in animals and humans-especially during development-may lay the foundations for disease later in life. At this point in history, we have much stronger knowledge about how EDCs alter gene-environment interactions via physiological, cellular, molecular, and epigenetic changes, thereby producing effects in exposed individuals as well as their descendants. Causal links between exposure and manifestation of disease are substantiated by experimental animal models and are consistent with correlative epidemiological data in humans. There are several caveats because differences in how experimental animal work is conducted can lead to difficulties in drawing broad conclusions, and we must continue to be cautious about inferring causality in humans. In this second Scientific Statement, we reviewed the literature on a subset of topics for which the translational evidence is strongest: 1) obesity and diabetes; 2) female reproduction; 3) male reproduction; 4) hormone-sensitive cancers in females; 5) prostate; 6) thyroid; and 7) neurodevelopment and neuroendocrine systems. Our inclusion criteria for studies were those conducted predominantly in the past 5 years deemed to be of high quality based on appropriate negative and positive control groups or populations, adequate sample size and experimental design, and mammalian animal studies with exposure levels in a range that was relevant to humans. We also focused on studies using the developmental origins of health and disease model. No report was excluded based on a positive or negative effect of the EDC exposure. The bulk of the results across the board strengthen the evidence

  12. EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals

    PubMed Central

    Chappell, V. A.; Fenton, S. E.; Flaws, J. A.; Nadal, A.; Prins, G. S.; Toppari, J.; Zoeller, R. T.

    2015-01-01

    The Endocrine Society's first Scientific Statement in 2009 provided a wake-up call to the scientific community about how environmental endocrine-disrupting chemicals (EDCs) affect health and disease. Five years later, a substantially larger body of literature has solidified our understanding of plausible mechanisms underlying EDC actions and how exposures in animals and humans—especially during development—may lay the foundations for disease later in life. At this point in history, we have much stronger knowledge about how EDCs alter gene-environment interactions via physiological, cellular, molecular, and epigenetic changes, thereby producing effects in exposed individuals as well as their descendants. Causal links between exposure and manifestation of disease are substantiated by experimental animal models and are consistent with correlative epidemiological data in humans. There are several caveats because differences in how experimental animal work is conducted can lead to difficulties in drawing broad conclusions, and we must continue to be cautious about inferring causality in humans. In this second Scientific Statement, we reviewed the literature on a subset of topics for which the translational evidence is strongest: 1) obesity and diabetes; 2) female reproduction; 3) male reproduction; 4) hormone-sensitive cancers in females; 5) prostate; 6) thyroid; and 7) neurodevelopment and neuroendocrine systems. Our inclusion criteria for studies were those conducted predominantly in the past 5 years deemed to be of high quality based on appropriate negative and positive control groups or populations, adequate sample size and experimental design, and mammalian animal studies with exposure levels in a range that was relevant to humans. We also focused on studies using the developmental origins of health and disease model. No report was excluded based on a positive or negative effect of the EDC exposure. The bulk of the results across the board strengthen the

  13. SMALL-SCALE IMPACT SENSITIVITY TESTING ON EDC37

    SciTech Connect

    HSU, P C; HUST, G; MAIENSCHEIN, J L

    2008-04-28

    EDC37 was tested at LLNL to determine its impact sensitivity in the LLNL's drop hammer system. The results showed that impact sensitivities of the samples were between 86 cm and 156 cm, depending on test methods. EDC37 is a plastic bonded explosive consisting of 90% HMX, 1% nitrocellulose and binder. We recently conducted impact sensitivity testing in our drop hammer system and the results are presented in this report.

  14. Th-17 Alloimmune Responses in Renal Allograft Biopsies From Recipients of Kidney Transplants Using Extended Criteria Donors During Acute T Cell-Mediated Rejection.

    PubMed

    Matignon, M; Aissat, A; Canoui-Poitrine, F; Grondin, C; Pilon, C; Desvaux, D; Saadoun, D; Barathon, Q; Garrido, M; Audard, V; Rémy, P; Lang, P; Cohen, J; Grimbert, P

    2015-10-01

    Although renal transplantation using expanded criteria donors has become a common practice, immune responses related to immunosenescence in those kidney allografts have not been studied yet in humans. We performed a retrospective molecular analysis of the T cell immune response in 43 kidney biopsies from patients with acute T cell-mediated rejection including 25 from recipients engrafted with a kidney from expanded criteria donor and 18 from recipients grafted with optimal kidney allograft. The clinical, transplant and acute T cell-mediated rejection characteristics of both groups were similar at baseline. The expression of RORγt, Il-17 and T-bet mRNA was significantly higher in the elderly than in the optimal group (p = 0.02, p = 0.036, and p = 0.01, respectively). Foxp3 mRNA levels were significantly higher in elderly patients experiencing successful acute T cell-mediated rejection reversal (p = 0.03). The presence of IL-17 mRNA was strongly associated with nonsuccessful reversal in elderly patients (p = 0.008). Patients with mRNA IL17 expression detection and low mRNA Foxp3 expression experienced significantly more treatment failure (87.5%) than patients with no mRNA IL17 expression and/or high mRNA Foxp3 expression (26.7%; p = 0.017). Our study suggests that the Th17 pathway is involved in pathogenesis and prognosis of acute T cell-mediated rejection in recipients of expanded criteria allograft.

  15. Reconditioning by end-ischemic hypothermic in-house machine perfusion: A promising strategy to improve outcome in expanded criteria donors kidney transplantation.

    PubMed

    Gallinat, Anja; Amrillaeva, Vera; Hoyer, Dieter P; Kocabayoglu, Peri; Benko, Tamas; Treckmann, Jürgen W; van Meel, Marieke; Samuel, Undine; Minor, Thomas; Paul, Andreas

    2017-03-01

    This clinical study evaluates end-ischemic hypothermic machine perfusion (eHMP) in expanded criteria donors (ECD) kidneys. eHMP was initiated upon arrival of the kidney in our center and continued until transplantation. Between 11/2011 and 8/2014 eHMP was performed in 66 ECD kidneys for 369 (98-912) minutes after 863 (364-1567) minutes of cold storage (CS). In 49 of 66 cases, the contralateral kidney from the same donor was preserved by static CS only and accepted by another Eurotransplant (ET) center. Five (10.2%) of these kidneys were ultimately judged as "not transplantable" by the accepting center and discarded. After exclusion of early unrelated graft losses, 43 kidney pairs from the same donor were eligible for direct comparison of eHMP vs CS only: primary non-function and delayed graft function (DGF) were 0% vs 9.3% (P=.04) and 11.6% vs 20.9% (P=.24). There was no statistically significant difference in 1-year graft survival (eHMP vs CS only: 97.7% vs 88.4%, P=.089). In a multivariate analysis, eHMP was an independent factor for prevention of DGF (OR: 0.28, P=.041). Development of DGF was the strongest risk factor for 1-year graft failure (Renal resistance: 38.2, P<.001). In summary, eHMP is a promising reconditioning technique to improve the quality and acceptance rate of suboptimal grafts. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Evidence-based criteria for the care and selection of blood donors, with some comments on the relationship to blood supply, and emphasis on the management of donation-induced iron depletion.

    PubMed

    Boulton, F

    2008-02-01

    Blood Services, which, in the UK, spend over 0.5% of the NHS budget, are generally subject to quality, regulatory, economic and political authority. As only persons in good health should give blood, Services have refined donor selection criteria and aim to base them on evidence; but they also have to balance the number of donations collected with product demand. Applying selection criteria inevitably leads to deferrals, which donors experience very negatively. Compared with successful donors, even temporary deferrals reduce return rates significantly, especially of first attenders. In order to encourage donor return and sustain supplies, selection criteria should be optimal. However, a major tool for managing patients--evidence from randomized controlled trials (RCTs)--cannot apply to donor selection, so criteria have to be defined by alternatives, such as clinical studies, epidemiology and even what experts deem to be pathophysiologically feasible. The recommended volume of blood taken from each donor at each attendance (450 mL, which was based on old studies) was increased because of greater processing losses (buffy-coat derived platelets, leucofiltration etc.). Although faint rates and donation-induced iron depletion are reduced by lowering bleeding volume and bleeding less frequently, other optimizing strategies including iron supplementation have been trialled and could be enhanced by more RCTs. Better but more complex indicators of donor iron status than one-off Hb thresholds are possible. Regulators and decision-makers must encourage more studies. This review does not consider aphaeresis donors of blood components other than red cells in detail, or the prevention of transfusion-transmitted infections.

  17. Impact of early graft function on 10-year graft survival in recipients of kidneys from standard- or expanded-criteria donors.

    PubMed

    Smail, Nassima; Tchervenkov, Jean; Paraskevas, Steven; Baran, Dana; Mucsi, Istvan; Hassanain, Mazen; Chaudhury, Prosanto; Cantarovich, Marcelo

    2013-07-27

    The use of kidneys from expanded-criteria donors (ECD) is regarded with caution. We compared 279 kidney transplant recipients (KTxR) from standard-criteria donors (SCD) and 237 from ECD, transplanted between January 1990 and December 2006. We evaluated the impact of immediate graft function (IGF), slow graft function (SGF), and delayed graft function (DGF) and the drop in estimated glomerular filtration rate (ΔeGFR) ≤ 30% or > 30% during the first year after transplantation on long-term patient and death-censored graft survival (DCGS). Ten-year patient survival was similar in SCD- or ECD-KTxR (P = 0.38). DCGS was better in SCD-KTxR versus ECD-KTxR (77.3% vs. 67.3%; P = 0.01). DCGS did not differ in either group experiencing IGF (P = 0.17) or DGF (P = 0.12). However, DCGS was worse in ECD-KTxR experiencing SGF (84.9% vs. 73.7%; P = 0.04). Predictors of DCGS were 1-year serum creatinine (hazard ratio, 1.03; P < 0.0001) and ΔeGFR > 30% between 1 and 12 months (Δ1-12eGFR) after transplantation (hazard ratio, 2.2; P = 0.02). In ECD-KTxR with IGF and more than 1-year follow-up, 10-year DCGS was better in those with Δ1-12eGFR ≤ 30% versus those with Δ1-12eGFR > 30% (83.8% vs. 53.6%; P = 0.01). Recipients of SCD or ECD kidneys with IGF or DGF had similar 10-year patient survival and DCGS. SGF had a worse impact on DCGS in ECD-KTxR. In addition to 1-year serum creatinine, Δ1-12eGFR > 30% is a negative predictor of DCGS. Larger studies should confirm if increasing the use of ECD, avoiding factors that contribute to SGF or DGF, and/or a decline in eGFR during the first year after transplantation may expand the donor pool and result in acceptable long-term outcomes.

  18. EVALUATION OF DRINKING WATER TREATMENT TECHNIQUES FOR EDC REMOVAL

    EPA Science Inventory

    Many of the chemicals identified as potential endocrine disrupting chemicals (EDCs) may be present in surface or ground waters used as drinking water sources, due to their disposal via domestic and industrial sewage treatment systems and wet-weather runoff. In order to decrease t...

  19. ASSESSEMNT OF GONAD SIZE IN TAUTOGOLABRUS ADSPERSUS AS AN INDICATOR OF REPRODUCTION AND EDC EXPOSURE

    EPA Science Inventory

    Cunner habitat includes estuarine and marine areas where sewage treatment and other discharges containing estrogenic (EDCs) are likely.

    Endocrine-disrupting chemicals (EDCs) in the environment may disturb the population dynamics of wildlife by affecting their reproductive...

  20. Comparison of sequential protocol using basiliximab versus antithymocyte globulin with high-dose mycophenolate mofetil in recipients of a kidney graft from an expanded-criteria donor.

    PubMed

    Pallet, Nicolas; Anglicheau, Dany; Martinez, Frank; Mamzer, Marie-France; Legendre, Christophe; Thervet, Eric

    2006-03-27

    This retrospective pilot study investigated use of high-dose mycophenolate mofetil with biological induction and sequential introduction of low-dose cyclosporine in recipients of expanded criteria donor (ECD) kidneys. Fifty-four patients received mycophenolate mofetil 3 g/day for 45 days, cyclosporine 4 mg/kg/day, prednisolone, and rabbit antithymocyte globulin (rATG, n=14) or basiliximab (n=40). Acute rejection incidence was 11.3% (7.1% with rATG, 12.6% with basiliximab). Delayed graft function was observed in 31 patients (54%). At one year, measured glomerular filtration rate was 54+/-4 ml/min, with no significant differences between induction therapies. Thirty patients (55%) required > or =1 MMF dose reduction within month 1 due to adverse events (gastrointestinal symptoms, 67%; leucopenia 33%). Leucopenia was more frequent with rATG, while gastrointestinal symptoms were more frequent with basiliximab. Cytomegalovirus replication occurred in three patients (23%) with rATG and 3 (8%) with basiliximab. In conclusion, high-dose MMF, corticosteroids, delayed low-dose cyclosporine and induction therapy offers an excellent risk-to-benefit ratio in patients receiving an ECD allograft.

  1. A randomized trial of basiliximab with three different patterns of cyclosporin A initiation in renal transplant from expanded criteria donors and at high risk of delayed graft function.

    PubMed

    Andrés, Amado; Marcén, Roberto; Valdés, Francisco; Plumed, Jaime Sánchez; Solà, Ricard; Errasti, Pedro; Lauzurica, Ricardo; Pallardó, Luis; Bustamante, Jesús; Amenábar, Juan José; Plaza, Juan José; Gómez, Ernesto; Grinyó, Josep Maria; Rengel, Manuel; Puig, Josep Maria; Sanz, Aurelio; Asensio, Concepción; Andrés, Inés

    2009-01-01

    This study assays therapy with basiliximab and different patterns of cyclosporin A (CsA) initiation in renal transplant (RT) recipients from expanded criteria donors (ECD) and at high risk of delayed graft function (DGF). A multicentre six-month open-label randomized trial with three parallel groups treated with basiliximab plus steroids, mycophenolate mofetil and different patterns of CsA initiation: early within 24 h post-RT at 3 mg/kg/d (Group 1; n = 38), and at 5 mg/kg/d (Group 2; n = 40), or delayed after 7-10 d at 5 mg/kg/d (Group 3; n = 36). There were no differences among groups in six months GFR (43.1 +/- 12, 48.0 +/- 14 and 47.2 +/- 17 mL/min, respectively), DGF (Group 1: 31%, Group 2: 37%, Group 3: 42%), nor biopsy-proven acute rejection, although clinically treated and biopsy-proven acute rejection was significantly higher in Group 3 (25%) vs. Group 1 (5.3%, p < 0.05). At six months no differences were observed in death-censored graft survival or patient survival. Induction therapy with basiliximab and three CsA-ME initiation patterns in RT recipients from ECD and at high risk of DGF presented good renal function and graft survival at six months. Late onset group did not achieve improvement in DGF rate and showed a higher incidence of clinically treated and biopsy-proven acute rejection.

  2. EVALUATION OF DRINKING WATER TREATMENT TECHNOLOGIES FOR REMOVAL OF ENDOCRINE DISRUPTING CHEMICALS (EDCS)

    EPA Science Inventory

    A number of the chemicals identified as potential EDCs have been observed in surface and ground waters leading to concern over the possible presence of EDCs in finished drinking waters. Although there has not yet been a determination of risks posed by EDCs in finished waters, it ...

  3. Polycystic ovary syndrome (PCOS) and endocrine disrupting chemicals (EDCs).

    PubMed

    Palioura, Eleni; Diamanti-Kandarakis, Evanthia

    2015-12-01

    Polycystic ovary syndrome (PCOS) is a heterogeneous disorder of unclear etiopathogenesis that is likely to involve genetic and environmental components synergistically contributing to its phenotypic expression. Endocrine disrupting chemicals (EDCs) and in particular Bisphenol A (BPA) represent a group of widespread pollutants intensively investigated as possible environmental contributors to PCOS pathogenesis. Substantial evidence from in vitro and animal studies incriminates endocrine disruptors in the induction of reproductive and metabolic aberrations resembling PCOS characteristics. In humans, elevated BPA concentrations are observed in adolescents and adult PCOS women compared to reproductively healthy ones and are positively correlated with hyperandrogenemia, implying a potential role of the chemical in PCOS pathophysiology, although a causal interference cannot yet be established. It is plausible that developmental exposure to specific EDCs could permanently alter neuroendocrine, reproductive and metabolic regulation favoring PCOS development in genetically predisposed individuals or it could accelerate and/or exacerbate the natural course of the syndrome throughout life cycle exposure.

  4. EDC DAAC: serving the land processes science community

    NASA Astrophysics Data System (ADS)

    Bailey, G. Bryan; Oleson, Lyndon R.

    1996-11-01

    The primary objective of the Earth Resources Observation System (EROS) Data Center (EDC) Distributed Active Archive Center (DAAC) for land processes data is to promote the interdisciplinary study and understanding of the integrated Earth system by providing remotely sensed and related ancillary data for the study, characterization, and monitoring of natural and anthropogenic conditions and processes existing and operating at or near the land surface. Generating, distributing, and preserving data and products from the National Aeronautics and Space Administration's (NASA) earth observing system (EOS) are primary functions of the DAAC. To that end, the EDC DAAC is using existing data sets in developing capabilities to efficiently and effectively ingest, process, manage, distribute, and archive for future generations land-related data collected by EOS sensors. Capabilities also are being developed to help users search for and acquire data and products, as well as to support their scientific application of those data and products. EDC DAAC programs and capability development activities address DAAC-defined science support requirements that relate to a broad spectrum of services and capabilities needed by science users.

  5. Changing blood donor screening criteria from permanent deferral for men who have sex with men to individual sexual risk assessment: no evidence of a significant impact on the human immunodeficiency virus epidemic in Italy

    PubMed Central

    Suligoi, Barbara; Pupella, Simonetta; Regine, Vincenza; Raimondo, Mariangela; Velati, Claudio; Grazzini, Giuliano

    2013-01-01

    Background In 2001, the criteria for blood donor eligibility in Italy were modified by a ministerial decree from a permanent deferral for "men who have sex with men" to an individual risk assessment of sexual behaviours. The aim of this study was to evaluate the impact of this change in donor screening criteria on the human immunodeficiency virus epidemic among blood donors in Italy. Materials and methods We used the data obtained from the Italian blood donor epidemiological surveillance system. We compared data collected in 2009 and 2010, when the individual risk assessment policy was applied, with data collected in 1999 when permanent deferral was applied for men who have sex with men based on a declaration of sexual orientation. We evaluated the change over time in the relative proportion of HIV antibody-positive donors who likely acquired the infection from men who have sex with men vs heterosexual sexual exposure; the relative risk was calculated using 1999 as the reference year. Results In all 3 years, the majority of HIV antibody-positive donors reported sexual exposure as a risk factor for HIV infection; this proportion increased over time, although not statistically significantly. Heterosexuals always accounted for at least 40% of all HIV antibody-positive cases. The rate of HIV antibody-positive donors increased similarly in men who have sex with men and heterosexuals; specifically, the rate of HIV antibody-positive cases per 100,000 donors was more than 2-fold higher among men who have sex with men in 2009–2010 than in 1999 (2009–2010 vs 1999, RR =2.8; P =0.06), and that among heterosexuals was 1.5 fold higher (P =0.18). Discussion When comparing the period before (1999) and after (2009–2010), the implementation of the individual risk assesment policy in 2001, no significant increase in the proportion of men who have sex with men compared to heterosexuals was observed among HIV antibody-positive blood donors, suggesting that the change in donor

  6. A review of the genotoxicity of 1,2-dichloroethane (EDC).

    PubMed

    Gwinn, Maureen R; Johns, Douglas O; Bateson, Thomas F; Guyton, Kathryn Z

    2011-01-01

    1,2-Dichloroethane (EDC, CAS#107-06-2) is a high production volume halogenated aliphatic hydrocarbon that is used mainly in the manufacture of vinyl chloride. EDC has been found in ambient and residential air samples, as well as in groundwater, surface water and drinking water. EDC has been well-studied in a variety of genotoxicity assays, and appears to involve the metabolic activation of the parent compound. We critically evaluated the genotoxicity data of EDC and its metabolites as part of an evaluation of carcinogenic mechanisms of action of EDC. EDC is genotoxic in multiple test systems via multiple routes of exposure. EDC has been shown to induce DNA adduct formation, gene mutations and chromosomal aberrations in the presence of key activation enzymes (including CYP450s and/or GSTs) in laboratory animal and in vitro studies. EDC was negative for clastogenesis as measured by the micronucleus assay in mice. In general, an increased level of DNA damage is observed related to the GSH-dependent bioactivation of EDC. Increased chromosomal aberrations with increased CYP450 expression were suggestive of a role for the oxidative metabolites of EDC in inducing chromosomal damage. Taken together, these studies demonstrate that EDC exposure, in the presence of key enzymes (including CYP450s and/or GSTs), leads to DNA adduct formation, gene mutations and chromosomal aberrations. Published by Elsevier B.V.

  7. Problems of selecting donors for artificial insemination

    PubMed Central

    Schoysman, R

    1975-01-01

    This paper is concerned with only one of the problems encountered in selecting donors for artificial insemination, that of choosing suitable donors. In Belgium medical students have generally been the donors of semen but Dr Schoysman examines the other choices of potential donors and outlines certain criteria for selecting them: these criteria are more explicit than those outlined by Professor Kerr and Miss Rogers on page 32. He also touches on the question of payment to donors. PMID:1165573

  8. EDC-mediated DNA attachment to nanocrystalline CVD diamond films.

    PubMed

    Christiaens, P; Vermeeren, V; Wenmackers, S; Daenen, M; Haenen, K; Nesládek, M; vandeVen, M; Ameloot, M; Michiels, L; Wagner, P

    2006-08-15

    Chemical vapour deposited (CVD) diamond is a very promising material for biosensor fabrication owing both to its chemical inertness and the ability to make it electrical semiconducting that allows for connection with integrated circuits. For biosensor construction, a biochemical method to immobilize nucleic acids to a diamond surface has been developed. Nanocrystalline diamond is grown using microwave plasma-enhanced chemical vapour deposition (MPECVD). After hydrogenation of the surface, 10-undecenoic acid, an omega-unsaturated fatty acid, is tethered by 254 nm photochemical attachment. This is followed by 1-ethyl-3-[3-dimethylaminopropyl]carbodiimide (EDC)-mediated attachment of amino (NH(2))-modified dsDNA. The functionality of the covalently bound dsDNA molecules is confirmed by fluorescence measurements, PCR and gel electrophoresis during 35 denaturation and rehybridisation steps. The linking method after the fatty acid attachment can easily be applied to other biomolecules like antibodies and enzymes.

  9. Performance of electrostatic dust collectors (EDCs) for endotoxin assessment in homes: Effect of mailing, placement, heating, and electrostatic charge.

    PubMed

    Kilburg-Basnyat, Brita; Metwali, Nervana; Thorne, Peter S

    2016-01-01

    Electrostatic Dust Collectors (EDCs) are in use for passive sampling of bioaerosols, but particular aspects of their performance have not yet been evaluated. This study investigated the effect of mailing EDCs on endotoxin loading and the effect of EDC deployment in front of, and away from, heated ventilation on endotoxin sampling. Endotoxin sampling efficiency of heated and unheated EDC cloths was also evaluated. Cross-country express mailing of dust-spiked EDCs yielded no significant changes in endotoxin concentrations compared to dust-only samples for both high-spiked EDCs (p = 0.30) and low-spiked EDCs (p = 0.36). EDCs were also deployed in 20 identical apartments with one EDC placed in front of the univent heater in each apartment and contemporaneous EDC placed on the built-in bookshelf in each apartment. The endotoxin concentrations were significantly different (p = 0.049) indicating that the placement of EDC does impact endotoxin sampling. Heated and unheated EDCs were deployed for 7 days in pairs in farm homes. There was a significant difference between endotoxin concentrations (p = 0.027) indicating that heating EDCs may diminish their electrostatic capabilities and impact endotoxin sampling. The last study investigated the electrostatic charge of 12 heated and 12 unheated EDC cloths. There was a significant difference in charge (p = 0.009) which suggests that heating EDC cloths may make them less effective for sampling. In conclusion, EDCs can be mailed to and from deployment sites, EDC placement in relationship to ventilation is crucial, and heating EDCs reduces their electrostatic charge which may diminish their endotoxin sampling capabilities.

  10. Performance of Electrostatic Dust Collectors (EDCs) for Endotoxin Assessment in Homes: Effect of Mailing, Placement, Heating and Electrostatic Charge

    PubMed Central

    Kilburg-Basnyat, Brita; Metwali, Nervana; Thorne, Peter S.

    2016-01-01

    Electrostatic Dust Collectors (EDCs) are in use for passive sampling of bioaerosols, but particular aspects of their performance have not yet been evaluated. This study investigated the effect of mailing EDCs on endotoxin loading and the effect of EDC deployment in front of and away from heated ventilation on endotoxin sampling. Endotoxin sampling efficiency of heated and unheated EDC cloths was also evaluated. Cross-country express mailing of dust-spiked EDCs yielded no significant changes in endotoxin concentrations compared to dust-only samples for both high spiked-EDCs (p=0.30) and low spiked-EDCs (p=0.36). EDCs were also deployed in 20 identical apartments with one EDC placed in front of the univent heater in each apartment and contemporaneous EDC placed on the built-in bookshelf in each apartment. The endotoxin concentrations were significantly different (p=0.049) indicating that the placement of EDC does impact endotoxin sampling. Heated and unheated EDCs were deployed for 7 days in pairs in farm homes. There was a significant difference between endotoxin concentrations (p=0.027) indicating that heating EDCs may diminish their electrostatic capabilities and impact endotoxin sampling. The last study investigated the electrostatic charge of 12 heated and 12 unheated EDC cloths. There was a significant difference in charge (p=0.009) which suggests that heating EDC cloths may make them less effective for sampling. In conclusion, EDCs can be mailed to and from deployment sites, EDC placement in relationship to ventilation is crucial, and heating EDCs reduces their electrostatic charge which may diminish their endotoxin sampling capabilities. PMID:26325020

  11. Living and Learning in a World of Diversities. An EDC Report Series.

    ERIC Educational Resources Information Center

    Mosaic, 1999

    1999-01-01

    This new report series grows out of internal discussions at the Education Development Center (EDC) about the meaning of equity in education, student diversity, and reflective practice. This premiere issue looks across the EDC at a wide array of projects focused on equity and diversity. The following articles are included: (1) "Introduction:…

  12. EUROLAS Data Center (EDC) - A new website for tracking the SLR data flow

    NASA Astrophysics Data System (ADS)

    Schwatke, C.

    2012-04-01

    Since the foundation of the International Laser Ranging Service (ILRS) in 1998, the EDC acts as one of the two global ILRS data centers, the Crustal Dynamics Data Information System (CDDIS) and the EUROLAS data center (EDC) at the DGFI. In 2009, the EDC became also an ILRS Operation Center (OS), which has the responsibility to verify the format of all incoming SLR observations. The SLR observations are submitted in different formats (Normal Points (CSTG), Normal Point (CRD), Full Rate (MERIT-II) and Full Rate (CRD)). In addition to the SLR observations, the EDC treats predictions (CPF), orbits and station coordinates. All data and products are handled in the internal data flow at the EDC. After processing data and products successful without errors they will be stored on the FTP at EDC (ftp://edc.dgfi.badw.de) or send via mail to the users. This web site (http://edc.dgfi.badw.de) contains an interface for station managers for uploading and quality control of tracking data. The interface gives feedback in case the upload was sucessful or a detailed description of errors is displayed. In addition summary information is provided on the latest data acquired by satellite and station.

  13. EFFECTS OF ENDOCRINE DISRUPTING CHEMICALS (EDCS) ON FETAL TESTES HORMONE PRODUCTION

    EPA Science Inventory

    Effects of Endocrine Disrupting Chemicals (EDCs) on Fetal Testes Hormone Production
    CS Lambright, VS Wilson, JR Furr, CJ Wolf, N Noriega, LE Gray, Jr
    US EPA, ORD/NHEERL/RTD, RTP, NC 27711

    Exposure to EDCs during critical periods of fetal sexual development can have...

  14. Organization versus activation: the role of endocrine-disrupting contaminants (EDCs) during embryonic development in wildlife.

    PubMed Central

    Guillette, L J; Crain, D A; Rooney, A A; Pickford, D B

    1995-01-01

    Many environmental contaminants disrupt the vertebrate endocrine system. Although they may be no more sensitive to endocrine-disrupting contaminants (EDCs) than other vertebrates, reptiles are good sentinels of exposure to EDCs due to the lability in their sex determination. This is exemplified by a study of alligators at Lake Apopka, Florida, showing that EDCs have altered the balance of reproductive hormones resulting in reproductive dysfunction. Such alterations may be activationally or organizationally induced. Much research emphasizes the former, but a complete understanding of the influence of EDCs in nature can be generated only after consideration of both activational and organizational alterations. The organizational model suggests that a small quantity of an EDC, administered during a specific period of embryonic development, can permanently modify the organization of the reproductive, immune, and nervous systems. Additionally, this model helps explain evolutionary adaptations to naturally occurring estrogenic compounds, such as phytoestrogens. PMID:8593864

  15. EDCs DataBank: 3D-Structure database of endocrine disrupting chemicals.

    PubMed

    Montes-Grajales, Diana; Olivero-Verbel, Jesus

    2015-01-02

    Endocrine disrupting chemicals (EDCs) are a group of compounds that affect the endocrine system, frequently found in everyday products and epidemiologically associated with several diseases. The purpose of this work was to develop EDCs DataBank, the only database of EDCs with three-dimensional structures. This database was built on MySQL using the EU list of potential endocrine disruptors and TEDX list. It contains the three-dimensional structures available on PubChem, as well as a wide variety of information from different databases and text mining tools, useful for almost any kind of research regarding EDCs. The web platform was developed employing HTML, CSS and PHP languages, with dynamic contents in a graphic environment, facilitating information analysis. Currently EDCs DataBank has 615 molecules, including pesticides, natural and industrial products, cosmetics, drugs and food additives, among other low molecular weight xenobiotics. Therefore, this database can be used to study the toxicological effects of these molecules, or to develop pharmaceuticals targeting hormone receptors, through docking studies, high-throughput virtual screening and ligand-protein interaction analysis. EDCs DataBank is totally user-friendly and the 3D-structures of the molecules can be downloaded in several formats. This database is freely available at http://edcs.unicartagena.edu.co.

  16. The measured temperature and pressure of EDC37 detonation products

    NASA Astrophysics Data System (ADS)

    Ferguson, J. W.; Richley, J. C.; Sutton, B. D.; Price, E.; Ota, T. A.

    2017-01-01

    We present the experimentally determined temperature and pressure of the detonation products of EDC37; a HMX based conventional high explosive. These measurements were performed on a series of cylinder tests. The temperature measurements were undertaken at the end of the cylinder with optical fibres observing the bare explosive through a LiF window. The temperature of the products was measured for approximately 2 µs using single colour pyrometry, multicolour pyrometry and also using time integrated optical emission spectroscopy with the results from all three methods being broadly consistent. The peak temperature was found to be ≈ 3600 K dropping to ≈ 2400 K at the end of the measurement window. The spectroscopy was time integrated and showed that the emission spectra can be approximated using a grey body curve between 520 - 800 nm with no emission or absorption lines being observed. The pressure was obtained using an analytical method which requires the velocity of the expanding cylinder wall and the velocity of detonation. The pressure drops from an initial CJ value of ≈ 38 GPa to ≈ 4 GPa after 2 µs.

  17. Roles of Edc3 in the oxidative stress response and CaMCA1-encoded metacaspase expression in Candida albicans.

    PubMed

    Jung, Jong-Hwan; Kim, Jinmi

    2014-11-01

    The Edc3 protein is an enhancer of mRNA decapping, and acts as a scaffold protein for the mRNA granules that are known as processing bodies in yeast. In the pathogenic yeast Candida albicans, various stresses, such as glucose depletion, oxidative stress, and filamentation defects, induce the accumulation of processing bodies. Here, we report that the edc3/edc3 deletion strain showed increased resistance to various stresses, including hydrogen peroxide, acetic acid, and high temperature. Oxidative stress is known to induce the intracellular accumulation of reactive oxygen species (ROS) and apoptotic cell death in C. albicans. We found that the ROS level was lower in edc3/edc3 cells than in wild-type cells following oxidative stress. We also observed that expression of the metacaspase gene CaMCA1 was decreased in edc3/edc3 cells. Overexpression of CaMCA1 suppressed the decreased accumulation of ROS and the increased resistance to hydrogen peroxide in edc3/edc3 cells. The catalase Cat1 and the superoxide dismutase Sod1 were upregulated in edc3/edc3 cells as compared with wild-type cells. On the basis of these findings, we suggest that EDC3 plays a critical role in the expression of CaMCA1 and the oxidative stress response in C. albicans.

  18. The egg-sharing model for human therapeutic cloning research: managing donor selection criteria, the proportion of shared oocytes allocated to research, and amount of financial subsidy given to the donor.

    PubMed

    Heng, Boon Chin; Tong, Guo Qing; Stojkovic, Miodrag

    2006-01-01

    Recent advances in human therapeutic cloning made by Hwang and colleagues have opened up new avenues of therapy for various human diseases. However, the major bottleneck of this new technology is the severe shortage of human donor oocytes. Egg-sharing in return for subsidized fertility treatment has been suggested as an ethically justifiable and practical solution to overcome the shortage of donor oocytes for therapeutic cloning. Because the utilization of shared oocytes in therapeutic cloning research does not result in any therapeutic benefit to a second party, this would necessitate a different management strategy compared to their use for the assisted conception of infertile women who are unable to produce any oocytes of their own. It is proposed that the pool of prospective egg-sharers in therapeutic cloning research be limited only to younger women (below 30 years of age) with indications for either male partner sub-fertility or tubal blockage. With regards to the proportion of the shared gametes being allocated to research, a threshold number of retrieved oocytes should be set that if not exceeded, would result in the patient being automatically removed from the egg-sharing scheme. Any excess supernumerary oocyte above this threshold number can be contributed to science, and allocation should be done in a randomized manner. Perhaps, a total of 10 retrieved oocytes from the patient may be considered a suitable threshold, since the chances of conception are unlikely to be impaired. With regards to the amount of subsidy being given to the patient, it is suggested that the proportion of financial subsidy should be equal to the proportion of the patient's oocytes being allocated to research. No doubt, the promise of future therapeutic benefit may be offered to the patient instead of financial subsidy. However, this is ethically controversial because therapeutic cloning has not yet been demonstrated to be a viable model of clinical therapy and any promises made to

  19. Blood Donor Management in China

    PubMed Central

    Shi, Ling; Wang, Jingxing; Liu, Zhong; Stevens, Lori; Sadler, Andrew; Ness, Paul; Shan, Hua

    2014-01-01

    Summary Despite a steady increase in total blood collections and voluntary non-remunerated blood donors, China continues to have many challenges with its blood donation system. The country's donation rate remains low at 9%o, with over 60% of donors being first-time donors. Generally there is a lack of adequate public awareness about blood donation. The conservative donor selection criteria, the relatively long donation interval, and the small donation volume have further limited blood supply. To ensure a sufficient and safe blood supply that meets the increasing clinical need for blood products, there is an urgent need to strengthen the country's blood donor management. This comprehensive effort should include educating and motivating more individuals especially from the rural areas to be involved in blood donation, developing rational and evidence-based selection criteria for donor eligibility, designing a donor follow-up mechanism to encourage more future donations, assessing the current donor testing strategy, improving donor service and care, building regional and national shared donor deferral database, and enhancing the transparency of the blood donation system to gain more trust from the general public. The purpose of the review is to provide an overview of the key process of and challenges with the blood donor management system in China. PMID:25254023

  20. Effects of carbon-based nanoparticles (CNPs) on the fate of endocrine disrupting chemicals (EDCs) in different agricultural soils.

    NASA Astrophysics Data System (ADS)

    Stumpe, Britta; Wolski, Sabrina; Marschner, Bernd

    2013-04-01

    Nanotechnology is a major innovative scientific and economic growth area. To date there is a lack about possible adverse effects that may be associated with manufactured nanomaterial in terrestrial environments. Since it is known that on the one hand carbon-based nanoparticles (CNPs) and endocrine disrupting chemicals (EDCs) strongly interact in wastewater and that on the other hand CNPs and EDCs are released together via wastewater irrigation to agricultural soils, knowledge of CNP effects on the EDC fate in the soil environment is needed for further risk assessments. The overall goal of this project is to gain a better understanding of interaction of CNPs with EDCs within the soil system. Three different soil samples were applied with different CNPs, EDCs and CNP-EDC complexes and incubated over a period of 6 weeks. The EDC mineralization as well as their uptake by soil microorganisms was monitored to describe impacts of the nanomaterial on the EDC fate. As quality control for the biological soil activity soil respiration, enzyme activities and the soil microbial biomass were monitored in all incubated soil samples. Clearly, EDCs bound in CNP complexes showed a decrease in mineralization. While the free EDCs showed a total mineralization of 34 to 45 %, the nano complexed EDCs were only mineralized to 12 to 15 %. Since no effects of the nanomaterial on the biological soil activity were observed, we conclude that the reduced EDC mineralization is directly linked to their interaction with the CNPs. Since additionally the EDC adsorption to CNPs reduced the EDC uptake by soil microorganism, we assume that CNPs generally form more or less recalcitrant aggregates which likely protect the associated EDCs from degradation.

  1. DEVELOPMENT OF CHEMICAL METHODS TO CHARACTERIZE EXPOSURE TO EDCS IN THE NEUSE RIVER BASIN

    EPA Science Inventory

    To develop a quantitative health and environmental risk assessment of endocrine disrupting compounds (EDCs), information on exposures is essential. A full exposure assessment has complex requirements that require preliminary information to direct further research in this area....

  2. DEVELOPMENT OF CHEMICAL METHODS TO CHARACTERIZE EXPOSURE TO EDCS IN THE NEUSE RIVER BASIN

    EPA Science Inventory

    To develop a quantitative health and environmental risk assessment of endocrine disrupting compounds (EDCs), information on exposures is essential. A full exposure assessment has complex requirements that require preliminary information to direct further research in this area....

  3. Effect of Transpiration on Plant Accumulation and Translocation of PPCP/EDCs

    PubMed Central

    Dodgen, Laurel K; Ueda, Aiko; Wu, Xiaoqin; Parker, David R; Gan, Jay

    2015-01-01

    The reuse of treated wastewater for agricultural irrigation in arid and hot climates where plant transpiration is high may affect plant accumulation of pharmaceutical and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs). In this study, carrot, lettuce, and tomato plants were grown in solution containing 16 PPCP/EDCs in either a cool-humid or a warm-dry environment. Leaf bioconcentration factors (BCF) were positively correlated with transpiration for chemical groups of different ionized states (p < 0.05). However, root BCFs were correlated with transpiration only for neutral PPCP/EDCs (p < 0.05). Neutral and cationic PPCP/EDCs showed similar accumulation, while anionic PPCP/EDCs had significantly higher accumulation in roots and significantly lower accumulation in leaves (p < 0.05). Results show that plant transpiration may play a significant role in the uptake and translocation of PPCP/EDCs, which may have a pronounced effect in arid and hot climates where irrigation with treated wastewater is common. PMID:25594843

  4. Effect of transpiration on plant accumulation and translocation of PPCP/EDCs.

    PubMed

    Dodgen, Laurel K; Ueda, Aiko; Wu, Xiaoqin; Parker, David R; Gan, Jay

    2015-03-01

    The reuse of treated wastewater for agricultural irrigation in arid and hot climates where plant transpiration is high may affect plant accumulation of pharmaceutical and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs). In this study, carrot, lettuce, and tomato plants were grown in solution containing 16 PPCP/EDCs in either a cool-humid or a warm-dry environment. Leaf bioconcentration factors (BCF) were positively correlated with transpiration for chemical groups of different ionized states (p < 0.05). However, root BCFs were correlated with transpiration only for neutral PPCP/EDCs (p < 0.05). Neutral and cationic PPCP/EDCs showed similar accumulation, while anionic PPCP/EDCs had significantly higher accumulation in roots and significantly lower accumulation in leaves (p < 0.05). Results show that plant transpiration may play a significant role in the uptake and translocation of PPCP/EDCs, which may have a pronounced effect in arid and hot climates where irrigation with treated wastewater is common.

  5. Reevaluating the dead donor rule.

    PubMed

    Collins, Mike

    2010-04-01

    The dead donor rule justifies current practice in organ procurement for transplantation and states that organ donors must be dead prior to donation. The majority of organ donors are diagnosed as having suffered brain death and hence are declared dead by neurological criteria. However, a significant amount of unrest in both the philosophical and the medical literature has surfaced since this practice began forty years ago. I argue that, first, declaring death by neurological criteria is both unreliable and unjustified but further, the ethical principles which themselves justify the dead donor rule are better served by abandoning that rule and instead allowing individuals who have suffered severe and irreversible brain damage to become organ donors, even though they are not yet dead and even though the removal of their organs would be the proximal cause of death.

  6. Empirical Establishment of Oligonucleotide Probe Design Criteria; Use of Microarrays with Different Probe Sizes for Monitoring Gene Expression; Temporal Transcriptomic Analysis as Desulfovibrio vulgaris Hildenborough Transitions into Stationary Phase during Electron Donor Depletion

    SciTech Connect

    He, Q.; He, Z.; Huang, K. H.; Alm, E. J.; Wan, X. F.; Hazen, T. C.; Arkin, A. P.; Wall, J. D.; Zhou, J. Z.; Fields, M. W.

    2005-07-15

    In order to experimentally establish the criteria for designing gene-specific and group-specific oligonucleotide probes, an oligonucleotide array was constructed that contained perfect match (PM) and mismatch (MM) probes (50mers and 70mers) based upon 4 genes. The effects of probe-target identity, continuous stretch, mismatch position, and hybridization free energy on specificity were examined. Little hybridization was observed at a probe-target identity of <85% for both 50mer and 70mer probes........Based on the experimental results, a set of criteria are suggested for the design of gene-specific and group-specific oligonucleotide probes, and these criteria should provide valuable information for the development of new software and algorithms for microarray-based studies.; Microarrays with oligonucleotides of different lengths were used to monitor gene expression at a wholegenome level. To determine what length of oligonucleotide is a better alternative to PCR-generated probes, the performance of oligonucleotide probes was systematically compared to that of their PCR-generated counterparts for 96 genes from Shewanella oneidensis MR-1 in terms of overall signal intensity, numbers of genes detected, specificity, sensitivity, and differential gene expression under experimental conditions. .......To evaluate differential gene expression under experimental conditions, S. oneidensis MR-1 cells were exposed to low- or high-pH conditions for 30 and 60 min, and the transcriptional profiles detected by oligonucleotide probes (50-mer, 60-mer, and 70-mer) were closely correlated with those detected by the PCR probes. The results demonstrated that 70-mer oligonucleotides can provide the performance most comparable to the performance obtained with PCR-generated probes.; Desulfovibrio vulgaris was cultivated in a defined medium, and biomass was sampled for approximately 70 h to characterize the shifts in gene expression as cells transitioned from the exponential to the

  7. Identification of Edc3p as an enhancer of mRNA decapping in Saccharomyces cerevisiae.

    PubMed Central

    Kshirsagar, Meenakshi; Parker, Roy

    2004-01-01

    The major pathway of mRNA decay in yeast initiates with deadenylation, followed by mRNA decapping and 5'-3' exonuclease digestion. An in silico approach was used to identify new proteins involved in the mRNA decay pathway. One such protein, Edc3p, was identified as a conserved protein of unknown function having extensive two-hybrid interactions with several proteins involved in mRNA decapping and 5'-3' degradation including Dcp1p, Dcp2p, Dhh1p, Lsm1p, and the 5'-3' exonuclease, Xrn1p. We show that Edc3p can stimulate mRNA decapping of both unstable and stable mRNAs in yeast when the decapping enzyme is compromised by temperature-sensitive alleles of either the DCP1 or the DCP2 genes. In these cases, deletion of EDC3 caused a synergistic mRNA-decapping defect at the permissive temperatures. The edc3Delta had no effect when combined with the lsm1Delta, dhh1Delta, or pat1Delta mutations, which appear to affect an early step in the decapping pathway. This suggests that Edc3p specifically affects the function of the decapping enzyme per se. Consistent with a functional role in decapping, GFP-tagged Edc3p localizes to cytoplasmic foci involved in mRNA decapping referred to as P-bodies. These results identify Edc3p as a new protein involved in the decapping reaction. PMID:15020463

  8. Environmental epigenomics: Current approaches to assess epigenetic effects of endocrine disrupting compounds (EDC's) on human health.

    PubMed

    Tapia-Orozco, Natalia; Santiago-Toledo, Gerardo; Barrón, Valeria; Espinosa-García, Ana María; García-García, José Antonio; García-Arrazola, Roeb

    2017-02-10

    Environmental Epigenomics is a developing field to study the epigenetic effect on human health from exposure to environmental factors. Endocrine disrupting chemicals have been detected primarily in pharmaceutical drugs, personal care products, food additives, and food containers. Exposure to endocrine-disrupting chemicals (EDCs) has been associated with a high incidence and prevalence of many endocrine-related disorders in humans. Nevertheless, further evidence is needed to establish a correlation between exposure to EDC and human disorders. Conventional detection of EDCs is based on chemical structure and concentration sample analysis. However, substantial evidence has emerged, suggesting that cell exposure to EDCs leads to epigenetic changes, independently of its chemical structure with non-monotonic low-dose responses. Consequently, a paradigm shift in toxicology assessment of EDCs is proposed based on a comprehensive review of analytical techniques used to evaluate the epigenetic effects. Fundamental insights reported elsewhere are compared in order to establish DNA methylation analysis as a viable method for assessing endocrine disruptors beyond the conventional study approach of chemical structure and concentration analysis.

  9. Uptake and Accumulation of Four PPCP/EDCs in Two Leafy Vegetables

    PubMed Central

    Dodgen, LK; Li, J; Parker, D; Gan, JJ

    2013-01-01

    Many pharmaceutical and personal care products (PPCPs) and endocrine-disrupting chemicals (EDCs) are present in reclaimed water, leading to concerns of human health risks from the consumption of food crops irrigated with reclaimed water. This study evaluated the potential for plant uptake and accumulation of four commonly occurring PPCP/EDCs, i.e., bisphenol A (BPA), diclofenac sodium (DCL), naproxen (NPX), and 4-nonylphenol (NP), by lettuce (Lactuca sativa) and collards (Brassica oleracea) in hydroponic culture, using 14C-labeled compounds. In both plant species, plant accumulation followed the order of BPA > NP > DCL > NPX and accumulation in roots was much greater than in leaves and stems. Concentrations of 14C-PPCP/EDCs in plant tissues ranged from 0.22±0.03 to 927± 213 ng/g, but nearly all 14C-residue was non-extractable. PPCP/EDCs, particularly BPA and NP, were also extensively transformed in the nutrient solution. Dietary uptake of these PPCP/EDCs by humans was predicted to be negligible. PMID:23911624

  10. Dimorphic placental stress: A repercussion of interaction between endocrine disrupting chemicals (EDCs) and fetal sex.

    PubMed

    Sood, Surbhi; Shekhar, Sudhanshu; Santosh, Winkins

    2017-02-01

    Placental homeostasis is critical for fetal development as it determines the health of mother and fetus during pregnancy and in later life. Interestingly even the fetus, in a sexually dimorphic manner, influences the pedantic growth and development of placenta. Although placenta is thought to act as a protective barrier against chemical exposures, certain endocrine disrupting chemicals (EDCs) that are circulating in mother's blood tend to cross placenta. These EDCs have been reported to cause changes in expression levels of certain genes, immunogenic factors and non-coding RNAs such as micro RNA (miRNA) and long non-coding RNA (lncRNA) leading to placental stress. We hypothesize that these changes in placenta occur in a sexually dimorphic manner as a result of interaction between EDC exposure and fetal sex. Therefore, we propose that the ability of placenta to respond and buffer EDC exposure depends on fetal sex and, hence the EDC associated disease susceptibility of one sex differs from the other.

  11. Wound closure with EDC cross-linked cultured skin substitutes grafted to athymic mice.

    PubMed

    Powell, Heather M; Boyce, Steven T

    2007-02-01

    Collagen-glycosaminoglycan (C-GAG) sponges are commonly utilized as a substitute for the extracellular matrix of dermal tissue. Cultured skin substitutes (CSS) were assessed, after fabrication using sponges cross-linked with 1-ethyl-3-3-dimethylaminopropylcarbodiimide hydrochloride (EDC) at 0, 1, 5, or 50 mm, for development of viable, stratified skin tissue anatomy in vitro, and for wound contraction and cell viability in vivo. Cross-linking the C-GAG sponges with EDC reduced in vitro contraction of the CSS from a 39% reduction in area in the 0 mm CSS to 0% in the 50 mm group. Conversely, the wounds closed with 0, 1 and 5 mm EDC groups exhibited significantly less wound contraction than the 50 mm group. Engraftment of human cells occurred in 86%, 83%, and 83% of the wounds treated with CSS fabricated using 0, 1, and 5 mm EDC cross-linked sponges, respectively, which were significantly higher engraftment rates than the 50 mm group (17%). These data suggest that low concentrations of EDC can be used to improve the biochemical stability of the C-GAG component of CSS in vitro, and promote stable wound closure.

  12. Uptake and accumulation of four PPCP/EDCs in two leafy vegetables.

    PubMed

    Dodgen, L K; Li, J; Parker, D; Gan, J J

    2013-11-01

    Many pharmaceutical and personal care products (PPCPs) and endocrine-disrupting chemicals (EDCs) are present in reclaimed water, leading to concerns of human health risks from the consumption of food crops irrigated with reclaimed water. This study evaluated the potential for plant uptake and accumulation of four commonly occurring PPCP/EDCs, i.e., bisphenol A (BPA), diclofenac sodium (DCL), naproxen (NPX), and 4-nonylphenol (NP), by lettuce (Lactuca sativa) and collards (Brassica oleracea) in hydroponic culture, using (14)C-labeled compounds. In both plant species, plant accumulation followed the order of BPA > NP > DCL > NPX and accumulation in roots was much greater than in leaves and stems. Concentrations of (14)C-PPCP/EDCs in plant tissues ranged from 0.22 ± 0.03 to 927 ± 213 ng/g, but nearly all (14)C-residue was non-extractable. PPCP/EDCs, particularly BPA and NP, were also extensively transformed in the nutrient solution. Dietary uptake of these PPCP/EDCs by humans was predicted to be negligible.

  13. Directional immobilization of antibody in a SPR sensor using EDC-activated protein A

    NASA Astrophysics Data System (ADS)

    Lee, Yeon Kyung; Lim, Jeong-Ok; Sohn, Young-Soo

    2013-05-01

    The EDC-activated protein A has been utilized to directionally immobilize anti-IgG in a miniaturized SPR sensor to enhance IgG detection capability. The SPR sensor chips modified by a self-assembled monolayer (SAM), protein A and the EDC-activated protein A as the linkage layer were compared by the SPR sensor. The SAM was formed on the Au (gold) surface sensor chip by immersing it in the SAM solution. The protein A was formed by injecting their solution to the Au chip. Thirdly, for the EDC-activated protein A, chemical procedure was carried out for the reactable surface of the Au chip. Anti-IgG, bovine serum albumin (BSA) and IgG (50 ng/ml, 100 ng/ml, 150 ng/ml) had been sequently injected into the SPR sensor. In results, the signal of the anti-IgG immobilized by the SAM was the largest increment among three linkage layers. However, the SPR sensor chip modified by EDC-activated protein A showed the highest sensitivity to IgG. From these results, we concluded that the SPR sensor using the EDC-activated protein A can be used to detect biomolecules with trace level concentration for early diagnosis of disease.

  14. QSAR classification of estrogen receptor binders and pre-screening of potential pleiotropic EDCs.

    PubMed

    Li, J; Gramatica, P

    2010-10-01

    Endocrine disrupting chemicals (EDCs) are suspected of posing serious threats to human and wildlife health through a variety of mechanisms, these being mainly receptor-mediated modes of action. It is reported that some EDCs exhibit dual activities as estrogen receptor (ER) and androgen receptor (AR) binders. Indeed, such compounds can affect the normal endocrine system through a dual complex mechanism, so steps should be taken not only to identify them a priori from their chemical structure, but also to prioritize them for experimental tests in order to reduce and even forbid their usage. To date, very few EDCs with dual activities have been identified. The present research uses QSARs, to investigate what, so far, is the largest and most heterogeneous ER binder data set (combined METI and EDKB databases). New predictive classification models were derived using different modelling methods and a consensus approach, and these were used to virtually screen a large AR binder data set after strict validation. As a result, 46 AR antagonists were predicted from their chemical structure to also have potential ER binding activities, i.e. pleiotropic EDCs. In addition, 48 not yet recognized ER binders were in silico identified, which increases the number of potential EDCs that are substances of very high concern (SVHC) in REACH. Thus, the proposed screening models, based only on structure information, have the main aim to prioritize experimental tests for the highlighted compounds with potential estrogenic activities and also to design safer alternatives.

  15. Polish Society of Endocrinology Position statement on endocrine disrupting chemicals (EDCs).

    PubMed

    Rutkowska, Aleksandra; Rachoń, Dominik; Milewicz, Andrzej; Ruchała, Marek; Bolanowski, Marek; Jędrzejuk, Diana; Bednarczuk, Tomasz; Górska, Maria; Hubalewska-Dydejczyk, Alicja; Kos-Kudła, Beata; Lewiński, Andrzej; Zgliczyński, Wojciech

    2015-01-01

    With the reference to the position statements of the Endocrine Society, the Paediatric Endocrine Society, and the European Society of Paediatric Endocrinology, the Polish Society of Endocrinology points out the adverse health effects caused by endocrine disrupting chemicals (EDCs) commonly used in daily life as components of plastics, food containers, pharmaceuticals, and cosmetics. The statement is based on the alarming data about the increase of the prevalence of many endocrine disorders such as: cryptorchidism, precocious puberty in girls and boys, and hormone-dependent cancers (endometrium, breast, prostate). In our opinion, it is of human benefit to conduct epidemiological studies that will enable the estimation of the risk factors of exposure to EDCs and the probability of endocrine disorders. Increasing consumerism and the industrial boom has led to severe pollution of the environment with a corresponding negative impact on human health; thus, there is great necessity for the biomonitoring of EDCs in Poland.

  16. INFLUENCE OF ENDOCRINE DISRUPTING COMPOUNDS (EDCS) ON MAMMARY GLAND DEVELOPMENT AND TUMOR SUSCEPTIBILITY

    EPA Science Inventory

    Influence of Endocrine Disrupting Compounds (EDCs) on Mammary Gland Development and Tumor Susceptibility.

    Suzanne E. Fenton1, and Jennifer Rayner1,2

    1 Reproductive Toxicology Division, NHEERL/ORD, U.S. EPA, Research Triangle Park, NC, and 2 Department of Environmen...

  17. Executive Summary to EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals

    PubMed Central

    Chappell, V. A.; Fenton, S. E.; Flaws, J. A.; Nadal, A.; Prins, G. S.; Toppari, J.; Zoeller, R. T.

    2015-01-01

    This Executive Summary to the Endocrine Society's second Scientific Statement on environmental endocrine-disrupting chemicals (EDCs) provides a synthesis of the key points of the complete statement. The full Scientific Statement represents a comprehensive review of the literature on seven topics for which there is strong mechanistic, experimental, animal, and epidemiological evidence for endocrine disruption, namely: obesity and diabetes, female reproduction, male reproduction, hormone-sensitive cancers in females, prostate cancer, thyroid, and neurodevelopment and neuroendocrine systems. EDCs such as bisphenol A, phthalates, pesticides, persistent organic pollutants such as polychlorinated biphenyls, polybrominated diethyl ethers, and dioxins were emphasized because these chemicals had the greatest depth and breadth of available information. The Statement also included thorough coverage of studies of developmental exposures to EDCs, especially in the fetus and infant, because these are critical life stages during which perturbations of hormones can increase the probability of a disease or dysfunction later in life. A conclusion of the Statement is that publications over the past 5 years have led to a much fuller understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability. These findings will prove useful to researchers, physicians, and other healthcare providers in translating the science of endocrine disruption to improved public health. PMID:26414233

  18. Transformation and Removal Pathways of Four Common PPCP/EDCs in Soil

    PubMed Central

    Dodgen, LK; Li, J; Wu, X; Lu, Z; Gan, JJ

    2014-01-01

    Pharmaceutical and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs) enter the soil environment via irrigation with treated wastewater, groundwater recharge, and land application of biosolids. The transformation and fate of PPCP/EDCs in soil affects their potential for plant uptake and groundwater pollution. This study examined four PPCP/EDCs (bisphenol A, diclofenac, naproxen, and 4-nonylphenol) in soil by using 14C-labeling and analyzing mineralization, extractable residue, bound residue, and formation of transformation products. At the end of 112 d of incubation, the majority of 14C-naproxen and 14C-diclofenac was mineralized to 14CO2, while a majority of 14C-bisphenol A and 14C-nonylphenol was converted to bound residue. After 112 d, the estimated half-lives of the parent compounds were only 1.4 – 5.4 d. However a variety of transformation products were found and several for bisphenol A and diclofenac were identified, suggesting the need to consider degradation intermediates in soils impacted by PPCP/EDCs. PMID:24997388

  19. NMR-based Metabolomics for Studying Toxicity, Compensation, and Recovery in Small Fish Exposed to EDCs

    EPA Science Inventory

    Determining the impact(s) on fish and other aquatic organisms of exposure to endocrine disrupting compounds (EDCs) is critical for determining the risks that these chemicals pose. However, to accurately evaluate these risks, beyond simply measuring a “before and after exposure” ...

  20. INFLUENCE OF ENDOCRINE DISRUPTING COMPOUNDS (EDCS) ON MAMMARY GLAND DEVELOPMENT AND TUMOR SUSCEPTIBILITY

    EPA Science Inventory

    Influence of Endocrine Disrupting Compounds (EDCs) on Mammary Gland Development and Tumor Susceptibility.

    Suzanne E. Fenton1, and Jennifer Rayner1,2

    1 Reproductive Toxicology Division, NHEERL/ORD, U.S. EPA, Research Triangle Park, NC, and 2 Department of Environmen...

  1. BIODEGRADABILITY OF SELECTED EDCS UNDER REDOX CONDITIONS TYPICAL OF WASTEWATER TREATMENT AND SEDIMENTS

    EPA Science Inventory

    A number of emerging chemicals being detected in the environment are now gaining attention for having possible endocrine disrupting capabilities. These endocrine disrupting chemicals (EDCs) have been shown to have adverse affects on the endocrine system of fish and wildlife. But ...

  2. NMR-based Metabolomics for Studying Toxicity, Compensation, and Recovery in Small Fish Exposed to EDCs

    EPA Science Inventory

    Determining the impact(s) on fish and other aquatic organisms of exposure to endocrine disrupting compounds (EDCs) is critical for determining the risks that these chemicals pose. However, to accurately evaluate these risks, beyond simply measuring a “before and after exposure” ...

  3. Executive Summary to EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals.

    PubMed

    Gore, A C; Chappell, V A; Fenton, S E; Flaws, J A; Nadal, A; Prins, G S; Toppari, J; Zoeller, R T

    2015-12-01

    This Executive Summary to the Endocrine Society's second Scientific Statement on environmental endocrine-disrupting chemicals (EDCs) provides a synthesis of the key points of the complete statement. The full Scientific Statement represents a comprehensive review of the literature on seven topics for which there is strong mechanistic, experimental, animal, and epidemiological evidence for endocrine disruption, namely: obesity and diabetes, female reproduction, male reproduction, hormone-sensitive cancers in females, prostate cancer, thyroid, and neurodevelopment and neuroendocrine systems. EDCs such as bisphenol A, phthalates, pesticides, persistent organic pollutants such as polychlorinated biphenyls, polybrominated diethyl ethers, and dioxins were emphasized because these chemicals had the greatest depth and breadth of available information. The Statement also included thorough coverage of studies of developmental exposures to EDCs, especially in the fetus and infant, because these are critical life stages during which perturbations of hormones can increase the probability of a disease or dysfunction later in life. A conclusion of the Statement is that publications over the past 5 years have led to a much fuller understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability. These findings will prove useful to researchers, physicians, and other healthcare providers in translating the science of endocrine disruption to improved public health.

  4. 21 CFR 640.12 - Suitability of donor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.12 Suitability of donor. The source blood for Red Blood Cells shall be obtained from a donor who meets the criteria for...

  5. 21 CFR 640.12 - Suitability of donor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.12 Suitability of donor. The source blood for Red Blood Cells shall be obtained from a donor who meets the criteria for...

  6. 21 CFR 640.12 - Suitability of donor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.12 Suitability of donor. The source blood for Red Blood Cells shall be obtained from a donor who meets the criteria for...

  7. 21 CFR 640.12 - Suitability of donor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.12 Suitability of donor. The source blood for Red Blood Cells shall be obtained from a donor who meets the criteria for...

  8. 21 CFR 640.12 - Suitability of donor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.12 Suitability of donor. The source blood for Red Blood Cells shall be obtained from a donor who meets the criteria for...

  9. Donor Selection for Adult- to- Adult Living Donor Liver Transplantation: Well Begun is Half Done

    PubMed Central

    Sharma, Amit; Ashworth, April; Behnke, Martha; Cotterell, Adrian; Posner, Marc; Fisher, Robert A.

    2012-01-01

    Background Donor selection criteria for adult-to-adult living donor liver transplantation vary with the medical center of evaluation. Living donor evaluation utilizes considerable resources and the non-maturation of potential into actual donors may sometimes prove fatal for patients with end stage liver disease. On the contrary, a thorough donor evaluation process is mandatory to ensure safe outcomes in otherwise healthy donors. We aimed to study the reasons for non-maturation of potential right lobe liver donors at our transplant center. Methods A retrospective data analysis of all potential living liver donors evaluated at our center from 1998 to 2010 was done. Results Overall 324 donors were evaluated for 219 potential recipients and 171 (52.7%) donors were disqualified. Common reasons for donor non-maturation included: (1) Donor reluctance, 21% (2) >10% macro-vesicular steatosis, 16% (3) assisted donor withdrawal, 14% (4) inadequate remnant liver volume, 13% (5) psychosocial issues, 7% and thrombophilia, 7%. Ten donors (6%) were turned down due to anatomical variations (8 biliary and 2 arterial anomalies). Donors older than 50 years and those with BMI over 25 were less likely to be accepted for donation. Conclusions We conclude that donor reluctance, hepatic steatosis and assisted donor withdrawal are major reasons for non-maturation of potential into actual donors. Anatomical variations and underlying medical conditions were not a major cause of donor rejection. A system in practice to recognize these factors early in the course of donor evaluation to improve the efficiency of the selection process and ensure donor safety is proposed. PMID:23128999

  10. Donor Tag Game

    MedlinePlus

    ... Games > Donor Tag Game Printable Version Donor Tag Game This feature requires version 6 or later of ... LGBTQ+ Donors Blood Donor Community Real Stories SleevesUp Games Facebook Avatars and Badges Banners eCards Enter your ...

  11. [Experimental behavioral tests using monkey and rat offspring born from mothers exposed perinatally to EDCs].

    PubMed

    Yoshikawa, Yasuhiro

    2005-06-01

    Purpose of this study is to conduct risk assessment of EDCs for the development of CNS in humans by extrapolation from the results of behavioral tests in rats and monkeys. Our hypotheses on the mechanism which gives an adverse effect of EDCs to the developing neural systems are as follows. Thyroid hormone (TH) disrupting chemicals induce deterioration of neural development and estrogen (E2) agonistic chemicals may disturb apoptosis of fetal neural cells resulting in injury of normal neural circuit. The strategy of this study is a bottom up system; for example, basic information was obtained by an experiment using rats and then an experiment using monkey was designed to adapt the results from rats. The monkey experiment data will be assessed in comparison with human behavior. The tactics of this study are, however, a top down system. It is neural behaviors which are an end point evaluation that are primarily performed. They are mother-infant interactions, social behaviors, open field test, memory and learning tests, etc. As for analysis of the mechanism of EDCs' adverse effect, we tried two methods: one is an in vivo drug biased test which interferes with the monoamine oxidase (MAO) system and the other is an in vitro primary neural cell culture. EDCs including BPA, NP, propylthiouracil (PTU) and PCB-OH are injected orally to pregnant rats from gestation day 3 (GD3) to post natal day 21 (PND21) at weaning and their offspring were tested. On the other hand TCDD, BPA and PCB effect are assessed in rhesus monkey or cynomolgus monkey offspring. The study is still continuing and we will present the results obtained to date.

  12. Short-term effects of environmentally relevant concentrations of EDC mixtures on Mytilus galloprovincialis digestive gland.

    PubMed

    Canesi, Laura; Borghi, Cristina; Ciacci, Caterina; Fabbri, Rita; Lorusso, Lucia Cecilia; Vergani, Laura; Marcomini, Antonio; Poiana, Giulio

    2008-05-30

    Endocrine disrupting compounds (EDCs), including both natural estrogens and estrogenic chemicals, are almost ubiquitous in the aquatic environment. In the marine bivalve Mytilus galloprovincialis different estrogenic compounds, both individually and in mixtures, were shown to affect the immune function both in vitro and in vivo. Moreover, individual estrogens, the natural estrogen 17beta-estradiol (E(2)) and the xenoestrogen bisphenol A (BPA), have been recently demonstrated to alter functional parameters and gene expression in mussel digestive gland, a tissue that plays a central role in metabolism and in nutrient distribution to the gonad during gamete maturation, with possible consequences on gametogenesis. In this work, the possible effects of a synthetic mixture of EDCs on the digestive gland were evaluated. The mixture contained seven estrogenic chemicals (17beta-estradiol, 17alpha-ethynyl estradiol, mestranol (MES), nonylphenol, nonylphenol monoethoxylate carboxylate (NP1EC), BPA, benzophenone (BP)), in proportions similar to those previously found in water samples of a coastal lagoon. Mussels were injected with different concentrations of the mixture (approximate nominal concentrations of total EDCs: 0.0177, 0.177, 1.77 and 177 ng/g dw) and tissues sampled 24 h post-injection. The mixture induced significant changes in lysosomal biomarkers (lysosomal membrane stability (LMS), neutral lipid (NL) and lipofuscin (LF) accumulation) as well as in the activities of catalase, glutathione transferase (GST), and of the glycolytic enzymes phosphofructokinase (PFK) and pyruvate kinase (PK). Moreover, downregulation of the gene transcription for the Mytilus estrogen receptor MeER1 isoform and for catalase, as evaluated by quantitative RT-PCR, were observed. Significant changes in lysosomal biomarkers, enzyme activities and gene transcription were also recorded at 72 h post-injection. The results demonstrate that short-term exposure to environmentally relevant

  13. Living Donor Practices in the United States

    PubMed Central

    Mandelbrot, Didier A.; Pavlakis, Martha

    2012-01-01

    Living donation is a common procedure in the United States. Substantial variation exists among transplant centers in their protocols and exclusion criteria for potential living donors. In the absence of clinical trial data to guide decisions about exclusion criteria, knowledge of current practices is an important first step in guiding the formulation of donor protocols as well as future studies. Certain trends in live donation practices have become apparent from surveys of transplant programs over the past few decades. Over the past 25 years, opposition in the US to living unrelated donation has gone from strong to essentially nonexistent. With respect to donor age, programs have become less strict regarding upper age limits, but stricter regarding younger donor candidates. Protocols regarding kidney function, blood pressure and diabetes screening also continue to evolve. Although donor follow up is mandated by the OPTN for two years after donation, a majority of donors are lost to follow up by one year. The most commonly cited barriers to donor follow up include donor inconvenience, cost issues including reimbursement to care providers, as well as direct and indirect costs to donors. Here, we review the current knowledge about living donor practices in the U.S. PMID:22732040

  14. Living donor practices in the United States.

    PubMed

    Mandelbrot, Didier A; Pavlakis, Martha

    2012-07-01

    Living kidney donation is a common procedure in the United States. Substantial variation exists between transplant centers in their protocols and exclusion criteria for potential living donors. In the absence of clinical trial data to guide decisions about exclusion criteria, knowledge of current practices is an important first step in guiding the formulation of donor protocols and future studies. Certain trends in living donation practices have become apparent from surveys of transplant programs over the past few decades. Over the past 25 years, opposition to living unrelated donation in the United States has gone from strong to essentially nonexistent. With respect to donor age, programs have become less strict regarding upper age limits but stricter regarding younger donor candidates. Protocols regarding kidney function, blood pressure, and diabetes screening also continue to evolve. Although donor follow-up is mandated by the Organ Procurement and Transplantation Network for 2 years after donation, a majority of donors are lost to follow-up by 1 year. The most commonly cited barriers to donor follow-up include donor inconvenience, cost issues including reimbursement to care providers, and direct and indirect costs to donors. In this article, we review the current knowledge about living donor practices in the United States. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  15. CHANGES IN GENE AND PROTEIN EXPRESSION IN ZEBRAFISH (DANIO RERIO) FOLLOWING EXPOSURE TO ENVIRONMENTALLY-RELEVANT ENDOCRINE DISRUPTING COMPOUNDS (EDCS)

    EPA Science Inventory

    Endocrine-disrupting chemicals (EDCs) are increasingly being reported in waterways worldwide and have been shown to affect fish species by disrupting numerous aspects of development, behavior, reproduction, and survival. Furthermore, new data have suggested that the reduced repr...

  16. CHANGES IN GENE AND PROTEIN EXPRESSION IN ZEBRAFISH (DANIO RERIO) FOLLOWING EXPOSURE TO ENVIRONMENTALLY-RELEVANT ENDOCRINE DISRUPTING COMPOUNDS (EDCS)

    EPA Science Inventory

    Endocrine-disrupting chemicals (EDCs) are increasingly being reported in waterways worldwide and have been shown to affect fish species by disrupting numerous aspects of development, behavior, reproduction, and survival. Furthermore, new data have suggested that the reduced repr...

  17. Mutational analysis of metacaspase CaMca1 and decapping activator Edc3 in the pathogenicity of Candida albicans.

    PubMed

    Jeong, Jeong-Hoon; Lee, Seok-Eui; Kim, Jinmi

    2016-12-01

    Candida albicans, an opportunistic fungal pathogen, displays apoptotic cell death in response to various stresses and a wide range of antifungal treatments. CaMca1, which is the only metacaspase in C. albicans, has been described as a key player in apoptotic cell death. Edc3 is an mRNA decapping activator and a scaffold protein of processing bodies. Edc3 was previously shown to regulate CaMCA1 expression and oxidative stress-induced apoptosis. In this study, we analyzed the contribution of the catalytic residues of the CaMca1 to the oxidative stress-induced apoptosis and pathogenicity of C. albicans. The CaMCA1(C292A) mutation decreased caspase activity to a level similar to that observed in the Camca1/Camca1 deletion strain and over-expression of CaMCA1(C292A) failed to suppress the oxidative-stress phenotypes of the edc3/edc3 mutant strain. The edc3/edc3, Camca1/Camca1, and CaMCA1(C292A) mutant strains were not virulent in a murine candidiasis model. Filamentation defects were observed in the Camca1/Camca1 mutant cells, whereas this defect was only partial in CaMCA1(C292A) mutant cells. These results suggest that CaMca1 and Edc3 play essential roles in the oxidative stress-induced apoptosis and virulence of C. albicans, and also support the notion that Edc3 is a key regulator of CaMca1 expression.

  18. [Kidney grafts from elderly donors].

    PubMed

    Hiesse, Christian; Pessione, Fabienne; Cohen, Sophie

    2003-06-07

    FROM AN EPIDEMIOLOGICAL POINT OF VIEW: The epidemiology of renal transplantation had greatly changed over the past 10 years. The increasing number of patients with renal failure and candidates for transplantation increases the demand for grafts, whereas the sampling rate of organs remains stable. The mean age of the donors is rising, hence underlining the question of the use of organs of so-called "borderline" quality. THE WEAK POINTS OF ELDERLY GRAFTS: Aging of the kidneys affects the structure of the parenchyma and renal function, which decreases, notably in hypertensive persons. The elderly graft exhibits a critical mass of nephrons that is insufficient to fulfil the functional requirements of a poorly equipped recipient. The recipient is more sensitive to the added agressions: prolonged ischemia and immunological and medicinal agressions. THE RESULTS OF RENAL GRAFT FROM ELDERLY DONORS: They are quantitatively and qualitatively inferior to those of renal transplants from "ideal" donors. The donor's age is a significant factor influencing negatively influences the survival of the transplanted kidney, but dependent on past vascular history. Good results regarding the maintenance of dialysis are obtained by selecting the donors and by avoiding added risk factors. THE ASSESSMENT OF A GRAFT FROM AN ELDERLY DONOR: This, basically, relies on clinical criteria: donor's history, cause of death and accurate measurement of the renal function. A biopsy of the graft, at the time of sampling, provides useful information. TRANSPLANTATION STRATEGY OF A GRAFT FROM AN ELDERLY DONOR: Donor-recipient matching by age is a common approach. Grafting of both kidneys in the same recipient is a method presently under assessment. The episode of ischemia must be reduced and the immunosuppressive therapy adapted.

  19. Comparison of EDCs removal in full and pilot scale membrane bioreactor plants: Effect of flux rate on EDCs removal in short SRT.

    PubMed

    Komesli, O T; Muz, M; Ak, M S; Bakırdere, S; Gökçay, C F

    2016-06-17

    Currently, it is estimated that over 1 billion people are short of adequate portable water and this is expected to increase to 2.5 billion in the year 2025. Membrane Bioreactors (MBR) are now accepted as important tools to extend the availability of water by facilitating the reuse of wastewaters. Sludge Retention Time (SRT) and liquid flux rate are the two most important parameters for controlling the MBR process. In this study, the removal of selected endocrine disrupter compounds (EDCs), diltiazem, progesterone, estrone (E1), carbamazepine (Cbz) and acetaminophen (Acet), by one full scale (VRM) and one pilot scale (clear-box) MBR plants was investigated. During the study, sludge age was set at 10 days and the sludge concentration was fixed at about 5.0 g/L. The transmembrane pressure (TMP) got higher with either increasing flux or sludge concentration in the membrane chamber. Therefore, changing the flux from 13 to 30 L/m(2)-h in both plants caused enhancement in TMP from -25 to -300 mbar in the clear-box and from -160 to over -350 in the full scale MBRs. It was understood that flux had very little effect on the removal of EDCs at very low concentrations. Moreover, diltiazem was completely removed in the full scale whereas no removal was achieved in the pilot scale. Estrone and progesterone were completely removed by biodegradation in both plants. Acetaminophen was completely removed in the full scale plant whereas over 95% removal was achieved in the pilot scale MBR.

  20. Cadaveric donor selection and management.

    PubMed

    Studer, Sean M; Orens, Jonathan B

    2004-12-01

    The current availability of lung donors is far exceeded by the number of potential transplant recipients who are waiting for an organ. This disparity results in significant morbidity and mortality for those on the waiting list. Although it is desirable to increase overall consent rates for organ donation, doing so requires an intervention to affect societal response. In contrast, increased procurement of organs from marginal donors and improved donor management may be realized through increased study and practice changes within the transplant community. Transplantation of organs from marginal or extended-criteria donors may result in some increase in complications or mortality, but this possibility must be weighed against the morbidity and risk of death risk faced by individuals on the waiting list. The effects of this trade-off are currently being studied in kidney transplantation, and perhaps in the near future lung transplantation may benefit from a similar analysis. Until that time, the limited data regarding criteria for donor acceptability must be incorporated into practice to maximize the overall benefits of lung transplantation.

  1. Novel guidelines for organ donor cancer screening.

    PubMed

    Hassanain, Mazen

    2014-05-20

    Donor transmitted malignancy is a real disastrous risk when dealing with expanded criteria donors. As donor age is increasing, guidelines for cancer screening of the elderly brain dead organ donors must be evidence-based but systematic review of such is sparse. Based on a review of published literature and our 20 years' experience, we propose a new series of guidelines concerning screening for the four most common malignancies: breast colon, lung and prostate cancer. Prospective testing of the efficacy of such protocol will then follow.

  2. 21 CFR 640.21 - Suitability of donors.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.21 Suitability of donors. (a) Whole blood donors shall meet the criteria for suitability prescribed in § 640.3. (b) (c) Plateletpheresis... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Suitability of donors. 640.21 Section 640.21 Food...

  3. 21 CFR 640.51 - Suitability of donors.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Cryoprecipitate § 640.51 Suitability of donors. (a) Whole blood donors shall meet the criteria for suitability prescribed in § 640.3. (b) Plasmapheresis... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Suitability of donors. 640.51 Section 640.51 Food...

  4. Occurrence and removal efficiencies of eight EDCs and estrogenicity in a STP.

    PubMed

    Zhang, Zhaohan; Feng, Yujie; Gao, Peng; Wang, Ce; Ren, Nanqi

    2011-05-01

    The occurrence and removal of eight endocrine disrupting compounds (EDCs), including estrone (E(1)), 17β-estradiol (E(2)), estriol (E(3)), 17α-ethinylestradiol (EE(2)), diethylstilbestrol (DES), bisphenol A (BPA), nonylphenol (NP) and octylphenol (OP), and their estrogenicities were investigated in a sewage treatment plant in Harbin city, China. The EDCs were extracted from wastewater samples by solid phase extraction (SPE) method and analyzed with gas chromatography coupled with mass spectrometry (GC-MS). The average concentrations in the influents and effluents ranged from 6.3 (EE(2)) to 1725.8 ng L(-1) (NP) and from EDCs were removed during the primary treatment, and the adsorption on solid particles was assumed as the dominant removal mechanism. The removal efficiencies in anoxic and aerobic biological treatment units ranged from -30.2% to 62.2% and from -8.3% to 83%. The yeast estrogen screen (YES) was used to analyze the estrogenicity of the test samples. The EEQ in the influents and effluents were in the range of 21.7-54.7 ng L(-1) and 3.5-29.6 ng L(-1), respectively. The overall EEQ removal efficiencies were in the range of 15.6-92.8%, and the biological treatment was crucial to EEQ removal. The total estrogenicity increased after primary treatment which might be owing to the deconjugating of estrogen compounds by microbial activity. The EEQ value based on chemical substrates calculation was larger than the results of the YES assay, with a ratio value of 3.94 ± 4.00 in all water samples.

  5. Occurrence and spatial distribution of EDCs and related compounds in waters and sediments of Iberian rivers.

    PubMed

    Gorga, Marina; Insa, Sara; Petrovic, Mira; Barceló, Damià

    2015-01-15

    The environmental presence of chemicals capable of affecting the endocrine system has become a matter of scientific and public concern after certain endocrine disruptor compounds (EDCs) have been detected in the aquatic environment. In this work, 31 different EDCs and related compounds (suspect EDCs) belonging to different contaminant classes were studied: 10 estrogens, natural and synthetic, 8 alkylphenolic compounds, bisphenol A, triclosan and triclorocaraban, 4 parabens, 2 benzotriazoles, 3 organophosphorous flame retardants and the chemical marker caffeine, in river water and sediment of four Iberian rivers (Ebro, Llobregat, Júcar and Guadalquivir). An extensive sampling has been undertaken in two monitoring campaigns (2010 and 2011). A total of 77 samples of water and 75 sediments were collected. For this propose two different multiresidue analytical methods were applied, using the automated online EQuan/TurboFlow™ liquid chromatography coupled to mass spectrometry detection in tandem. In terms of concentrations the compounds found at the highest average concentrations were: nonylphenol monocarboxylate (NP1EC), tolyltriazole (TT), tris(chloroisopropyl)phosphate (TCPP) found at average concentrations above 100 ng/L, followed by 1H-benzotriazole and tris(butoxyethyl)phosphate (TBEP) found at average concentration higher than 50 ng/L. Natural and synthetic hormones were found at low levels not exceeding 16 ng/L and 7 ng/g for water and sediment, respectively, however they contributed to more than 80% of the total estrogenicity of the samples (expressed as the equivalents of estradiol EEQ, ng/L). Regarding the spatial distribution of these contaminants, the Llobregat river was found to be the most contaminated river basin, having sites near the mouth of the river the ones with the highest contaminant load. In the Ebro river basin several hot spots were identified and Júcar showed to be the least contaminated. Overall, the study confirmed the presence of

  6. Immobilization of cytochrome c on cysteamine-modified gold electrodes with EDC as coupling agent.

    PubMed

    De Wael, Karolien; Buschop, Hans; De Smet, Lina; Adriaens, Annemie

    2008-07-15

    Cyclic voltammetry has been applied for the characterization of cross-linked horse heart cytochrome c (HHC) on cysteamine-modified gold electrodes. The cross-linking, i.e. amide bond formation, between the proteins was achieved by using 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC) as coupling reagent. The optimal conditions for the formation of the HHC film were determined by varying the HHC concentration. In addition the reproducibility, stability and the influence of the scan rate upon these films were investigated with cyclic voltammetry. The protein film stability in a 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES) buffer solution was tested by UV/vis absorption spectroscopy.

  7. One-dimensional plate impact experiments on the cyclotetramethylene tetranitramine (HMX) based explosive EDC32

    NASA Astrophysics Data System (ADS)

    Burns, Malcolm J.; Gustavsen, Richard L.; Bartram, Brian D.

    2012-09-01

    Eight one-dimensional plate impact experiments have been performed to study both the Shock to Detonation Transition and Hugoniot state in the cyclotetramethylene tetranitramine (HMX) based explosive EDC32. The experiments covered shock pressures ranging from 0.59 to 7.5 GPa with sustained shocks, double shocks, and short pulse shocks. Experiments were instrumented with embedded magnetic particle velocity gauges. Results include; (1) wave profiles of particle velocity vs. time vs. depth in the explosive, (2) time-distance coordinates for onset of detonation vs. initial shock pressure (aka the Pop-plot), (3) a reactants Hugoniot, and (4) measurement of the Hugoniot Elastic Limit of 0.22.GPa.

  8. The Medically Complex Living Kidney Donor: Glucose Metabolism as Principal Cause of Donor Declination.

    PubMed

    Guthoff, Martina; Nadalin, Silvio; Fritsche, Andreas; Königsrainer, Alfred; Häring, Hans-Ulrich; Heyne, Nils

    2016-01-26

    Transplant centers are increasingly confronted with medically complex living kidney donor candidates. Considerable differences exist among centers regarding handling of these patients and little data is available on characteristics, evaluation outcome and declination criteria. We now demonstrate impaired glucose metabolism to be the largest single cause of donor declination. Follow-up of 133 donor-recipient pairs, presenting to our transplant center between 03/2007 and 06/2012 was included in the analysis. Evaluation outcome of donor-recipient pairs was assessed and declinations stratified into donor or recipient reasons and underlying conditions. 65 donor-recipient pairs (49%) were accepted for transplantation, 68 (51%) were declined upon first evaluation. 77% of declinations were for donor- and 23% for recipient reasons. Almost half of donor declinations resulted from increased cardiovascular risk with the presence of diabetes mellitus or prediabetes as the largest single cause of declination. Glucose metabolism is key in donor risk assessment and precludes kidney donation if abnormal. The high prevalence emphasizes the need for prevention. Prediabetes defines a cohort at risk and response to lifestyle intervention allows for individual risk stratification, thereby potentially increasing the number of persons eligible for kidney donation. Unification of evaluation criteria, as well as prospective long-term follow-up is required to account for increasingly complex living kidney donors.

  9. Stabilization of collagen with EDC/NHS in the presence of L-lysine: a comprehensive study.

    PubMed

    Usha, R; Sreeram, K J; Rajaram, A

    2012-02-01

    This paper reports the effect of L-lysine on the conformational, rheological, and thermal properties of 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC) and N-hydroxysuccinimide (NHS) cross linked collagen and investigates the influence of l-lysine on the self assembly processes of collagen. In the absence of L-lysine, the rheological characterization of collagen cross linked with EDC/NHS showed an increase in shearing stress with shearing speed indicating that the collagen chains become rigid and the molecules are reluctant to flow. On the other hand, the increase in shearing stress with shearing speed is comparatively much less in the presence of L-lysine indicating a greater flexibility of the collagen molecules. The self assembly processes of collagen treated with EDC/NHS in the absence and presence of L-lysine were characterized using powder XRD, FT-IR, polarizing optical microscopy and kinetic studies. XRD studies show an increase in peak intensity and sharpness in the presence of L-lysine indicating the enhancement of crystallinity of collagen nano-fibrils. FT-IR results suggest that the incorporation of L-lysine in the EDC/NHS cross linking favors the molecular stability of collagen. From the present study, it is possible to conclude that the pre-treatment of collagen with L-lysine enhances EDC/NHS cross linking and can be used for biomaterial applications.

  10. Removal of endocrine disrupting chemicals (EDCs) using low pressure reverse osmosis membrane (LPROM).

    PubMed

    Razak, A R A; Ujang, Z; Ozaki, H

    2007-01-01

    Endocrine disrupting chemicals (EDCs) are the focus of current environmental issues, as they can cause adverse health effects to animals and human, subsequent to endocrine function. The objective of this study was to remove a specific compound of EDCs (i.e. pentachlorophenol, C(6)OCL(5)Na, molecular weight of 288 g/mol) using low pressure reverse osmosis membrane (LPROM). A cross flow module of LPROM was used to observe the effects of operating parameters, i.e. pH, operating pressure and temperature. The design of the experiment was based on MINITAB(TM) software, and the analysis of results was conducted by factorial analysis. It was found that the rejection of pentachlorophenol was higher than 80% at a recovery rate of 60 to 70%. The rejection was subjected to increase with the increase of pH. The flux was observed to be increased with the increase of operating pressure and temperature. This study also investigated the interaction effects between operating parameters involved.

  11. Donor cell leukemia.

    PubMed

    Ruiz-Arguelles, Alejandro

    2012-04-01

    Minimal residual disease refers to the tumour cells that are still present in a given patient after completion of a therapeutic scheme. The demonstration and quantification of residual neoplastic cells has a crucial impact in clinical decision making, for it might prompt continuation of treatment, while the absence of such cells might serve as evidence to withdraw therapy. Therefore, both sensitivity and specificity of the methods used to unravel residual neoplastic cells must be highly reliable and robust. Flow cytometry has been widely used for this purpose, and its clinical performance depends mainly on the criteria of interpretation, rather than in the technique by itself; molecular biology techniques have proved to be highly sensitive and specific but unfortunately they cannot be used in all patients or in all types of leukemia. Finally, the development of donor cell leukemia in transplanted patients, might mimic residual disease and add more confusion to an already controversial issue. These topics are discussed in this paper.

  12. An analysis of the lack of donor pancreas utilization from younger adult organ donors.

    PubMed

    Wiseman, Alexander C; Wainright, Jennifer L; Sleeman, Elizabeth; McBride, Maureen A; Baker, Tim; Samana, Ciara; Stock, Peter

    2010-09-15

    Donor pancreas utilization rates for whole organ transplant have remained low and have decreased over time. To identify the reasons for nonuse of pancreas from donors who meet common baseline acceptance criteria, we examined Organ Procurement and Transplantation Network data from 2005 to 2007 and identified a subgroup of 1763 "potential pancreas donors" defined by age (19-40 years), body mass index (<30 kg/m), successful liver donation, and negative viral serology testing, which were not used. We characterize this cohort of potential donors including reasons for refusal, factors that may contribute to pancreas acceptance and function, and potential explanations for the lack of growth in pancreas organ utilization.

  13. Phenolic endocrine disrupting chemicals (EDCs) in Anzali Wetland, Iran: elevated concentrations of 4-nonylphenol, octhylphenol and bisphenol A.

    PubMed

    Mortazavi, Samar; Bakhtiari, Alireza Riyahi; Sari, Abbas Esmaili; Bahramifar, Nader; Rahbarizade, Fatemeh

    2012-05-01

    We have studied the distribution and value of phenolic endocrine disrupting chemicals (EDCs) in surface sediment samples taken from Anzali Wetland, Iran. These samples were collected from 22 stations during the time span of June-May 2010. In each of the sampling stations, we detected 4-nonylphenol (4-NP), octylphenol (OP), and bisphenol A (BPA) with maximal concentrations of 29, 4.3, and 7 μg g(-1) dry weight (dw), respectively. High levels of alkylphenols (APs) and BPA were also found near urban areas. Furthermore there were no significant differences between those stations in terms of the detected levels. One of the important factors in controlling the fate of these compounds in the aquatic environment appeared to be Total Organic Carbon (TOC). Hierarchical cluster analysis showed differences in the biomarker characteristics of EDCs and TOC between the stations. Our findings indicate that EDCs are ubiquitous in sediments from northeast Wetlands of Iran, contaminating the aquatic habitats in this area.

  14. Rationally Modified Estrogen Receptor Protein as a Bio-Recognition Element for the Detection of EDC Pollutants: Strategies and Opportunities

    PubMed Central

    Pedotti, Mattia; Ferrero, Valentina Elisabetta Viviana; Lettieri, Teresa; Colpo, Pascal; Follonier, Stephane; Calzolai, Luigi; Varani, Luca

    2015-01-01

    The estrogen receptor protein (ER) can bind a vast number of organic pollutants widely spread in the environment and collectively known as Endocrine Disrupting Chemicals, EDCs. Its broad selectivity makes it an ideal bio-recognition element for the detection of EDCs. Here we describe the strategy and rationale for the design of ER based biosensors and assays that generate a signal in the presence of EDCs. The opportunity to use either natural or rationally modified ER molecules is discussed. The latter approach was successfully applied in the EU-FP7 project RADAR, with the aim to develop a novel biosensor for the detection of organic pollutants both in the environment and in commercial water products. PMID:25734791

  15. Considerations in the Derivation of Water Quality Criteria for Endocrine-disrupting Chemicals

    EPA Science Inventory

    When the USEPA’s 1985 guidelines for deriving numerical water quality criteria (WQC) for the protection of aquatic life were developed there was little anticipation that endocrine-disrupting chemicals (EDCs) would be come a widespread environmental issue. While the basic guidelin...

  16. Bioavailability of endocrine disrupting chemicals (EDCs): Liposome-water partitioning and lipid membrane permeation

    NASA Astrophysics Data System (ADS)

    Kwon, Jung-Hwan

    The bioavailability of endocrine disrupting chemicals (EDCs) is a function of a number of parameters including the ability of the chemical to partition into organic tissue and reach receptor sites within an organism. In this dissertation, equilibrium partition coefficients between water and lipid membrane vesicles and artificial lipid membrane permeability were investigated for evaluating bioavailability of aqueous pollutants. Structurally diverse endocrine disrupting chemicals were chosen as model compounds for partitioning experiments and simple hydrophobic organic chemicals were used for the evaluation of a parallel artificial membrane device developed to mimic bioconcentration rates in fish. Hydrophobic interactions represented by octanol/water partition coefficients (KOWs) were not appropriate for estimating lipid membrane/water partition coefficients (Klipws) for the selected EDCs having a relatively large molar liquid volume (MLV) and containing polar functional groups. Correlations that include MLV and polar surface area (PSA) reduce the predicted value of log K lipw, suggesting that lipid membranes are less favorable than 1-octanol for a hydrophobic solute because of the changes in membrane fluidity and the amount of cholesterol in the lipid bilayers. These results suggested that KOW alone has limited potential for estimating K lipw, and MLV or PSA may be used as additional descriptors for developing quantitative structure-activity relationships (QSARs). The poor correlations between KOW and Klipw observed in this research may be due to the highly organized structure of lipid bilayers. Measured thermodynamic constants demonstrated that the entropy contribution becomes more dominant for more organized liposomes having saturated lipid tails. This implies that entropy-driven partitioning process makes Klipw different from KOW especially for more saturated lipid bilayer membranes. In the parallel artificial membrane system developed, a membrane filter

  17. Removal of selected pharmaceuticals and personal care products (PPCPs) and endocrine-disrupting chemicals (EDCs) during sand filtration and ozonation at a municipal sewage treatment plant.

    PubMed

    Nakada, Norihide; Shinohara, Hiroyuki; Murata, Ayako; Kiri, Kentaro; Managaki, Satoshi; Sato, Nobuyuki; Takada, Hideshige

    2007-11-01

    We investigated the efficiencies of removal of 24 pharmaceutically active compounds (PhACs) during sand filtration and ozonation in an operating municipal sewage treatment plant (STP). The target compounds were 2 phenolic antiseptics (thymol, triclosan), 5 acidic analgesics or anti-inflammatories (ibuprofen, naproxen, ketoprofen, fenoprofen, mefenamic acid), 4 amide pharmaceuticals (propyphenazone, crotamiton, carbamazepine, diethyltoluamide), 7 antibiotics (sulfapyridine, sulfamethoxazole, trimethoprim, azithromycin, erythromycin anhydride, clarithromycin, roxithromycin), 3 phenolic endocrine-disrupting chemicals (EDCs) (nonylphenol:NP, octylphenol:OP, bisphenol A:BPA) and 3 natural estrogens (17 beta-estradiol:E2, estrone:E1, estriol:E3). Ozonation removed approximately 80% or more of the phenolic antiseptics, crotamiton, sulfonamide and macrolide antibiotics, and 17 beta-estradiol. Their removal is discussed in terms of chemical structure. The study ascertained the validity of ozonation mechanisms proposed by previous studies in an actually running STP. Compounds with a CC double bond or an aromatic structure with electron donors (e.g., phenol, alkyl, methoxy, or non-protonated amine) were susceptible to ozonation. Compounds with amide structures were resistant. Removal of the PhACs during sand filtration was generally inefficient, probably because of their low hydrophobicities. The combination of ozonation and sand filtration with activated sludge treatment gave efficient removal (>80%) of all the target compounds except carbamazepine and diethyltoluamide. Among all the steps in the plant, ozonation contributed substantially to overall removal of naproxen, ketoprofen, triclosan, crotamiton, sulfapyridine, macrolide antibiotics, and estrone.

  18. [Assessment and selection of kidney living donors].

    PubMed

    Gentil Govantes, Miguel Ángel; Pereira Palomo, Porfirio

    2010-01-01

    Donor protection should always be taken account during the selection and assessment of a living donor. On these terms, the evaluation of a potential donor must include these issues: 1) The donor act is altruistic, consciousness and out of coercion; 2) Life expectancy and quality of life of the recipient will improve after the living donor kidney transplantation; 3) The donor has normal renal function and the potential risk of developing nephropathy in the long term follow up is scarce (familiar nephropathies and other processes that may increase the potential risk for renal disease in the future, like severe hypertension, diabetes, etc must be ruled out). The glomerular filtrate should meet criteria for the normal function corresponding to age furthermore the absence of proteinuria and urine smear is normal; 4) The screening in the donor should contemplate those clinical situations or diseases non related to the kidney function but might elevate the surgical and/or anesthesia risk besides disease transmission to the recipient (as neoplasia or infections); 5) The surgical act is possible without technical difficulties and always performed after a negative result of the crossmatch between donor and recipient. The living donor evaluation process will follow a different schedule based on each particular case and the center facilities. Any case, the mentioned process is divided in two parts: The first one contains an initial screening (using non invasive and low cost tests) that allows discarding contraindications for donation (in both donor and recipient). In a second phase the assessment of the donor varies with donor characteristics. However, a test for renal function is mandatory besides imaging techniques (like angioTC), screening for transmissible diseases and a detailed evaluation for psychosocial aspects preferably made by professional. Moreover Spanish policy on living donation requires a report with information about the consent for donation developed by an

  19. CCHCR1 interacts with EDC4, suggesting its localization in P-bodies

    SciTech Connect

    Ling, Y.H.; Wong, C.C.; Li, K.W.; Chan, K.M.; Boukamp, P.; Liu, W.K.

    2014-09-10

    Coiled‐coil alpha‐helical rod protein 1 (CCHCR1) is suggested as a candidate biomarker for psoriasis for more than a decade but its function remains poorly understood because of the inconsistent findings in the literature. CCHCR1 protein is suggested to be localized in the cytoplasm, nucleus, mitochondria, or centrosome and to regulate various cellular functions, including steroidogenesis, proliferation, differentiation, and cytoskeleton organization. In this study, we attempted to find a consensus between these findings by identifying the interaction partners of CCHCR1 using co-immunoprecipiation with a stable cell line expressing EGFP-tagged CCHCR1. Out of more than 100 co-immunoprecipitants identified by liquid chromatography-tandem mass spectrometry (LC-MS/MS), the enhancer of mRNA-decapping protein 4 (EDC4), which is a processing body (P-body) component, was particularly found to be the major interacting partner of CCHCR1. Confocal imaging confirmed the localization of CCHCR1 in P-bodies and its N-terminus is required for this subcellular localization, suggesting that CCHCR1 is a novel P-body component. As P-bodies are the site for mRNA metabolism, our findings provide a molecular basis for the function of CCHCR1, any disruption of which may affect the transcriptome of the cell, and causing abnormal cell functions. - Highlights: • We identified CCHCR1 as a novel P-body component. • We identified EDC4 as the major interacting partner of CCHCR1. • N-terminus of CCHCR1 protein is required for its P-bodies localization.

  20. TRANSGENERATIONAL (IN UTERO/LACTATIONAL) EXPOSURE PROTOCOL TO INVESTIGATE THE EFFECTS OF ENDOCRINE DISRUPTING COMPOUNDS (EDCS) IN RATS

    EPA Science Inventory

    This protocol is designed to evaluate the effects of Endocrine Disrupting Compounds (EDCs) through fetal (transplacental) and/or neonatal (via the dam's milk) exposure during the critical periods of reproductive organogenesis in the rat. Continued direct exposure to the F1 pups...

  1. Degradation of the endocrine disrupting chemicals (EDCs) carbamazepine, clofibric acid, and iopromide by corona discharge over water.

    PubMed

    Krause, Holger; Schweiger, Bianca; Schuhmacher, Jörg; Scholl, Saskia; Steinfeld, Ute

    2009-04-01

    Common wastewater treatment plants often do not eliminate endocrine disrupting chemicals (EDCs). Aqueous solutions of three EDCs were treated with an enhanced corona discharge technology. The three EDCs were clofibric acid, a blood lipid regulator, carbamazepine, an antiepileptic drug, and iopromide, a contrast media. To simulate real conditions, EDC solutions containing landfill leachate were also used. In our setup, two barrier electrodes provided an atmospheric pressure corona discharge over a thin water film, in which the counter-electrode was submerged. Clofibric acid, carbamazepine, and iopromide were effectively removed from a single solution. After a treatment of 15min, there were no traces of iopromide estrogen activity either as a single substance or as degradation products when using an E-Screen Assay. Continuous treatment was compared with pulsed treatment using carbamazepine solutions mixed with pretreated landfill leachate. Best degradation results were achieved with a 500 W continuous duty cycle treatment. Counter-electrodes from materials such as boron doped diamond (BDD), titanium iridium oxide, and iron were investigated for their influences on the process effectivity. Significant improvements were achieved by using an enclosed reactor, BDD electrodes, and circulating only a fresh air or argon/air mixture as cooling gas through the barrier electrodes.

  2. METABOLOMICS AS A TOOL FOR DISCRIMINATING AMONG ADAPTIVE, COMPENSATORY, AND TOXIC RESPONSES UPON EXPOSURE OF SMALL FISH TO EDCS

    EPA Science Inventory

    Determining the impact(s) of exposure on aquatic organisms by endocrine disrupting compounds (EDCs) is essential for determining the risks that these chemicals pose. However, to accurately evaluate these risks, beyond simply measuring a before and after exposure snapshot, resear...

  3. METABOLOMICS AS A TOOL FOR DISCRIMINATING AMONG ADAPTIVE, COMPENSATORY, AND TOXIC RESPONSES UPON EXPOSURE OF SMALL FISH TO EDCS

    EPA Science Inventory

    Determining the impact(s) of exposure on aquatic organisms by endocrine disrupting compounds (EDCs) is essential for determining the risks that these chemicals pose. However, to accurately evaluate these risks, beyond simply measuring a before and after exposure snapshot, resear...

  4. TRANSGENERATIONAL (IN UTERO/LACTATIONAL) EXPOSURE PROTOCOL TO INVESTIGATE THE EFFECTS OF ENDOCRINE DISRUPTING COMPOUNDS (EDCS) IN RATS

    EPA Science Inventory

    This protocol is designed to evaluate the effects of Endocrine Disrupting Compounds (EDCs) through fetal (transplacental) and/or neonatal (via the dam's milk) exposure during the critical periods of reproductive organogenesis in the rat. Continued direct exposure to the F1 pups...

  5. The Need for New Donor Stratification to Predict Graft Survival in Deceased Donor Kidney Transplantation.

    PubMed

    Yang, Shin Seok; Yang, Jaeseok; Ahn, Curie; Min, Sang Il; Ha, Jongwon; Kim, Sung Joo; Park, Jae Berm

    2017-05-01

    The aim of this study was to determine whether stratification of deceased donors by the United Network for Organ Sharing (UNOS) criteria negatively impacts graft survival. We retrospectively reviewed deceased donor and recipient pretransplant variables of kidney transplantations that occurred between February 1995 and December 2009. We compared clinical outcomes between standard criteria donors (SCDs) and expanded criteria donors (ECDs). The deceased donors consisted of 369 patients. A total of 494 transplant recipients were enrolled in this study. Mean age was 41.7±11.4 year (range 18-69) and 273 patients (55.4%) were male. Mean duration of follow-up was 8.8±4.9 years. The recipients from ECD kidneys were 63 patients (12.8%). The overall mean cold ischemia time was 5.7±3.2 hours. Estimated glomerular filtration rate at 1, 2, and 3 years after transplantation were significantly lower in ECD transplants (1 year, 62.2±17.6 vs. 51.0±16.4, p<0.001; 2 year, 62.2±17.6 vs. 51.0±16.4, p=0.001; 3 year, 60.9±23.5 vs. 54.1±18.7, p=0.047). In multivariate analysis, donor age (≥40 years) was an independent risk factor for graft failure. In Kaplan-Meier analyses, there was no significant difference in death-censored graft survival (Log rank test, p>0.05), although patient survival was lower in ECDs than SCDs (Log rank test, p=0.011). Our data demonstrate that stratification by the UNOS criteria does not predict graft survival. In order to expand the donor pool, new criteria for standard/expanded donors need to be modified by regional differences.

  6. Identification of the Rps28 binding motif from yeast Edc3 involved in the autoregulatory feedback loop controlling RPS28B mRNA decay.

    PubMed

    Kolesnikova, Olga; Back, Régis; Graille, Marc; Séraphin, Bertrand

    2013-11-01

    In the yeast Saccharomyces cerevisiae, the Edc3 protein was previously reported to participate in the auto-regulatory feedback loop controlling the level of the RPS28B messenger RNA (mRNA). We show here that Edc3 binds directly and tightly to the globular core of Rps28 ribosomal protein. This binding occurs through a motif that is present exclusively in Edc3 proteins from yeast belonging to the Saccharomycetaceae phylum. Functional analyses indicate that the ability of Edc3 to interact with Rps28 is not required for its general function and for its role in the regulation of the YRA1 pre-mRNA decay. In contrast, this interaction appears to be exclusively required for the auto-regulatory mechanism controlling the RPS28B mRNA decay. These observations suggest a plausible model for the evolutionary appearance of a Rps28 binding motif in Edc3.

  7. Volunteer donor apheresis.

    PubMed

    Waxman, Dan A

    2002-02-01

    Volunteer donor apheresis has evolved from early plasmapheresis procedures that collected single components into technically advanced multicomponent procedures that can produce combinations of red blood cells, platelets, and plasma units. Blood collection and utilization is increasing annually in the United States. The number of apheresis procedures is also increasing such that single donor platelet transfusions now exceed platelet concentrates from random donors. Donor qualifications for apheresis vary from those of whole blood. Depending on the procedure, the donor weight, donation interval, and platelet count must be taken into consideration. Adverse effects of apheresis are well known and fortunately occur in only a very small percentage of donors. The recruitment of volunteer donors is one of the most challenging aspects of a successful apheresis program. As multicomponent apheresis becomes more commonplace, it is important for collection centers to analyze the best methods to recruit and collect donors.

  8. Transplanting Kidneys from Deceased Donors With Severe Acute Kidney Injury.

    PubMed

    Heilman, R L; Smith, M L; Kurian, S M; Huskey, J; Batra, R K; Chakkera, H A; Katariya, N N; Khamash, H; Moss, A; Salomon, D R; Reddy, K S

    2015-08-01

    Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ≥2.0 mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin-fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non-AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p-value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes.

  9. Herceptin Conjugates Linked by EDC Boost Direct Tumor Cell Death via Programmed Tumor Cell Necrosis

    PubMed Central

    Hughes, Dennis; Esteva, Francisco J.; Liu, Bolin; Chandra, Joya; Li, Shulin

    2011-01-01

    Tumor-targeted antibody therapy is one of the safest biological therapeutics for cancer patients, but it is often ineffective at inducing direct tumor cell death and is ineffective against resistant tumor cells. Currently, the antitumor efficacy of antibody therapy is primarily achieved by inducing indirect tumor cell death, such as antibody-dependent cell cytotoxicity. Our study reveals that Herceptin conjugates, if generated via the crosslinker EDC (1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride), are capable of engendering human epidermal growth factor receptor 2 (Her2) positive tumor cells death. Using a high-performance liquid chromatography (HPLC) system, three peaks with estimated molecular weights of antibody monomer, dimer, and trimer were isolated. Both Herceptin trimer and dimer separated by HPLC induced significant levels of necrotic tumor cell death, although the trimer was more effective than the dimer. Notably, the Herceptin trimer also induced Herceptin-resistant tumor cell death. Surprisingly different from the known cell death mechanism that often results from antibody treatment, the Herceptin trimer elicited effective and direct tumor cell death via a novel mechanism: programmed cell necrosis. In Her2-positive cells, inhibition of necrosis pathways significantly reversed Herceptin trimer-induced cell death. In summary, the Herceptin trimer reported herein harbors great potential for overcoming tumor cell resistance to Herceptin treatment. PMID:21853100

  10. Surface modification of tungsten carbide by electrical discharge coating (EDC) using a titanium powder suspension

    NASA Astrophysics Data System (ADS)

    Janmanee, Pichai; Muttamara, Apiwat

    2012-07-01

    Surface modification by a titanium coating layer onto a tungsten carbide surface by electrical discharge coating (EDC) was studied by considering a titanium coating modification as well as the completeness of the tungsten carbide surface. This was carried out by electrical discharge machining (EDM). The tungsten carbide material was produced using a fluid dielectric oil, which was mixed with titanium powder. The current and duty cycles were varied resulting in a change in the titanium coating layer thickness. Also, an analysis of the chemical composition using energy dispersive spectroscopy (EDS) revealed that a titanium coating layer was formed causing the hardness of the titanium surface to be close to that of tungsten carbide. The completeness of the surface was evaluated using scanning electron microscopy (SEM) and a small number of microcracks were found on the surface since the microcracks were filled and substituted by titanium powder and carbon (a hydrocarbon) that decomposed from the dielectric that acted as a combiner (TiC). Also, the high concentration of carbon increased the amount of Ti and C combination and TiC was formed, which enhanced the surface hardness of the coated layer to 1750 HV. The surface roughness of the coated layer decreased and this reduced the formation of microcracks on the surface workpiece.

  11. Exchange donor renal transplantation.

    PubMed

    Kim, Soo Jin; Kim, Myoung Soo; Park, Kiil

    2013-01-01

    Nearly 20 years of experience at Severance Hospital has shown that utilizing exchange donors increases the donor pool safely, with outcomes comparable to living related donor grafts. The exchange donor program is invaluable for incompatible donor-recipient pairs to consecutively proceed to transplantation. Recently, newer desensitization protocols have been devised to approach incompatible donor-recipient pairs, but not without risks. These desensitization protocols may be an alternative when confronting the limitations in the exchange program. Therefore, the exchange program and the desensitization protocols should be complementary, not competing strategies and centers should weigh the merits and limitations of each protocol in each incompatible donor-recipient pair to select the optimal method for a safe and successful transplantation.

  12. Unrelated adult stem cell donor medical suitability: recommendations from the World Marrow Donor Association Clinical Working Group Committee.

    PubMed

    Lown, R N; Philippe, J; Navarro, W; van Walraven, S M; Philips-Johnson, L; Fechter, M; Pawson, R; Bengtsson, M; Beksac, M; Field, S; Yang, H; Shaw, B E

    2014-07-01

    The World Marrow Donor Association (WMDA) fosters collaboration between international registries to facilitate the exchange of hematopoietic stem cell products for unrelated stem cell donor transplantation. As indications for hematopoietic SCT grow, the movement of products across the world will increase. Although competent authorities may regulate products within their country, there is a need to protect the best interests of donors and recipients by identifying universal donor medical suitability criteria. Within this report the WMDA provides a background to unrelated adult donor and recipient safety, recommends a common framework for assessing the health of unrelated adult donors at each stage of the donation pathway and presents a novel mechanism for sharing international consensus criteria for individual medical and lifestyle conditions. Wherever possible, these criteria are evidence-based. By establishing a donor medical suitability working group, the WMDA has developed a process through which donor centers and registries may request a consensus opinion on conditions not already listed, as well as challenge existing criteria. Guidance from the WMDA is intended to complement, not supersede, guidance from national competent authorities and international regulatory bodies.

  13. The effect of donor age on survival after lung transplantation.

    PubMed

    Izbicki, Gabriel; Shitrit, David; Aravot, Dan; Fink, Gershon; Saute, Milton; Idelman, Leonid; Bakal, Ilana; Sulkes, Jaqueline; Kramer, Mordechai R

    2002-06-01

    Historically, donor age above 55 years has been considered to be a relative contraindication for organ transplantation. The shortage of organs for transplantation has led to the expansion of the donor pool by accepling older donors. To compare the 1 year follow-up in patients after lung transplantation from older donors (> 50 years old) and in patients after transplantation from younger donors (< or = 50 years). The study group comprised all adult patients who underwent lung transplantation at the Rabin Medical Center between May 1997 and August 2001. Donors were classified into two groups according to their age: < or = 50 years (n = 20) and > 50 years (n = 9). Survival, number and total days of hospitalization, development of bronchiolitis obliterans syndrome, and pulmonary function tests, were examined 1 year after transplantation. We performed 29 lung transplantations in our center during the observed period. Donor age had no statistically significant impact on 1 year survival after lung transplantation. There was no statistically significant effect on lung function parameters, the incidence of hospitalization or the incidence of bronchiolitis obliterans between both donor age groups at 1 year after transplantation. Donor age did not influence survival or important secondary end-points 1 year after lung transplantation By liberalizing donor criteria of age up to 65 years, we can expand the donor pool, while assessing other possible mechanisms to increase donor availability.

  14. Management to optimize organ procurement in brain dead donors.

    PubMed

    Mascia, L; Mastromauro, I; Viberti, S; Vincenzi, M; Zanello, M

    2009-03-01

    The demand for donor organs continues to exceed the number of organs available for transplantation. Many reasons may account for this discrepancy, such as the lack of consent, the absence of an experienced coordinator team able to solve logistical problems, the use of strict donor criteria, and suboptimal, unstandardized critical care management of potential organ donors. This has resulted in efforts to improve the medical care delivered to potential organ donors, so as to reduce organ shortages, improve organ procurement, and promote graft survival. The physiological changes that follow brain death entail a high incidence of complications jeopardizing potentially transplantable organs. Adverse events include cardiovascular changes, endocrine and metabolic disturbances, and disruption of internal homeostasis. Brain death also upregulates the release of pro-inflammatory molecules. Recent findings support the hypothesis that a preclinical lung injury characterized by an enhanced inflammatory response is present in potential donors and may predispose recipients to an adverse clinical prognosis following lung transplantation. In clinical practice, hypotension, diabetes insipidus, relative hypothermia, and natremia are more common than disseminated intravascular coagulation, cardiac arrhythmias, pulmonary oedema, acute lung injury, and metabolic acidosis. Strategies for the management of organ donors exist and consist of the normalization of donor physiology. Management has been complicated by the recent use of ''marginal'' donors and donors of advanced age or with ''extended'' criteria. Current guidelines suggest that the priority of critical care management for potential organ donors should be shifted from a ''cerebral protective'' strategy to a multimodal strategy aimed to preserve peripheral organ function.

  15. Artificial Intelligence Techniques to Optimize the EDC/NHS-Mediated Immobilization of Cellulase on Eudragit L-100

    PubMed Central

    Zhang, Yu; Xu, Jing-Liang; Yuan, Zhen-Hong; Qi, Wei; Liu, Yun-Yun; He, Min-Chao

    2012-01-01

    Two artificial intelligence techniques, namely artificial neural network (ANN) and genetic algorithm (GA) were combined to be used as a tool for optimizing the covalent immobilization of cellulase on a smart polymer, Eudragit L-100. 1-Ethyl-3-(3-dimethyllaminopropyl) carbodiimide (EDC) concentration, N-hydroxysuccinimide (NHS) concentration and coupling time were taken as independent variables, and immobilization efficiency was taken as the response. The data of the central composite design were used to train ANN by back-propagation algorithm, and the result showed that the trained ANN fitted the data accurately (correlation coefficient R2 = 0.99). Then a maximum immobilization efficiency of 88.76% was searched by genetic algorithm at a EDC concentration of 0.44%, NHS concentration of 0.37% and a coupling time of 2.22 h, where the experimental value was 87.97 ± 6.45%. The application of ANN based optimization by GA is quite successful. PMID:22942683

  16. Artificial intelligence techniques to optimize the EDC/NHS-mediated immobilization of cellulase on Eudragit L-100.

    PubMed

    Zhang, Yu; Xu, Jing-Liang; Yuan, Zhen-Hong; Qi, Wei; Liu, Yun-Yun; He, Min-Chao

    2012-01-01

    Two artificial intelligence techniques, namely artificial neural network (ANN) and genetic algorithm (GA) were combined to be used as a tool for optimizing the covalent immobilization of cellulase on a smart polymer, Eudragit L-100. 1-Ethyl-3-(3-dimethyllaminopropyl) carbodiimide (EDC) concentration, N-hydroxysuccinimide (NHS) concentration and coupling time were taken as independent variables, and immobilization efficiency was taken as the response. The data of the central composite design were used to train ANN by back-propagation algorithm, and the result showed that the trained ANN fitted the data accurately (correlation coefficient R(2) = 0.99). Then a maximum immobilization efficiency of 88.76% was searched by genetic algorithm at a EDC concentration of 0.44%, NHS concentration of 0.37% and a coupling time of 2.22 h, where the experimental value was 87.97 ± 6.45%. The application of ANN based optimization by GA is quite successful.

  17. Blood donor selection in European Union directives: room for improvement

    PubMed Central

    de Kort, Wim; Mayr, Wolfgang; Jungbauer, Christof; Vuk, Tomislav; Kullaste, Riin; Seifried, Erhard; Grazzini, Giuliano; de Wit, Jeroen; Folléa, Gilles

    2016-01-01

    Background Transfusion-transmissible infections have made both blood bankers and health authorities overly cautious. The general public expects and hence reinforces this policy. To obtain a high level of blood product safety, blood and plasma donors have to meet increasingly stringent eligibility criteria; however, it is not known whether this policy translates into improved outcomes for patients. There is a risk that the management of donors does not match the ambition of greater safety for patients. European directives related to the collection process and donor selection will probably be reconsidered in the next few years. Material and methods The development of European directives on donor selection and their basis in the literature were reviewed with an emphasis on the background and considerations for eligibility criteria to be included in the directives. Results The precautionary principle appears to be the predominant reason behind the set of eligibility criteria. However, the formal eligibility criteria, put into force in 2004, do not balance with the developments of the past decade in laboratory tests and measures that have substantially reduced actual infection risks. In no cases were the effects of eligibility criteria on the donor pool and donor well-being quantified. Regional differences in the epidemiology of transfusion-transmissible infections were not taken into consideration either. Discussion First, the Authors promote the collection of epidemiological data on the incidence and prevalence of conditions in the general population and in blood and plasma donors which could pose a risk for transfused patients, in order to use these data as a basis for decision-making in donor-selection policies. Second, the Authors suggest including allowance for differential deferral criteria throughout Europe, based on factual risk levels. There should be an accepted balance between donor and patient welfare, and also between risk to transfusion safety and risk of

  18. Accumulation of endocrine disrupting chemicals (EDCs) in the polychaete Paraprionospio sp. from the Yodo River mouth, Osaka Bay, Japan.

    PubMed

    Nurulnadia, Mohd Yusoff; Koyama, Jiro; Uno, Seiichi; Kito, Asami; Kokushi, Emiko; Bacolod, Eugene Tan; Ito, Kazuki; Chuman, Yasutaka

    2014-03-01

    This study presents the levels of endocrine disrupting chemicals (EDCs) accumulated by Paraprionospio sp. from the Yodo River mouth, Osaka Bay. Since high concentrations of nonylphenol (NP), bisphenol A (BP), octylphenol (OP), 17β-estradiol (E2), and estrone (E1) have been measured in sediment from Osaka Bay, some bioaccumulation could be expected particularly in benthic animals. EDCs were analysed in Paraprionospio sp., a dominant benthic species in Osaka Bay. The results showed that Paraprionospio sp. had accumulated varying concentrations (wet weight; w.w.) of NP at 1,460-4,410 ng/g; BP at 22.5-39.6 ng/g; OP at 18.9-45.4 ng/g; E2 at 0.89-4.35 ng/g; and E1 at 0.06-2.50 ng/g. Accumulation of NP and OP were highest among the samples gathered in summer (July 2008), while concentrations of BP, E2, and E1 did not much differs within 3 years. EDC levels in Paraprionospio sp. were apparently greater than those in sediments showing bioaccumulation.

  19. Novel collagen scaffolds prepared by using unnatural D-amino acids assisted EDC/NHS crosslinking.

    PubMed

    Krishnamoorthy, Ganesan; Sehgal, Praveen Kumar; Mandal, Asit Baran; Sadulla, Sayeed

    2013-01-01

    This work discusses the preparation and characterization of novel collagen scaffolds by using unnatural D-amino acids (Coll-D-AAs)-assisted 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC)/N-hydroxyl succinimide(NHS)-initiated crosslinking. The mechanical strength, hydrothermal and structural stability, resistance to biodegradation and the biocompatibility of Coll-D-AAs matrices were investigated. The results from Thermo mechanical analysis, Differential scanning calorimetric analysis and Thermo gravimetric analysis of the Coll-D-AAs matrices indicate a significant increase in the tensile strength (TS, 180±3), % elongation (% E, 80±9), elastic modulus (E, 170±4) denaturation temperature (T d, 108±4) and a significant decrease in decomposition rate (Tg, 64±6). Scanning electron microscopic and Atomic force microscopic analyses revealed a well-ordered with properly oriented and well-aligned structure of the Coll-D-AAs matrices. FT-IR results suggest that the incorporation of D-AAs favours the molecular stability of collagen matrix. The D-AAs stabilizing the collagen matrices against degradation by collagenase would have been brought about by protecting the active sites in collagen. The Coll-D-AAs matrices have good biocompatibility when compared with native collagen matrix. Molecular docking studies also indicate better understanding of bonding pattern of collagen with D-AAs. These Coll-D-AAs matrices have been produced in high mechanical strength, thermally and biologically stable, and highly biocompatible forms that can be further manipulated into the functional matrix suitable in designing scaffolds for tissue engineering and regenerative medical applications.

  20. Donor insemination: eugenic and feminist implications.

    PubMed

    Hanson, F A

    2001-09-01

    One concern regarding developments in genetics is that, when techniques such as genetic engineering become safe and affordable, people will use them for positive eugenics: to "improve" their offspring by enpowering them with exceptional qualities. Another is whether new reproductive technologies are being used to improve the condition of women or as the tools of a patriarchal system that appropriates female functions to itself and exploits women to further its own ends. Donor insemination is relevant to both of these issues. The degree to which people have used donor insemination in the past for positive eugenic purposes may give some insight into the likelihood of developing technologies being so used in the future. Donor insemination provides women with the opportunity to reproduce with only the most remote involvement of a man. To what degree do women take advantage of this to liberate themselves from male dominance? Through questionnaires and interviews, women who have used donor insemination disclosed their criteria for selecting sperm donors. The results are analyzed for the prevalence of positive eugenic criteria in the selection process and women's attitudes toward minimizing the male role in reproduction.

  1. Characterization of emissions of dioxins and furans from ethylene dichloride (EDC), vinyl chloride (VCM) and polyvinylchloride (PVC) facilities in the United States.

    SciTech Connect

    Carroll, W.F. Jr.; Borrelli, F.E.; Garrity, P.J.; Jacobs, R.A.; Lewis, J.W.; McCreedy, R.L.; Weston, A.F.; Ledvina, J.C.

    1997-12-31

    Members of The Vinyl Inst., under the auspices of its Dioxin Characterization Program have analyzed for potential dioxin/furan (PCDD/F) concentrations in polyvinylchloride (PVC) resins, treated wastewater effluent, ethylene dichloride (EDC) product and wastewater sludge at EDC, vinyl chloride (VCM) and PVC facilities. No 2,3,7,8-TCDD was detected in any sample analyzed under the program to date. Results from wastewater sludge analysis are pending. Trace concentrations (low pg/g) of PCDD/F were detected in only a few samples of PVC resins and ethylene dichloride (EDC) product. Treated wastewater contained low ppq concentrations of PCDD/F. All concentrations are expressed as Toxicity Equivalents (TEQ). Extrapolation of these data shows that the contribution of EDC/VCM/PVC manufacturing via these media constitutes less than 1 percent of the US annual dioxin emission to the environment.

  2. O-Glycosyl Donors

    NASA Astrophysics Data System (ADS)

    López, J. Cristóbal

    O-Glycosyl donors, despite being one of the last successful donors to appear, have developed themselves into a burgeoning class of glycosyl donors. They can be classified in two main types: O-alkyl and O-aryl (or hetaryl) glycosyl donors. They share, however, many characteristics, they can be (1) synthesized from aldoses, either by modified Fisher glycosidation (O-alkyl) or by nucleophilic aromatic substitution (O-aryl or O-hetaryl), (2) stable to diverse chemical manipulations, (3) directly used for saccharide coupling, and (4) chemoselectively activated. Among these, n-pentenyl glycosides stand apart. They were the first O-alkyl glycosyl donors to be described and have paved the way to many conceptual developments in oligosaccharide synthesis. The development of the chemoselectivity-based "armed-disarmed" approach for saccharide coupling, including its stereoelectronic or torsional variants, now extended to other kinds of glycosyl donors, was first recognized in n-pentenyl glycosides. The chemical manipulation of the anomeric substituent in the glycosyl donor to induce reactivity differences between related species (sidetracking) was also introduced in n-pentenyl glycosides. An evolution of this concept, the "latent-active" strategy for glycosyl couplings, first described in thioglycosyl donors (vide infra), has been elegantly applied to O-glycosyl donors. Thus, allyl and vinyl glycosides, 2-(benzyloxycarbonyl)benzyl (BCB) glycosides and 2'-carboxybenzyl (CB) glycosides are useful "latent-active" glycosyl pairs. Finally, unprotected 3-methoxy-2-pyridyl (MOP) glycosides have been used in glycosylation processes with moderate success.

  3. Yeast Edc3 Targets RPS28B mRNA for Decapping by Binding to a 3′ Untranslated Region Decay-Inducing Regulatory Element

    PubMed Central

    Li, Chunfang; Roy, Bijoyita

    2014-01-01

    mRNA decapping commits a transcript to complete turnover in eukaryotic cells. In yeast, general mRNA decapping requires the Dcp1/Dcp2 decapping enzyme and a set of decapping activators, including Pat1, Dhh1, Edc3, and the Lsm1-7 complex. The exact function and mode of action of each of these decapping activators in mRNA decapping largely remain elusive. Here, we analyzed the role of Edc3 in the decay of yeast RPS28B mRNA, a pathway triggered by a negative-feedback autoregulatory mechanism. We show that Edc3-mediated RPS28B mRNA decay requires either of two orthologous proteins, Rps28a and Rps28b, expressed from the RPS28A and RPS28B genes, respectively. Contrary to a generally accepted model, we found that Rps28b does not bind to the 3′-untranslated region (UTR) regulatory element in RPS28B mRNA. Instead, Edc3 is directly involved in binding the element, and Rps28b binds Edc3 and regulates its activity. Decay of RPS28B mRNA requires the Lsm and YjeF-N domains of Edc3, but surprisingly, decay of YRA1 pre-mRNA, the only other known substrate of Edc3, requires only the Lsm domain. Collectively, our experiments reveal a new role for Edc3 in mRNA substrate recognition and suggest that this activity is subject to intricate regulation by additional factors, including the Rps28 ribosomal protein. PMID:24492965

  4. [Evaluation and follow-up of living kidney donors].

    PubMed

    Giessing, M; Schönberger, B; Fritsche, L; Budde, K

    2004-01-23

    An increase in waiting time for a cadaveric organs and a better graft-function, graft- and patient-survival with kidneys from a living donors have lead to an increase in living-donor renal transplantation in the therapy of end-stage renal disease. In Germany, with the implementation of a transplantation law in 1997 and due to improved surgical techniques (laparoscopy) the proportion of living renal donors has almost tripled during the last five years. The transplantation law also names the potential donors, including not only genetically related but also emotionally related donors. Inclusion criteria for living donation are age > 18 years, mental ability to give consent and an altruistic motivation (exclusion of financial benefits for the donor). If ABO blood group compatibility between donor and recipient is given and a cross match does not reveal immunologic obstacles a thorough medical and psychological examination must be performed with the potential donor. All risk factors for the donor beyond the actual operation must be excluded. Therefore all organ-systems have to be evaluated and risks for the donor as well as transferable pathologies and infections must be ruled out. International guidelines help to perform an efficient evaluation. Following organ donation the donor should be medically controlled as requested by law. Also, psychological counselling should be offered. The aim is to minimize risks for the single kidney and to recognize early potentially kidney damaging affections.

  5. The Outcomes of Living Kidney Donation from Medically Complex Donors: Implications for the Donor and the Recipient.

    PubMed

    Niemi, Matthew; Mandelbrot, Didier A

    2014-03-01

    Living kidney donation is an important option for patients with end-stage renal disease (ESRD), and has improved life expectancy and quality for patients otherwise requiring maintenance dialysis or deceased-donor transplantation. Given the favorable outcomes of live donation and the shortage of organs to transplant, individuals with potentially unfavorable demographic and clinical characteristics are increasingly being permitted to donate kidneys. While this trend has successfully expanded the live donor pool, it has raised concerns as to which acceptance criteria are safe. This review aims to summarize the existing literature on the outcomes of transplantation from medically complex, living kidney donors, including both donor and recipient outcomes when available.

  6. The Outcomes of Living Kidney Donation from Medically Complex Donors: Implications for the Donor and the Recipient

    PubMed Central

    Niemi, Matthew; Mandelbrot, Didier A.

    2014-01-01

    Living kidney donation is an important option for patients with end-stage renal disease (ESRD), and has improved life expectancy and quality for patients otherwise requiring maintenance dialysis or deceased-donor transplantation. Given the favorable outcomes of live donation and the shortage of organs to transplant, individuals with potentially unfavorable demographic and clinical characteristics are increasingly being permitted to donate kidneys. While this trend has successfully expanded the live donor pool, it has raised concerns as to which acceptance criteria are safe. This review aims to summarize the existing literature on the outcomes of transplantation from medically complex, living kidney donors, including both donor and recipient outcomes when available. PMID:24579060

  7. Donor Telomere Length SAA

    Cancer.gov

    A new NCI study has found that, among patients with severe aplastic anemia who received a hematopoietic cell transplant from an unrelated donor, those whose donor white blood cells had longer telomeres had higher survival rates five-years after transplant

  8. Rich Donors, Poor Countries

    ERIC Educational Resources Information Center

    Thomas, M. A.

    2012-01-01

    The shifting ideological winds of foreign aid donors have driven their policy towards governments in poor countries. Donors supported state-led development policies in poor countries from the 1940s to the 1970s; market and private-sector driven reforms during the 1980s and 1990s; and returned their attention to the state with an emphasis on…

  9. New technologies for infectious screening of organ donors.

    PubMed

    Fishman, J A

    2011-01-01

    Viral, bacterial, parasitic, prion, and fungal infections, although uncommon, have been transmitted via organ and tissue allografts. Improved screening techniques for infectious diseases in organ donors have helped to reduce disease transmission. Reports of clusters of donor-derived infections illustrate the need to improve the screening of tissue and organ donors. Available microbiologic assays, including molecular tests, are generally designed for use as diagnostic tools in individuals believed to have a specific infection based on clinical or epidemiological criteria. These assays are frequently unsuitable in the screening of deceased organ donors. Nucleic acid testing may reduce the risk of disease transmission by detecting early-stage infection, including those from human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in the "window" period before antibody seroconversion can be documented. Screening of organ donors for potential pathogens cannot completely exclude the risk of disease transmission. The process of donor screening must continue to evolve with advances in diagnostic technologies for infectious diseases.

  10. Superior Survival Using Living Donors and Donor-Recipient Matching Using a Novel Living Donor Risk Index

    PubMed Central

    Goldberg, David S.; French, Benjamin; Abt, Peter L; Olthoff, Kim; Shaked, Abraham

    2014-01-01

    The deceased-donor organ supply in the U.S. has not been able to keep pace with the increasing demand for liver transplantation. We examined national OPTN/UNOS data from 2002–2012 to assess whether LDLT has surpassed deceased donor liver transplantation (DDLT) as a superior method of transplantation, and used donor and recipient characteristics to develop a risk score to optimize donor and recipient selection for LDLT. From 2002–2012, there were 2,103 LDLTs and 46,674 DDLTs that met the inclusion criteria. The unadjusted 3-year graft survival for DDLTs was 75.5% (95% CI: 75.1–76.0%) compared with 78.9% (95% CI: 76.9–80.8%; p<0.001) for LDLTs that were performed at experienced centers (>15 LDLTs), with substantial improvement in LDLT graft survival over time. In multivariable models, LDLT recipients transplanted at experienced centers with either autoimmune hepatitis or cholestatic liver disease had significantly lower risks of graft failure (HR: 0.56, 95% CI: 0.37–0.84 and HR: 0.76, 95% CI: 0.63–0.92, respectively). An LDLT risk score that included both donor and recipient variables facilitated stratification of LDLT recipients into high, intermediate, and low-risk groups, with predicted 3-year graft survival ranging from >87% in the lowest risk group to <74% in the highest risk group. Current post-transplant outcomes for LDLT are equivalent, if not superior to DDLT when performed at experienced centers. An LDLT risk score can be used to optimize LDLT outcomes and provides objective selection criteria for donor selection in LDLT. PMID:25042283

  11. Lung donor treatment protocol in brain dead-donors: A multicenter study.

    PubMed

    Miñambres, Eduardo; Pérez-Villares, Jose Miguel; Chico-Fernández, Mario; Zabalegui, Arturo; Dueñas-Jurado, Jose María; Misis, Maite; Mosteiro, Fernando; Rodriguez-Caravaca, Gil; Coll, Elisabeth

    2015-06-01

    The shortage of lung donors for transplantation is the main limitation among patients awaiting this type of surgery. We previously demonstrated that an intensive lung donor-treatment protocol succeeded in increasing the lung procurement rate. We aimed to validate our protocol for centers with or without lung transplant programs. A quasi-experimental study was performed to compare lung donor rate before (historical group, 2010 to 2012) and after (prospective group, 2013) the application of a lung management protocol for donors after brain death (DBDs) in six Spanish hospitals. Lung donor selection criteria remained unchanged in both periods. Outcome measures for lung recipients were early survival and primary graft dysfunction (PGD) rates. A total of 618 DBDs were included: 453 in the control period and 165 in the protocol period. Donor baseline characteristics were similar in both periods. Lung donation rate in the prospective group was 27.3%, more than twice that of the historical group (13%; p < 0.001). The number of lungs retrieved, grafts transplanted, and transplants performed more than doubled over the study period. No differences in early recipients' survival between groups were observed (87.6% vs. 84.5%; p = 0.733) nor in the rate of PGD. Implementing our intensive lung donor-treatment protocol increases lung procurement rates. This allows more lung transplants to be performed without detriment to either early survival or PGD rate. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  12. Application of radio-immunoassays to assess the fate of estrogen EDCs in full scale wastewater treatment plants.

    PubMed

    Surujlal-Naicker, Swastika; Bux, Faizal

    2013-01-01

    Wastewater effluents have been documented as major contributors of hormone endocrine disrupting compounds (EDCs) in to the aquatic ecosystem. The need for rapid, simple and cost effective methods to detect these EDCs has increased. The use of Radio-immunoassays (RIA) were assessed to determine the fate of estradiol in a laboratory batch test and the three natural estrogens (estrone (E1), estradiol (E2) and estriol (E3)) in wastewater treatment plants (WWTPs) with different types of configurations. Precision of the RIAs were done using intra-assay and inter-assay validations. The E2 intra-assay variation was <8% and inter-assay variation was <11% for standards 1 to 6. E1 RIA showed less than 8% for both the intra-assay and inter-assay variations. E3 RIA showed extremely good variations with both the intra and inter-assay variations being below <8% for all standards. The lab scale investigation showed a 94% reduction in E2 after 5 h and after 10 h both E2 and E1 were no longer detected. The simple activated sludge process, the biological nutrient removal (BNR) activated sludge process and the oxidation pond had final effluent concentrations of 10.75, 5.96 and 25.48 pg E2/mL respectively; 20.80, 9.30 and 46.55 pg E1/mL, respectively, and 0.12, 0.07 and 0.17 ng E3/mL, respectively. Thus far findings indicated that the RIA can be employed as a rapid technique for detection of natural estrogens in water. Results indicate that these potential problematic hormone EDCs are still present in final wastewater effluents that are discharged in to South African aquatic sources.

  13. [Banff score changes in kidneys from marginal donors].

    PubMed

    Borda, Bernadett; Szederkényi, Edit; Ottlakán, Aurél; Kemény, Éva; Szabó, Viktor; Hódi, Zoltán; Lázár, György

    2016-02-21

    Despite an increase in the number of cadaver donors and the number of overall organ transplantations, the dramatic increase in the waiting list makes it necessary to reconsider donor criteria. The authors examined whether differences could exist in the function and/or morphology of transplanted kidneys originated from marginal and ideal donors one and five years after transplantation. Kidney function and histopathologic findings were analysed and compared one and 5 years after transplantation in 97 patients having marginal donor kidneys and 178 patients who received ideal donor kidneys. Serum creatinine level was significantly higher (p = 0.0001) and estimated glomerular filtration rate was significantly lower (p = 0.003) in patients having marginal donor kidneys as compared to those with ideal donor kidneys 5 years after transplantation. Morphological changes in the transplanted kidneys such as tubulitis (p = 0.014) and interstitial inflammation (p = 0.025) were significantly more frequently present in patients with marginal donor kidneys than in those with ideal donor kidneys one year after transplantation. Despite an absence of differences in kidney function one year after kidney transplantation between patients having marginal and ideal donor kidneys, morphologic differences in the transplanted kidneys can be detected between the two groups of patients.

  14. [Motivations of oocytes donors].

    PubMed

    Cauvin, P

    2009-01-01

    Oocyte donation is a complex situation that requires the applicant couple to deal with the presence of the donor in the history of the child conception. Accepting the eggs is not the same thing than accepting the donor. Her place in the child's life depends on how his parents will accept her phantasmal reality beyond her real person. Paying attention to the story told by the donors on their motivations may help parents internalize this conception to three. We show from two clinical observations, that the generosity of donors is connected to personal issues that do not relate to unborn child or its parents. If there are two mothers in oocyte donation, they are not really in competition because there are also two children: the child conceived through donation is that of the project of the couple, the child to which the donor thinks, is and will remain in phantasmal domain, i.e. linked to the personal history of the donor. We also show that the psychological interview fully responds to the donor expectations when it seeks to highlight her motives.

  15. Detection of phenolic endocrine disrupting chemicals (EDCs) from maternal blood plasma and amniotic fluid in Indian population.

    PubMed

    Shekhar, Sudhanshu; Sood, Surbhi; Showkat, Sadiya; Lite, Christy; Chandrasekhar, Anjalakshi; Vairamani, Mariappanadar; Barathi, S; Santosh, Winkins

    2017-01-15

    There is a widespread exposure of general population, including pregnant women and developing fetuses, to the endocrine disrupting chemicals (EDCs). These chemicals have been reported to be present in urine, blood serum, breast milk and amniotic fluid. We aimed to investigate the association between the maternal exposure and in utero fetal exposure levels of these chemicals to study their transfer from maternal to fetal unit indicating prenatal exposure. Samples of maternal blood and amniotic fluid were collected as set from 53 pregnant women at full term. Nine phenolic EDCs, methyl paraben (MP; 20.92ng/mL and 18.92ng/mL), ethyl paraben (EP; 1.97ng/ mL and 1.89ng/mL), propyl paraben (PP; 19.22ng/mL and 18.82ng/mL), butyl paraben (BP; 1.11ng/mL and 1.37ng/mL), p-hydroxybenzoic acid (PHBA; 29.99ng/mL and 26.15ng/mL), bisphenol A (BPA; 7.43ng/mL and 7.75ng/mL), triclosan (TCS; 7.17ng/mL and 7.04ng/mL), octyl phenol (OP; 5.46ng/mL and 5.72ng/mL) and nonyl phenol (NP; 9.38ng/mL and 8.44ng/mL), were simultaneously detected in samples of maternal blood plasma and amniotic fluid respectively using Gas Chromatography-Mass Spectrometry (GC-MS). Highest positive correlation was found for total concentration of 4-nonyl phenol, NP (r=0.575, p<0.001), whereas the lowest positive correlation was found for free form of bisphenol A, BPA (r=0.343, p<0.05), when compared between the two matrices. Our results suggest that maternal exposure to several EDCs is positively associated with in utero exposure to the developing fetus. Future studies should focus on collection of amniotic fluid at different trimesters and the corresponding maternal samples to better characterize the pharmacokinetics and the associated disease etiologies of these EDCs during fetal development.

  16. Is the Kidney Donor Risk Index a step forward in the assessment of deceased donor kidney quality?

    PubMed

    Lee, Alison P K; Abramowicz, Daniel

    2015-08-01

    The allocation of deceased donor kidneys has become more complex because of the increasing spectrum of donors and recipients age and comorbidities. Several scoring systems have been proposed to evaluate the donor quality of deceased donor kidneys, based on clinical, pathological or combined parameters to predict the risk of renal allograft failure. Nonetheless, besides the dichotomous extended criteria donor (ECD) score, none of the others have been used in clinical practice because of numerous reasons, ranging from lack of robust validation to the technical challenges associated with the evaluation of donor biopsies. Recently, the Kidney Donor Risk Index (KDRI) and Profile Index (KDPI) were introduced in the USA as a refined version of the ECD score. This scoring system is based on 10 donor factors, therefore providing a finely granulated evaluation of donor quality without the need of a kidney biopsy.Here, we review the advantages and drawbacks of the main scoring systems, and we describe the components of the KDRI and KDPI. It is an easily accessible online tool, based solely on donor factors readily available at the moment of the donor offer. Importantly, the KDPI has also been made part of the 'longevity matching' allocation in the USA, where the best kidneys are allocated to the recipients with the longest predicted post-transplant survival. The KDRI should provide us with a robust qualitative evaluation of deceased donor quality, and therefore will probably play a role in deceased donor kidney allocation policies across Europe in the near future. Hopefully, the KDRI and the KDPI should help transplant programmes to better allocate the scarce resource of deceased donor kidneys.

  17. National Marrow Donor Program

    DTIC Science & Technology

    2008-08-05

    IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor 10 IIB.3.1 Aim 1 – Phase I of EM Haplotype Logic No Activity 10 IIB.3.2 Aim 2 – Enhancement...1.1 Aim 1 – Donor Recipient Pair Project Open 12 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD 13 IIC.2.1 Aim 1 – Analysis of Non-HLA Loci Open 13...and on the nuances of HLA typing can be used to design computer algorithms to predict the best matched donor. IIB.3.1 Aim 1: Phase I of EM

  18. National Marrow Donor Program

    DTIC Science & Technology

    2010-11-05

    AlGorithm to Predict Best Donor Task 1 -Incorporate Frequencies into Matchin" AI"orithm Open Task 2 - Enhancement of EM Algorithm Open Task 3 - Optimal...Immunooenetic Studies Ob.jective 1- Influence ofHLA Mismatches Task I - Donor Recipient Pair Project Open Objective 1- Role of Other Loci and GVHD Task I...typing can be used to design computer algorithms to predict the best matched donor. IIB.3. Task 1: Period 8 Activity: Phase I of EM Worked on a

  19. National Marrow Donor Program

    DTIC Science & Technology

    2008-11-17

    Algorithm No Activity 13 IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor 14 IIB.3.1 Aim 1 – Phase I of EM Haplotype Logic No Activity 14 IIB...of HLA Mismatches 15 IIC.1.1 Aim 1 – Donor Recipient Pair Project Open 15 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD 16 IIC.2.1 Aim 1...frequencies and on the nuances of HLA typing can be used to design computer algorithms to predict the best matched donor. IIB.3.1 Aim 1: Phase I of EM

  20. Exchange-donor renal transplantation.

    PubMed

    Huh, Kyu Ha; Kim, Hyun Jung; Jeon, Kyung Ock; Kiml, Beom Seok; Kim, Yu Seun; Park, Kill

    2009-01-01

    Exchange-donor programs may prevent the current loss of many suitable living donors. Both incompatible donor-recipient pairs--with ABO incompatibility or positive cross-matches--and compatible pairs who wish to locate more suitable donors should be encouraged to participate in exchange-donor programs. Advantages and limitations of exchange-donor programs must be carefully explained to prevent interfamilial conflict. Exchange-donor programs may relieve shortages of donor organs and offer good posttransplant outcomes. Therefore, this program should be widely implemented.

  1. Blood donation and blood donor mortality after adjustment for a healthy donor effect.

    PubMed

    Ullum, Henrik; Rostgaard, Klaus; Kamper-Jørgensen, Mads; Reilly, Marie; Melbye, Mads; Nyrén, Olof; Norda, Rut; Edgren, Gustaf; Hjalgrim, Henrik

    2015-10-01

    Studies have repeatedly demonstrated that blood donors experience lower mortality than the general population. While this may suggest a beneficial effect of blood donation, it may also reflect the selection of healthy persons into the donor population. To overcome this bias, we investigated the relation between blood donation frequency and mortality within a large cohort of blood donors. In addition, our analyses also took into consideration the effects of presumed health differences linked to donation behavior. Using the Scandinavian Donation and Transfusion database (SCANDAT), we assessed the association between annual number of donations in 5-year windows and donor mortality by means of Poisson regression analysis. The analyses included adjustment for demographic characteristics and for an internal healthy donor effect, estimated among elderly donors exempted from continued donation because of age criteria. Statistical analyses included 1,182,495 donors of whom 15,401 died during 9,526,627 person-years of follow-up. Analyses adjusted only for demographic characteristics showed a 18.6% reduction in mortality per additional annual donation (95% confidence interval [CI], 16.8%-20.4%). After additional adjustment for the internal healthy donor effect, each additional annual donation was associated with a 7.5% decreased mortality risk 7.5% (95% CI, 5.7%-9.4%). We observed an inverse relationship between donation frequency and mortality. The magnitude of the association was reduced after adjustment for an estimate of self-selection in the donor population. Our observations indicate that repeated blood donation is not associated with premature death, but cannot be interpreted as conclusive evidence of a beneficial health effect. © 2015 AABB.

  2. Laparoscopic donor nephrectomy.

    PubMed

    Deger, S; Giessing, M; Roigas, J; Wille, A H; Lein, M; Schönberger, B; Loening, S A

    2005-01-01

    Laparoscopic live donor nephrectomy (LDN) has removed disincentives of potential donors and may bear the potential to increase kidney donation. Multiple modifications have been made to abbreviate the learning curve while at the same time guarantee the highest possible level of medical quality for donor and recipient. We reviewed the literature for the evolution of the different LDN techniques and their impact on donor, graft and operating surgeon, including the subtleties of different surgical accesses, vessel handling and organ extraction. We performed a literature search (PubMed, DIMDI, medline) to evaluate the development of the LDN techniques from 1995 to 2003. Today more than 200 centres worldwide perform LDN. Hand-assistance has led to a spread of LDN. Studies comparing open and hand-assisted LDN show a reduction of operating and warm ischaemia times for the hand-assisted LDN. Different surgical access sites (trans- or retroperitoneal), different vessel dissection approaches, donor organ delivery techniques, delivery sites and variations of hand-assistance techniques reflect the evolution of LDN. Proper techniques and their combination for the consecutive surgical steps minimize both warm ischaemia time and operating time while offering the donor a safe minimally invasive laparoscopic procedure. LDN has breathed new life into the moribund field of living kidney donation. Within a few years LDN could become the standard approach in living kidney donation. Surgeons working in this field must be trained thoroughly and well acquainted with the subtleties of the different LDN techniques and their respective advantages and disadvantages.

  3. In vivo evaluation of a biodegradable EDC/NHS-cross-linked gelatin peripheral nerve guide conduit material.

    PubMed

    Chang, Ju-Ying; Lin, Jia-Horng; Yao, Chun-Hsu; Chen, Jiunn-Horng; Lai, Tung-Yuan; Chen, Yueh-Sheng

    2007-04-10

    Peripheral nerve regeneration has been evaluated using a biodegradable nerve conduit, which is made of a 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC)/N-hydroxysuccinimide (NHS) cross-linked gelatin. The EDC/NHS crosslinked gelatin (ENG) conduit is brownish in appearance, and is concentric and round with a smooth outer surface and inner lumen. After subcutaneous implantation on the dorsal side of a rat, the degraded ENG conduit only evoked a mild tissue response, with the formation of a thin tissue capsule surrounding the conduit. Biodegradability of the ENG conduit and its effectiveness as a guidance channel has been examined by its use to repair a 10 mm gap in the rat sciatic nerve. As a result, the tubes degraded throughout the implantation period, but still remained circular with a thin round lumen until they were completely integrated with the enclosed nerves. Successful regeneration through the gap occurred in all the conduits over the three experimental periods of 4, 8, and 12 weeks. Histological observation showed that numerous myelinated axons had crossed through the gap region even at the shortest implantation period of 4 weeks. Peak amplitude, area under the muscle action potential curve, and nerve conductive velocity all showed an increase as a function of the recovery period, which indicates that the nerve had undergone adequate regeneration. These results indicate the superiority of the ENG materials and suggest that the novel ENG conduits provide a promising tool for neuro-regeneration.

  4. Simultaneously photocatalytic treatment of hexavalent chromium (Cr(VI)) and endocrine disrupting compounds (EDCs) using rotating reactor under solar irradiation.

    PubMed

    Kim, Youngji; Joo, Hyunku; Her, Namguk; Yoon, Yeomin; Sohn, Jinsik; Kim, Sungpyo; Yoon, Jaekyung

    2015-05-15

    In this study, simultaneous treatments, reduction of hexavalent chromium (Cr(VI)) and oxidation of endocrine disrupting compounds (EDCs), such as bisphenol A (BPA), 17α-ethinyl estradiol (EE2) and 17β-estradiol (E2), were investigated with a rotating photocatalytic reactor including TiO₂ nanotubes formed on titanium mesh substrates under solar UV irradiation. In the laboratory tests with a rotating type I reactor, synergy effects of the simultaneous photocatalytic reduction and oxidation of inorganic (Cr(VI)) and organic (BPA) pollutants were achieved. Particularly, the concurrent photocatalytic reduction of Cr(VI) and oxidation of BPA was higher under acidic conditions. The enhanced reaction efficiency of both pollutants was attributed to a stronger charge interaction between TiO₂ nanotubes (positive charge) and the anionic form of Cr(VI) (negative charge), which are prevented recombination (electron-hole pair) by the hole scavenging effect of BPA. In the extended outdoor tests with a rotating type II reactor under solar irradiation, the experiment was extended to examine the simultaneous reduction of Cr(VI) in the presence of additional EDCs, such as EE2 and E2 as well as BPA. The findings showed that synergic effect of both photocatalytic reduction and oxidation was confirmed with single-component (Cr(VI) only), two-components (Cr(VI)/BPA, Cr(VI)/EE2, and Cr(VI)/E2), and four-components (Cr(VI)/BPA/EE2/E2) under various solar irradiation conditions.

  5. Interactions of fish gelatin and chitosan in uncrosslinked and crosslinked with EDC films: FT-IR study.

    PubMed

    Staroszczyk, Hanna; Sztuka, Katarzyna; Wolska, Julia; Wojtasz-Pająk, Anna; Kołodziejska, Ilona

    2014-01-03

    Films based on fish gelatin, chitosan and blend of fish gelatin and chitosan before and after cross-linking with EDC have been characterized by FT-IR spectroscopy. The FT-IR spectrum of fish gelatin film showed the characteristic amide I, amide II and amide III bands, and the FT-IR spectrum of chitosan film confirmed that the polymer was only a partially deacetylated product, and included CH3-C=O and NH2 groups, the latter both in their free -NH2 and protonated -NH3(+) form. Analysis of FT-IR spectra of two-component, fish gelatin-chitosan film revealed the formation not only of hydrogen bonds within and between chains of polymers, but also of electrostatic interactions between -COO(-) of gelatin and -NH3(+) of chitosan. Modification with EDC provided cross-linking of composites of the film. New iso-peptide bonds formed between activated carboxylic acid groups of glutamic or aspartic acid residue of gelatin and amine groups of gelatin or/and chitosan. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Blood stem cell procurement: donor safety issues.

    PubMed

    Anderlini, P; Przepiorka, D; Körbling, M; Champlin, R

    1998-06-01

    Allogeneic transplantation of rhG-CSF-mobilized peripheral blood stem cells (PBSCs) is now being increasingly performed, but safety considerations for hematologically normal PBSC donors have not been fully addressed. Experience in this area is rapidly accumulating, however, and on the basis of currently available data, a consensus is gradually emerging on several issues: (1) rhG-CSF treatment and PBSC collection seem to have an acceptable short-term safety profile in normal donors. There is a need for continued safety monitoring, however. (2) rhG-CSF doses up to 10 microg/kg/day show a consistent dose-response relationship with the mobilization (and collection) of CD34+ progenitor cells, and this dose is acceptable for routine clinical use. Whether higher doses are superior (or cost-effective) remains to be determined, and they may produce more severe side-effects. The potential risks of marked leukocytosis (arbitrarily defined as a leukocyte count of more than 70 x 10(9)/l) have been a concern, and rhG-CSF dose reduction is performed by many centers to maintain leukocyte counts below this level. (3) Transient post-donation cytopenias, involving granulocytes, lymphocytes and platelets, may occur and are at least partly related to the leukapheresis procedure. These are generally asymptomatic and self-limited; follow-up blood counts are not necessarily required. Reinfusion of autologous platelet-rich plasma should be considered for donors with expected post-donation thrombocytopenia (platelet count <80-100 x 10(9)/l). (4) Donors should meet the eligibility criteria which apply to donors of apheresis platelets, with the exception that pediatric (as well as elderly) donors may also be considered. There is insufficient information at this time to clearly establish definite contraindications for PBSC collection in a hematologically normal donor. Potential contraindications include the presence of inflammatory, autoimmune or rheumatologic disorders, as well as

  7. Evaluation of high-risk living kidney donors.

    PubMed

    Tangdhanakanond, Kawin; Mandelbrot, Didier

    2015-01-01

    Careful evaluation of potential living kidney donors is crucial to assure the well being of the donors, especially because they do not gain any direct medical benefit from donation. This process also helps assess the quality and safety of the organs donated to the recipients. While all programs share these goals, donor selection criteria vary significantly among U.S. transplant centers. In part, this is due to the limited data that exists as to long-term outcomes among donors who are medically complex, or at higher risk for complications, such as those with hypertension, obesity, or lower kidney function. This article reviews available evidence regarding outcomes after living donation and current trends in U.S. practices, and seeks to provide practical guidance in evaluating high-risk potential living kidney donors.

  8. Donor versus no-donor comparison of newly diagnosed myeloma patients included in the HOVON-50 multiple myeloma study.

    PubMed

    Lokhorst, Henk M; van der Holt, Bronno; Cornelissen, Jan J; Kersten, Marie-José; van Oers, Marinus; Raymakers, Reinier; Minnema, Monique C; Zweegman, Sonja; Janssen, Jeroen J; Zijlmans, Mark; Bos, Gerard; Schaap, Nicolaas; Wittebol, Shulamiet; de Weerdt, Okke; Ammerlaan, Rianne; Sonneveld, Pieter

    2012-06-28

    To prospectively evaluate allogeneic stem cell transplantation (allo-SCT) for myeloma as part of first-line therapy, a donor versus no-donor analysis was performed of patients treated in the HOVON-50 study, a study that was originally designed to examine thalidomide combined with intensive therapy. Two hundred sixty patients having received an autologous-SCT fulfilled the criteria to be included, 138 patients without an HLA-identical sibling donor and 122 patients with a donor. After a median follow-up of 77 months, complete remission, progression-free survival (PFS), and overall survival were not significantly different between the 2 groups. PFS at 6 years was 28% for patients with a donor versus 22% for patients without a donor (P = .19) and overall survival at 6 years from high-dose melphalan was 55%, irrespective of having a donor (P = .68). Cumulative incidence of nonrelapse mortality at 6 years after autologous-SCT was 16% in the donor group versus 3% in the no-donor group (P < .001). However, PFS was significantly prolonged in the 99 patients who actually proceeded to allo-SCT compared with the 115 patients who continued maintenance or received a second high-dose melphalan, but the difference did not translate into a prolonged survival benefit. These results do not support a general application of allo-SCT in all myeloma patients as part of first-line therapy.

  9. Psychosocial impact of pediatric living-donor kidney and liver transplantation on recipients, donors, and the family: a systematic review.

    PubMed

    Thys, Kristof; Schwering, Karl-Leo; Siebelink, Marion; Dobbels, Fabienne; Borry, Pascal; Schotsmans, Paul; Aujoulat, Isabelle

    2015-03-01

    Living-donor kidney and liver transplantation intend to improve pediatric recipients' psychosocial well-being, but psychosocial impact in recipients strongly depends upon the impact on the donor and the quality of family relations. We systematically reviewed quantitative and qualitative studies addressing the psychosocial impact of pediatric living-donor kidney and liver transplantation in recipients, donors, and the family. In accordance with the PRISMA guidelines, we systematically searched the databases Medline, Web of Knowledge, Cinahl, Embase, ERIC, and Google Scholar. We identified 23 studies that satisfied our inclusion criteria. Recipients had improved coping skills and satisfactory peer relationships, but also reported anxiety and depressive symptoms, worried about the future, and had a negative body image. Similarly, donors experienced increased self-esteem, empowerment, and community awareness, but also complained of postoperative pain and a lack of emotional support. With respect to family impact, transplantation generated a special bond between the donor and the recipient, characterized by gratitude and admiration, but also raised new expectations concerning the recipient's lifestyle. As psychological problems in recipients were sometimes induced by feelings of guilt and indebtedness toward the donor, we recommend more research on how gift exchange dynamics function within donor-recipient relationships, enrolling donors and recipients within the same study. © 2014 Steunstichting ESOT.

  10. Pure laparoscopic donor right hepatectomy in a living donor with type 3a biliary variation: A case report.

    PubMed

    Han, Young Seok; Ha, Heontak; Kwon, Hyung Jun; Chun, Jae Min

    2017-09-01

    With refinements in the operative technique, laparoscopic surgery has become the standard practice for liver resection. In the field of living donor liver transplantation, a few centers adopted laparoscopic surgery as an alternative to conventional open donor hepatectomy, and the application of pure laparoscopic donor right hepatectomy has been limited to the donors with simple, favorable biliary anatomy. The candidate donor was a 19-year-old woman with type 3a bile duct variation. After confirming precise cutting points under the guidance of a radiopaque marker rubber band, the bile ducts were divided and the remnant stumps were closed with suture and clipping using Hem-o-lok, respectively. The postoperative course was uneventful and she was satisfactory 6 months after surgery. A laparoscopic donor hepatectomy for the living donor with biliary variation was feasible. Biliary variations are commonly encountered during living donor surgery, and we think that such variations in laparoscopic donor hepatectomy need to be overcome to expand the selection criteria.

  11. Systems of donor transfer.

    PubMed

    de Charro, F T; Akveld, H E; Hessing, D J

    1993-10-01

    The development of medical knowledge has resulted in a demand in society for donor organs, but the recruitment of donor organs for transplantation is difficult. This paper aims to provide some general insights into the complex interaction processes involved. A laissez-faire policy, in which market forces are relied on, is not acceptable from an ethical and legal point of view in most western European countries. Especially at the demand side of the exchange of donor organs, commercialism is to be opposed. We judge the use of commercial incentives at the supply side less unacceptable in theory but not feasible in western European countries. Since market forces are deemed unacceptable as instruments for coordinating demand and supply of donor organs, donor procurement has to be considered as a collective good, and therefore governments are faced with the responsibility of making sure that alternative interaction and distribution mechanisms function. The role of organ procurement agencies (OPAs) in societal interaction concerning postmortem organ donation is described using a two-dimensional conceptualisation scheme. Medical aspects of living organ donation are described. An international comparative description of legal systems to regulate living organ donation in western European countries completes this survey.

  12. Maternal and fetal tissue accumulation of selected endocrine disrupting compounds (EDCs) following exposure to sewage sludge-treated pastures before or after conception.

    PubMed

    Rhind, S M; Kyle, C E; Mackie, C; McDonald, L; Zhang, Z; Duff, E I; Bellingham, M; Amezaga, M R; Mandon-Pepin, B; Loup, B; Cotinot, C; Evans, N P; Sharpe, R M; Fowler, P A

    2010-08-05

    Liver concentrations of selected pollutant classes were determined in groups of sheep fetuses and their dams, at 55 (Experiment 1) and 110 (Experiment 2) days of gestation (term = 145 d) following exposure, throughout their breeding lives and after mating, to pasture treated with either inorganic fertiliser (control, CC) or with sewage sludge (treated, TT). In a unique study designed to separate the respective contributions of environmental sources and mobilised tissue to the available EDC burden, in additional groups of animals, pollutant burdens at 110 days gestation were assessed following exposure to the respective treatments, either throughout their breeding lives until mating, but not thereafter (TC), or only between mating and slaughter (CT) (Experiment 3). With very few exceptions, maternal and fetal liver concentrations of diethylhexyl phthalate (DEHP) and selected polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDE) and polycyclic aromatic hydrocarbons (PAHs) were not significantly affected by sludge exposure in any group. In some cases, maternal and fetal tissue EDC concentrations were different but the differences were not consistent, and maternal and fetal concentrations of none of the classes of chemical were significantly correlated. It was not possible to identify a single chemical, or class of chemical, that may be responsible for previously observed physiological effects of exposure to sludge-treated pastures. It is concluded that exposure of sheep to pastures fertilised with sewage sludge was not associated with increased liver concentrations of EDCs, irrespective of the stage of development at which they were measured and of maternal tissue mobilisation and EDC release during gestation. Thus, retrospective measurements of EDC tissue burdens could not be used to accurately assess earlier fetal EDC insults.

  13. Maternal and fetal tissue accumulation of selected endocrine disrupting compounds (EDCs) following exposure to sewage sludge-treated pastures before or after conception

    PubMed Central

    Kyle, C. E.; Mackie, C.; McDonald, L.; Zhang, Z.; Duff, E. I.; Bellingham, M.; Amezaga, M. R.; Mandon-Pepin, B.; Loup, B.; Cotinot, C.; Evans, N. P.; Sharpe, R. M.; Fowler, P. A.

    2010-01-01

    Liver concentrations of selected pollutant classes were determined in groups of sheep fetuses and their dams, at 55 (Experiment 1) and 110 (Experiment 2) days of gestation (term = 145 d) following exposure, throughout their breeding lives and after mating, to pasture treated with either inorganic fertiliser (control, CC) or with sewage sludge (treated, TT). In a unique study designed to separate the respective contributions of environmental sources and mobilised tissue to the available EDC burden, in additional groups of animals, pollutant burdens at 110 days gestation were assessed following exposure to the respective treatments, either throughout their breeding lives until mating, but not thereafter (TC), or only between mating and slaughter (CT) (Experiment 3). With very few exceptions, maternal and fetal liver concentrations of diethylhexyl phthalate (DEHP) and selected polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDE) and polycyclic aromatic hydrocarbons (PAHs) were not significantly affected by sludge exposure in any group. In some cases, maternal and fetal tissue EDC concentrations were different but the differences were not consistent, and maternal and fetal concentrations of none of the classes of chemical were significantly correlated. It was not possible to identify a single chemical, or class of chemical, that may be responsible for previously observed physiological effects of exposure to sludge-treated pastures. It is concluded that exposure of sheep to pastures fertilised with sewage sludge was not associated with increased liver concentrations of EDCs, irrespective of the stage of development at which they were measured and of maternal tissue mobilisation and EDC release during gestation. Thus, retrospective measurements of EDC tissue burdens could not be used to accurately assess earlier fetal EDC insults. PMID:20676422

  14. Exchange living-donor kidney transplantation: merits and limitations.

    PubMed

    Huh, Kyu Ha; Kim, Myoung Soo; Ju, Man Ki; Chang, Hye Kyung; Ahn, Hyung Joon; Lee, Su Hyung; Lee, Jong Hoon; Kim, Soon Il; Kim, Yu Seun; Park, Kiil

    2008-08-15

    The shortage of donor organs is one of the major barriers to transplantation worldwide. After the success of the direct exchange donor (swap) program in Korea since 1991, we have developed a swap-around program. However, reports on the long-term outcomes of exchange donor programs are scarce. From September 1995 to September 2006, we performed 1193 cases of renal transplantation, including 398 cases from living-unrelated donors. The living-unrelated donors included 129 exchange donors and 269 nonexchange donors. We compared the outcomes of the exchange program with that of the nonexchange program, and examined the merits and limitations of the exchange program. The reasons for the exchange program were ABO incompatibility (n=84, 65.1%), human leukocyte antigen mismatching beyond our criteria (n=39, 30.2%), or positive lymphocyte crossmatch (n=6, 4.7%). The overall 10-year graft survival (86.3%) of exchange transplantation was comparable with that of nonexchange (82.3%) or one- haplotype matched living-related (81.2%) transplantation (P=0.2994). In multivariate analysis, exchange versus nonexchange donors did not affect graft survival. The proportion of blood-type O donors was much lower in the exchange group (29.5%) than in the nonexchange group (42.4%; P=0.026). Blood-type O kidneys were preferentially allocated to blood-type O recipients (78.9%) in the exchange group as compared with the nonexchange group (54.4%; P=0.007). We achieved excellent outcomes by using a donor exchange program as an option to reduce the donor organ shortage. However, the exchange donor program has no added benefit for blood-type O recipients.

  15. Does size matter? Kidney transplant donor size determines kidney function among living donors

    PubMed Central

    Narasimhamurthy, Meenakshi; Smith, Lachlan M.; Machan, Jason T.; Reinert, Steven E.; Gohh, Reginald Y.; Dworkin, Lance D.; Merhi, Basma; Patel, Nikunjkumar; Beland, Michael D.

    2017-01-01

    Background Kidney donor outcomes are gaining attention, particularly as donor eligibility criteria continue to expand. Kidney size, a useful predictor of recipient kidney function, also likely correlates with donor outcomes. Although donor evaluation includes donor kidney size measurements, the association between kidney size and outcomes are poorly defined. Methods We examined the relationship between kidney size (body surface area-adjusted total volume, cortical volume and length) and renal outcomes (post-operative recovery and longer-term kidney function) among 85 kidney donors using general linear models and time-to-chronic kidney disease data. Results Donors with the largest adjusted cortical volume were more likely to achieve an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 over a median 24-month follow-up than those with smaller cortical volumes (P <0.001), had a shorter duration of renal recovery (1.3–2.2 versus 32.5 days) and started with a higher eGFR at pre-donation (107–110 versus 91 mL/min/1.73 m2) and immediately post-nephrectomy (∼63 versus 50–51 mL/min/1.73 m2). Similar findings were seen with adjusted total volume and length. Conclusions Larger kidney donors were more likely to achieve an eGFR ≥60 mL/min/1.73 m2 with renal recovery over a shorter duration due to higher pre-donation and initial post-nephrectomy eGFRs. PMID:28638611

  16. Donor human milk banking and the emergence of milk sharing.

    PubMed

    Landers, Susan; Hartmann, Ben T

    2013-02-01

    Donor human milk has emerged as the preferred substrate to feed extremely preterm infants, when mother's own milk is unavailable. This article summarizes the clinical data demonstrating the safety, efficacy, and cost-effectiveness of feeding donor human milk to premature babies. It describes the current state of milk banking in North America, as well as other parts of the world, and the differing criteria for donor selection, current pasteurization techniques, and quality control measures. A risk assessment methodology is proposed, which would allow milk banks globally to assess the safety of their process and respond appropriately to differing risk environments. Copyright © 2013. Published by Elsevier Inc.

  17. Influence of EDC/NHS coupling chemistry on stability and cytotoxicity of ZnO nanoparticles modified with proteins

    NASA Astrophysics Data System (ADS)

    Keleştemur, Seda; Altunbek, Mine; Culha, Mustafa

    2017-05-01

    The toxicity of ZnO nanoparticles (NPs) is a growing concern due to its increasing use in several products including sunscreens, paints, pigments and ceramics for its antibacterial, antifungal, anti-corrosive and UV filtering properties. The toxicity of ZnO NPs is mostly attributed to the Zn2+ release causing an increase in the intracellular reactive oxygen species (ROS) level. The surface modification with a biocompatible ligand or a polymer can be a good strategy to reduce dissolution based toxicity. In two previous studies, the conflicting results with EDC/NHS coupling chemistry for ZnO NPs were reported. In this study, the same surface modification strategy with an emphasis on the stability of ZnO NPs is clarified. First, the density of -OH groups on the ZnO NPs is increased with hydrogen peroxide (H2O2) treatment, and then a silica coating on the ZnO NPs (Si-ZnO) surface is performed. Finally, a covalent attachment of bovine serum albumin (BSA) on three different concentrations of ZnO-Si is carried out by EDC/NHS coupling chemistry. ZnO NPs have a very high dissolution rate under acidic conditions of EDC/NHS coupling chemistry as determined from the ICP-MS analysis. In addition, the amount of ZnO NPs in coupling reaction has an important effect on the dissolution rate of Zn2+ and dependently BSA attached on the ZnO NP surfaces. Finally, the cytotoxicity of the BSA modified Si-ZnO NPs on human lung cancer (A549) and human skin fibroblast (HSF) is evaluated. Although an increased association of BSA modified ZnO NPs with cells was observed, the modification significantly decreased their cytotoxicity. This can be explained with the decreased active surface area of ZnO NPs with the surface modification. However, an increase in the mitochondrial depolarization and ROS production was observed depending on the amount of BSA coverage.

  18. National Marrow Donor Program

    DTIC Science & Technology

    2009-11-04

    7 IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor IIB.3.1 Aim 1 – Phase I of EM Haplotype Logic No Activity 7 IIB.3.2 Aim 2 – Enhancement...Recipient Pair Project Open 9 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD IIC.2.1 Aim 1 – Analysis of Non-HLA Loci Open 10 IIC.2.2 Aim 2 – Related...and haplotype frequencies and on the nuances of HLA typing can be used to design computer algorithms to predict the best matched donor. IIB.3.1 Aim

  19. National Marrow Donor Program

    DTIC Science & Technology

    2009-08-14

    Task 4 – Genotype Lists & Matching Algorithm Open 9 IIB.3 Objective 3 – Algorithm to Predict Best Donor IIB.3 Task 1 – Incorporate Frequencies into...of HLA Mismatches IIC.1 Task 1 – Donor Recipient Pair Project Open 12 IIC.2 Objective 1 – Role of Other Loci and GVHD IIC.2 Task 1 – Analysis...3: Registry data on HLA allele and haplotype frequencies and on the nuances of HLA typing can be used to design computer algorithms to predict the

  20. National Marrow Donor Program

    DTIC Science & Technology

    2009-08-14

    Closed 12 IIB.2 Aim 4 – Genotype Lists & Matching Algorithm No Activity 12 IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor IIB.3 Aim 1 – Phase I...Mismatches IIC.1 Aim 1 – Donor Recipient Pair Project Open 15 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD IIC.2 Aim 1 – Analysis of Non-HLA...potential to type as DRB1*1506 and those where one or both haplotypes could not be predicted were retained for further typing (N=221). National

  1. ODM2CDA and CDA2ODM: tools to convert documentation forms between EDC and EHR systems.

    PubMed

    Dugas, Martin

    2015-05-26

    Clinical trials apply standards approved by regulatory agencies for Electronic Data Capture (EDC). Operational Data Model (ODM) from Clinical Data Interchange Standards Consortium (CDISC) is commonly used. Electronic Health Record (EHR) systems for patient care predominantly apply HL7 standards, specifically Clinical Document Architecture (CDA). In recent years more and more patient data is processed in electronic form. An open source reference implementation was designed and implemented to convert forms between ODM and CDA format. There are limitations of this conversion method due to different scope and design of ODM and CDA. Specifically, CDA has a multi-level hierarchical structure and CDA nodes can contain both XML values and XML attributes. Automated transformation of ODM files to CDA and vice versa is technically feasible in principle.

  2. The process of EDC-NHS cross-linking of reconstituted collagen fibres increases collagen fibrillar order and alignment

    SciTech Connect

    Shepherd, D. V. Shepherd, J. H.; Cameron, R. E.; Best, S. M.; Ghose, S.; Kew, S. J.

    2015-01-01

    We describe the production of collagen fibre bundles through a multi-strand, semi-continuous extrusion process. Cross-linking using an EDC (1-ethyl-3-(3-dimethylaminopropyl)carbodiimide), NHS (N-hydroxysuccinimide) combination was considered. Atomic Force Microscopy and Raman spectroscopy focused on how cross-linking affected the collagen fibrillar structure. In the cross-linked fibres, a clear fibrillar structure comparable to native collagen was observed which was not observed in the non-cross-linked fibre. The amide III doublet in the Raman spectra provided additional evidence of alignment in the cross-linked fibres. Raman spectroscopy also indicated no residual polyethylene glycol (from the fibre forming buffer) or water in any of the fibres.

  3. Preparation of thin film nanofibrous composite NF membrane based on EDC/NHS modified PAN-AA nanofibrous substrate

    NASA Astrophysics Data System (ADS)

    Yang, Y.; Wang, X.; Hsiao, B. S.

    2016-07-01

    A novel kind of thin-film nanofibrous composite (TFNC) nanofiltration (NF) membranes consisting of a polyamide (PA) barrier layer were successfully fabricated by interfacial polymerization (IFP) based on electrospun double-layer nanofibrous substrates, which have an ultrathin poly (acrylonitrile-co-acrylic acid) (PAN-AA) nanofibrous layer as top layer and a thicker polyacrylonitrile (PAN) nanofiber layer as bottom porous support layer. Immersing PAN/PAN-AA nanofibrous substrates into 1-ethyl-(3-3-dimethylaminopropyl) carbodiimide hydrochloride/N-hydroxysuccinimide (EDC/NHS) aqueous solution and piperazine (PIP) aqueous solution (0.20 wt%) sequentially for a period of time, the carboxyl groups on PAN-AA nanofibers were activated by carbodiimide and then reacted with the amide groups. The as prepared composite membrane has an integrated structure with high rejection rate (98.0%); high permeate flux (40.4 L/m2h) for MgSO4 aqueous solution (2 g/L).

  4. Report From the American Society of Transplantation Conference on Donor Heart Selection in Adult Cardiac Transplantation in the United States.

    PubMed

    Kobashigawa, J; Khush, K; Colvin, M; Acker, M; Van Bakel, A; Eisen, H; Naka, Y; Patel, J; Baran, D A; Daun, T; Luu, M; Olymbios, M; Rogers, J; Jeevanandam, V; Esmailian, F; Pagani, F D; Lima, B; Stehlik, J

    2017-10-01

    Cardiac transplantation remains the only definitive treatment for end-stage heart failure. Transplantation rates are limited by a shortage of donor hearts. This shortage is magnified because many hearts are discarded because of strict selection criteria and concern for regulatory reprimand for less-than-optimal posttransplant outcomes. There is no standardized approach to donor selection despite proposals to liberalize acceptance criteria. A donor heart selection conference was organized to facilitate discussion and generate ideas for future research. The event was attended by 66 participants from 41 centers with considerable experience in cardiac donor selection. There were state-of-the-art presentations on donor selection, with subsequent breakout sessions on standardizing the process and increasing utilization of donor hearts. Participants debated misconceptions and established agreement on donor and recipient risk factors for donor selection and identified the components necessary for a future donor risk score. Ideas for future initiatives include modification of regulatory practices to consider extended criteria donors when evaluating outcomes and prospective studies aimed at identifying the factors leading to nonacceptance of available donor hearts. With agreement on the most important donor and recipient risk factors, it is anticipated that a consistent approach to donor selection will improve rates of heart transplantation. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. National Marrow Donor Program

    DTIC Science & Technology

    2011-04-29

    This task is closed. IID.1 Task 3: Expand Immuno- biology Research Period 1 Activity: • No activity this quarter. National Marrow Donor Program...Development Authority IT Information Technology BBMT Biology of Blood and Marrow Transplant IRB Institutional Review Board BCP Business...Stem Cell Transplantation CREG Cross Reactive Groups OCR /ICR Optical Character Recognition/Intelligent Character Recognition CSS Center Support

  6. Living Donor Liver Transplantation

    MedlinePlus

    ... instructions before and after surgery. • Have a compatible blood type. • Have an emotional tie with the recipient. • Not ... test is to find out if the donor's blood type matches the recipient’s blood type. Next, the transplant ...

  7. Dialing for Donors

    ERIC Educational Resources Information Center

    Schaffhauser, Dian

    2012-01-01

    When times get tough, grown children often turn to their parents for help--for some extra cash, even somewhere to stay. For colleges and universities, that role is filled by alumni donors. In 2011, with education budgets slashed across the country, giving accounted for 6.5 percent of college expenditures, according to the Council for Aid to…

  8. Dialing for Donors

    ERIC Educational Resources Information Center

    Schaffhauser, Dian

    2012-01-01

    When times get tough, grown children often turn to their parents for help--for some extra cash, even somewhere to stay. For colleges and universities, that role is filled by alumni donors. In 2011, with education budgets slashed across the country, giving accounted for 6.5 percent of college expenditures, according to the Council for Aid to…

  9. Assessing elements of informed consent among living donors

    PubMed Central

    Valapour, M; Kahn, JP; Bailey, R; Matas, AJ

    2011-01-01

    Living organ donors – 50% of solid organ donors in the United States – represent a unique population who accept medical risk for the benefit of another. One of the main justifications for this practice has been respect for donor autonomy, as realized through informed consent. In this retrospective study of living donors, we investigate 2 key criteria of informed consent: (1) depth of understanding and (2) degree of voluntariness. In our survey of 262 living kidney donors 2 to 40 months post donation, we found that more than 90% understood the effects of living donation on recipient outcomes, the screening process, and the short-term medical risks of donation. In contrast, only 69% understood the psychological risks of donation; 52% the long-term medical risks of donation; and 32%, the financial risks of donation. Understanding the effects of living donation on recipient outcomes was the only factor that would affect donors' decision to donate again. 40% of donors reported feeling some pressure to donate. Donors who are related to the recipient were more likely to report feeling pressure to donate. We conclude that more studies of informed consent are needed to identify factors that may compromise the validity of informed consent. PMID:21158924

  10. Optimized donor management and organ preservation before kidney transplantation.

    PubMed

    Mundt, Heiko M; Yard, Benito A; Krämer, Bernhard K; Benck, Urs; Schnülle, Peter

    2016-09-01

    Kidney transplantation is a major medical improvement for patients with end-stage renal disease, but organ shortage limits its widespread use. As a consequence, the proportion of grafts procured from extended criteria donors (ECD) has increased considerably, but this comes along with increased rates of delayed graft function (DGF) and a higher incidence of immune-mediated rejection that limits organ and patient survival. Furthermore, most grafts are derived from brain dead organ donors, but the unphysiological state of brain death is associated with significant metabolic, hemodynamic, and pro-inflammatory changes, which further compromise patient and graft survival. Thus, donor interventions to preserve graft quality are fundamental to improve long-term transplantation outcome, but interventions must not harm other potentially transplantable grafts. Several donor pretreatment strategies have provided encouraging results in animal models, but evidence from human studies is sparse, as most clinical evidence is derived from single-center or nonrandomized trials. Furthermore, ethical matters have to be considered especially concerning consent from donors, donor families, and transplant recipients to research in the field of donor treatment. This review provides an overview of clinically proven and promising preclinical strategies of donor treatment to optimize long-term results after kidney transplantation. © 2015 Steunstichting ESOT.

  11. USING 1H-NMR METABOLOMICS TO CHARACTERIZE ALTERED METABOLIC PROFILES IN ZEBRAFISH (DANIO RERIO) EXPOSED TO THE MODEL EDCS 17 ALPHA-ETHINYLESTRADIOL (EE2) AND FADROZOLE

    EPA Science Inventory

    Elevated levels of endocrine-disrupting chemicals (EDCs) have been reported in waterways worldwide and have been shown to affect numerous aspects of development, behavior, reproduction, and survival in various fish species. We have examined the effects of the synthetic steroid 17...

  12. 1H-NMR METABOLOMICS ANALYIS OF ZEBRAFISH (DANIO RERIO) EXPOSED TO THE ENVIRONMENTALLY-RELEVANT EDC 17 ALPHA-ETHINYLESTRADIOL (EE2)

    EPA Science Inventory

    Elevated levels of endocrine-disrupting chemicals (EDCs) have been reported in waterways worldwide and have been shown to affect numerous aspects of development, behavior, reproduction, and survival in various fish species. We have examined the effects of the synthetic steroid 1...

  13. 1H-NMR METABOLOMICS ANALYIS OF ZEBRAFISH (DANIO RERIO) EXPOSED TO THE ENVIRONMENTALLY-RELEVANT EDC 17 ALPHA-ETHINYLESTRADIOL (EE2)

    EPA Science Inventory

    Elevated levels of endocrine-disrupting chemicals (EDCs) have been reported in waterways worldwide and have been shown to affect numerous aspects of development, behavior, reproduction, and survival in various fish species. We have examined the effects of the synthetic steroid 1...

  14. Simultaneous determination of PPCPs, EDCs, and artificial sweeteners in environmental water samples using a single-step SPE coupled with HPLC-MS/MS and isotope dilution.

    PubMed

    Tran, Ngoc Han; Hu, Jiangyong; Ong, Say Leong

    2013-09-15

    A high-throughput method for the simultaneous determination of 24 pharmaceuticals and personal care products (PPCPs), endocrine disrupting chemicals (EDCs) and artificial sweeteners (ASs) was developed. The method was based on a single-step solid phase extraction (SPE) coupled with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and isotope dilution. In this study, a single-step SPE procedure was optimized for simultaneous extraction of all target analytes. Good recoveries (≥ 70%) were observed for all target analytes when extraction was performed using Chromabond(®) HR-X (500 mg, 6 mL) cartridges under acidic condition (pH 2). HPLC-MS/MS parameters were optimized for the simultaneous analysis of 24 PPCPs, EDCs and ASs in a single injection. Quantification was performed by using 13 isotopically labeled internal standards (ILIS), which allows correcting efficiently the loss of the analytes during SPE procedure, matrix effects during HPLC-MS/MS and fluctuation in MS/MS signal intensity due to instrument. Method quantification limit (MQL) for most of the target analytes was below 10 ng/L in all water samples. The method was successfully applied for the simultaneous determination of PPCPs, EDCs and ASs in raw wastewater, surface water and groundwater samples collected in a local catchment area in Singapore. In conclusion, the developed method provided a valuable tool for investigating the occurrence, behavior, transport, and the fate of PPCPs, EDCs and ASs in the aquatic environment.

  15. USING 1H-NMR METABOLOMICS TO CHARACTERIZE ALTERED METABOLIC PROFILES IN ZEBRAFISH (DANIO RERIO) EXPOSED TO THE MODEL EDCS 17 ALPHA-ETHINYLESTRADIOL (EE2) AND FADROZOLE

    EPA Science Inventory

    Elevated levels of endocrine-disrupting chemicals (EDCs) have been reported in waterways worldwide and have been shown to affect numerous aspects of development, behavior, reproduction, and survival in various fish species. We have examined the effects of the synthetic steroid 17...

  16. Possible strategies for EDC testing in the future: exploring roles of pathway-based in silico, in vitro and in vivo methods

    EPA Science Inventory

    Current methods for screening, testing and monitoring endocrine-disrupting chemicals (EDCs) rely relatively substantially upon moderate- to long-term assays that can, in some instances, require significant numbers of animals. Recent developments in the areas of in vitro testing...

  17. Possible strategies for EDC testing in the future: exploring roles of pathway-based in silico, in vitro and in vivo methods

    EPA Science Inventory

    Current methods for screening, testing and monitoring endocrine-disrupting chemicals (EDCs) rely relatively substantially upon moderate- to long-term assays that can, in some instances, require significant numbers of animals. Recent developments in the areas of in vitro testing...

  18. Construction of amphiphilic segments on polypropylene nonwoven surface and its application in removal of endocrine disrupting compounds (EDCs) from aqueous solution

    NASA Astrophysics Data System (ADS)

    Liu, Kai; Wei, Junfu; Zhou, Xiangyu; Liu, Nana

    2015-05-01

    The amphiphilic segments on polypropylene nonwoven (PP nonwoven) surface were constructed using the ultraviolet (UV) irradiation graft polymerization for the removal of endocrine disrupting compounds (EDCs) with different polarity from aqueous solution. The stearyl acrylate (SA) as hydrophobic functional monomer was introduced onto the surface of PP nonwoven fabric at first stage and then the hydroxyethyl acrylate (HEA) as hydrophilic functional monomer was introduced subsequently. The effect of functional monomer concentration and UV irradiation time on grafting ratio was studied and discussed. The novel amphiphilic structure was designed and constructed based on adsorption capacity for the target micropollutants. The structure and composition of the amphiphilic adsorption materials were characterized by Fourier transform infrared spectrometer (FTIR), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and contact angle (CA). The adsorption behaviors for EDCs of the amphiphilic adsorption materials were studied and the results indicated that the adsorption capacity and adsorption rate were superior to single SA grafted PP nonwoven (PP-g-SA) and single HEA grafted PP nonwoven (PP-g-HEA). The novel amphiphilic adsorption material was efficient for the removal of EDCs with different polarity and could be utilized as a potential adsorption material for removing EDCs from aqueous solution.

  19. Evaluating deceased donor registries: identifying predictive factors of donor designation.

    PubMed

    Hajhosseini, Babak; Stewart, Bryan; Tan, Jane C; Busque, Stephan; Melcher, Marc L

    2013-03-01

    The objectives of this study were to evaluate and compare the performance of the deceased donor registries of the 50 states and the District of Columbia and to identify possible predictive factors of donor designation. Data were collected retrospectively by Donate Life America using a questionnaire sent to Donor Designation Collaborative state teams between 2007 and 2010. By the end of 2010, there were 94,669,081 designated donors nationwide. This accounted for 39.8 per cent of the U.S. population aged 18 years and over. The number of designated organ donors and registry-authorized recovered donors increased each year; however, the total number of recovered donors in 2010 was the lowest since 2004. Donor designation rate was significantly higher when license applicants were verbally questioned at the Department of Motor Vehicles (DMV) regarding their willingness to register as a donor and when DMV applicants were not given an option on DMV application forms to contribute money to support organ donation, compared with not being questioned verbally, and being offered an option to contribute money. State registries continue to increase the total number of designated organ donors; however, the current availability of organs remains insufficient to meet the demand. These data suggest that DMV applicants who are approached verbally regarding their willingness to register as a donor and not given an option on DMV application forms to contribute money to support organ donation might be more likely to designate themselves to be a donor.

  20. Potential impact on blood availability and donor iron status of changes to donor hemoglobin cutoff and interdonation intervals.

    PubMed

    Spencer, Bryan R; Johnson, Bryce; Wright, David J; Kleinman, Steven; Glynn, Simone A; Cable, Ritchard G

    2016-08-01

    A minimum male hemoglobin (Hb) level of 13.0 g/dL becomes a Food and Drug Administration requirement effective May 2016. In addition, extending whole blood (WB) interdonation intervals (IDIs) beyond 8 weeks has been considered to reduce iron depletion in repeat blood donors. This study estimates the impact these changes might have on blood availability and donor iron status. Six blood centers participating in Retrovirus Epidemiology Donor Study-II (REDS-II) collected information on all donation visits from 2006 to 2009. Simulations were developed from these data using a multistage approach that first sought to adequately reproduce the patterns of donor return, Hb and ferritin levels, and outcomes of a donor's visit (successful single- or double-red blood cell donation, deferral for low Hb) observed in REDS-II data sets. Modified simulations were used to predict the potential impact on the blood supply and donor iron status under different Hb cutoff and IDI qualification criteria. More than 10% of WB donations might require replacement under many simulated scenarios. Longer IDIs would reduce the proportion of donors with iron depletion, but 80% of these donors may remain iron-depleted if minimal IDIs increased to 12 or 16 weeks. Higher Hb cutoffs and longer IDIs are predicted to have a potentially large impact on collections but only a modest impact on donor iron depletion. Efforts to address iron depletion should be targeted to at-risk donors, such as iron supplementation programs for frequent donors, and policy makers should try to avoid broadly restrictive donation requirements that could substantially reduce blood availability. © 2016 AABB.

  1. Evaluation of living liver donors.

    PubMed

    Rudow, Dianne LaPointe; Brown, Robert S

    2003-06-01

    As a result of the cadaveric organ shortage, the number of centers performing living donor liver transplantation has increased. Living donor liver transplantation provides immediate organ availability and avoids the risk of life-threatening complications that occur with long waiting times for cadaveric organs; however, it puts a healthy person at risk for little personal gain. A standardized approach to donor evaluation ensures safety to potential donors. Careful medical (physical examination as well as laboratory and radiological evaluation) and psychological evaluation is imperative to reduce donor complications and ensure good outcomes in recipients. A social worker and psychiatrist assess for mental competency, provide emotional support, and can serve as independent donor advocates. Informed understanding and consent are crucial aspects of the evaluation and include ensuring that the donor understands all potential complications and is free of coercion. Safety of the donor must be the highest priority.

  2. Being a Living Donor: Risks

    MedlinePlus

    ... Living Donation / Being a Living Donor / Risks Facts History Organs Frequently Asked Questions Discussing Living Donation Types Related Non-Related Non-Directed Paired Donation Blood Type Incompatible Positive Crossmatch Being a Living Donor ...

  3. Selecting the best haploidentical donor.

    PubMed

    McCurdy, Shannon R; Fuchs, Ephraim J

    2016-10-01

    The substantial evidence of the safety of human leukocyte antigen (HLA)-haploidentical (haplo) blood or marrow transplantation (BMT) has led to its increasing utilization. When prioritizing HLA-matched grafts, patients frequently have few or no donors from whom to choose. However, a given patient may have multiple suitable haplo donors. Therefore factors other than HLA-match become critical for selecting the best donor. We recommend a donor selection algorithm based on the donor-specific antibodies, ABO match, donor age, donor sex, and cytomegalovirus (CMV) serostatus match. Despite provocative initial evidence, further studies are warranted to determine whether there is any benefit to selecting a haplo donor based on the number of HLA-mismatches, natural killer cell alloreactivity, or the presence of non-inherited maternal HLA antigens. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The S. pombe mRNA decapping complex recruits cofactors and an Edc1-like activator through a single dynamic surface

    PubMed Central

    Wurm, Jan Philip; Overbeck, Jan; Sprangers, Remco

    2016-01-01

    The removal of the 5′ 7-methylguanosine mRNA cap structure (decapping) is a central step in the 5′–3′ mRNA degradation pathway and is performed by the Dcp1:Dcp2 decapping complex. The activity of this complex is tightly regulated to prevent premature degradation of the transcript. Here, we establish that the aromatic groove of the EVH1 domain of Schizosaccharomyces pombe Dcp1 can interact with proline-rich sequences in the exonuclease Xrn1, the scaffolding protein Pat1, the helicase Dhh1, and the C-terminal disordered region of Dcp2. We show that this region of Dcp1 can also recruit a previously unidentified enhancer of decapping protein (Edc1) and solved the crystal structure of the complex. NMR relaxation dispersion experiments reveal that the Dcp1 binding site can adopt multiple conformations, thus providing the plasticity that is required to accommodate different ligands. We show that the activator Edc1 makes additional contacts with the regulatory domain of Dcp2 and that an activation motif in Edc1 increases the RNA affinity of Dcp1:Dcp2. Our data support a model where Edc1 stabilizes the RNA in the active site, which results in enhanced decapping rates. In summary, we show that multiple decapping factors, including the Dcp2 C-terminal region, compete with Edc1 for Dcp1 binding. Our data thus reveal a network of interactions that can fine-tune the catalytic activity of the decapping complex. PMID:27354705

  5. Recruitment of prospective donors: what do they expect from a homepage of a blood transfusion service?

    PubMed

    Moog, R; Fourné, K

    2007-08-01

    In times of shrinking donor population, the recruitment of donors is of utmost importance. Recruitment can be done by personal communication, advertisement/information, classical mass media (newspaper, radio, TV) or new computerized media. The aim of this study was to gain information about the donors' demands of an Internet presentation of a blood transfusion service. Between October and December 2004 inclusive, prospective donors were asked to complete a survey about the impact of Internet information for blood donors. The survey contained questions measuring demographics, education and motivation for blood donation. In addition, the survey included questions that measured Internet access, duration of online time and donors' demands for an Internet presentation of a blood transfusion service. Donors were asked to tick a box with predefined answers. In cases where no options were applied, donors were requested to specify their answers. One hundred and fourteen prospective donors (71 female, 43 male) with a median age of 25 years (range 18-57 years) completed the survey. Most donors (57.9%) were 18-30 years old. Forty-two (36.8%) of the surveyed donors were repeat donors, whereas 72 (63.2%) were first-time donors. The majority of donors were informed about blood donation from relatives or friends (70.7% repeat donors and 67.7% first-time donors). Most of them had Internet access (85.7% repeat donors and 90.3% first-time donors). Exclusive use of private access was more often reported in repeat donors (77.8%), whereas both private and professional access was more frequently used in first-time donors (32.3%). Most donors used the Internet access daily, followed by weekly and monthly use. Multiple answers were given about the importance of desired information about the topic 'blood donation'. Both first-time and repeat donors wanted to be informed about organizational details of blood donation such as opening times, eligibility criteria, donation process and the kind

  6. National Marrow Donor Program

    DTIC Science & Technology

    2008-08-05

    Information Report • Added additional tests: Chagas (screening) and Chagas (confirmatory), along with their results and test dates performed • Revisions...Disease Marker screen and Cord Information (Detailed and Summary) and Cord Lab Summary Reports o The Chagas EIA test text was changed to Chagas (screening...o The RIPA (confirmatory) test was changed to Chagas (confirmatory) National Marrow Donor Program® N000014-08-1-0058 QUARTER PROGRESS REPORT

  7. Complications of donor apheresis.

    PubMed

    Winters, Jeffrey L

    2006-07-01

    A decreasing blood donor pool in the presence of increasing blood transfusion demands has resulted in the need to maximally utilize each blood donor. This has led to a trend in the increasing use of automated blood collections. While apheresis donation shares many reactions and injuries with whole blood donation, because of the differences, unique complications also exist. Overall, evidence in the literature suggests that the frequency of reactions to apheresis donation is less than that seen in whole blood donation, though the risk of reactions requiring hospitalization is substantially greater. The most common apheresis-specific reaction is hypocalcemia due to citrate anticoagulation, which, while usually mild, has the potential for severely injuring the donor. Other reactions to apheresis donation are uncommon (e.g., hypotension) or rare (e.g., air embolism). More worrisome, and in need of additional study, are the long-term effects of apheresis donation. Recent evidence suggests that repeated apheresis platelet donations may adversely effect thrombopoiesis as well as bone mineralization. Granulocyte donation has also been implicated in unexpected long-term consequences.

  8. Potential donor segregation to promote blood donation.

    PubMed

    Martín-Santana, Josefa D; Beerli-Palacio, Asunción

    2008-04-01

    This work is set in the field of social marketing and more specifically in the context of blood donation. Its principal objective focuses on segregating potential donors by using the inhibitors or barriers to a blood donation behaviour as criteria. Moreover, an analysis of the predisposition to donate blood, the intrinsic and extrinsic motivations for donating blood, and the incentives that may stimulate their donation conduct was conducted for each of the four identified groups. The results reveal that the four segments differ significantly in their predisposition to donate, in their motivations and in the incentives that encourage them to donate blood.

  9. Donor acute kidney injury and short-term graft outcome in renal transplantation.

    PubMed

    Jacobi, Johannes; Rebhan, Dirk; Heller, Katharina; Velden, Joachim; Hilgers, Karl F; Wullich, Bernd; Eckardt, Kai-Uwe; Amann, Kerstin U

    2014-10-01

    With increased waiting times for kidney transplantation, marginal organs from expanded criteria donors (ECD) are increasingly offered for allocation. In addition to ECD status, donors may have suffered from acute kidney injury (AKI) prior to organ procurement. In this retrospective cohort study, we studied short-term allograft function in 517 kidney transplants performed between the years 2008-2014. Recipients of allografts from deceased organ donors were categorized as standard criteria donors (SCD) or ECD with or without AKI defined by RIFLE criteria. Of 382 deceased donations, 174 (45.5%) were classified as ECD and 63 (16.5%) fulfilled AKI criteria. Donor creatinine on hospital admission was similar, whereas creatinine before organ procurement differed (p < 0.001). Despite these differences, serum creatinine and eGFR at discharge and after one yr showed only minor differences between kidneys with or without AKI. In multivariate linear regression analyses, donor AKI was not a predictor of one-yr allograft function. Given the poor prognosis of dialysis patients and the increase in waiting time, kidneys from SCD and ECD donors with AKI should be allocated for transplantation. In case of ECD donors with AKI, recipients should be informed about the possibility of permanent non-function or early graft loss. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Frequency of West Nile Virus Infection in Iranian Blood Donors.

    PubMed

    Aghaie, Afsaneh; Aaskov, John; Chinikar, Sadegh; Niedrig, Matthias; Banazadeh, Soudabeh; Mohammadpour, Hashem Khorsand

    2016-09-01

    West Nile virus (WNV) can be transmitted by blood transfusions and organ transplants. This study was a retrospective study which was performed in Blood Transfusion Center to evaluate the WNV infection in blood donors in Iran. A total of 540 blood samples were taken from volunteer healthy donors who referred for blood donation to Chabahar Blood Center. The presence of WNV was studied by detecting immunoglobulin G (IgG) WNV by enzyme linked immune sorbent assay (ELISA). Demonstration of elevated WNV IgG confirmed by immunoflouorescence assay (IFA) Euroimmun kit. Out of the 540 samples 17.96 % (97 cases) were seropositive by ELISA and 1.48 % (8 cases) was seropositive by IFA. This means that 8.24 % of ELISA seropositive samples were confirmed by IFA. Special attention should be paid to criteria of donor selection, albeit positive results may be due to a previous infection in these donors.

  11. Preparation and properties of EDC/NHS mediated crosslinking poly (gamma-glutamic acid)/epsilon-polylysine hydrogels.

    PubMed

    Hua, Jiachuan; Li, Zheng; Xia, Wen; Yang, Ning; Gong, Jixian; Zhang, Jianfei; Qiao, Changsheng

    2016-04-01

    In this paper, a novel pH-sensitive poly (amino acid) hydrogel based on poly γ-glutamic acid (γ-PGA) and ε-polylysine (ε-PL) was prepared by carbodiimide (EDC) and N-hydroxysuccinimide (NHS) mediated polymerization. The influence of PGA/PL molar ratio and EDC/NHS concentration on the structure and properties was studied. Fourier transform infrared spectroscopy (FT-IR) and X-ray photoelectron spectroscopy (XPS) proved that hydrogels were crosslinked through amide bond linkage, and the conversion rate of a carboxyl group could reach 96%. Scanning electron microscopy (SEM) results showed a regularly porous structure with 20 μm pore size in average. The gelation time in the crosslink process of PGA/PL hydrogels was within less than 5 min. PGA/PL hydrogels had excellent optical performance that was evaluated by a novel optotype method. Furthermore, PGA/PL hydrogels were found to be pH-sensitive, which could be adjusted to the pH of swelling media intelligently. The terminal pH of swelling medium could be controlled at 5 ± 1 after equilibrium when the initial pH was within 3-11. The swelling kinetics was found to follow a Voigt model in deionized water but a pseudo-second-order model in normal saline and phosphate buffer solution, respectively. The differential swelling degrees were attributed to the swelling theory based on the different ratio of -COOH/-NH2 and pore size in hydrogels. The results of mechanical property indicated that PGA/PL hydrogels were soft and elastic. Moreover, PGA/PL hydrogels exhibited excellent biocompatibility by cell proliferation experiment. PGA/PL hydrogels could be degraded in PBS solution and the degradation rate was decreased with the increase of the molar ratio of PL. Considering the simple preparation process and pH-sensitive property, these PGA/PL hydrogels might have high potential for use in medical and clinical fields. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Chloride, nitrate and sulphate high resolution records for the last two glacial-interglacial cycles from EDC ice core.

    NASA Astrophysics Data System (ADS)

    Migliori, A.; Becagli, S.; Benassai, S.; Castellano, E.; Severi, M.; Traversi, R.; Udisti, R.

    2003-04-01

    During the 2001/2002 Antarctic campaign, in field Fast Ion Chromatographic analysis was continued on the EPICA Dome C ice core (EDC) yielding chloride, nitrate and sulphate high-resolution records up to 2160 m depth. This depth interval is supposed to cover the last two glacial/interglacial cycles. Since EDC isotopic measurements are in progress at present, chemical profiles were compared with deuterium profile from Vostok ice core, aiming to study the relationship between climatic and environmental changes. All the components show lower and rather constant background levels over the two interglacial periods (Holocene and Eemian) with respect to glacial ones. Sulphate background profile, perturbed by a large number of volcanic spikes, shows a little sensitivity to glacial/interglacial climatic changes. Since the variations of the sulphate concentration are similar in extent to the estimated snow accumulation changes, this component does not seem to be affected by significant changes in source intensity and transport efficiency during the different climatic periods. Chloride and nitrate concentration profiles exhibit a higher variability along the ice core, with very low and stable interglacial values and high and noisy glacial levels. By comparing the Vostok deuterium profile in the last glacial period, where the temporal resolution of isotopic measurement is particularly high, a good correspondence between chloride maxima and deuterium minima can be observed, even for short-term variations. Both environmental variations and glaciological features can modulate the response of chloride to the temperature changes. Indeed, post-depositional effects through HCl re-emission into the atmosphere heavily affect chloride. Its persistence in the snow layers is therefore related to snow accumulation rate and snow acidity. In cold periods, despite the lower accumulation rate, the higher alkaline dust atmospheric load is able to fix higher chloride snow concentration preventing

  13. Living kidney donor follow-up: state-of-the-art and future directions, conference summary and recommendations.

    PubMed

    Leichtman, Alan; Abecassis, Michael; Barr, Mark; Charlton, Marian; Cohen, David; Confer, Dennis; Cooper, Mathew; Danovitch, Gabriel; Davis, Connie; Delmonico, Francis; Dew, Mary Amanda; Garvey, Cathy; Gaston, Robert; Gill, John; Gillespie, Brenda; Ibrahim, Hassan; Jacobs, Cheryl; Kahn, Jeffery; Kasiske, Bert; Kim, Joseph; Lentine, Krista; Manyalich, Marti; Medina-Pestana, Jose; Merion, Robert; Moxey-Mims, Marva; Odim, Jonah; Opelz, Gerhard; Orlowski, Janice; Rizvi, Abid; Roberts, John; Segev, Dorry; Sledge, Tina; Steiner, Robert; Taler, Sandra; Textor, Steven; Thiel, Gil; Waterman, Amy; Williams, Errol; Wolfe, Robert; Wynn, James; Matas, Arthur J

    2011-12-01

    In light of continued uncertainty regarding postkidney donation medical, psychosocial and socioeconomic outcomes for traditional living donors and especially for donors meeting more relaxed acceptance criteria, a meeting was held in September 2010 to (1) review limitations of existing data on outcomes of living kidney donors; (2) assess and define the need for long-term follow-up of living kidney donors; (3) identify the potential system requirements, infrastructure and costs of long-term follow-up for living kidney donor outcomes in the United States and (4) explore practical options for future development and funding of United States living kidney donor data collection, metrics and endpoints. Conference participants included prior kidney donors, physicians, surgeons, medical ethicists, social scientists, donor coordinators, social workers, independent donor advocates and representatives of payer organizations and the federal government. The findings and recommendations generated at this meeting are presented.

  14. Identifying potential kidney donors using social networking web sites.

    PubMed

    Chang, Alexander; Anderson, Emily E; Turner, Hang T; Shoham, David; Hou, Susan H; Grams, Morgan

    2013-01-01

    Social networking sites like Facebook may be a powerful tool for increasing rates of live kidney donation. They allow for wide dissemination of information and discussion and could lessen anxiety associated with a face-to-face request for donation. However, sparse data exist on the use of social media for this purpose. We searched Facebook, the most popular social networking site, for publicly available English-language pages seeking kidney donors for a specific individual, abstracting information on the potential recipient, characteristics of the page itself, and whether potential donors were tested. In the 91 pages meeting inclusion criteria, the mean age of potential recipients was 37 (range: 2-69); 88% were US residents. Other posted information included the individual's photograph (76%), blood type (64%), cause of kidney disease (43%), and location (71%). Thirty-two percent of pages reported having potential donors tested, and 10% reported receiving a live-donor kidney transplant. Those reporting donor testing shared more potential recipient characteristics, provided more information about transplantation, and had higher page traffic. Facebook is already being used to identify potential kidney donors. Future studies should focus on how to safely, ethically, and effectively use social networking sites to inform potential donors and potentially expand live kidney donation.

  15. Lung transplantation with lungs from older donors: recipient and surgical factors affect outcomes.

    PubMed

    Shigemura, Norihisa; Horai, Tetsuya; Bhama, Jay K; D'Cunha, Jonathan; Zaldonis, Diana; Toyoda, Yoshiya; Pilewski, Joseph M; Luketich, James D; Bermudez, Christian A

    2014-10-27

    A shortage of donors has compelled the use of extended-criteria donor organs in lung transplantation. The purpose of this study was to evaluate the impact of using older donors on outcomes after lung transplantation using current protocols. From January 2003 to August 2009, 593 lung transplants were performed at our institution. We compared 87 patients (14.7%) who received lungs from donors aged 55 years or older with 506 patients who received lungs from donors less than 55 years old. We also examined risk factors for mortality in recipients of lungs from older donors. The incidence of major complications including severe primary graft dysfunction and early mortality rates were similar between the groups. However, posttransplant peak FEV1 was lower in the patients who received lungs from older donors (71.7% vs. 80.7%, P<0.05). In multivariate analysis, recipient pulmonary hypertension (transpulmonary pressure gradient >20 mm Hg) and prolonged intraoperative cardiopulmonary bypass were significant risk factors for mortality in the recipients of lungs from older donors. This large, single-center experience demonstrated that transplanting lungs from donors older than 55 years did not yield worse short- or long-term outcomes as compared with transplanting lungs from younger donors. However, transplanting lungs from older donors into recipients with pulmonary hypertension or recipients who required prolonged cardiopulmonary bypass increased the risk for mortality. Although lungs from older donors should not be excluded because of donor age alone, surgeons should carefully consider their patient selection criteria and surgical plans when transplanting lungs from older donors.

  16. Rejection of pharmaceuticals and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs) by low pressure reverse osmosis membranes.

    PubMed

    Ozaki, H; Ikejima, N; Shimizu, Y; Fukami, K; Taniguchi, S; Takanami, R; Giri, R R; Matsui, S

    2008-01-01

    This paper aims to elucidate retention characteristics of some pharmaceuticals and personal care products (PPCPs), and endocrine disrupting chemicals (EDCs), by two polyamide low pressure reverse osmosis (LPRO) membranes. Feed solution pH did not have an influence on rejections of undissociated solutes, which was most likely governed by adsorption, size exclusion and diffusion simultaneously. Size exclusion was presumably dominant, especially with tight membranes (UTC-70U). Rejections of the solutes with low dipole moment (<1.0 debye) decreased with increasing octanol-water partition coefficient (K(ow)). The solutes with large K(ow) values were most likely adsorbed on membrane and subsequently passed through it resulting in larger diffusion coefficient (D(p)). The rejections decreased with increasing D(p) values irrespective of their dipole moments. Rejections of solutes with comparatively larger dipole moments might be dominated by diffusion and/or convection rather than their hydrophobicity. However, rejections of solutes with hydroxyl and carboxyl functional groups by UTC-60 increased with solution pH. More than 80% rejections were obtained for degree of dissociation (alpha)>0.5. Electrostatic repulsion played a key role for rejection of dissociated solutes, especially by loose LPRO membranes. Therefore, assessing the dissociation degree at desired pH values can be a key step to obtain an insight of rejection mechanisms by polyamide membranes. (c) IWA Publishing 2008.

  17. Charlotte - EDC Evaluation and Demonstration (CEED) Human-in-the-Loop Results Briefing to ATD-2 FAA Partners

    NASA Technical Reports Server (NTRS)

    Chevalley, Eric

    2016-01-01

    The Charlotte EDC Evaluation and Demonstration (CEED) was the first Human-In-The-Loop experiment under the Air Traffic Management Technology Demonstration-2 (ATD-2) project. The purpose of the study was fourfold: 1) to establish a simulation environment (Charlotte) for airspace operations for ATD-2 technology, 2) to simulate current-day departures and arrival operations, 3) to assess the impact of current Traffic Management Initiatives (TMI) on Charlotte (CLT) departure flows and en route operations in Washington (ZDC) and Atlanta Centers (ZTL), and 4) to assess the impact of departure takeoff time compliance on airspace operations. The experimental design compared 3 TMIs and 2 compliance levels. Fourteen FAA retired controllers participated in the simulation. In addition, two Traffic Management Coordinators from ZTL and ZDC managed traffic flows. Surface and airborne delays, control efficiency, throughput, realism, workload, and acceptability were assessed and will be compared across the experimental conditions. Participants rated the simulation as very realistic. Results indicate that different TMIs have different impacts on surface and airspace delay. Departure compliance indicates partial benefits to sector complexity and controller workload. This simulation will provide an initial assessment of the tactical scheduling problems that the ATD-2 technology will address in the near term.

  18. Recommendations for use of marginal donors in heart transplantation: Brazilian Association of Organs Transplantation guideline.

    PubMed

    Fiorelli, A I; Stolf, N A G; Pego-Fernandes, P M; Oliveira Junior, J L; Santos, R H B; Contreras, C A M; Filho, D D L; Dinkhuysen, J J; Moreira, M C V; Mejia, J A C; Castro, M C R

    2011-01-01

    The high prevalence of heart failure has increased the candidate list for heart transplantation; however, there is a shortage of viable donated organs, which is responsible for the high mortality of patients awaiting a transplantation. Because the marginal donor presents additional risk factors, it is not considered to be an ideal donor. The use of a marginal donor is only justified in situations when the risk of patient death due to heart disease is greater than that offered by the donor. These recommendations sought to expand the supply of donors, consequently increasing the transplant rate. We selected articles based on robust evidence to provide a substratum to develop recommendations for donors who exceed the traditional acceptance criteria. Recipient survival in the immediate postoperative period is intimately linked to allograft quality. Primary allograft failure is responsible for 38% to 40% of immediate deaths after heart transplantation: therefore; marginal donor selection must be more rigorous to not increase the surgical risk. The main donor risk factors with the respective evidence levels are: cancer in the donor (B), female donor (B), donor death due to hemorrhagic stroke (B), donor age above 50 years (relative risk [RR] = 1.5) (B), weight mismatch between donor and recipient < 0.8 (RR = 1.3) (B), ischemia > 240 minutes (RR = 1.2) (B), left ventricular dysfunction with ejection fraction below 45% (B), and use of high doses of vasoactive drugs (dopamine > 15 mg/kg·min) (B). Factors that impact recipient mortality are: age over 50 years (RR = 1.5); allograft harvest at a distance; adult recipient weighing more than 20% of the donor; high doses of vasoactive drugs (dopamine greater than 15 mg/kg·min) and ischemic time >4 hours. The use of a marginal donor is only justified when it is able to increase life expectancy compared with clinical treatment, albeit the outcomes are interior to those using an ideal donor.

  19. Deceased donor kidney transplantation from donors with acute renal failure due to rhabdomyolysis.

    PubMed

    Mekeel, K L; Moss, A A; Mulligan, D C; Chakkera, H A; Hamawi, K; Mazur, M J; Heilman, R L; Reddy, K S

    2009-07-01

    With the current shortage of solid organs for transplant, the transplant community continues to look for ways to increase the number of organ donors, including extending the criteria for donation. In rhabdomyolysis, the byproducts of skeletal muscle breakdown leak into the circulation resulting in acute renal failure in up to 30% of patients. In nonbrain dead patients, this condition is reversible and most patients recover full renal function. Seven potential donors had rhabdomyolysis with acute renal failure as evidenced by the presence of urine hemoglobin, plasma creatinine kinase levels of greater than five times the normal and elevated creatinine. One donor required dialysis. At our institution, 10 kidneys were transplanted from the seven donors. Two grafts had immediate function, five grafts experienced slow graft function and three grafts had delayed graft function requiring hemodialysis. At a mean of 8.7 months posttransplant (2.4-25.2 months), all patients have good graft function, are off dialysis and have a mean creatinine of 1.3 (0.7-1.8). In conclusion, our experience suggests that rhabdomyolysis with acute renal failure should not be a contraindication for donation, although recipients may experience slow or delayed graft function.

  20. Integrated testing of an electrochemical depolarized CO2 concentrator /EDC/ and a Bosch CO2 reduction subsystem /BRS/. [in spaceborne oxygen reclamation system

    NASA Technical Reports Server (NTRS)

    Schubert, F. H.; Clark, D. C.; Quattrone, P. D.

    1976-01-01

    An oxygen reclamation system (ORS) in a spacecraft has the task to revitalize the spacecraft atmosphere by recovering the elementary oxygen from metabolically produced carbon dioxide and water vapor. Life support subsystems which can form such an ORS are an electrochemical depolarized carbon dioxide concentrator (EDC), a Bosch carbon dioxide reduction subsystem (BRS), and an oxygen generation subsystem (OGS). A total recovery of the oxygen from metabolically generated carbon dioxide can be obtained with the aid of system composed of the considered three subsystems. Attention is given to the control concept which assures an integrated operation of the EDC, BRS, and OGS. A description is presented of the test results obtained during 86 days of testing.

  1. Short- and long-term temporal changes in soil concentrations of selected endocrine disrupting compounds (EDCs) following single or multiple applications of sewage sludge to pastures.

    PubMed

    Rhind, S M; Kyle, C E; Ruffie, H; Calmettes, E; Osprey, M; Zhang, Z L; Hamilton, D; McKenzie, C

    2013-10-01

    Temporal changes in soil burdens of selected endocrine disrupting compounds were determined following application to pasture of either sewage sludge or inorganic fertilizer. Soil polycyclic aromatic hydrocarbon and polychlorinated biphenyl concentrations were not altered. Changes in concentrations of diethylhexyl phthalate (DEHP) and PBDEs 47 and 99 differed with season but concentrations remained elevated for more than three weeks after application, when grazing animals are normally excluded from pasture. It is concluded that single applications of sewage sludge can increase soil concentrations of some, but not all classes of EDCs, possibly to concentrations sufficient to exert biological effects when different chemicals act in combination, but patterns of change depend on season and soil temperature. Analysis of soil from pasture subjected to repeated sludge applications, over 13 years, provided preliminary evidence of greater increases in soil burdens of all of the EDC groups measured, including all of the PBDE congeners measured. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Knee donor-site morbidity after mosaicplasty - a systematic review.

    PubMed

    Andrade, Renato; Vasta, Sebastiano; Pereira, Rogério; Pereira, Hélder; Papalia, Rocco; Karahan, Mustafa; Oliveira, J Miguel; Reis, Rui L; Espregueira-Mendes, João

    2016-12-01

    Mosaicplasty has been associated with good short- to long-term results. Nevertheless, the osteochondral harvesting is restricted to the donor-site area available and it may lead to significant donor-site morbidity. Provide an overview of donor-site morbidity associated with harvesting of osteochondral plugs from the knee joint in mosaicplasty procedure. Comprehensive search using Pubmed, Cochrane Library, SPORTDiscus and CINAHL databases was carried out through 10(th) October of 2016. As inclusion criteria, all English-language studies that assessed the knee donor-site morbidity after mosaicplasty were accepted. The outcomes were the description and rate of knee donor-site morbidity, sample's and cartilage defect's characterization and mosaicplasty-related features. Correlation between mosaicplasty features and rate of morbidity was performed. The methodological and reporting quality were assessed according to Coleman's methodology score. Twenty-one studies were included, comprising a total of 1726 patients, with 1473 and 268 knee and ankle cartilage defects were included. The defect size ranged from 0.85 cm(2) to 4.9 cm(2) and most commonly 3 or less plugs (averaging 2.9 to 9.4 mm) were used. Donor-site for osteochondral harvesting included margins of the femoral trochlea (condyles), intercondylar notch, patellofemoral joint and upper tibio-fibular joint. Mean donor-site morbidity was 5.9 % and 19.6 % for knee and ankle mosaicplasty procedures, respectively. Concerning knee-to-knee mosaicplasty procedures, the most common donor-site morbidity complaints were patellofemoral disturbances (22 %) and crepitation (31 %), and in knee-to-ankle procedures there was a clear tendency for pain or instability during daily living or sports activities (44 %), followed by patellofemoral disturbances, knee stiffness and persistent pain (13 % each). There was no significant correlation between rate of donor-site morbidity and size of the defect, number and size of the

  3. [Psychosomatic selection of living liver donors].

    PubMed

    Erim, Y; Senf, W

    2001-01-01

    In the Essen University Clinic for Psychotherapy and Psychosomatics, between January and December 2000, 54 potential liver donors and 12 kidney donors were examined. All the kidney donors were found to be suitable; 7 potential liver donors were rejected on psychosomatic grounds. Reasons for the rejection were addiction (1 donor), suspected financial dependency of the donor on the recipient (1 donor) and, in the case of one donor not related to the recipient, the apparent lack of a special emotional attachment. During the actual evaluation interview, 4 potential donors reversed their original decision. Such a psychosomatic evaluation is a great help for donors in clarifying their motives and their decision.

  4. Shifting paradigms in eligibility criteria for live kidney donation: a systematic review.

    PubMed

    Ahmadi, Ali R; Lafranca, Jeffrey A; Claessens, Laura A; Imamdi, Raoul M S; IJzermans, Jan N M; Betjes, Michiel G H; Dor, Frank J M F

    2015-01-01

    As the organ shortage increases, inherently the demand for donor kidneys continues to rise. Thus, live kidney donation is essential for increasing the donor pool. In order to create successful expansion, extended criteria live kidney donors should be considered. This review combines current guidelines with all available literature in this field, trying to seek and establish the optimal extended criteria. Comprehensive searches were carried out in major databases until November 2013 to search for articles regarding older age, overweight and obesity, hypertension, vascular anomalies/multiplicity, nulliparous women, and minors as donors. Of the 2079 articles found, 152 fell within the scope of the review. Five major guidelines were included and reviewed. Based on the literature search, live kidney donation in older donors (up to 70 years of age) seems to be safe as outcome is comparable to younger donors. Obese donors have comparable outcome to lean donors, in short- and mid-term follow-up. Since little literature is available proving the safety of donation of hypertensive donors, caution is advised. Vascular multiplicity poses no direct danger to the donor and women of childbearing age can be safely included as donors. Although outcome after donation in minors is shown to be comparable to adult donors, they should only be considered if no other options exist. We conclude that the analyzed factors above should not be considered as absolute contraindications for donation.

  5. A perspective on the selection of unrelated donors and cord blood units for transplantation

    PubMed Central

    Spellman, Stephen R.; Eapen, Mary; Logan, Brent R.; Mueller, Carlheinz; Rubinstein, Pablo; Setterholm, Michelle I.; Woolfrey, Ann E.; Confer, Dennis L.; Hurley, Carolyn K.

    2012-01-01

    Selection of a suitable graft for allogeneic hematopoietic stem cell transplantation involves consideration of both donor and recipient characteristics. Of primary importance is sufficient donor-recipient HLA matching to ensure engraftment and acceptable rates of GVHD. In this Perspective, the National Marrow Donor Program and the Center for International Blood and Marrow Transplant Research provide guidelines, based on large studies correlating graft characteristics with clinical transplantation outcomes, on appropriate typing strategies and matching criteria for unrelated adult donor and cord blood graft selection. PMID:22596257

  6. A perspective on the selection of unrelated donors and cord blood units for transplantation.

    PubMed

    Spellman, Stephen R; Eapen, Mary; Logan, Brent R; Mueller, Carlheinz; Rubinstein, Pablo; Setterholm, Michelle I; Woolfrey, Ann E; Horowitz, Mary M; Confer, Dennis L; Hurley, Carolyn K

    2012-07-12

    Selection of a suitable graft for allogeneic hematopoietic stem cell transplantation involves consideration of both donor and recipient characteristics. Of primary importance is sufficient donor-recipient HLA matching to ensure engraftment and acceptable rates of GVHD. In this Perspective, the National Marrow Donor Program and the Center for International Blood and Marrow Transplant Research provide guidelines, based on large studies correlating graft characteristics with clinical transplantation outcomes, on appropriate typing strategies and matching criteria for unrelated adult donor and cord blood graft selection.

  7. POTENTIAL IMPACT ON BLOOD AVAILABILITY AND DONOR IRON STATUS OF CHANGES TO DONOR HEMOGLOBIN CUTOFF AND INTERDONATION INTERVALS

    PubMed Central

    Spencer, Bryan R.; Johnson, Bryce; Wright, David J.; Kleinman, Steven; Glynn, Simone A.; Cable, Ritchard G.

    2016-01-01

    BACKGROUND A minimum male hemoglobin (Hb) of 13.0 g/dL will become an FDA requirement in May 2016. In addition, extending whole blood (WB) interdonation intervals (IDIs) beyond 8 weeks has been considered in order to reduce iron depletion in repeat blood donors. This study estimates the impact these changes might have on blood availability and donor iron status. STUDY DESIGN AND METHODS Six blood centers participating in REDS-II collected information on all donation visits from 2006–09. Simulations were developed from these data using a multi-stage approach that first sought to adequately reproduce the patterns of donor return, Hb and ferritin levels, and outcomes of a donor’s visit (successful single or double RBC donation, deferral for low Hb) observed in REDS-II datasets. Modified simulations were used to predict the potential impact on the blood supply and donor iron status under different Hb cutoff and IDI qualification criteria. RESULTS More than 10% of WB donations might require replacement under many simulated scenarios. Longer IDIs would reduce the proportion of donors with iron depletion, but 80% of these donors may remain iron-depleted if minimal IDIs increased to 12 or 16 weeks. CONCLUSION Higher Hb cutoffs and longer IDIs are predicted to have a potentially large impact on collections but only a modest impact on donor iron depletion. Efforts to address iron depletion should be targeted to at-risk donors, such as iron supplementation programs for frequent donors, and policy makers should try to avoid broadly restrictive donation requirements that could substantially reduce blood availability. PMID:27237451

  8. [Educated donor--safe patient].

    PubMed

    Szymczyk-Nuzka, Małgorzata

    2011-03-01

    The safety of transfusion is still improving and very important is raising of education among donors. The important element is also awareness of the possibility of withdrawing themselves from the donation process when they know that their blood isn't suitable for recipients. The aim of this study was checked of donor's knowledge about the risk of transfusion transmitted infections. The 581 regular donors (86.2% men, mean age 32 years) who answered of questions about tests which are performed in donation, and about their knowledge of transmission infections by transfusions. Donors gave blood average four times a year, for 11 years. Over 85% of respondents believed that blood is safe. More than half of donors knew that during donation can be detected anemia, syphilis, jaundice, but 50% believed that the hepatitis viruses can be detected after one week after infection. More than 80% of donors knew about the possibility of detecting of HIV infection, but 11% written that HIV can be detected after one day after infection. Approximately 50% of donors believed that can be detected diabetes during donation, and more than 12% of them--that can be detected thyropathy and cancer. The 30% of blood donors didn't know what tests were performed in the blood donations. Donors (80%) knew about the risk groups. Donors (50%) knew correct temporary disqualification periods after surgery and tattoo also, but 17% of them indicated a shorter period of disqualification. 43% of donors shortened the time after gastroscopy. Over 30% of donors didn't know about risks of infection in case of contact with alien blood. A lot of donors (63.3%) knew about the possibility of withdrawing themselves from the donation and 43.5% of them knew about this rule. The donor doesn't need to know the details of detection of infections in blood, but donor need to know that he should be aware that even a few months is needed to obtain a reliable result, which translates into transfusion safety. For this purpose

  9. [Clinical evaluation of living donor].

    PubMed

    Scolari, Maria Piera; Comai, G; La Manna, G; Liviano D'Arcangelo, G; Monti, M; Feliciangeli, G; Stefoni, S

    2009-01-01

    When possible, living donor transplantation represents the best therapeutic strategy for patients suffering from chronic renal failure. Studying the donor allows a complete and thorough clinical, laboratory and instrumental assessment that guarantees good organ function whilst protecting the health of the donor. The main parameters considered within this framework are age, renal function, nephrological complications, comorbidities (diabetes, hypertension, obesity, etc.), malignancies, and infection. Moreover, particular attention is paid to the sociopsychological aspects of the donation, particularly related to the donor, the recipient, and the entire family situation.

  10. Endocrine disrupting compounds (EDCs) and pharmaceuticals and personal care products (PPCPs) in the aquatic environment: implications for the drinking water industry and global environmental health.

    PubMed

    Rahman, M F; Yanful, E K; Jasim, S Y

    2009-06-01

    Endocrine disrupting compounds (EDCs) and pharmaceuticals and personal care products (PPCPs) are a group of chemical compounds with diverse physical and chemical properties. Recent studies have indicated undesired effects of EDCs and PPCPs at their reported trace concentrations (ng l(-1) to microg l(-1)). This paper reviews the current knowledge on the sources, properties, occurrence and health impacts of EDCs and PPCPs, and their removal from drinking water using ozonation and ozone/hydrogen peroxide-based advanced oxidation. The paper also examines the potential threats posed by these chemicals to drinking water and public health. While these compounds are known to have adverse effects on ecosystem health, notably in the fish population, a similar link is yet to be established between ingestion of these compounds through drinking water and human health. In addition, data on the effectiveness of existing methods for the removal of these compounds are not conclusive. Further studies are required to characterize risks, and also to evaluate and optimize existing removal processes. Also concerted international effort is urgent to cut down the risk of exposure and restrain the production and marketing of toxic chemicals.

  11. EDCs, estrogenicity and genotoxicity reduction in a mixed (domestic + textile) secondary effluent by means of ozonation: a full-scale experience.

    PubMed

    Bertanza, G; Papa, M; Pedrazzani, R; Repice, C; Mazzoleni, G; Steimberg, N; Feretti, D; Ceretti, E; Zerbini, I

    2013-08-01

    WWTP (wastewater treatment plant) effluents are considered to be a major source for the release in the aquatic environment of EDCs (Endocrine-Disrupting Compounds), a group of anthropogenic substances able to alter the normal function of the endocrine system. The application of conventional processes (e.g. activated sludge with biological nitrogen removal) does not provide complete elimination of all these micropollutants and, consequently, an advanced treatment should be implemented. This experimental work was conducted on the tertiary ozonation stage of a 140,000 p.e. activated sludge WWTP, treating a mixed domestic and textile wastewater: an integrated monitoring, including both chemical (nonylphenol, together with the parent compounds mono- and di-ethoxylated, and bisphenol A were chosen as model EDCs) and biological (estrogenic and genotoxic activities) analyses, was carried out. Removal efficiencies of measured EDCs varied from 20% to 70%, depending on flow conditions (ozone dosage being 0.5 gO3/gTOC). Biological tests, furthermore, displayed that the oxidation stage did not significantly reduce (only by 20%) the estrogenicity of the effluent and revealed the presence and/or formation of genotoxic compounds. These results highlight the importance of the application of an integrated (biological+chemical) analytical procedure for a global evaluation of treatment suitability; poor performances recorded in this study have been attributed to the presence of a significant industrial component in the influent wastewater. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Mutations in DCPS and EDC3 in autosomal recessive intellectual disability indicate a crucial role for mRNA decapping in neurodevelopment.

    PubMed

    Ahmed, Iltaf; Buchert, Rebecca; Zhou, Mi; Jiao, Xinfu; Mittal, Kirti; Sheikh, Taimoor I; Scheller, Ute; Vasli, Nasim; Rafiq, Muhammad Arshad; Brohi, M Qasim; Mikhailov, Anna; Ayaz, Muhammad; Bhatti, Attya; Sticht, Heinrich; Nasr, Tanveer; Carter, Melissa T; Uebe, Steffen; Reis, André; Ayub, Muhammad; John, Peter; Kiledjian, Megerditch; Vincent, John B; Jamra, Rami Abou

    2015-06-01

    There are two known mRNA degradation pathways, 3' to 5' and 5' to 3'. We identified likely pathogenic variants in two genes involved in these two pathways in individuals with intellectual disability. In a large family with multiple branches, we identified biallelic variants in DCPS in three affected individuals; a splice site variant (c.636+1G>A) that results in an in-frame insertion of 45 nucleotides and a missense variant (c.947C>T; p.Thr316Met). DCPS decaps the cap structure generated by 3' to 5' exonucleolytic degradation of mRNA. In vitro decapping assays showed an ablation of decapping function for both variants in DCPS. In another family, we identified a homozygous mutation (c.161T>C; p.Phe54Ser) in EDC3 in two affected children. EDC3 stimulates DCP2, which decaps mRNAs at the beginning of the 5' to 3' degradation pathway. In vitro decapping assays showed that altered EDC3 is unable to enhance DCP2 decapping at low concentrations and even inhibits DCP2 decapping at high concentration. We show that individuals with biallelic mutations in these genes of seemingly central functions are viable and that these possibly lead to impairment of neurological functions linking mRNA decapping to normal cognition. Our results further affirm an emerging theme linking aberrant mRNA metabolism to neurological defects.

  13. Mutations in DCPS and EDC3 in autosomal recessive intellectual disability indicate a crucial role for mRNA decapping in neurodevelopment

    PubMed Central

    Ahmed, Iltaf; Buchert, Rebecca; Zhou, Mi; Jiao, Xinfu; Mittal, Kirti; Sheikh, Taimoor I.; Scheller, Ute; Vasli, Nasim; Rafiq, Muhammad Arshad; Brohi, M. Qasim; Mikhailov, Anna; Ayaz, Muhammad; Bhatti, Attya; Sticht, Heinrich; Nasr, Tanveer; Carter, Melissa T.; Uebe, Steffen; Reis, André; Ayub, Muhammad; John, Peter; Kiledjian, Megerditch; Vincent, John B.; Jamra, Rami Abou

    2015-01-01

    There are two known mRNA degradation pathways, 3′ to 5′ and 5′ to 3′. We identified likely pathogenic variants in two genes involved in these two pathways in individuals with intellectual disability. In a large family with multiple branches, we identified biallelic variants in DCPS in three affected individuals; a splice site variant (c.636+1G>A) that results in an in-frame insertion of 45 nucleotides and a missense variant (c.947C>T; p.Thr316Met). DCPS decaps the cap structure generated by 3′ to 5′ exonucleolytic degradation of mRNA. In vitro decapping assays showed an ablation of decapping function for both variants in DCPS. In another family, we identified a homozygous mutation (c.161T>C; p.Phe54Ser) in EDC3 in two affected children. EDC3 stimulates DCP2, which decaps mRNAs at the beginning of the 5′ to 3′ degradation pathway. In vitro decapping assays showed that altered EDC3 is unable to enhance DCP2 decapping at low concentrations and even inhibits DCP2 decapping at high concentration. We show that individuals with biallelic mutations in these genes of seemingly central functions are viable and that these possibly lead to impairment of neurological functions linking mRNA decapping to normal cognition. Our results further affirm an emerging theme linking aberrant mRNA metabolism to neurological defects. PMID:25701870

  14. Analysis of blood donor pre-donation deferral in Dubai: characteristics and reasons.

    PubMed

    Al Shaer, Laila; Sharma, Ranjita; AbdulRahman, Mahera

    2017-01-01

    To ensure an adequate and safe blood supply, it is crucial to select suitable donors according to stringent eligibility criteria. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aims to define donor pre-donation deferral rates, causes of deferral, and characteristics of deferred donors in Dubai. This retrospective study was conducted on all donors who presented for allogeneic blood donation between January 1, 2010, until June 30, 2013, in Dubai Blood Donation Centre, accredited by the American Association of Blood Banks. The donation and deferral data were analyzed to determine the demographic characteristics of accepted and deferred donors, and frequency analyses were also conducted. Among 142,431 individuals presenting during the study period, 114,827 (80.6%) were accepted for donation, and 27,604 (19.4%) were deferred. The overall proportion of deferrals was higher among individuals less than 21 years old (35%, P<0.000), females (44% were deferred compared to 15% of males, P<0.0001), and first-time donors (22% were deferred vs 14% of repeat donors, P<0.0001). The main causes for a temporary deferral were low hemoglobin and high blood pressure. The deferral rate among blood donors in Dubai is relatively high compared to the internationally reported rates. This rate was higher among first-time donors and females, with low hemoglobin as the major factor leading to a temporary deferral of donors. Strategies to mitigate deferral and improve blood donor retention are urged in Dubai to avoid additional stress on the blood supply.

  15. Artificial insemination with donor sperm (AID): heterogeneity in sperm banking facilities in a single country (Belgium).

    PubMed

    Thijssen, A; Dhont, N; Vandormael, E; Cox, A; Klerkx, E; Creemers, E; Ombelet, W

    2014-01-01

    Due to the high inflow of foreign patients seeking cross-border reproductive care in Belgium and the increased number of lesbian couples and single women who call for artificial insemination with donor sperm (AID), Belgian sperm banks nowadays face a shortage in donor sperm. However, since there is no central registration system for sperm donors in Belgium, no figures are currently available supporting this statement. Therefore a study was performed to obtain a detailed overview of the sperm banking facilities in Belgium. Questionnaires were sent to all Belgian centres for assisted reproduction with laboratory facilities (n = 18) to report on their sperm banking methods. The results showed that 82% of the centres rely partially or completely on foreign donor sperm. Moreover, four of the thirteen centres that have their own sperm bank use imported donor sperm in > 95% AID cycles. Our results show that in 63% of the Belgian AID cycles imported Danish donor sperm is being used. Donor recruitment is mainly performed through the centre's website (61%) or by distributing flyers in the centre (46%) and 9 to 180 potential donors have been recruited per centre in 2013. Eventually, 15 to 50% of these candidate donors were accepted. Different criteria for donor acceptance are handled by the centres: donor age limits range from 18-25 to 36-46 years old, and thresholds for sperm normality differ considerably. We can conclude that a wide variation in methods associated with sperm banking is observed in Belgian centres.

  16. Association of Metabolic Syndrome With Kidney Function and Histology in Living Kidney Donors

    PubMed Central

    Ohashi, Y.; Thomas, G.; Nurko, S.; Stephany, B.; Fatica, R.; Chiesa, A.; Rule, A. D.; Srinivas, T.; Schold, J. D.; Navaneethan, S. D.; Poggio, E. D.

    2013-01-01

    The selection of living kidney donors is based on a formal evaluation of the state of health. However, this spectrum of health includes subtle metabolic derangements that can cluster as metabolic syndrome. We studied the association of metabolic syndrome with kidney function and histology in 410 donors from 2005 to 2012, of whom 178 donors were systematically followed after donation since 2009. Metabolic syndrome was defined as per the NCEP ATPIII criteria, but using a BMI > 25 kg/m2 instead of waist circumference. Following donation, donors received counseling on lifestyle modification. Metabolic syndrome was present in 50 (12.2%) donors. Donors with metabolic syndrome were more likely to have chronic histological changes on implant biopsies than donors with no metabolic syndrome (29.0% vs. 9.3%, p < 0.001). This finding was associated with impaired kidney function recovery following donation. At last follow-up, reversal of metabolic syndrome was observed in 57.1% of donors with predonation metabolic syndrome, while only 10.8% of donors developed de novo metabolic syndrome (p < 0.001). In conclusion, metabolic syndrome in donors is associated with chronic histological changes, and nephrectomy in these donors was associated with subsequent protracted recovery of kidney function. Importantly, weight loss led to improvement of most abnormalities that define metabolic syndrome. PMID:23865821

  17. Artificial insemination with donor sperm (AID): heterogeneity in sperm banking facilities in a single country (Belgium)

    PubMed Central

    Thijssen, A.; Dhont, N.; Vandormael, E.; Cox, A.; Klerkx, E.; Creemers, E.; Ombelet, W.

    2014-01-01

    Due to the high inflow of foreign patients seeking cross-border reproductive care in Belgium and the increased number of lesbian couples and single women who call for artificial insemination with donor sperm (AID), Belgian sperm banks nowadays face a shortage in donor sperm. However, since there is no central registration system for sperm donors in Belgium, no figures are currently available supporting this statement. Therefore a study was performed to obtain a detailed overview of the sperm banking facilities in Belgium. Questionnaires were sent to all Belgian centres for assisted reproduction with laboratory facilities (n = 18) to report on their sperm banking methods. The results showed that 82% of the centres rely partially or completely on foreign donor sperm. Moreover, four of the thirteen centres that have their own sperm bank use imported donor sperm in > 95% AID cycles. Our results show that in 63% of the Belgian AID cycles imported Danish donor sperm is being used. Donor recruitment is mainly performed through the centre’s website (61%) or by distributing flyers in the centre (46%) and 9 to 180 potential donors have been recruited per centre in 2013. Eventually, 15 to 50% of these candidate donors were accepted. Different criteria for donor acceptance are handled by the centres: donor age limits range from 18-25 to 36-46 years old, and thresholds for sperm normality differ considerably. We can conclude that a wide variation in methods associated with sperm banking is observed in Belgian centres. PMID:25009728

  18. Donor Deferral Characteristics for Plateletpheresis at a Tertiary Care Center in India- A Retrospective Analysis

    PubMed Central

    Pujani, Mukta; Jyotsna, P Lalita; Pahuja, Sangeeta; Pathak, Chintamani; Jain, Manjula

    2014-01-01

    Background: The demand for plateletpheresis is increasing day by day due to its many merits over random donor platelets. However, in our country, there is a dearth of apheresis donors due to greater devotion and time required for the procedure and lack of awareness. Aim: The aim of the present study is to analyse the reasons for deferral of apheresis donors at a tertiary care center. Materials and Methods: This retrospective analysis was conducted to study the causes, frequency and the type of plateletpheresis donor deferral at regional blood transfusion center, Lady Hardinge Medical College and associated Shrimati Sucheta Kriplani Hospital and Kalawati Saran Childrens’ Hospital. The study was undertaken over a period of two years (from January 2010 to December 2011. Results: Out of a total of 343 donors screened, 87 donors were deferred, the overall deferral rate being 25.36%. The most frequent cause of deferral was a low platelet count accounting for 43.5% of all the causes followed by a low hemoglobin level (27.05%). Among the donors deferred for anaemia, 15 out of 23 (65.2%) had hemoglobin in the range of 11.5-12.4gm%, representing 17.2% of all deferrals. Conclusion: Based on these findings and the scarcity of apheresis donors in our country, we are of the opinion that the selection criteria for plateletpheresis donors should be revised to accommodate more donors and reduce deferral rate without compromising on the health of the donors. PMID:25177566

  19. National Decline in Donor Heart Utilization With Regional Variability: 1995–2010

    PubMed Central

    Khush, K. K.; Zaroff, J. G.; Nguyen, J.; Menza, R.; Goldstein, B. A.

    2015-01-01

    The severe shortage of donor hearts limits the availability of transplantation for the growing population of patients with end-stage heart disease. We examined national trends in donor heart acceptance for transplant. OPTN data were analyzed for all potential adult cardiac organ donors between 1995 and 2010. Donor heart disposition was categorized as transplanted, declined for transplant or other. We studied changes in the probability of donor heart acceptance according to demographic and clinical characteristics, nationwide and by UNOS region. Of 82 053 potential donor hearts, 34% were accepted and 48% were declined (18% used for other purposes). There was a significant decrease in donor heart acceptance from 44% in 1995 to 29% in 2006, and subsequent increase to 32% in 2010. Older donor age, female sex and medical co-morbidities predicted non-acceptance. Donor age and co-morbidities increased during the study period, with a concomitant decrease in acceptance of hearts from donors with undesirable characteristics. Overall, predictors of heart non-use were similar across UNOS regions, although utilization varied between regions. Regional variation suggests a potential to improve heart acceptance rates in under-performing regions, and supports research and policy efforts aimed at establishing evidence-based criteria for donor heart evaluation and acceptance for transplantation. PMID:25676093

  20. Barriers to the use of a federal travel grant by living kidney donors.

    PubMed

    Hays, Rebecca E; Thomas, Amy Elaine; Mathias, Erin; Mezrich, Joshua; Mandelbrot, Didier A

    2017-02-01

    Living organ donation involves significant out-of-pocket costs, which burden donor candidates and may be an obstacle to donation. There is a single US grant (the National Living Donor Assistance Center-NLDAC) to cover live donor travel costs. Although there may be center-specific variability in grant utilization, prospective donors-and their intended recipients-must also meet eligibility criteria. In fact, the NLDAC grant is used by <10% of US live donors annually. We studied 154 consecutive kidney donor clinic evaluations (November 1, 2014-August 30, 2015) to determine eligibility and usage patterns during the evaluation process. Of these, 63 (41%) were local, had travel benefits, or declined. Of the remaining 91 prospective donors who might have benefited from grant support, only 29 (32%) obtained the grant. The other 62 (68%) did not meet eligibility screening. The major reason prospective donors were ineligible was that the recipient's household income was outside the required means test (ie, >300% of the federal poverty level) (n=51; 82%). The remaining exclusions (n=11; 18%) included being a nondirected donor, not meeting residency requirements, and "other." Expanding NLDAC eligibility criteria-by broadening the recipient means test or by taking steps to eliminate it from the NLDAC charter-would reduce financial burdens associated with live donation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Which Donor for Uterus Transplants: Brain-Dead Donor or Living Donor? A Systematic Review.

    PubMed

    Lavoué, Vincent; Vigneau, Cécile; Duros, Solène; Boudjema, Karim; Levêque, Jean; Piver, Pascal; Aubard, Yves; Gauthier, Tristan

    2017-02-01

    The aim of this systematic review was to evaluate and compare the pros and cons of using living donors or brain-dead donors in uterus transplantation programs, 2 years after the first worldwide live birth after uterus transplantation. The Medline database and the Central Cochrane Library were used to locate uterine transplantation studies carried out in human or nonhuman primates. All types of articles (case reports, original studies, meta-analyses, reviews) in English or French were considered for inclusion. Overall, 92 articles were screened and 44 were retained for review. Proof of concept for human uterine transplantation was demonstrated in 2014 with a living donor. Compared with a brain-dead donor strategy, a living donor strategy offers greater possibilities for planning surgery and also decreases cold ischemia time, potentially translating into a higher success rate. However, this approach poses ethical problems, given that the donor is exposed to surgery risks but does not derive any direct benefit. A brain-dead donor strategy is more acceptable from an ethical viewpoint, but its feasibility is currently unproven, potentially owing to a lack of compatible donors, and is associated with a longer cold ischemia time and a potentially higher rejection rate. The systematic review demonstrates that uterine transplantation is a major surgical innovation for the treatment of absolute uterine factor infertility. Living and brain-dead donor strategies are not mutually exclusive and, in view of the current scarcity of uterine grafts and the anticipated future rise in demand, both will probably be necessary.

  2. Cloning of circadian rhythmic pathway genes and perturbation of oscillation patterns in endocrine disrupting chemicals (EDCs)-exposed mangrove killifish Kryptolebias marmoratus.

    PubMed

    Rhee, Jae-Sung; Kim, Bo-Mi; Lee, Bo-Young; Hwang, Un-Ki; Lee, Yong Sung; Lee, Jae-Seong

    2014-08-01

    To investigate the effect of endocrine disrupting chemicals (EDCs) on the circadian rhythm pathway, we cloned clock and circadian rhythmic pathway-associated genes (e.g. Per2, Cry1, Cry2, and BMAL1) in the self-fertilizing mangrove killifish Kryptolebias marmoratus. The promoter region of Km-clock had 1 aryl hydrocarbon receptor element (AhRE, GTGCGTGACA) and 8 estrogen receptor (ER) half-sites, indicating that the AhRE and ER half sites would likely be associated with regulation of clock protein activity during EDCs-induced cellular stress. The Km-clock protein domains (bHLH, PAS1, PAS2) were highly conserved in five additional fish species (zebrafish, Japanese medaka, Southern platyfish, Nile tilapia, and spotted green pufferfish), suggesting that the fish clock protein may play an important role in controlling endogenous circadian rhythms. The promoter regions of Km-BMAL1, -Cry1, -Cry2, and -Per2 were found to contain several xenobiotic response elements (XREs), indicating that EDCs may be able to alter the expression of these genes. To analyze the endogenous circadian rhythm in K. marmoratus, we measured expression of Km-clock and other circadian rhythmic genes (e.g. Per2, Cry1, Cry2, and BMAL1) in different tissues, and found ubiquitous expression, although there were different patterns of transcript amplification during different developmental stages. In an estrogen (E2)-exposed group, Km-clock expression was down-regulated, however, a hydroxytamoxifen (TMX, nonsteroid estrogen antagonist)-exposed group showed an upregulated pattern of Km-clock expression, suggesting that the expression of Km-clock is closely associated with exposure to EDCs. In response to the exposure of bisphenol A (BPA) and 4-tert-octyphenol (OP), Km-clock expression was down-regulated in the pituitary/brain, muscle, and skin in both gender types (hermaphrodite and secondary male). In juvenile K. marmoratus liver tissue, expression of Km-clock and other circadian rhythmic pathway

  3. Dual kidney transplants from adult marginal donors successfully expand the limited deceased donor organ pool.

    PubMed

    Stratta, Robert J; Farney, Alan C; Orlando, Giuseppe; Farooq, Umar; Al-Shraideh, Yousef; Palanisamy, Amudha; Reeves-Daniel, Amber; Doares, William; Kaczmorski, Scott; Gautreaux, Michael D; Iskandar, Samy S; Hairston, Gloria; Brim, Elizabeth; Mangus, Margaret; El-Hennawy, Hany; Khan, Muhammad; Rogers, Jeffrey

    2016-04-01

    The need to expand the organ donor pool remains a formidable challenge in kidney transplantation (KT). The use of expanded criteria donors (ECDs) represents one approach, but kidney discard rates are high because of concerns regarding overall quality. Dual KT (DKT) may reduce organ discard and optimize the use of kidneys from marginal donors. We conducted a single-center retrospective review of outcomes in adult recipients of DKTs from adult marginal deceased donors (DD) defined by limited renal functional capacity. If the calculated creatinine clearance in an adult DD was <65 mL/min, then the kidneys were transplanted as a DKT. Over 11.5 yr, 72 DKTS were performed including 45 from ECDs, 17 from donation after cardiac death (DCD) donors, and 10 from standard criteria donors (SCD). Mean adult DD and recipient ages were both 60 yr, including 29 DDs and 26 recipients ≥65 yr of age. Mean pre-DKT waiting and dialysis vintage times were 12 months and 25 months, respectively. Actual patient and graft survival rates were 84.7% and 70.8%, respectively, with a mean follow-up of 58 months. One yr and death-censored graft survival rates were 90% and 80%, respectively. Outcomes did not differ by DD category, recipient age, or presence of delayed graft function (DGF). Eleven patients died at a mean of 32 months post-DKT (eight with functioning grafts) and 13 other patients experienced graft losses at a mean of 33 months. The incidence of DGF was 25%; there were two cases (2.8%) of primary non-function. Mean length of initial hospital stay was 7.2 d. Mean serum creatinine and glomerular filtration rate levels at 12 and 24 months were 1.5 and 53 and 1.5 mg/dL and 51 mL/min/1.73 m(2) , respectively. DKT graft survival and function were superior to concurrent single ECD and similar to concurrent SCD KTs. Two patients underwent successful kidney retransplantation, so the dialysis-free rate in surviving patients was 87%. The proportion of total renal function transplanted from

  4. [Deceased organ donors, legal regulations governing diagnosis of brain death, overview of donors and liver transplants in the Czech Republic].

    PubMed

    Pokorná, E

    2013-08-01

    The key restriction of transplantation medicine globally, as well as in the Czech Republic, concerns the lack of organs. The number of deceased donors, and thus the availability of organ transplants, has been stagnating in our country. The paper describes current legal regulations governing the dia-gnosis of brain death and primary legal and medical criteria for the contraindication of the deceased for organ explantation, gives an overview of the number of liver transplants, age structure, and diagnosis resulting in brain death of the deceased liver donors in the Czech Republic.

  5. The Dirt on the Donors.

    ERIC Educational Resources Information Center

    Walker, Mary Margaret

    1996-01-01

    A discussion of donor records in college and university fund-raising programs looks at a variety of issues, including who sees them (administrators, donors, volunteers, and members of the legal profession), how access to them is controlled, and what is kept in them. Suggestions are offered for managing such records, and the experiences of a number…

  6. Management of Young Blood Donors

    PubMed Central

    Newman, Bruce H.

    2014-01-01

    Summary The emphasis on high-school blood drives and acceptance of 16-year-old blood donors led to more research on physiologic and psychological ways to decrease vasovagal reaction rates in young blood donors and to increase donor retention. Research on how to accomplish this has been advantageous for the blood collection industry and blood donors. This review discussed the current situation and what can be done psychologically, physiologically, and via process improvements to decrease vasovagal reaction rates and increase donor retention. The donation process can be significantly improved. Future interventions may include more dietary salt, a shorter muscle tension program to make it more feasible, recommendations for post-donation muscle tension / squatting / laying down for lightheadedness, more donor education by the staff at the collection site, more staff attention to donors with fear or higher risk for a vasovagal reaction (e.g. estimated blood volume near 3.5 l, first-time donor), and a more focused donation process to ensure a pleasant and safer procedure. PMID:25254024

  7. Urinary biomarkers after donor nephrectomy.

    PubMed

    Hoogendijk-van den Akker, Judith M; Warlé, Michiel C; van Zuilen, Arjan D; Kloke, Heinrich J; Wever, Kim E; d'Ancona, Frank C H; Ӧzdemir, Denise M D; Wetzels, Jack F M; Hoitsma, Andries J

    2015-05-01

    As the beginning of living-donor kidney transplantation, physicians have expressed concern about the possibility that unilateral nephrectomy can be harmful to a healthy individual. To investigate whether the elevated intra-abdominal pressure (IAP) during laparoscopic donor nephrectomy causes early damage to the remaining kidney, we evaluated urine biomarkers after laparoscopic donor nephrectomy. We measured albumin and alpha-1-microglobulin (α-1-MGB) in urine samples collected during and after open and laparoscopic donor nephrectomy and laparoscopic cholecystectomy and colectomy. Additionally, kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured in urine samples collected during and after laparoscopic donor nephrectomy and colectomy. The same biomarkers were studied in patients randomly assigned to standard or low IAP during laparoscopic donor nephrectomy. We observed a peak in urinary albumin excretion during all procedures. Urine α-1-MGB rose in the postoperative period with a peak on the third postoperative day after donor nephrectomy. Urine α-1-MGB did not increase after laparoscopic cholecystectomy and colectomy. After laparoscopic nephrectomy, we observed slight increases in urine KIM-1 during surgery and in urine NGAL at day 2-3 after the procedure. After laparoscopic colectomy, both KIM-1 and NGAL were increased in the postoperative period. There were no differences between the high- and low-pressure procedure. Elevated urinary α-1-MGB suggests kidney damage after donor nephrectomy, occurring irrespective of IAP during the laparoscopic procedure.

  8. Endocrine Disrupting Chemicals (EDCs)

    MedlinePlus

    ... metabolism (how the body converts food to fuel), reproduction, growth and development, and the way your body ... body. It controls overall endocrine system functions including reproduction, stress responses, growth, lactation (production and secretion of ...

  9. The risk for hepatitis C infection in blood donors in Cluj County, Romania.

    PubMed

    Hâţu, G; Brumboiu, M I; Czernichow, P; Bocşan, I S

    2014-05-01

    Blood products safety is based on different criteria including the selection of blood donors. Blood donors referred to Cluj County (Romania) Blood Transfusion Centre in January-March 2012 completed a self-administered questionnaire and were examined by a physician. Data collected from first-time and repeat donors were compared for possible risk factors for hepatitis C infection. In total, 1100 donors were selected. In first-time donors, most frequent factors were age<26 years, female gender and history of health care procedures. Behavioural risk factors (e.g. drug use, sexual promiscuity) may not be properly filtered out in blood donors, suggesting the necessity of improving the health screening process. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Donor attention to reading materials.

    PubMed

    O'Brien, S F; Osmond, L; Choquet, K; Yi, Q-L; Goldman, M

    2015-11-01

    Mandatory predonation reading materials inform donors about risk factors for transmissible disease, possible complications of donation and changes to the donation process. We aimed to assess the attention to predonation reading materials and factors which may affect attention. A national survey in 2008 of 18,108 blood donors asked about self-assessed attention to reading the materials. In face-to-face interviews, 441 donors completed additional questions about reading the materials and a literacy test. Qualitative interviews of 27 donors assessed their approach to reading. In the national survey, most of the first-time donors said they read all or most of the materials (90.9% first-time vs. 57.6% repeat donors, P < 0.001) and 66% vs. 23.1% reported reading them carefully (P < 0.001). In face-to-face interviews comparing those who read materials carefully, skimmed or did not read, most knew that donors are informed of positive transmissible disease test results (97.1%, 95.5, 98.0 P > 0.05), but fewer recalled seeing the definition of sex (77.2%, 56.9, 24.2 P < 0.001). Literacy was poor (30.5% frustration level, 60.3% instructional, 9.2% independent) but similar when those who read materials carefully, skimmed or did not read were compared (P > 0.05). Qualitative interviews showed that donors are reluctant to read any more than necessary and decide based on perceived importance or relevance. Attention to predonation reading materials tends to be better among first-time donors. The effectiveness is limited by low motivation to read, especially for repeat donors, as well as poor literacy. © 2015 International Society of Blood Transfusion.

  11. The Lombardy Rare Donor Programme.

    PubMed

    Revelli, Nicoletta; Villa, Maria Antonietta; Paccapelo, Cinzia; Manera, Maria Cristina; Rebulla, Paolo; Migliaccio, Anna Rita; Marconi, Maurizio

    2014-01-01

    In 2005, the government of Lombardy, an Italian region with an ethnically varied population of approximately 9.8 million inhabitants including 250,000 blood donors, founded the Lombardy Rare Donor Programme, a regional network of 15 blood transfusion departments coordinated by the Immunohaematology Reference Laboratory of the Ca' Granda Ospedale Maggiore Policlinico in Milan. During 2005 to 2012, Lombardy funded LORD-P with 14.1 million euros. During 2005-2012 the Lombardy Rare Donor Programme members developed a registry of blood donors and a bank of red blood cell units with either rare blood group phenotypes or IgA deficiency. To do this, the Immunohaematology Reference Laboratory performed extensive serological and molecular red blood cell typing in 59,738 group O or A, Rh CCDee, ccdee, ccDEE, ccDee, K- or k- donors aged 18-55 with a record of two or more blood donations, including both Caucasians and ethnic minorities. In parallel, the Immunohaematology Reference Laboratory implemented a 24/7 service of consultation, testing and distribution of rare units for anticipated or emergent transfusion needs in patients developing complex red blood cell alloimmunisation and lacking local compatible red blood cell or showing IgA deficiency. Red blood cell typing identified 8,747, 538 and 33 donors rare for a combination of common antigens, negative for high-frequency antigens and with a rare Rh phenotype, respectively. In June 2012, the Lombardy Rare Donor Programme frozen inventory included 1,157 red blood cell units. From March 2010 to June 2012 one IgA-deficient donor was detected among 1,941 screened donors and IgA deficiency was confirmed in four previously identified donors. From 2005 to June 2012, the Immunohaematology Reference Laboratory provided 281 complex red blood cell alloimmunisation consultations and distributed 8,008 Lombardy Rare Donor Programme red blood cell units within and outside the region, which were transfused to 2,365 patients with no

  12. Iron deficiency in blood donors: a national cross-sectional study.

    PubMed

    Salvin, Hannah E; Pasricha, Sant-Rayn; Marks, Denese C; Speedy, Joanna

    2014-10-01

    Iron deficiency (ID) is an important consequence of blood donation. The epidemiology of this problem in the blood donor population was therefore studied to enable appropriate targeting of potential solutions to donor ID. A nationally representative, cluster-based cross-sectional study of Australian blood donors was performed. Donors were eligible for inclusion if they fulfilled criteria for blood donation or were deferred due to low or falling hemoglobin. Ferritin was measured and demographic and donation data were collected. A total of 3094 blood donors were recruited, of which samples were collected from 3049 donors; 1873 had exclusively donated whole blood (WB only), 242 had exclusively made apheresis donations, and 530 had not donated ("new" donors) in the previous 24 months. The prevalence of ID in new female donors was 12.0% compared with 1.3% in males. The prevalence of ID in female WB-only donors was 26.4%; it increased with donation frequency and decreased with age. The prevalence in male WB-only donors was 6.3% with no evident change with age or donation frequency. The prevalence of ID in apheresis-only donors (females 6.3%; males 2.2%) did not significantly exceed that of new donors nor did it change with donation frequency. Importantly, the risk of ID could not be satisfactorily predicted in an individual donor by his or her anemia status or with predictive modeling incorporating demographic and donation data. ID is especially prevalent in female, premenopausal, frequent WB donors. Strategies to combat ID should be implemented, specifically targeting this group. © 2014 The Australian Red Cross Blood Service. Transfusion © 2014 AABB.

  13. Support of Unrelated Stem Cell Donor Searches by Donor Center-Initiated HLA Typing of Potentially Matching Donors

    PubMed Central

    Schmidt, Alexander H.; Solloch, Ute V.; Baier, Daniel; Grathwohl, Alois; Hofmann, Jan; Pingel, Julia; Stahr, Andrea; Ehninger, Gerhard

    2011-01-01

    Large registries of potential unrelated stem cell donors have been established in order to enable stem cell transplantation for patients without HLA-identical related donors. Donor search is complicated by the fact that the stored HLA information of many registered donors is incomplete. We carried out a project that was aimed to improve chances of patients with ongoing donor searches to find an HLA-matched unrelated donor. For that purpose, we carried out additional donor center-initiated HLA-DRB1 typing of donors who were only typed for the HLA loci A and B so far and were potential matches for patients in need of a stem cell transplant. In total, 8,861 donors were contacted for donor center-initiated HLA-DRB1 typing within 1,089 donor searches. 12 of these donors have donated stem cells so far, 8 thereof for their respective target patients. We conclude that chances of patients with ongoing donor searches to find an HLA-matched unrelated donor can indeed be improved by donor-center initiated typing that is carried out in addition to the standard donor search process. Our results also raise questions regarding the appropriate use of incompletely typed donors within unrelated donor searches. PMID:21625451

  14. Relationship between blood donors' iron status and their age, body mass index and donation frequency.

    PubMed

    Moghadam, Ali Malekshahi; Natanzi, Mahboobeh Mehrabani; Djalali, Mahmoud; Saedisomeolia, Ahmad; Javanbakht, Mohammad Hassan; Saboor-Yaraghi, Ali Akbar; Zareei, Mahnaz

    2013-01-01

    Regular blood donation may decrease body iron storage and lead to anemia. The aim here was to evaluate the iron status of Iranian male blood donors and the impact of age, body mass index (BMI) and donation frequency over one year, on iron status indices. Cross-sectional, descriptive and analytical study at Tehran Blood Transfusion Center, Tehran, Iran. Between July and September 2011, 117 male blood donors were selected and divided into four groups according to their frequency of blood donation. Thirty male non-donors were also recruited as controls after adjusting for age, weight, height, smoking habits and monthly income. Iron status indices and some criteria such as general health and dietary measurements were determined among all subjects. The values of the iron-related parameters were significantly lower among donors than among non-donors. Only total iron binding capacity (TIBC) was found to be significantly higher among different donor groups than in the controls. A significant positive correlation was observed between age and serum ferritin (SF) only among the donors who had donated once within the preceding year. The iron status indices did not show any significant relationship with BMI among donors or non-donors. A donation frequency of more than twice a year had a significant influence on iron-related parameters. Therefore, without annual measurement of these parameters, further phlebotomies may lead to iron deficiency and donor rejection in the future.

  15. Living kidney donors and ESRD.

    PubMed

    Ross, Lainie Friedman

    2015-07-01

    There are more than 325 living kidney donors who have developed end-stage renal disease and have been listed on the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) deceased donor kidney wait list. The OPTN/UNOS database records where these kidney donors are listed and, if they donated after April 1994, where that donation occurred. These 2 locations are often not the same. In this commentary, I examine whether a national living donor registry should be created and whether transplantation centers should be notified when one of their living kidney donors develops end-stage renal disease. I consider and refute 5 potential objections to center notification. I explain that transplantation centers should look back at these cases and input data into a registry to attempt to identify patterns that could improve donor evaluation protocols. Creating a registry and mining the information it contains is, in my view, our moral and professional responsibility to future patients and the transplantation endeavor. As individuals and as a community, we need to acknowledge the many unknown risks of living kidney donation and take responsibility for identifying these risks. We then must share information about these risks, educate prospective donors about them, and attempt to minimize them.

  16. Family donors are critical and legitimate in developing countries

    PubMed Central

    Allain, Jean-Pierre; Sibinga, Cees Th Smit

    2016-01-01

    Introduction: For many years, family blood donors have been considered less safe than volunteer non-remunerated blood donors and actively discouraged by international organisations and affluent countries support agencies for developing countries. In addition to safety, pressure and coercion was considered unethical. However these assumptions were not supported by evidence. Aims of the study: To assemble recently collected evidence to reopen the assessment whether or not the ban of family blood donors is justified. Methods: Review of old and recent literature through Pubmed and references from identified articles. Results and Discussion: Viral marker data comparing confirmed seroprevalence in 1st time volunteer non-remunerated donors (VNRD) and family/replacement donors (FRD) corrected for gender and age, show no significant difference between the two groups. Evidence has been provided that for both VNRD and FAD benevolence is more appropriate than altruism. The two groups merge for psychological attitude to donation for which knowing someone needing transfusion is a powerful incentive to give blood. Excluding a life or death situation found in areas where severe blood shortage justifies replacement donation, pressures are exerted on both VNRD and FRD. There is no evidence of coercion of FRD. FRDs therefore meet all criteria for VNRD and are willing to become VNRD and to repeat donation. Ostracising FRD is illegitimate and damaging to the blood supply in resource poor areas. In some countries no difference is made between the two groups of donors representing similar populations asked to give blood in different circumstances. Conclusions: FRDs remain a critical source of volunteer, non-remunerated, blood meeting all classical criteria of VNRD that should be considered legitimate and indispensable at this point in time instead of discouraged. PMID:27011664

  17. How to motivate whole blood donors to become plasma donors.

    PubMed

    Godin, Gaston; Germain, Marc

    2014-01-01

    This study tested the efficacy of interventions to recruit new plasma donors among whole blood donors. A sample of 924 donors was randomized to one of three conditions: control; information only by nurse; and information plus self-positive image message by nurse (SPI). Participants in the control condition only received a leaflet describing the plasma donation procedure. In the two experimental conditions the leaflet was explained face-to-face by a nurse. The dependent variables were the proportion of new plasma donors and the number of donations at six months. Overall, 141 (15.3%) new plasma donors were recruited at six months. There were higher proportions of new plasma donors in the two experimental conditions compared to the control condition (P < .001); the two experimental conditions did not differ. Also, compared to the control condition, those in the experimental conditions (all Ps < .001) gave plasma more often (information only by nurse:  d = .26; SPI: d = .32); the SPI intervention significantly outperformed (P < .05) the information only by nurse condition. The results suggest that references to feelings of SPI such as feeling good and being proud and that giving plasma is a rewarding personal experience favor a higher frequency of plasma donation.

  18. How to Motivate Whole Blood Donors to Become Plasma Donors

    PubMed Central

    2014-01-01

    This study tested the efficacy of interventions to recruit new plasma donors among whole blood donors. A sample of 924 donors was randomized to one of three conditions: control; information only by nurse; and information plus self-positive image message by nurse (SPI). Participants in the control condition only received a leaflet describing the plasma donation procedure. In the two experimental conditions the leaflet was explained face-to-face by a nurse. The dependent variables were the proportion of new plasma donors and the number of donations at six months. Overall, 141 (15.3%) new plasma donors were recruited at six months. There were higher proportions of new plasma donors in the two experimental conditions compared to the control condition (P < .001); the two experimental conditions did not differ. Also, compared to the control condition, those in the experimental conditions (all Ps < .001) gave plasma more often (information only by nurse:  d = .26; SPI: d = .32); the SPI intervention significantly outperformed (P < .05) the information only by nurse condition. The results suggest that references to feelings of SPI such as feeling good and being proud and that giving plasma is a rewarding personal experience favor a higher frequency of plasma donation. PMID:25530909

  19. Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction

    PubMed Central

    de Matos, Ana Cristina Carvalho; Requião-Moura, Lúcio Roberto; Clarizia, Gabriela; Durão, Marcelino de Souza; Tonato, Eduardo José; Chinen, Rogério; de Arruda, Érika Ferraz; Filiponi, Thiago Corsi; Pires, Luciana Mello de Mello Barros; Bertocchi, Ana Paula Fernandes; Pacheco-Silva, Alvaro

    2015-01-01

    ABSTRACT Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, a condition considered by many as a contraindication for organ acceptance and therefore one of the main causes for kidney discard. Since these are well-selected donors and with no chronic diseases, such as hypertension, renal disease, or diabetes, many studies showed that the use of donors with acute renal failure should be encouraged, because, in general, acute renal dysfunction is reversible. Although most studies demonstrated these grafts have more delayed function, the results of graft and patient survival after transplant are very similar to those with the use of standard donors. Clinical and morphological findings of donors, the use of machine perfusion, and analysis of its parameters, especially intrarenal resistance, are important tools to support decision-making when considering the supply of organs with renal dysfunction. PMID:26154553

  20. Pharmaceuticals and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs) in stormwater canals and Bayou St. John in New Orleans, Louisiana, USA.

    PubMed

    Boyd, Glen R; Palmeri, Jordan M; Zhang, Shaoyuan; Grimm, Deborah A

    2004-10-15

    Samples were collected from two stormwater canals and a recreational urban waterway known as Bayou St. John in New Orleans, Louisiana, USA and analyzed for a range of pharmaceuticals and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs). Concentrations of 7 PPCPs and EDCs were measured by a method that provides for simultaneous extraction and quantification of the following compounds: clofibric acid, naproxen, ibuprofen, fluoxetine, clorophene, triclosan, bisphenol A. The method also was used as an indicator of the occurrence of estrogenic compounds by targeting estrone and 17beta-estradiol. The two canals (Orleans and London) are used to drain a portion of the city's stormwater directly into the Mississippi River or Lake Pontchartrain. Bayou St. John is located between the two canals and supplied with water from Lake Pontchartrain. Results from the 6-month sampling period indicated the following concentration ranges for the two stormwater canals: naproxen (ND - 145 ng/l), ibuprofen (ND - 674 ng/l), triclosan (ND - 29 ng/l) and bisphenol A (1.9-158 ng/l). Concentrations of these target analytes increased with cumulative rainfall. For bayou waters, only naproxen (2.1-4.8 ng/l) and bisphenol A (0.9-44 ng/l) were detected. Estrone was detected but determined non-quantifiable for multiple sampling events at the 3 sites. None of the other target analytes (clofibric acid, fluoxetine, clorophene, and 17beta-estradiol) were detected above their method detection levels. Results of this study demonstrate the occurrence of PPCPs and EDCs in New Orleans stormwater canals and Bayou St. John. Results also demonstrate the use of this analytical technique as an indicator of non-point source sewage contamination in New Orleans stormwater canals.

  1. Immobilization strategy for enhancing sensitivity of immunosensors: L-Asparagine-AuNPs as a promising alternative of EDC-NHS activated citrate-AuNPs for antibody immobilization.

    PubMed

    Raghav, Ragini; Srivastava, Sudha

    2016-04-15

    This paper addresses the question - Is EDC-NHS activated gold nanoparticles modified electrode surface the best available option for antibody immobilization for immunosensor fabrication? Is there any other alternative covalent immobilization strategy for orthogonal orientation of antibody, ensuring enhanced sensitivity of immunosensors? Does EDC-NHS activation of carboxyl functionalized nanoparticles surface really leads to orthogonal or directed immobilization of antibody? Gold nanoparticles synthesized using L-Asparagine as reducing and stabilization agent were employed for orthogonal immobilization of antibody for immunosensor fabrication. Anti-CA125 antibody was used as a model system for immunosensor fabrication. A comparative evaluation of immunosensors fabricated using L-Asparagine stabilized gold nanoparticles and citrate stabilized gold nanoparticles via different immobilization strategies/chemistries was done. The three strategies involved immobilization of Anti-CA125 antibody - (1) after EDC-NHS activation of citrate stabilized gold nanoparticles, (2) directly onto citrate stabilized gold nanoparticles and (3) directly onto L-Asparagine stabilized gold nanoparticles modified electrode surfaces. Comparative evaluation of Impedimetric response characteristics showed 2.5 times increase in sensitivity (349.36 Ω/(IU/mL)/cm(2)) in case of third strategy as compared to first (147.53 Ω/(IU/mL)/cm(2)) and twice that of second strategy (166.24 Ω/(IU/mL)/cm(2)). Additionally, an extended dynamic range of 0-750 IU/mL was observed while for others it was up to 500 IU/mL. Amino acid coated gold nanoparticles ensured orthogonal immobilization, lesser randomization, with 88% of active antibody available for antigen binding as opposed to other two strategies with less than 30% active antibody.

  2. Donor states in inverse opals

    SciTech Connect

    Mahan, G. D.

    2014-09-21

    We calculate the binding energy of an electron bound to a donor in a semiconductor inverse opal. Inverse opals have two kinds of cavities, which we call octahedral and tetrahedral, according to their group symmetry. We put the donor in the center of each of these two cavities and obtain the binding energy. The binding energies become very large when the inverse opal is made from templates with small spheres. For spheres less than 50 nm in diameter, the donor binding can increase to several times its unconfined value. Then electrons become tightly bound to the donor and are unlikely to be thermally activated to the semiconductor conduction band. This conclusion suggests that inverse opals will be poor conductors.

  3. Donor states in inverse opals

    NASA Astrophysics Data System (ADS)

    Mahan, G. D.

    2014-09-01

    We calculate the binding energy of an electron bound to a donor in a semiconductor inverse opal. Inverse opals have two kinds of cavities, which we call octahedral and tetrahedral, according to their group symmetry. We put the donor in the center of each of these two cavities and obtain the binding energy. The binding energies become very large when the inverse opal is made from templates with small spheres. For spheres less than 50 nm in diameter, the donor binding can increase to several times its unconfined value. Then electrons become tightly bound to the donor and are unlikely to be thermally activated to the semiconductor conduction band. This conclusion suggests that inverse opals will be poor conductors.

  4. Donor selection in heart transplantation

    PubMed Central

    Emani, Sitaramesh; Sai-Sudhakar, Chittoor B.; Higgins, Robert S. D.; Whitson, Bryan A.

    2014-01-01

    There is increased scrutiny on the quality in health care with particular emphasis on institutional heart transplant survival outcomes. An important aspect of successful transplantation is appropriate donor selection. We review the current guidelines as well as areas of controversy in the selection of appropriate hearts as donor organs to ensure optimal outcomes. This decision is paramount to the success of a transplant program as well as recipient survival and graft function post-transplant. PMID:25132976

  5. The decapping activator Edc3 and the Q/N-rich domain of Lsm4 function together to enhance mRNA stability and alter mRNA decay pathway dependence in Saccharomyces cerevisiae

    PubMed Central

    Huch, Susanne; Müller, Maren; Muppavarapu, Mridula; Gommlich, Jessie; Balagopal, Vidya; Nissan, Tracy

    2016-01-01

    ABSTRACT The rate and regulation of mRNA decay are major elements in the proper control of gene expression. Edc3 and Lsm4 are two decapping activator proteins that have previously been shown to function in the assembly of RNA granules termed P bodies. Here, we show that deletion of edc3, when combined with a removal of the glutamine/asparagine rich region of Lsm4 (edc3Δ lsm4ΔC) reduces mRNA stability and alters pathways of mRNA degradation. Multiple tested mRNAs exhibited reduced stability in the edc3Δ lsm4ΔC mutant. The destabilization was linked to an increased dependence on Ccr4-mediated deadenylation and mRNA decapping. Unlike characterized mutations in decapping factors that either are neutral or are able to stabilize mRNA, the combined edc3Δ lsm4ΔC mutant reduced mRNA stability. We characterized the growth and activity of the major mRNA decay systems and translation in double mutant and wild-type yeast. In the edc3Δ lsm4ΔC mutant, we observed alterations in the levels of specific mRNA decay factors as well as nuclear accumulation of the catalytic subunit of the decapping enzyme Dcp2. Hence, we suggest that the effects on mRNA stability in the edc3Δ lsm4ΔC mutant may originate from mRNA decay protein abundance or changes in mRNPs, or alternatively may imply a role for P bodies in mRNA stabilization. PMID:27543059

  6. The decapping activator Edc3 and the Q/N-rich domain of Lsm4 function together to enhance mRNA stability and alter mRNA decay pathway dependence in Saccharomyces cerevisiae.

    PubMed

    Huch, Susanne; Müller, Maren; Muppavarapu, Mridula; Gommlich, Jessie; Balagopal, Vidya; Nissan, Tracy

    2016-10-15

    The rate and regulation of mRNA decay are major elements in the proper control of gene expression. Edc3 and Lsm4 are two decapping activator proteins that have previously been shown to function in the assembly of RNA granules termed P bodies. Here, we show that deletion of edc3, when combined with a removal of the glutamine/asparagine rich region of Lsm4 (edc3Δ lsm4ΔC) reduces mRNA stability and alters pathways of mRNA degradation. Multiple tested mRNAs exhibited reduced stability in the edc3Δ lsm4ΔC mutant. The destabilization was linked to an increased dependence on Ccr4-mediated deadenylation and mRNA decapping. Unlike characterized mutations in decapping factors that either are neutral or are able to stabilize mRNA, the combined edc3Δ lsm4ΔC mutant reduced mRNA stability. We characterized the growth and activity of the major mRNA decay systems and translation in double mutant and wild-type yeast. In the edc3Δ lsm4ΔC mutant, we observed alterations in the levels of specific mRNA decay factors as well as nuclear accumulation of the catalytic subunit of the decapping enzyme Dcp2. Hence, we suggest that the effects on mRNA stability in the edc3Δ lsm4ΔC mutant may originate from mRNA decay protein abundance or changes in mRNPs, or alternatively may imply a role for P bodies in mRNA stabilization. © 2016. Published by The Company of Biologists Ltd.

  7. Ethical issues relating to renal transplantation from prediabetic living donor

    PubMed Central

    2014-01-01

    Background In Mexico, diabetes mellitus is the main cause of end − stage kidney disease, and some patients may be transplant candidates. Organ supply is limited because of cultural issues. And, there is a lack of standardized clinical guidelines regarding organ donation. These issues highlight the tension surrounding the fact that living donors are being selected despite being prediabetic. This article presents, examines and discusses using the principles of non-maleficience, autonomy, justice and the constitutionally guaranteed right to health, the ethical considerations that arise from considering a prediabetic person as a potential kidney donor. Discussion Diabetes is an absolute contraindication for donating a kidney. However, the transplant protocols most frequently used in Mexico do not consider prediabetes as exclusion criteria. In prediabetic persons there are well known metabolic alterations that may compromise the long − term outcomes of the transplant if such donors are accepted. Even so, many of them are finally included because there are not enough donor candidates. Both, families and hospitals face the need to rapidly accept prediabetic donors before the clinical conditions of the recipient and the evolution of the disease exclude him/her as a transplant candidate; however, when using a kidney potentially damaged by prediabetes, neither the donor’s nor the recipient’s long term health is usually considered. Considering the ethical implication as well as the clinical and epidemiological evidence, we conclude that prediabetic persons are not suitable candidates for kidney donation. This recommendation should be taken into consideration by Mexican health institutions who should rewrite their transplant protocols. Summary We argue that the decision to use a kidney from a living donor known to be pre-diabetic or from those persons with family history of T2DM, obesity, hypertension, or renal failure, should be considered unethical in Mexico

  8. Assessment of dysplastic hematopoiesis: lessons from healthy bone marrow donors.

    PubMed

    Parmentier, Stefani; Schetelig, Johannes; Lorenz, Kerstin; Kramer, Michael; Ireland, Robin; Schuler, Ulrich; Ordemann, Rainer; Rall, Gabi; Schaich, Markus; Bornhäuser, Martin; Ehninger, Gerhard; Kroschinsky, Frank

    2012-05-01

    According to WHO 2008 guidelines, the required percentage of cells manifesting dysplasia in the bone marrow to qualify as significant is 10% or over in one or more hematopoietic cell lineages, but this threshold is controversial. No 'normal' values have been established. Therefore, we investigated dyshematopoiesis in bone marrow aspirate squash preparations of 120 healthy bone marrow donors. Bone marrow squash slides of 120 healthy unrelated bone marrow donors were examined independently by 4 experienced morphologists. Samples were taken from the first aspiration during the harvest. Bone marrow preparation and assessment were performed according to WHO recommendations and ICSH guidelines. More than 10% dysmyelopoiesis could be detected in 46% of bone marrow aspirate squash preparations with 26% in 2 or more cell lineages and 7% in 3 cell lineages in healthy bone marrow donors. Donors under the age of 30 years exhibited more dysgranulopoietic changes and dysmegakaryopoietic changes (P<0.001) compared to the older donors. Female donors showed more dysgranulopoietic changes than male donors (P = 0.025). The concordance rate between the 4 investigators was modest in dysgranulopoiesis but poor in dyserythropoiesis and dysmegakaryopoiesis. The poor reliability of the 10% cut off was partly related to the proximity of the current criteria to the observed cut-off mean values of the normal population. These findings question the current WHO threshold of the 10% or over necessary for the percentage of cells manifesting dysplasia to be considered significant, and suggest that either a higher threshold would be more appropriate or different thresholds should be set for each lineage.

  9. Clinical outcome of pancreas transplantation from marginal donors in Japan.

    PubMed

    Tomimaru, Y; Ito, T; Kawamoto, K; Hama, N; Wada, H; Kobayashi, S; Eguchi, H; Tanemura, M; Mori, M; Doki, Y; Nagano, H

    2014-04-01

    In Japan, absolute shortage of donors still continues even after the law allowing organ transplantation from deceased donors came into force in 1997. With the passage of the waiting period after registration for pancreas transplantation (PTx), both deaths and serious cases of diabetic complications necessitating withdrawal of the registration have undoubtedly increased. Therefore, so-called "marginal donor" (MD) has been considered as a potential solution for shortage of donors in Japan. The aim of the present study is to evaluate feasibility of MD in terms of post-PTx outcomes using data from Japan Organ Transplantation Network. A total of 148 PTx were performed from deceased donors in Japan from 2000 to 2012. MD was defined as follows: (1) >45 years old; (2) hemodynamically unstable at harvest using a high-dose dopamine or more than 2 vasopressors; or (3) non-heart-beating status. Postoperative outcomes after PTx were compared between the MD group and the non-MD group. Among the 148 PTx donors, 108 donors (73.0%) satisfied the criteria of MD. Early graft loss of pancreas graft during 3 months post-transplant was observed in 15 patients (10.1%), and the marginality (MD vs non-MD) was not significantly correlated with the early loss of pancreas graft. The overall patient survival of the MD group (1, 3, 5 years: 94.7%, 94.7%, 94.7%) was not significantly different from that of the non-MD group (1, 3, 5 years: 95.0%, 95.0%, 95.0%). Pancreas graft survival in the MD group (1, 3, 5 years: 80.9%, 73.2%, 66.0%) seemed to be slightly lower than that in the non-MD group (1, 3, 5 years: 92.5%, 85.2%, 77.4%), but no statistically significant differences were found between the 2 groups. These results suggest the feasibility of the use of MD for PTx.

  10. Space Tethers Design Criteria

    NASA Technical Reports Server (NTRS)

    Tomlin, Donald D.; Faile, Gwyn C.; Hayashida, Kazuo B.; Frost, Cynthia L.; Wagner, Carole Y.; Mitchell, Michael L.; Vaughn, Jason A.; Galuska, Michael J.

    1998-01-01

    The small expendable deployable system and tether satellite system programs did not have a uniform written criteria for tethers. The JSC safety panel asked what criteria was used to design the tethers. Since none existed, a criteria was written based on past experience for future tether programs.

  11. Right Lobe Living Donors Ages 55 and Older in Liver Transplantation.

    PubMed

    Kim, Seong Hoon; Lee, Eung Chang; Shim, Jae Ryong; Park, Sang Jae

    2017-07-22

    Insufficient is the evidence for safe use of elderly donors in adult-to-adult living donor liver transplantation (LDLT). The aim of this study was to evaluate the outcomes of right lobe LDLT by donor age (≥55 vs. <55 years). All living donors who underwent right hepatectomy at the authors' institution between March 2008 and December 2015 were divided into 2 groups: group A with an age ≥ 55 and group B with an age < 55. The selection criteria for elderly donor were preservation of middle hepatic vein, remnant liver volume ≥30%, and no or mild fatty liver. The matching criteria of recipients for the elderly donor grafts were model for end-stage liver disease score<25, graft-to-recipient weight ratio>0.8%, and body mass index<25kg/m(2) . Perioperative data, complications by the Clavien classification, and the outcomes with at least 12 months follow-up were compared. Forty-two donors were enrolled in group A and 498 in group B. No significant differences in operative parameters were observed between the two groups. The peak postoperative AST, ALT, and total bilirubin levels made no difference between the two groups. The peak INR level was significantly lower in group A than in group B (p=0.001). All donors recovered completely with no significant differences in overall complications between the two groups. All recipients of grafts from donors in group A showed good initial function with no significant differences in 1-year graft and patient survival or biliary complications between two groups. These results provide clinical evidence for feasibility of right hepatectomy in living donors aged ≥ 55 years without compromising donor safety or recipient outcomes. This article is protected by copyright. All rights reserved. © 2017 by the American Association for the Study of Liver Diseases.

  12. Motivations for Giving of Alumni Donors, Lapsed Donors and Non-Donors: Implications for Christian Higher Education

    ERIC Educational Resources Information Center

    Rugano, Emilio Kariuki

    2011-01-01

    This descriptive and causal comparative study sought to identify motivations for alumni donor acquisition and retention in Christian institutions of higher learning. To meet this objective, motivations for alumni donors, lapsed donors, and non-donors were analyzed and compared. Data was collected through an electronic survey of a stratified sample…

  13. Motivations for Giving of Alumni Donors, Lapsed Donors and Non-Donors: Implications for Christian Higher Education

    ERIC Educational Resources Information Center

    Rugano, Emilio Kariuki

    2011-01-01

    This descriptive and causal comparative study sought to identify motivations for alumni donor acquisition and retention in Christian institutions of higher learning. To meet this objective, motivations for alumni donors, lapsed donors, and non-donors were analyzed and compared. Data was collected through an electronic survey of a stratified sample…

  14. Do donor oocyte cycles comply with ASRM/SART embryo transfer guidelines? An analysis of 13,393 donor cycles from the SART registry.

    PubMed

    Acharya, Kelly S; Keyhan, Sanaz; Acharya, Chaitanya R; Yeh, Jason S; Provost, Meredith P; Goldfarb, James M; Muasher, Suheil J

    2016-09-01

    To analyze donor oocyte cycles in the Society for Assisted Reproductive Technology (SART) registry to determine: 1) how many cycles complied with the 2009 American Society for Reproductive Medicine/SART embryo transfer guidelines; and 2) cycle outcomes according to the number of embryos transferred. For donor oocyte IVF with donor age <35 years, the consideration of single-embryo transfer was strongly recommended. Retrospective cohort study of United States national registry information. Not applicable. A total of 13,393 donor-recipient cycles from 2011 to 2012. Embryos transferred in donor IVF cycles. Percentage of compliant cycles, multiple pregnancy rate. There were 3,157 donor cleavage-stage transfers and 10,236 donor blastocyst transfers. In the cleavage-stage cycles, 88% met compliance criteria. The multiple pregnancy rate (MPR) was significantly higher in the noncompliant cycles. In a subanalysis of compliant cleavage-stage cycles, 91% transferred two embryos and only 9% single embryos. In those patients transferring two embryos, the MPR was significantly higher (33% vs. 1%). In blastocyst transfers, only 28% of the cycles met compliance criteria. The MPR was significantly higher in the noncompliant blastocyst cohort at 53% (compared with 2% in compliant cycles). The majority of donor cleavage-stage transfers are compliant with current guidelines, but the transfer of two embryos results in a significantly higher MPR compared with single-embryo transfer. The majority of donor blastocyst cycles are noncompliant, which appears to be driving an unacceptably high MPR in these cycles. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. The Assembly of EDC4 and Dcp1a into Processing Bodies Is Critical for the Translational Regulation of IL-6.

    PubMed

    Seto, Eri; Yoshida-Sugitani, Reiko; Kobayashi, Toshihiko; Toyama-Sorimachi, Noriko

    2015-01-01

    Macrophages play critical roles in the onset of various diseases and in maintaining homeostasis. There are several functional subsets, of which M1 and M2 macrophages are of particular interest because they are differentially involved in inflammation and its resolution. Here, we investigated the differences in regulatory mechanisms between M1- and M2-polarized macrophages by examining mRNA metabolic machineries such as stress granules (SGs) and processing bodies (P-bodies). Human monocytic leukemia THP-1 cells cultured under M1-polarizing conditions (M1-THPs) had less ability to assemble oxidative-stress-induced SGs than those cultured under M2-polarizing conditions (M2-THPs). In contrast, P-body assembly in response to oxidative stress or TLR4 stimulation was increased in M1-THPs as compared to M2-THPs. These results suggest that mRNA metabolism is controlled differently in M1-THPs and M2-THPs. Interestingly, knocking down EDC4 or Dcp1a, which are components of P-bodies, severely reduced the production of IL-6, but not TNF-α in M1-THPs without decreasing the amount of IL-6 mRNA. This is the first report to demonstrate that the assembly of EDC4 and Dcp1a into P-bodies is critical in the posttranscriptional regulation of IL-6. Thus, improving our understanding of the mechanisms governing mRNA metabolism by examining macrophage subtypes may lead to new therapeutic targets.

  16. The Assembly of EDC4 and Dcp1a into Processing Bodies Is Critical for the Translational Regulation of IL-6

    PubMed Central

    Kobayashi, Toshihiko; Toyama-Sorimachi, Noriko

    2015-01-01

    Macrophages play critical roles in the onset of various diseases and in maintaining homeostasis. There are several functional subsets, of which M1 and M2 macrophages are of particular interest because they are differentially involved in inflammation and its resolution. Here, we investigated the differences in regulatory mechanisms between M1- and M2-polarized macrophages by examining mRNA metabolic machineries such as stress granules (SGs) and processing bodies (P-bodies). Human monocytic leukemia THP-1 cells cultured under M1-polarizing conditions (M1-THPs) had less ability to assemble oxidative-stress-induced SGs than those cultured under M2-polarizing conditions (M2-THPs). In contrast, P-body assembly in response to oxidative stress or TLR4 stimulation was increased in M1-THPs as compared to M2-THPs. These results suggest that mRNA metabolism is controlled differently in M1-THPs and M2-THPs. Interestingly, knocking down EDC4 or Dcp1a, which are components of P-bodies, severely reduced the production of IL-6, but not TNF-α in M1-THPs without decreasing the amount of IL-6 mRNA. This is the first report to demonstrate that the assembly of EDC4 and Dcp1a into P-bodies is critical in the posttranscriptional regulation of IL-6. Thus, improving our understanding of the mechanisms governing mRNA metabolism by examining macrophage subtypes may lead to new therapeutic targets. PMID:25970328

  17. 91-Year-Old Allograft: Oldest Surviving Donor Heart Still Going: A Case Report.

    PubMed

    Doctorian, T; Narasimha, D; Stoletniy, L; Sakr, A

    2017-09-01

    For patients with end-stage heart failure, heart transplantation remains one of the most successful therapies with excellent long-term survival rates. However, over the past few decades, there has been a worsening supply/demand mismatch given the rising epidemic of heart failure and the relatively fixed availability of donor hearts. In this case report, we describe the case of a 30-year-old woman who underwent transplantation with a 68-year-old donor heart and who has survived for 23 years without any major cardiac problems. To our knowledge, this patient has one of the oldest surviving donor hearts (91-year-old heart). Review of the latest guidelines and recent studies have demonstrated a gradual expansion of donor criteria to meet this critical shortage of donor organs. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Comparison of Two Questionnaires on Informed Consent in "Marginal" Donor Liver.

    PubMed

    Bruzzone, P; Balla, A; Quaresima, S; Seitaj, A; Intini, G; Giannarelli, D; Paganini, A M

    2016-03-01

    The necessity of liver donors has contributed to overcoming the traditional criteria and to propose new ones for the acceptance of livers for transplantation. For this reason expanded or extended criteria donation (ECD) or even overextended criteria for marginal or high-risk organ donors have been developed. Ethical, Legal and Psychological Aspects of Organ Transplantation (ELPAT) and European Liver and Intestine Transplant Association (ELITA) - European Liver Transplantation Registry (ELTR) coordinated the distribution of a previously reported questionnaire that was sent to 53 European liver transplant centers. Criteria were divided based on the response rate. Donor criteria such as steatosis and serum sodium >165 mmol/L, as well as recipient criteria such as previous history of cancer, were not considered contraindications to transplantation in more than 60% of cases. Criteria such as ICU (intensive care unit) stay, body mass index >30, serum bilirubin >3 mg/dL, and HIV infection or critical illness were not considered adequate for transplantation in 30% to 59% of cases. On the other hand, there was no agreement on other extended liver donor and recipient criteria, such as age up to 80 years, serum glutamic oxaloacetic transaminase >90 U/L, serum glutamic pyruvic transaminase >105 U/L, high-risk sex practices, drug users, patients older than 65 years, and patients younger than 65 years, respectively. Criteria such as serum sodium could not be considered ECD criteria. In conclusion, development of more studies and inclusion of more liver transplantation centers are required to confirm these data.

  19. Dengue antibodies in blood donors

    PubMed Central

    Ribas-Silva, Rejane Cristina; Eid, Andressa Ahmad

    2012-01-01

    Background Dengue is an urban arbovirus whose etiologic agent is a virus of the genus Flavorius with four distinct antigen serotypes (DENV-1, DENV-2, DENV-3 and DENV-4) that is transmitted to humans through the bite of the mosquito Aedes aegypti. The Campo Mourão region in Brazil is endemic for dengue fever. Obtective The aim of this study was to evaluate the presence of IgG and IgM antibodies specific to the four serotypes of dengue in donors of the blood donor service in the city of Campo Mourão. Methods Epidemiological records were evaluated and 4 mL of peripheral blood from 213 blood donors were collected in tubes without anticoagulant. Serum was then obtained and immunochromatographic tests were undertaken (Imuno-Rápido Dengue IgM/IgGTM). Individuals involved in the study answered a social and epidemiological questionnaire on data which included age, gender and diagnosis of dengue. Results Only three (1.4%) of the 213 blood tests were positive for IgG anti-dengue antibodies. No donors with IgM antibody, which identifies acute infection, were identified. Conclusions The results of the current analysis show that the introduction of quantitative or molecular serological methods to determine the presence of anti-dengue antibodies or the detection of the dengue virus in blood donors in endemic regions should be established so that the quality of blood transfusions is guaranteed. PMID:23049418

  20. Donor Hemovigilance with Blood Donation

    PubMed Central

    Diekamp, Ulrich; Gneißl, Johannes; Rabe, Angela; Kießig, Stephan T.

    2015-01-01

    Background Reports on unexpected events (UEs) during blood donation (BD) inadequately consider the role of technical UEs. Methods Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations, and UEs from January 1, 2008 to June 30, 2011. Results 6,605 UEs were observed during 166,650 BDs from 57,622 donors for a corrected incidence of 4.30% (0.66% local, 1.59% systemic, 2.04% technical UEs). 2.96% of BDs were accompanied by one UE and 0.45% by >1 UE (2-4). 6.3% of donors donating blood for their first time, 3.5% of those giving blood for their second time, and 1.9% of donors giving their third or more BD experienced UEs. Most common UEs were: discontinued collections due to venous access problems, repeated venipuncture, and small hematomas. Severe circulatory UEs occurred at a rate of 16 per 100,000 BDs. Conclusions Technical UEs were common during BD. UEs accompanied first and second donations significantly more often than subsequent donations. PMID:26195932

  1. APOL1 genotype and kidney transplantation outcomes from deceased African American donors

    PubMed Central

    Freedman, Barry I.; Pastan, Stephen O.; Israni, Ajay K.; Schladt, David; Julian, Bruce A.; Gautreaux, Michael D.; Hauptfeld, Vera; Bray, Robert A.; Gebel, Howard M.; Kirk, Allan D.; Gaston, Robert S.; Rogers, Jeffrey; Farney, Alan C.; Orlando, Giuseppe; Stratta, Robert J.; Mohan, Sumit; Ma, Lijun; Langefeld, Carl D.; Bowden, Donald W.; Hicks, Pamela J.; Palmer, Nicholette D.; Palanisamy, Amudha; Reeves-Daniel, Amber M.; Brown, W. Mark; Divers, Jasmin

    2015-01-01

    Background Two apolipoprotein L1 gene (APOL1) renal-risk variants in donors and African American (AA) recipient race are associated with worse allograft survival in deceased-donor kidney transplantation (DDKT) from AA donors. To detect other factors impacting allograft survival from deceased AA kidney donors, APOL1 renal-risk variants were genotyped in additional AA kidney donors. Methods APOL1 genotypes were linked to outcomes in 478 newly analyzed DDKTs in the Scientific Registry of Transplant Recipients. Multivariate analyses accounting for recipient age, sex, race, panel reactive antibody level, HLA match, cold ischemia time, donor age, and expanded-criteria donation were performed. These 478 transplantations and 675 DDKTs from a prior report were jointly analyzed. Results Fully-adjusted analyses limited to the new 478 DDKTs replicated shorter renal allograft survival in recipients of APOL1-two-renal-risk-variant kidneys (HR 2.00; p=0.03). Combined analysis of 1153 DDKTs from AA donors revealed donor APOL1 high-risk genotype (HR 2.05; p=3×10−4), older donor age (HR 1.18; p=0.05), and younger recipient age (HR 0.70; p=0.001) adversely impacted allograft survival. Although prolonged allograft survival was seen in many recipients of APOL1-two-renal-risk-variant kidneys, follow-up serum creatinine concentrations were higher than in recipients of zero/one APOL1-renal-risk variant kidneys. A competing risk analysis revealed that APOL1 impacted renal allograft survival, but not recipient survival. Interactions between donor age and APOL1 genotype on renal allograft survival were non-significant. Conclusions Shorter renal allograft survival is reproducibly observed after DDKT from APOL1-two-renal-risk-variant donors. Younger recipient age and older donor age have independent adverse effects on renal allograft survival. PMID:26566060

  2. APOL1 Genotype and Kidney Transplantation Outcomes From Deceased African American Donors.

    PubMed

    Freedman, Barry I; Pastan, Stephen O; Israni, Ajay K; Schladt, David; Julian, Bruce A; Gautreaux, Michael D; Hauptfeld, Vera; Bray, Robert A; Gebel, Howard M; Kirk, Allan D; Gaston, Robert S; Rogers, Jeffrey; Farney, Alan C; Orlando, Giuseppe; Stratta, Robert J; Mohan, Sumit; Ma, Lijun; Langefeld, Carl D; Bowden, Donald W; Hicks, Pamela J; Palmer, Nicholette D; Palanisamy, Amudha; Reeves-Daniel, Amber M; Brown, W Mark; Divers, Jasmin

    2016-01-01

    Two apolipoprotein L1 gene (APOL1) renal-risk variants in donors and African American (AA) recipient race are associated with worse allograft survival in deceased-donor kidney transplantation (DDKT) from AA donors. To detect other factors impacting allograft survival from deceased AA kidney donors, APOL1 renal-risk variants were genotyped in additional AA kidney donors. The APOL1 genotypes were linked to outcomes in 478 newly analyzed DDKTs in the Scientific Registry of Transplant Recipients. Multivariate analyses accounting for recipient age, sex, race, panel-reactive antibody level, HLA match, cold ischemia time, donor age, and expanded criteria donation were performed. These 478 transplantations and 675 DDKTs from a prior report were jointly analyzed. Fully adjusted analyses limited to the new 478 DDKTs replicated shorter renal allograft survival in recipients of APOL1 2-renal-risk-variant kidneys (hazard ratio [HR], 2.00; P = 0.03). Combined analysis of 1153 DDKTs from AA donors revealed donor APOL1 high-risk genotype (HR, 2.05; P = 3 × 10), older donor age (HR, 1.18; P = 0.05), and younger recipient age (HR, 0.70; P = 0.001) adversely impacted allograft survival. Although prolonged allograft survival was seen in many recipients of APOL1 2-renal-risk-variant kidneys, follow-up serum creatinine concentrations were higher than that in recipients of 0/1 APOL1 renal-risk-variant kidneys. A competing risk analysis revealed that APOL1 impacted renal allograft survival, but not recipient survival. Interactions between donor age and APOL1 genotype on renal allograft survival were nonsignificant. Shorter renal allograft survival is reproducibly observed after DDKT from APOL1 2-renal-risk-variant donors. Younger recipient age and older donor age have independent adverse effects on renal allograft survival.

  3. Ex vivo lung perfusion allows successful transplantation of donor lungs from hanging victims.

    PubMed

    Bennett, Daine T; Reece, T Brett; Smith, Phillip D; Grandhi, Miral Sadaria; Rove, Jessica A Yu; Justison, George A; Mitchell, John D; Fullerton, David A; Zamora, Martin R; Weyant, Michael J

    2014-09-01

    Donor lungs acquired from victims of asphyxiation by hanging are not routinely used for lung transplantation because of the associated lung injury. Ex vivo lung perfusion (EVLP) is a technique to evaluate marginal donor lungs before transplantation. We report here our experience with the use of EVLP in donor lungs procured from victims of asphyxia by hanging. Lungs from 5 donors who became brain dead secondary to hanging were evaluated by EVLP. Donor organs were perfused according to trial protocol. Donor lungs were accepted for transplantation if they maintained a PaO2 greater than or equal to 350 mm Hg, had a clear roentgenogram, and had no significant worsening of physiologic metrics. Perfused organs included single and double lung blocs, and all were perfused without technical incident. Three of the 5 donor organs evaluated met criteria for transplantation after 3 hours of EVLP and were transplanted. Donor organs rejected for transplantation showed either signs of worsening PaO2 or deterioration of physiologic metrics. There were no intraoperative complications in the patients who underwent transplantation, and all were alive at 30 days. We report here the successful use of EVLP to assess donor lungs acquired from victims of asphyxiation by hanging. The use of EVLP in this particular group of donors has the potential to expand the available donor pool. We demonstrate that EVLP is a viable option for evaluating the function of lung allografts before transplantation and would recommend that all donor lungs obtained from hanging victims undergo EVLP to assess their suitability for transplantation. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  4. The dead donor rule: effect on the virtuous practice of medicine.

    PubMed

    Chaten, Frank C

    2014-07-01

    The President's Council on Bioethics in 2008 reaffirmed the necessity of the dead donor rule and the legitimacy of the current criteria for diagnosing both neurological and cardiac death. In spite of this report,many have continued to express concerns about the ethics of donation after circulatory death, the validity of determining death using neurological criteria and the necessity for maintaining the dead donor rule for organ donation. I analysed the dead donor rule for its effect on the virtuous practice of medicine by physicians caring for potential organ donors. The dead donor rule consistently impedes physicians in fulfilling their primary duty to act for the good of their prospective donor patients. This compromises the virtue of fidelity. It also weakens many other virtues necessary for physicians to provide excellent end-of-life care. The dead donor rule, while ethically powerful in theory, loses its force during translation to the bedside. This is so because the rule mandates simultaneous life and death within the same body for organ donation, a biological status that is inherently contradictory. The rule should be rejected as an ethical norm governing vital organ transplantation at the end of life. Its elimination will strengthen the doctor–patient relationship and foster trustworthiness in organ procurement.

  5. Defining Language Ability: The Criteria for Criteria.

    ERIC Educational Resources Information Center

    Brindley, Geoff

    Problems associated with criterion-referenced language testing are discussed in the context of both standardized proficiency testing and classroom assessment. First, different interpretations of criterion-referencing are examined. A range of approaches for defining criteria and performance levels in second language assessment are outlined, and…

  6. Allogeneic blood stem cell transplantation: considerations for donors.

    PubMed

    Anderlini, P; Körbling, M; Dale, D; Gratwohl, A; Schmitz, N; Stroncek, D; Howe, C; Leitman, S; Horowitz, M; Gluckman, E; Rowley, S; Przepiorka, D; Champlin, R

    1997-08-01

    -rich plasma should be considered for donors with expected postdonation thrombocytopenia (platelet count < 80 to 100 x 10(9)/L). (4) Donors should meet the eligibility criteria which apply to donors of apheresis platelets, with the exception that pediatric donors may also be considered. Any deviation from these criteria should have supporting documentation. There is insufficient information at this time to clearly establish definite contraindications for PBSC collection in a hematologically normal donor. Potential contraindications include the presence of inflammatory, autoimmune, or rheumatologic disorders, as well as atherosclerotic or cerebrovascular disease. (5) The creation of an International PBSC Donor Registry is desirable to facilitate monitoring the long-term effects of the procedure. Individual institutions or donor centers are encouraged to establish their own PBSC donor follow-up system, preferably with a standardized approach to data collection.

  7. Differing Tales of Two Patients after Receiving a Kidney Transplant from a Donor with Disseminated Intravascular Coagulation

    PubMed Central

    Kadambi, Pradeep V.; Gamilla-Crudo, Ann K.; Almiani, Mohammad; Josephson, Michelle A.

    2014-01-01

    In order to decrease the time on the deceased donor kidney wait list and to have more organs available, criteria for acceptable organs for transplant could be made less stringent. There are reports of successful recipient outcomes using kidney donors presenting with disseminated intravascular coagulation (DIC). We report a unique circumstance where two patients received kidneys from the same deceased donor who had DIC; one patient developed thrombotic microangiopathy (TMA) while the other did not. This difference in outcome may indicate that both donor and recipient factors contribute to the development of posttransplant TMA. PMID:25061532

  8. When thoracic organ recipients become abdominal organ donors: sharing the risks and benefits of transplantation: a case report.

    PubMed

    Chua, S; Swaminathan, R; Irish, A

    2015-01-01

    The increasing demand for organ donation has resulted in the use of expanded-criteria donors. Solid organ transplant recipients and potential recipients represent a unique pool of selected organ donors that may help to meet this demand. We present 2 cases, a lung transplant recipient and a patient on the lung transplant waiting list, who became kidney donors to 4 recipients. These donations illustrate the interrelated risks and benefits for transplant recipients who themselves can become unintended, but effective donors. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  9. Biological Water Quality Criteria

    EPA Pesticide Factsheets

    Page contains links to Technical Documents pertaining to Biological Water Quality Criteria, including, technical assistance documents for states, tribes and territories, program overviews, and case studies.

  10. Anencephalic infants as organ donors.

    PubMed

    Botkin, J R

    1988-08-01

    Transplantation technology has been refined in recent years and now offers hope to pediatric patients with a variety of end stage disease processes. The lack of available donors for the smallest potential organ recipients has led to the suggestion that anencephalic infants be used as organ donors. This suggested policy is contrary to current law and raises fundamental ethical issues relating to the definition of death and the treatment of the dying. The technical issues in the potential organ supply from this source are described and the opposing ethical positions developing in this debate are discussed.

  11. The use of neoplastic donors to increase the donor pool.

    PubMed

    Fiaschetti, P; Pretagostini, R; Stabile, D; Peritore, D; Oliveti, A; Gabbrielli, F; Cenci, S; Ricci, A; Vespasiano, F; Grigioni, W F

    2012-09-01

    The aim of the study was to evaluate the experience of the Centre-Sud Transplant Organization (OCST) area using cadaveric donor with neoplastic diseases to evaluate the possibility of transmission to recipients. From January 1, 2003, to December 31, 2010, the neoplastic risk has been reported to be 5.4% (377/4654 referred donors). In 2003, the number of donors with a tumor and their mean age were respectively: 60 (10.3%) and 59.6 ± 19.9; 2004: 33 (5.2%) and 61.4 ± 15.9; 2005: 32 (6%) and 62.8 ± 15.5; 2006: 46 (7%) and 60.7 ± 19.1; 2007: 51 (7%) and 58.9 ± 16; in 2008: 58 (7%) and 59.7 ± 19.6; 2009: 47 (7%) and 57 ± 26; 2010: 49 (7%) and 64 ± 16. The organ most affected by tumor has been the central nervous system (18%). The tumor was diagnosed before in 325 (86%) cases, versus during organ retrieval in 48 (12.7%) donor operations but before, which four cases (1%) occured after transplantation. According to the histological types and grades, 28 evaluated donors (8.2%) were suitable for transplantation. The histological types were: thyroid carcinoma (n = 3); prostate carcinoma (n = 8), renal clear cell carcinoma (n = 7), oncocytoma (n = 1), meningiomas (n = 2), dermofibrosarcoma (n = 1); verrucous carcinoma of the vulva (n = 1), colon adenocarcinoma (n = 1), grade II astrocytoma (n = 1), adrenal gland tumor (n = 1), gastric GIST (n = 1), oligodendroglioma (n = 1). Forty-five organs were retrieved (22 livers, 19 kidneys, 3 hearts, and 1 pancreas) and transplanted into 44 recipients with 1 liver-kidney combined transplantation. Four recipients died due to causes not related to the tumor. No donor-transmitted tumor was detected among the recipients. Donation is absolutely not indicated in cases of tumors with high metastatic potential and high grades. Performing an accurate evaluation of the donor, taking into account the histological grade, currently can allow, organ retrieval and transplantation with an acceptable risk.

  12. [Abstract bodies, concrete risks: clinical devices and the health of ova donors in Argentine reproductive medicine].

    PubMed

    Ariza, Lucía

    2016-01-01

    Using a methodological perspective grounded in science and technology studies, this article analyzes two sociotechnical devices used in Argentine reproductive medicine (biostatistical measures and donation registries) with the aim of controlling both the so-called "genetic risk" arising from the use of donated ova as well as the health risks to female donors. By examining how the deployment of monitoring criteria disregards the specificity of ova donation, the article suggests that it is not the absence of control measures and clinical criteria that produces an inadequate monitoring of such risks, but rather the concrete ways in which such measures are implemented that results in potential harms to the health of female donors.

  13. Competing risks and the development of adaptive management plans for water resources: Field reconnaissance investigation of risks to fishes and other aquatic biota exposed to endocrine disrupting chemicals (edcs) in lake mead, Nevada USA

    USGS Publications Warehouse

    Linder, G.; Little, E.E.

    2009-01-01

    The analysis and characterization of competing risks for water resources rely on a wide spectrum of tools to evaluate hazards and risks associated with their management. For example, waters of the lower Colorado River stored in reservoirs such as Lake Mead present a wide range of competing risks related to water quantity and water quality. These risks are often interdependent and complicated by competing uses of source waters for sustaining biological resources and for supporting a range of agricultural, municipal, recreational, and industrial uses. USGS is currently conducting a series of interdisciplinary case-studies on water quality of Lake Mead and its source waters. In this case-study we examine selected constituents potentially entering the Lake Mead system, particularly endocrine disrupting chemicals (EDCs). Worldwide, a number of environmental EDCs have been identified that affect reproduction, development, and adaptive behaviors in a wide range of organisms. Many EDCs are minimally affected by current treatment technologies and occur in treated sewage effluents. Several EDCs have been detected in Lake Mead, and several substances have been identified that are of concern because of potential impacts to the aquatic biota, including the sport fishery of Lake Mead and endangered razorback suckers (Xyrauchen texanus) that occur in the Colorado River system. For example, altered biomarkers relevant to reproduction and thyroid function in fishes have been observed and may be predictive of impaired metabolism and development. Few studies, however, have addressed whether such EDC-induced responses observed in the field have an ecologically significant effect on the reproductive success of fishes. To identify potential linkages between EDCs and species of management concern, the risk analysis and characterization in this reconnaissance study focused on effects (and attendant uncertainties) that might be expressed by exposed populations. In addition, risk reduction

  14. Transfusion safety in francophone African countries: an analysis of strategies for the medical selection of blood donors

    PubMed Central

    Tayou, Claude Tagny; Kouao, Maxime Diané; Touré, Hamane; Gargouri, Jalel; Fazul, Ahamada Said; Ouattara, Siaka; Anani, Ludovic; Othmani, Habiba; Feteke, Lochina; Dahourou, Honorine; Mbensa, Guy Olivier; Molé, Simplice; Nébié, Yacouba; Mbangue, Madeleine; Toukam, Michel; Boulahi, Mahommed Ould; Andriambelo, Lalatiana Valisoa; Rakoto, Olivat; Baby, Mounirou; Yahaya, Rakia; Bokilo, Amelia; Senyana, Florent; Mbanya, Dora; Shiboski, Caroline; Murphy, Edward L.; Lefrère, Jean Jacques

    2013-01-01

    BACKGROUND The goal of selecting a healthy blood donor is to safeguard donors and reduce the risks of infections and immunologic complications for recipients. STUDY DESIGN AND METHODS To evaluate the blood donor selection process, a survey was conducted in 28 blood transfusion centers located in 15 francophone African countries. Data collected included availability of blood products, risk factors for infection identified among blood donor candidates, the processing of the information collected before blood collection, the review process for the medical history of blood donor candidates, and deferral criteria for donor candidates. RESULTS During the year 2009, participating transfusion centers identified 366,924 blood donor candidates. A mean of 13% (range, 0%–36%) of the donor candidates were excluded based solely on their medical status. The main risk factors for blood-borne infections were having multiple sex partners, sexual intercourse with occasional partners, and religious scarification. Most transfusion centers collected this information verbally instead of having a written questionnaire. The topics least addressed were the possible complications relating to the donation, religious scarifications, and history of sickle cell anemia and hemorrhage. Only three centers recorded the temperature of the blood donors. The deferral criteria least reported were sickle cell anemia, piercing, scarification, and tattoo. CONCLUSIONS The medical selection process was not performed systemically and thoroughly enough, given the regional epidemiologic risks. It is essential to identify the risk factors specific to francophone African countries and modify the current medical history questionnaires to develop a more effective and relevant selection process. PMID:22014098

  15. Living donor liver transplantation for hepatocellular carcinoma achieves better outcomes

    PubMed Central

    Lin, Chih-Che

    2016-01-01

    Liver transplantation (LT) for hepatocellular carcinoma (HCC) at Kaohsiung Chang Gung Memorial Hospital mainly relies on live donor LT (LDLT). Owing to taking the risk of LD, we are obligated to adopt strict selection criteria for HCC patients and optimize the pre-transplant conditions to ensure a high disease-free survival similar to those without HCC, even better than deceased donor LT (DDLT). Better outcomes are attributed to excellent surgical results and optimal patient selection. The hospital mortality of primary and salvage LDLT are lower than 2% in our center. Although Taiwan Health Insurance Policy extended the Milan to University of California, San Francisco (UCSF) criteria in 2006, selection criteria will not be consolidated to take into account only by the morphologic size/number of tumors but also by their biology. The criteria are divided into modifiable image morphology, alpha fetoprotein (AFP), and positron emission tomography (PET) scan with standard uptake value (SUV) and unmodifiable unfavorable pathology such as HCC combined with cholangiocarcinoma (CC), sarcomatoid type, and poor differentiation. Downstaging therapy is necessary for HCC patients beyond criteria to fit all modifiable standards. The upper limit of downstaging treatment seems to be extended by more effective drug eluting transarterial chemoembolization in cases without absolute contraindications. In contrast, the pitfall of unmodifiable tumor pathology should be excluded by the findings of pretransplant core biopsy/resection if possible. More recently, achieving complete tumor necrosis in explanted liver could almost predict no recurrence after transplant. Necrotizing therapy is advised if possible before transplant even the tumor status within criteria to minimize the possibility of tumor recurrence. LDLT with low surgical mortality in experienced centers provides the opportunities of optimizing the pre-transplant tumor conditions and timing of transplant to achieve better

  16. The living anonymous kidney donor: lunatic or saint?

    PubMed

    Henderson, Antonia J Z; Landolt, Monica A; McDonald, Michael F; Barrable, William M; Soos, John G; Gourlay, William; Allison, Colleen J; Landsberg, David N

    2003-02-01

    Studies indicate that 11% to 54% of individuals surveyed would consider donating a kidney, while alive, to a stranger. The idea of 'living anonymous donors' (LADs) as a donor source, however, has not been embraced by the medical community. Reservations focus on the belief that LADs might be psychologically unstable and thus unsuitable donors. Our goal was to inform policy development by exploring the psycho-social make up and motivations of the LAD. Ninety-three unsolicited individuals contacted our center expressing interest in living anonymous donation. Of these, 43 participated in our study, completing two extensive inventories of psychopathology and personality disorder and taking part in the Comprehensive Psycho-Social Interview (CPSI). From the Personality Assessment Inventory (PAI), the revised NEO Personality Inventory (NEO PI-R), and the CPSI, coders assessed psychological health, psycho-social suitability, commitment, and motivations. Twenty-one participants passed the stringent criteria to be considered potential LADs. Content analysis of motivations showed that potential LADs were more likely than non-LADs (those who did not pass the criteria) to have a spiritual belief system and to be altruistic. Non-LADs were more likely than potential LADs to use donation to make a statement against their families. The authors conclude with a preliminary outline of eight policy recommendations.

  17. The Dead Donor Rule: Can It Withstand Critical Scrutiny?

    PubMed Central

    Miller, Franklin G.; Truog, Robert D.; Brock, Dan W.

    2010-01-01

    Transplantation of vital organs has been premised ethically and legally on “the dead donor rule” (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as “brain dead” and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the “moral fiction” that donors are dead when vital organs are procured. PMID:20439355

  18. Identifying appropriate recipients for CDC infectious risk donor kidneys.

    PubMed

    Chow, E K H; Massie, A B; Muzaale, A D; Singer, A L; Kucirka, L M; Montgomery, R A; Lehmann, H P; Segev, D L

    2013-05-01

    Over 10% of deceased donors in 2011 met PHS/CDC criteria for infectious risk donor (IRD), and discard rates are significantly higher for kidneys from these donors. We hypothesized that patient phenotypes exist for whom the survival benefit outweighs the infectious risk associated with IRDs. A patient-oriented Markov decision process model was developed and validated, based on SRTR data and meta-analyses of window period risks among persons with IRD behaviors. The Markov model allows patients to see, for their phenotype, their estimated survival after accepting versus declining an IRD offer, graphed over a 5-year horizon. Estimated 5-year survival differences associated with accepting IRDs ranged from -6.4% to +67.3% for a variety of patient phenotypes. Factors most predictive of the survival difference with IRD transplantation were age, PRA, previous transplant, and the expected time until the next non-IRD deceased donor offer. This study suggests that survival benefit derived from IRD kidneys varies widely by patient phenotype. Furthermore, within the inherent limitations of model-based prediction, this study demonstrates that it is possible to identify those predicted to benefit from IRD kidneys, and illustrates how estimated survival curves based on a clinical decision can be presented to better inform patient and provider decision-making.

  19. The dead donor rule: can it withstand critical scrutiny?

    PubMed

    Miller, Franklin G; Truog, Robert D; Brock, Dan W

    2010-06-01

    Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)-the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured.

  20. Plutonium storage criteria

    SciTech Connect

    Chung, D.; Ascanio, X.

    1996-05-01

    The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less than 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.

  1. Single-Donor Leukophoretic Technique

    NASA Technical Reports Server (NTRS)

    Eberhardt, R. N.

    1977-01-01

    Leukocyte separation-and-retrieval device utilizes granulocyte and monocyte property of leukoadhesion to glass surfaces as basis of their separation from whole blood. Device is used with single donor technique and has application in biological and chemical processing, veterinary research and clinical care.

  2. For Donors Who Have Everything.

    ERIC Educational Resources Information Center

    Shubeck, Theresa

    1990-01-01

    Most major donors don't need another plaque or formal dinner. Development officers need to be more imaginative and less materialistic in expressing their institution's thanks, personalizing them by tying the gesture in with something distinctive about the institution or the gift. Development office teamwork and care help promote donor…

  3. Physician Migration: Donor Country Impact

    ERIC Educational Resources Information Center

    Aluwihare, A. P. R.

    2005-01-01

    Physician migration from the developing to developed region of a country or the world occurs for reasons of financial, social, and job satisfaction. It is an old phenomenon that produces many disadvantages for the donor region or nation. The difficulties include inequities with the provision of health services, financial loss, loss of educated…

  4. Single-Donor Leukophoretic Technique

    NASA Technical Reports Server (NTRS)

    Eberhardt, R. N.

    1977-01-01

    Leukocyte separation-and-retrieval device utilizes granulocyte and monocyte property of leukoadhesion to glass surfaces as basis of their separation from whole blood. Device is used with single donor technique and has application in biological and chemical processing, veterinary research and clinical care.

  5. Donor Hemovigilance during Preparatory Plasmapheresis

    PubMed Central

    Diekamp, Ulrich; Gneißl, Johannes; Rabe, Angela; Kießig, Stephan T.

    2014-01-01

    Summary Background Reports on unexpected donor events (UEs) during preparatory plasmapheresis (PPP) are scarce, and rarely consider technical UEs. Methods Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into the PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations and UEs from January 1, 2008 to June 30, 2011. Results 66,822 UEs were observed during 1,107,846 PPPs for a corrected incidence of 6.55% (1.4% local, 0.55% systemic, 4.6% technical UEs). 3.36% of PPPs were accompanied by 1 UE and 1.18% by >1 UE (2-5). 13.7% of donors undergoing PPP for the first time, 9.7% of those having a second PPP and 4.0% of those having a third or more PPPs were associated with UEs. Most common UEs were repeated venipuncture, and broken-off collection due to venous access problems and small hematomas. Severe systemic UEs occurred at a rate of 36 per 100,000 PPPs. Conclusions Technical UEs were common with PPP. UEs accompanied first and second donations significantly more frequently than for subsequent donations. PMID:24847188

  6. The Blood Donor Deferral Register

    PubMed Central

    Brunkhart, Donald E.; Ellis, Frank R.

    1979-01-01

    The paper will describe the American National Red Cross' national hepatitis surveillance registry known as the Donor Defferal Registry (DDR), and its implementation in the Missouri/Illinois Region. Attention will be given specially to computer structure and processing strategy, impact on the clinical incidence of hepatitis and the cost of the DDR.

  7. High prevalence of subclinical iron deficiency in whole blood donors not deferred for low hemoglobin.

    PubMed

    Baart, A Mireille; van Noord, Paulus A H; Vergouwe, Yvonne; Moons, Karel G M; Swinkels, Dorine W; Wiegerinck, Erwin T; de Kort, Wim L A M; Atsma, Femke

    2013-08-01

    Blood donors that meet the hemoglobin (Hb) criteria for donation may have undetected subclinical iron deficiency. The aim of this study was to assess the prevalence of subclinical iron deficiency in whole blood donors with Hb levels above cutoff levels for donation by measuring zinc protoporphyrin (ZPP) levels. In addition, prevalence rates based on other iron variables were assessed for comparison. The study population comprised 5280 Dutch whole blood donors, who passed the Hb criteria for donation. During donor screening, Hb levels were measured in capillary samples (finger prick), and venous blood samples were taken for measurements of ZPP and other iron variables. These variables included ferritin, transferrin saturation, soluble transferrin receptor (sTfR), hepcidin, red blood cell mean corpuscular volume (MCV), and mean cell Hb (MCH). With a ZPP cutoff level of at least 100 μmol/mol heme, subclinical iron deficiency was present in 6.9% of male donors and in 9.8% of female donors. Based on other iron variables, iron deficiency was also observed. Prevalence rates ranged from 4.8% (based on transferrin saturation) to 27.4% (based on hepcidin concentration) in men and from 5.6% (based on sTfR concentration) to 24.7% (based on hepcidin concentration) in women. Results from this study showed that subclinical iron deficiency is prevalent among blood donors that meet the Hb criteria for blood donation, based on ZPP levels and on other iron variables. This finding needs attention because these donors are at increased risk of developing iron deficiency affecting Hb formation and other cellular processes. © 2012 American Association of Blood Banks.

  8. Donor hypernatremia before procurement and early outcomes following pediatric liver transplantation.

    PubMed

    Kaseje, Neema; McLin, Valerie; Toso, Christian; Poncet, Antoine; Wildhaber, Barbara E

    2015-08-01

    The demand for transplantable organs far outweighs the supply. Recently, efforts have been made to increase the donor pool by adopting extended criteria for livers, including those from hypernatremic donors. Currently, there is no clear evidence that the use of organs from hypernatremic donors has detrimental effects on pediatric liver transplantation (LT) recipients. Our aim was to use the Scientific Registry of Transplant Recipients database to evaluate the effects of donor hypernatremia on 30-day outcomes in pediatric LT recipients. We performed an analysis of 2325 children who underwent whole or partial LT between 2005 and 2010. First, we sought to determine a donor sodium threshold for increased mortality following pediatric LT. Second, we examined rates of mortality and graft failure at 30 days after LT in patients receiving grafts from hypernatremic donors compared to patients receiving grafts from normonatremic donors. Hypernatremia was defined as a donor sodium level of ≥160 µmol/L. The primary outcome measure was mortality at 30 days after transplant. The secondary outcome measure was graft failure at 30 days after transplant. There was no threshold sodium level for increased 30-day mortality following pediatric LT. Mean recipient ages/weights, Pediatric End-Stage Liver Disease/Model for End-Stage Liver Disease scores, and mean cold and warm ischemia times were similar between the 2 study groups. There were no significant differences in mortality rates (3.9% versus 4.5%; P = 0.87) and graft failure rates (2.2% versus 1.9%; P = 1.00) in patients receiving grafts from hypernatremic donors compared to patients receiving grafts from normonatremic donors at 30 days after LT. In conclusion, donor hypernatremia just before procurement does not appear to have negative effects on mortality and graft failure rates at 30 days following pediatric LT. © 2015 American Association for the Study of Liver Diseases.

  9. Patients benefit from the addition of KIR repertoire data to the donor selection procedure for unrelated haematopoietic stem cell transplantation.

    PubMed

    Schellekens, Jennifer; Rozemuller, Erik H; Petersen, Eefke J; van den Tweel, Jan G; Verdonck, Leo F; Tilanus, Marcel G J

    2008-02-01

    Killer cell immunoglobulin-like receptors (KIRs) expressed on donor natural killer (NK) cells are important for induction of NK cell alloreactivity in haematopoietic stem cell transplantation (HSCT). Current criteria in the selection procedure of an unrelated donor do not account for this potential NK alloresponse. In this study the KIR gene repertoire of 21 HSCT patients and all their potential, unrelated donors (N=64) has been identified by the sequence-specific priming (SSP) procedure. KIR genotype characteristics are correlated with HLA and clinical data. These data show that for 16 cases an HLA compatible alternative donor was available. Among those 16 were 8 donors with a favourable predicted NK alloreactivity directed against the leukaemic cells. In conclusion, it is feasible and clinically relevant to add the KIR repertoire to the unrelated donor selection procedure.

  10. Psychosocial counselling of identifiable sperm donors.

    PubMed

    Visser, M; Mochtar, M H; de Melker, A A; van der Veen, F; Repping, S; Gerrits, T

    2016-05-01

    What do identifiable sperm donors feel about psychosocial counselling? Identifiable sperm donors found it important that psychosocial counselling focused on emotional consequences and on rules and regulations and they expected to have access to psychosocial counselling at the time that donor-offspring actually sought contact. Most studies on sperm donors are on anonymous donors and focus on recruitment, financial compensation, anonymity and motivations. There is limited knowledge on the value that identifiable sperm donors place on psychosocial counselling and what their needs are in this respect. We performed a qualitative study from March until June 2014 with 25 identifiable sperm donors, who were or had been a donor at the Centre for Reproductive Medicine of the Academic Medical Centre in Amsterdam any time between 1989 and 2014. We held semi-structured in-depth interviews with identifiable sperm donors with an average age of 44 years. The interviews were fully transcribed and analysed using the constant comparative method of grounded theory. Twelve out of 15 donors (former donors ITALIC! n = 8, active donors ITALIC! n = 7) who had received a counselling session during their intake procedure found it important that they had been able to talk about issues such as the emotional consequences of donation, disclosure to their own children, family and friends, future contact with donor-offspring and rules and regulations. Of the 10 former donors who had received no counselling session, 8 had regretted the lack of intensive counselling. In the years following their donation, most donors simply wanted to know how many offspring had been born using their sperm and had no need for further counselling. Nevertheless, they frequently mentioned that they were concerned about the well-being of 'their' offspring. In addition, they would value the availability of psychosocial counselling in the event that donor-offspring actually sought contact. A limitation of our study is its

  11. Screening of deceased organ donors: no easy answers.

    PubMed

    Huang, Robert C; Fishman, Jay A

    2011-01-27

    Transmission of infection to recipients of solid organs is uncommon but well documented. Improved technologies for the diagnosis of infectious diseases suggest possible changes to paradigms used in the screening of organ donors to prevent disease transmission with transplantation. Available microbiologic assays, including molecular tests, are generally designed for use as diagnostic tools in individuals believed to have a specific infection based on clinical or epidemiological criteria. By contrast, these assays often lack the performance characteristics required for screening of deceased organ donors. This challenge is apparent with the analysis of assays for human T-cell lymphotropic virus-I and -II in low-risk populations. Changing epidemiologic patterns associated with the spread of novel pathogens or altered patterns of immigration will necessitate flexibility in the "list" of potential pathogens. Individual benefits from transplantation generally outweigh the risk of transmission of infection. However, this favorable experience will not obviate the need to continuously improve screening practices.

  12. Donor characteristics can influence overall transplant activities: the Italian experience.

    PubMed

    Bertoni, E; Rosati, A; Zanazzi, M; Becherelli, P; Gallo, M; Salvadori, M

    2004-01-01

    The notable increase in organ donations and transplants in Italy in recent years has lead to the development of an atypical approach to kidney transplantation. All propitious considerations left aside regarding the organ donation rate which has placed Italy among the European leaders, a careful comparative evaluation of the data taken from Italian and international registries demonstrates that renal transplantations in Italy have not shared the same significant growth. The typology of the donors has influenced in a decisive way not only the number of renal transplantations, but also the access to transplant for some age groups and probably even the quality and cost. The overall view which emerges is complex and somewhat contradictory, but we believe that this perspective can furnish solid arguments for choices that need not to be delayed for the living donor transplant, the divulgence of a donation culture in the population, and the criteria for the allocation of the organs.

  13. An HLA matched donor! An HLA matched donor? What do you mean by: HLA matched donor?

    PubMed

    van Rood, J J; Oudshoorn, M

    1998-07-01

    The term 'an HLA matched donor' is in general used without giving exact information on the level of resolution of the HLA typing. This can lead to misunderstandings. A proposal is formulated to agree on using six match categories according to the HLA typing technique used to indicate the level of confidence of the matching.

  14. A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India

    PubMed Central

    Garg, Ketan; Kaushik, Ankit; Sharma, Richa; Rawat, DS; Mandal, AK

    2016-01-01

    Introduction With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. Aim To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. Materials and Methods Records of single donor apheresis were retrospectively analysed from 1st January 2010 to 31st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included – age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. Results Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. Conclusion We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors. PMID:28050376

  15. Fire protection design criteria

    SciTech Connect

    1997-03-01

    This Standard provides supplemental fire protection guidance applicable to the design and construction of DOE facilities and site features (such as water distribution systems) that are also provided for fire protection. It is intended to be used in conjunction with the applicable building code, national Fire Protection Association Codes and Standards, and any other applicable DOE construction criteria. This Standard, along with other delineated criteria, constitutes the basic criteria for satisfying DOE fire and life safety objectives for the design and construction or renovation of DOE facilities.

  16. Becoming a Blood Stem Cell Donor

    MedlinePlus Videos and Cool Tools

    ... Find out why Close Becoming a Blood Stem Cell Donor NCIcancertopics Loading... Unsubscribe from NCIcancertopics? Cancel Unsubscribe ... considered becoming a bone marrow or blood stem cell donor? Follow this true story of a former ...

  17. Live donor transplantation--the incompetent donor: comparative law.

    PubMed

    Wolfman, Samuel; Shaked, Tali

    2008-12-01

    Informed consent of the patient to medical treatment is an essential prerequisite for any invasive medical procedure. However in emergency cases, when the patient is unable to sign a consent form due to unconsciousness or to psychotic state, than the primary medical consideration shall take place. In such a case, in order to save life or even prevent a major medical hazard to the patient, doctors are allowed, in certain cases and in accordance with well accepted medical practice, to perform invasive procedures, major surgery or risky pharmacological treatment, without the explicit consent of the patient. All the above refers to the cases when avoidance of such non-consented treatment may harm severely the health and wellbeing of the patient and there is no doubt that such treatment is for the ultimate benefit of the patient. The question, however, shall arise when such a medical procedure is not necessarily for the benefit of the patient, but rather for the benefit of somebody else. Such is the case in the transplantation area and the question of living donor-donee relationship. This paper shall analyze the legal situation in cases of non competent donors whose consent cannot be considered legal consent given in full understanding and out of free will. It will also compare three legal systems, the Israeli, the American and the traditional Jewish law, with regard to the different approaches to this human problem, where the autonomy of the donor may be sacrificed for the purpose of saving life of another person.

  18. Characteristics of donors who do or do not return to give blood and barriers to their return

    PubMed Central

    Wevers, Anne; Wigboldus, Daniël H.J.; de Kort, Wim L.A.M.; van Baaren, Rick; Veldhuizen, Ingrid J.T.

    2014-01-01

    Background In the Netherlands about 50% of whole blood donors return to give blood after an invitation to donate. This study aimed to investigate the characteristics of donor return behaviour and to gain insight into the barriers to blood donation reported by the donors themselves. Materials and methods A total of 4,901 whole blood donors were invited to donate in week 39 of 2009. Barriers mentioned by donors who informed the blood bank for not donating were registered for 1 month. Logistic regression analyses assessed relevant characteristics of return behaviour, such as age and blood type, in men and women separately. Results Of the invited donors, 55% returned to give a donation, whereas 45% did not return. Male donors were more likely to return when they were older, had a higher previous return rate and had no past deferrals. The same pattern was found among women, but was less strong. The main barriers were: time constraints (35%), preference to postpone donation due to general physical problems although being eligible to donate (29%), and being ineligible to donate due to medical deferral criteria (9%). Discussion Specific donor characteristics are associated with return behaviour. Not donating due to time constraints could mean that donors do not feel the urgency of donating blood. Interventions targeted to increase commitment among specific donor groups should be tested further. PMID:23522891

  19. The 40 donors per million population plan: an action plan for improvement of organ donation and transplantation in Spain.

    PubMed

    Matesanz, R; Marazuela, R; Domínguez-Gil, B; Coll, E; Mahillo, B; de la Rosa, G

    2009-10-01

    Spain has been showing the highest rate of deceased donor organ recovery in the world for a whole country, namely, 33-35 donors per million population (pmp) during the last years. This activity is attributed to the so-called Spanish Model of organ donation, an integrated approach to improve organ donation since the start of the Organización Nacional de Trasplantes (ONT) in 1989. However, in 2007 there were 7/17 regions with >40 donors pmp and a marked regional variability. Thus, ONT has set a large-scale, comprehensive strategy to achieve a substantial improvement in donation and transplantation in Spain in the coming years: The 40 Donors pmp Plan. The overall objective is to increase the average rate of deceased donors to 40 pmp between 2008 and 2010. The areas of improvement, specific objectives, and actions have come from deep reflection on the data and the material generated from multidisciplinary discussions and open consultation with the donation and transplantation community. Detection and management of brain-dead donors, with 4 specific subareas: access to intensive care units, new forms of hospital management, foreigners and ethnic minorities, and evaluation/maintenance of thoracic organ donors. Expanded criteria donors, with 3 subareas: aging, donors with positive tests to certain viral serologies, and donors with rare diseases. Special surgical techniques. Donation after cardiac death.

  20. Water Quality Criteria

    EPA Pesticide Factsheets

    EPA develops water quality criteria based on the latest scientific knowledge to protect human health and aquatic life. This information serves as guidance to states and tribes in adopting water quality standards.

  1. NSF adopts new criteria

    NASA Astrophysics Data System (ADS)

    Friebele, Elaine

    Beginning in October, grant proposals submitted to the National Science Foundation will be reviewed according to new criteria. The four aspects now used by NSF reviewers to evaluate proposals will be reduced to two: intellectual merit and broader impact to society.NSF's more comprehensive strategic plan and stronger emphasis on education prompted the first change in its merit review criteria since 1981. The second new criterion—the proposed activity's impact to society—combines two present criteria regarding the relevance of the research and its effect on the infrastructure of science and engineering. The new criteria are organized in a way that, according to administrators, should make them more flexible and easier to use.

  2. Aquatic Life Criteria - Atrazine

    EPA Pesticide Factsheets

    Documents pertaining to Acute and Chronic Ambient Water Quality Aquatic Life Criteria for Atrazine (Freshwater and Salt Water). This document contains the safe levels of Atrazine in water that should protect to the majority of species.

  3. Aquatic Life Criteria - Cadmium

    EPA Pesticide Factsheets

    Documents pertaining to 2016 Acute and Chronic Aquatic Life Ambient Water Quality Criteria for Cadmium (Freshwater, Estuarine/marine). These documents contain the safe levels of Cadmium in water that should protect to the majority of species.

  4. Aquatic Life Criteria - Carbaryl

    EPA Pesticide Factsheets

    Documents pertaining to 2012 Final National Recommended Aquatic Life Ambient Water Quality Criteria for Carbaryl (Freshwater, Estuarine/marine). These documents contain the safe levels of Carbaryl in water that should protect to the majority of species.

  5. Aquatic Life Criteria - Ammonia

    EPA Pesticide Factsheets

    Documents related to EPA's final 2013 Aquatic Life Ambient Water Quality Criteria for Ammonia (Freshwater). These documents pertain to the safe levels of Ammonia in water that should protect to the majority of species.

  6. Aquatic Life Criteria - Copper

    EPA Pesticide Factsheets

    Documents pertain to Aquatic Life Ambient Water Quality criteria for Copper (2007 Freshwater, 2016 Estuarine/marine). These documents contain the safe levels of Copper in water that should protect to the majority of species.

  7. Aquatic Life Criteria - Lead

    EPA Pesticide Factsheets

    References and documents pertaining to Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Lead. These documents include the safe levels of Lead in water that should protect the majority of species.

  8. Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation

    PubMed Central

    Spoon, Emerentia Q. W.; van de Wetering, Jacqueline; IJzermans, Jan N. M.; Dor, Frank J. M. F.

    2017-01-01

    Background The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. Methods An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. Results 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Conclusions Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based. PMID:28732093

  9. Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation.

    PubMed

    Lafranca, Jeffrey A; Spoon, Emerentia Q W; van de Wetering, Jacqueline; IJzermans, Jan N M; Dor, Frank J M F

    2017-01-01

    The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based.

  10. Amphiphilic NO-donor antioxidants.

    PubMed

    Chegaev, Konstantin; Lazzarato, Loretta; Rolando, Barbara; Marini, Elisabetta; Lopez, Gloria V; Bertinaria, Massimo; Di Stilo, Antonella; Fruttero, Roberta; Gasco, Alberto

    2007-02-01

    Models of amphiphilic NO-donor antioxidants 24-26 were designed and synthesized. The products were obtained by linking a lipophilic tail (C(6), C(8), C(10)) with a polar head constituted by the 2,6-dimethoxyphenol antioxidant joined to the NO-donor 3-furoxancarboxamide substructure through a bridge containing a quaternary ammonium group. Compound 23, containing the shortest C(2)-alkyl chain, was also studied as a reference. The antioxidant properties (TBARS and LDL oxidation assays) and the vasodilator properties of the compounds were studied in vitro. The ability of these products to interact with phospholipid vesicles was also investigated by NMR techniques. The results indicate that both activities are modulated by the ability of the compounds to accumulate on phospholipid layers.

  11. Organ Donor Recovery Performed at an Organ Procurement Organization-Based Facility Is an Effective Way to Minimize Organ Recovery Costs and Increase Organ Yield.

    PubMed

    Doyle, Majella; Subramanian, Vijay; Vachharajani, Neeta; Collins, Kelly; Wellen, Jason R; Stahlschmidt, Emily; Brockmeier, Diane; Coleman, Jason; Kappel, Dean; Chapman, William C

    2016-04-01

    A new era in organ donation with national redistricting is being proposed. With these proposals, costs of organ acquisition are estimated to more than double. Traditionally, organ recoveries occur in the donor hospital setting, incurring premium hospital expenses. The aim of the study was to determine organ recovery costs and organ yield for donor recoveries performed at an organ procurement organization (OPO) facility. In 2001, we established an OPO facility and in 2008 began transferring the donor expeditiously when brain death was declared. The OPO donor and hospital costs on a per donor basis were calculated. Donation after cardiac death donors cannot be transferred and were included in the hospital cost analysis. From January 2009 to December 2014, nine hundred and sixty-three donors originating in our OPO had organs recovered and transplanted. Seven hundred and sixty-six (79.5%) donors were transferred to the OPO facility 8.6 hours (range 0.6 to 23.6 hours) after declaration of brain death. Donor recovery cost was 51% less when donors were transferred to the OPO facility ($16,153 OPO recovery vs $33,161 hospital recovery; p < 0.0001). Organ yield was 27.5% better (3.43 organs) from OPO-recovered donors vs an organ yield of 2.69 from hospital-recovered donors (p < 0.0001). Standard criteria donor organ yield from our OPO was 6% higher than the national average (3.92 vs 3.7 nationally; p = 0.012) and expanded criteria donor organ yield was 18% higher (2.2 vs 1.87 nationally; p = 0.03). An OPO facility for donor organ recovery increases efficiency and organ yield, reduces costs, and minimizes organ acquisition charge. As we face new considerations with broader sharing, increased efficiencies, cost. and organ use should be considered. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Designing shallow donors in diamond

    NASA Astrophysics Data System (ADS)

    Moussa, Jonathan

    2015-03-01

    The production of n-type semiconducting diamond has been a long-standing experimental challenge. The first-principles simulation of shallow dopants in semiconductors has been a long-standing theoretical challenge. A desirable theoretical goal is to identify impurities that will act as shallow donors in diamond and assess their experimental viability. I will discuss this identification process for the LiN4 donor complex. It builds a scientific argument from several models and computational results in the absence of computational tools that are both trustworthy and computationally tractable for this task. I will compare the theoretical assessment of viability with recent experimental efforts to co-dope diamond with lithium and nitrogen. Finally, I discuss the computational tools needed to facilitate future work on this problem and some preliminary simulations of donors near diamond surfaces. Sandia National Laboratories is a multi-program lab managed and operated by Sandia Corp., a wholly owned subsidiary of Lockheed Martin Corp., for the U.S. Department of Energy's National Nuclear Security Administration under Contract DE-AC04-94AL85000.

  13. Mental health status after living donor hepatectomy.

    PubMed

    Wang, Szu-Han; Lin, Ping-Yi; Wang, Jiun-Yi; Huang, Mei-Feng; Lin, Hui-Chuan; Hsieh, Chia-En; Hsu, Ya-Lan; Chen, Yao-Li

    2017-05-01

    Donor safety and preservation of donor health after living liver donation are of paramount importance. In addition, the preoperative mental state of a donor is an important factor in determining the psychological impact of donor hepatectomy. Thus, we aimed to explore the mental health status of living liver donors after hepatectomy. We enrolled 60 donors who were scheduled to undergo living donor hepatectomy during the period January 2014 to March 2015 at a single medical center. Mental health status was measured before and 3 months after surgery using 3 self-report questionnaires, namely the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms, the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to measure quality of life, and the Chinese Health Questionnaire (CHQ) to screen for minor psychiatric disorders. A comparison of the pre- and postdonation CES-D scores revealed a significant reduction in depressive symptoms after surgery (P = .031). There were significant improvements in the physical health domain (P = .031), the psychological health domain (P = .005), the social relationships domain (P = .005), and the environmental health domain (P = .010) of the WHOQOL-BREF. There were no significant changes in CHQ scores after donor hepatectomy (P = .136). All donors reported that they would donate again if required. Approximately one-third (33.3%) of donors experienced more pain than they had anticipated in the immediate postoperative period, and 20.0% of donors had complications after donor hepatectomy. Donor mental health status tended to improve as donors regained physical function during the 1st 3 months of recovery. Long-term monitoring of living donors' mental health is needed to minimize the adverse psychological outcomes of living liver donation.

  14. Alternative allogeneic donor sources for transplantation for childhood diseases: unrelated cord blood and haploidentical family donors.

    PubMed

    Cairo, Mitchell S; Rocha, Vanderson; Gluckman, Eliane; Hale, Gregory; Wagner, John

    2008-01-01

    Allogeneic stem cell transplantation has been demonstrated to be curative in a wide variety of pediatric malignant and nonmalignant diseases, and can be traced back over 50 years ago to the original report of Thomas et al. HLA matched sibling donors have been the gold standard for pediatric recipients requiring allogeneic donors for both nonmalignant and malignant conditions. However, only 25% of potential pediatric recipients possesses an HLA-matched sibling donor, and the frequency is even less in those with genetic nonmalignant conditions because of genetically affected other siblings within the family. Therefore, 75% to 90% of potential pediatric recipients require alternative allogeneic donor cells for treatment of their underlying conditions. Potential alternative allogeneic donor sources include unrelated cord blood donors, unrelated adult donors, and haploidentical family donors. In this article we review the experience of both unrelated cord blood donor and haploidentical family donor transplants in selected pediatric malignant and nonmalignant conditions.

  15. Impact of a lung transplantation donor-management protocol on lung donation and recipient outcomes.

    PubMed

    Angel, Luis F; Levine, Deborah J; Restrepo, Marcos I; Johnson, Scott; Sako, Edward; Carpenter, Andrea; Calhoon, John; Cornell, John E; Adams, Sandra G; Chisholm, Gary B; Nespral, Joe; Roberson, Ann; Levine, Stephanie M

    2006-09-15

    One of the limitations associated with lung transplantation is the lack of available organs. To determine whether a lung donor-management protocol could increase the number of lungs for transplantation without affecting the survival rates of the recipients. We implemented the San Antonio Lung Transplant protocol for managing potential lung donors according to modifications of standard criteria for donor selection and strategies for donor management. We then compared information gathered during a 4-yr period, during which the protocol was used with information gathered during a 4-yr period before protocol implementation. Primary outcome measures were the procurement rate of lungs and the 30-d and 1-yr survival rates of recipients. We reviewed data from 711 potential lung donors. The mean rate of lung procurement was significantly higher (p < 0.0001) during the protocol period (25.5%) than during the pre-protocol period (11.5%), with an estimated risk ratio of 2.2 in favor of the protocol period. More patients received transplants during the protocol period (n = 121) than during the pre-protocol period (n = 53; p < 0.0001). Of 98 actual lung donors during the protocol period, 53 (54%) had initially been considered poor donors; these donors provided 64 (53%) of the 121 lung transplants. The type of donor was not associated with significant differences in recipients' 30-d and 1-yr survival rates or any clinical measures of adequate graft function. The protocol was associated with a significant increase in the number of lung donors and transplant procedures without compromising pulmonary function, length of stay, or survival of the recipients.

  16. A review of life quality in living donors after liver transplantation

    PubMed Central

    Xu, Dong-Wei; Long, Xi-Dai; Xia, Qiang

    2015-01-01

    Living-donor liver transplantation (LDLT) has increasingly performed all around the world. However, LDLT donors achieve no medical benefits and are exposed to the risk of complications, and even death. The potential effects of LDLT on donor safety, donor recovery, and post-donation psychological impairment are essential to be better understood. We searched the MEDLINE database to identify articles about the quality of life (QOL) in adults after LDLT donation. Twenty-eight studies with a total of 1944 donors were included in the review. 14 of the 28 studies (50%) had a cross-sectional design, and the remaining half had a prospective design. The Physical Component Score (PCS) decreased immediately after the donation, then returned to the baseline within 6 to 12 months while the Mental Component Score (MCS) remains comparable to that of normative population throughout the procedure. Compared with the left graft (LG) donors, right graft (RG) donors were significantly older, had longer hospital stays and higher rates of postoperative complications, and a higher recipient mortality rate, while there were no difference in the PCS and MCS between the two groups. Our review clearly indicates that the LDLT donors can endure the donation procedure and return to their normal daily life without major problem in the short term. However, to improve the donor selection criteria and ensure the QOL in donors throughout donation procedure, more studies with longer follow up and larger samples are essential and predictors of poor QOL should be identified in study with sufficient response rate and ideal control groups. PMID:25784970

  17. Interactions between science, government and media on selection and testing of donors.

    PubMed

    Sazama, K

    1998-01-01

    The international media attention to "bad blood" has fueled governmental action in countries around the world. Donor selection criteria continue to expand, focusing most recently on the possibility of exclusion due to intranasal cocaine use and, in the US, due to incarceration for more than 72 hours. As newer methods of testing evolve, more deferrals will occur due to improved testing. An emerging area of concern is the non-standardized notification of donors who are ineligible to donate and lack of a centralized listing of such deferred donors. Because of the consequences to recipients, improvements in both donor questioning and testing are necessary. Further studies are needed to understand and improve these processes.

  18. Realizing HOPE: The Ethics of Organ Transplantation from HIV infected Donors

    PubMed Central

    Durand, Christine M.; Segev, Dorry; Sugarman, Jeremy

    2016-01-01

    The HIV Organ Policy Equity (HOPE) Act now allows transplantation of organs from HIV infected (HIV+) living and deceased donors to HIV+ individuals with end-stage organ disease in the United States. Although clinical experience with such transplants is limited to a small number of HIV+ to HIV+ deceased donor kidney transplants in South Africa, unprecedented HIV+ to HIV+ liver transplants and living donor kidney transplants are also now on the horizon. Initially all HIV+ to HIV+ transplants will occur under research protocols with safeguards and criteria mandated by the National Institutes of Health (NIH). Nevertheless, this historic change brings ethical opportunities and challenges. For HIV+ individuals in need of organ transplant, issues of access, risk, and consent must be considered. For potential HIV+ donors, there are additional ethical challenges of privacy, fairness and the right to donate. Careful consideration of the ethical issues involved are critical to the safe and appropriate evaluation of this novel approach to transplantation. PMID:27043422

  19. Frequency of dengue virus infection in blood donors in Sistan and Baluchestan province in Iran.

    PubMed

    Aghaie, Afsaneh; Aaskov, John; Chinikar, Sadegh; Niedrig, Matthias; Banazadeh, Soudabeh; Mohammadpour, Hashem Khorsand

    2014-02-01

    Risk of dengue virus in the blood supply has been demonstrated in recent studies. In this paper, Chabahar in Sistan and Baluchestan province, south east of Iran, was selected for studying dengue infection because of its climatic and geographical situation in the middle of the transit way between East Asia and other countries. The blood samples were taken from volunteer healthy donors who were referred to the Chabahar Blood Center for blood donation. The presence of dengue virus (DENV) was studied by detecting IgG to DENV by enzyme linked immune sorbent assay (ELISA). Reactive ELISA results were confirmed by an immune flouorescence assay (IFA). According to the results, some of the healthy donors were infected by DENV, which could not been recognized in donor selection. Therefore, special attention should be paid to the criteria of donor selection and additional screening tests are recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Heteroaromatic donors in donor-acceptor-donor based fluorophores facilitate zinc ion sensing and cell imaging.

    PubMed

    Sreejith, Sivaramapanicker; Divya, Kizhumuri P; Jayamurthy, Purushothaman; Mathew, Jomon; Anupama, V N; Philips, Divya Susan; Anees, Palappuravan; Ajayaghosh, Ayyappanpillai

    2012-11-01

    The excited state intra molecular charge transfer (ICT) property of fluorophores has been extensively used for the design of fluorescent chemosensors. Herein, we report the synthesis and properties of three donor–π-acceptor–π-donor (D–π-A–π-D) based molecular probes BP, BT and BA. Two heteroaromatic rings, pyrrole (BP), and thiophene (BT) and a non-heteroaromatic ring N-alkoxy aniline (BA) were selected as donor moieties which were linked to a bipyridine binding site through a vinylic linkage. The heteroaromatic systems BP and BT perform selective and ratiometric emission signalling for zinc ions whereas the non-heteroaromatic probe BA does not. The advantages of the D–π-A–π-D design strategy in the design of ICT based probes for the selective fluorescent ratiometric signalling of zinc ions in biological media is discussed. Further, the use of BP, BT and BA for imaging Zn(2+) ions from MCF-7 cell lines is demonstrated.

  1. Artificial corneas versus donor corneas for repeat corneal transplants

    PubMed Central

    Akpek, Esen K; Alkharashi, Majed; Hwang, Frank S; Ng, Sueko M; Lindsley, Kristina

    2014-01-01

    Background Individuals who have failed one or more full thickness penetrating keratoplasties (PKs) may be offered repeat corneal surgery using an artificial or donor cornea. An artificial or prosthetic cornea is known as a keratoprosthesis. Both donor and artificial corneal transplantations involve removal of the diseased and opaque recipient cornea (or the previously failed cornea) and replacement with another donor or prosthetic cornea. Objectives To assess the effectiveness of artificial versus donor corneas in individuals who have had one or more failed donor corneal transplantations. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2013, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2013), EMBASE (January 1980 to November 2013), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to November 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 27 November 2013. Selection criteria Two review authors independently assessed reports from the electronic searches to identify randomized controlled trials (RCTs) or controlled clinical trials (CCTs). We resolved discrepancies by discussion or consultation with a third review author. Data collection and analysis For discussion purposes, we assessed findings from observational cohort studies and non-comparative case series. No data synthesis was performed. Main results We did not identify any RCTs or CCTs comparing artificial corneas with donor corneas for repeat corneal transplantations. Authors

  2. [Serum ferritin in donors with regular plateletpheresis].

    PubMed

    Ma, Chun-Hui; Guo, Ru-Hua; Wu, Wei-Jian; Yan, Jun-Xiong; Yu, Jin-Lin; Zhu, Ye-Hua; He, Qi-Tong; Luo, Yi-Hong; Huang, Lu; Ye, Rui-Yun

    2011-04-01

    This study was aimed to evaluate the impact of regular donating platelets on serum ferritin (SF) of donors. A total of 93 male blood donors including 24 initial plateletpheresis donors and 69 regular plateletpheresis donors were selected randomly. Their SF level was measured by ELISA. The results showed that the SF level of initial plateletpheresis donors and regular plateletpheresis donors were 91.08 ± 23.38 µg/L and 57.16 ± 35.48 µg/L respectively, and all were in normal levels, but there was significant difference between the 2 groups (p < 0.05). The SF level decreased when the donation frequency increased, there were no significant differences between the groups with different donation frequency. Correlation with lifetime donations of platelets was not found. It is concluded that regular plateletpheresis donors may have lower SF level.

  3. Is laparoscopic live donor hepatectomy justified ethically?

    PubMed

    Soubrane, Olivier; Gateau, Valérie; Lefève, Céline

    2016-04-01

    Live donor liver transplant (LDLT) was first reported in the 1990s and quickly raised ethical considerations, mainly related to the risk brought to the donor. The question of donor safety was even more accurate with the occurrence of laparoscopy, a technique which could allegedly increase the risk of severe intraoperative complications. Besides the questions of justice and autonomy, donor safety remains the main ethical debate of LDLT. Considering the lack of comparative assessment of postoperative outcomes, the Jury of the last Consensus meeting held in Japan in 2014 called for the creation of international registries to help to determine the benefit/risk ratio of laparoscopic donor hepatectomy. Since randomized studies are very unlikely to occur, benchmarking comparisons, between liver and kidney donors for instance, may also help to define standard practice. At last, donors' points of view should also be taken into account in the evaluation of those innovative procedures. © 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  4. Flight Termination Criteria

    NASA Astrophysics Data System (ADS)

    Haber, Jerold M.; Larson, Erik

    2013-09-01

    The first line of defense in protecting the public against the threat of injury from a failing space booster is the flight termination system. Consequently, these systems must be highly reliable and the criteria for flight termination must be carefully formulated. Criteria must be developed based on observable data that allows adequate time for the data to be assessed and a flight termination action to be triggered. Criteria should be set so that 1) the chance a good vehicle will be terminated is small, 2) the chance of failing to terminate an errant vehicle before it can hazard population centers or valuable assets is minimal, and 3) there is assurance that the combination of the planned trajectory and mission rules do not induce excessive risks to land based populations, air lanes, and shipping lanes should the vehicle need to be terminated [1].This paper provides an overview of the approaches to developing and implement flight termination criteria and a tool for understanding risk implications of proposed criteria.

  5. Living donor liver transplantation from an asymptomatic mother who was a carrier for ornithine transcarbamylase deficiency.

    PubMed

    Wakiya, T; Sanada, Y; Urahashi, T; Ihara, Y; Yamada, N; Okada, N; Egami, S; Sakamoto, K; Murayama, K; Hakamada, K; Yasuda, Y; Mizuta, K

    2012-09-01

    Liver transplantation (LT) has been adopted as a radical treatment for ornithine transcarbamylase deficiency (OTCD), yielding favorable outcomes. Despite the fact that it is an inheritable disease, a blood relative who is heterozygous for the disorder must sometimes be used as a liver donor for living donor LT. There is ongoing discussion regarding the use of heterozygous donors, however, to our knowledge, no cases where donation was determined based on the Ornithine transcarbamylase (OTC) activity before LT have been reported. Between May 2001 and April 2011, 17 patients were indicated for living donor LT because of OTCD at our facility. There were three cases with heterozygous donor candidate (17.6%). All heterozygous candidates underwent a liver biopsy to measure their OTC activity before LT and made efforts to secure the safety of the both donor and recipient. Two of 3 candidates had headaches sometimes, and their activity was less than 40%, and thus they were not employed as the donor. One candidate with 104.4% activity was employed, yielding favorable outcomes. Our current experience supported the effectiveness of our donation criteria, however it is necessary to collect sufficient data on a large number of patients to confirm the safety of the procedure.

  6. Achieving Direct Closure of the Anterolateral Thigh Flap Donor Site—An Algorithmic Approach

    PubMed Central

    Pachón Suárez, Jaime Eduardo; Sadigh, Parviz Lionel; Shih, Hsiang-Shun; Hsieh, Ching-Hua

    2014-01-01

    Background: Minimizing donor-site morbidity after free flap harvest is of paramount importance. In this article, we share our experience with achieving primary closure of 58 anterolateral thigh (ALT) free flap donor sites using a simple algorithm in cases where primary closure would otherwise have not been possible. Methods: Between 2004 and 2010, 58 patients who underwent free ALT flap reconstruction were included in the study. The inclusion criteria were those who had flap width requirements that were wider than 16% of the thigh circumference and had achieved direct primary closure of the donor site by the use of our technique. Results: Primary closure of the donor sites was facilitated in all cases by the use of 3 distinct techniques. This included the use of the V-Y advancement technique in 13 patients, split skin paddle technique in 7 patients, and the tubed skin paddle design in 38 patients. No episodes of postoperative wound dehiscence at the donor site were encountered; however, 2 cases were complicated by superficial wound infections that settled with a course of antibiotics. Conclusions: Direct primary closure of the ALT donor site can be facilitated by the use of our simple algorithm. Certain strategies need to be adopted at the design stage; however, the techniques used are simple and reliable, produce superior cosmetic results at the donor site, save time, and spare the patient the morbidity associated with the harvest of a skin graft. PMID:25426349

  7. [Iron deficiency prevalence in blood donors: a systematic review, 2001-2011].

    PubMed

    Mantilla-Gutiérrez, Carmen Yulieth; Cardona-Arias, Jaiberth Antonio

    2012-01-01

    Blood donation is associated with decreased iron stores in blood donors which may affect the development of physiological functions and overall health. Previous studies reported a wide variation in the prevalence of iron deficiency in this population (1% to 62%). So, we want to establish the prevalence of iron deficiency in blood donors from a systematic review of the literature. Exhaustive and reproducible search of literature in 7 databases, based in a protocol for searching in 4 languages between 2001 to 2011 with inclusion and exclusion criteria and information extraction. The analysis was based on the calculation of frequencies and specific prevalence by sex and number of previous donations, with their respective confidence intervals in Excel and Epidat (3.0). A total of 16.979 donors, 5.096 regular, with 59% men. The prevalence of iron deficiency found was 13% (IC 95%: 12,4 to 13,4) with a range between 1% and 62%. Prevalence statistically higher was observed in women (19,56%) and repetitive donors (20,36%). We obtained iron deficiency prevalence in blood donors over higher risk groups like children, being higher in female and repetitive donors. That suggests the need to encouraged blood banks in the application of protocols designed to preserve healthy donors and this will result in an adequate blood supply.

  8. Simulation shows that HLA-matched stem cell donors can remain unidentified in donor searches

    PubMed Central

    Sauter, Jürgen; Solloch, Ute V.; Giani, Anette S.; Hofmann, Jan A.; Schmidt, Alexander H.

    2016-01-01

    The heterogeneous nature of HLA information in real-life stem cell donor registries may hamper unrelated donor searches. It is even possible that fully HLA-matched donors with incomplete HLA information are not identified. In our simulation study, we estimated the probability of these unnecessarily failed donor searches. For that purpose, we carried out donor searches in several virtual donor registries. The registries differed by size, composition with respect to HLA typing levels, and genetic diversity. When up to three virtual HLA typing requests were allowed within donor searches, the share of unnecessarily failed donor searches ranged from 1.19% to 4.13%, thus indicating that non-identification of completely HLA-matched stem cell donors is a problem of practical relevance. The following donor registry characteristics were positively correlated with the share of unnecessarily failed donor searches: large registry size, high genetic diversity, and, most strongly correlated, large fraction of registered donors with incomplete HLA typing. Increasing the number of virtual HLA typing requests within donor searches up to ten had a smaller effect. It follows that the problem of donor non-identification can be substantially reduced by complete high-resolution HLA typing of potential donors. PMID:26876789

  9. Simulation shows that HLA-matched stem cell donors can remain unidentified in donor searches

    NASA Astrophysics Data System (ADS)

    Sauter, Jürgen; Solloch, Ute V.; Giani, Anette S.; Hofmann, Jan A.; Schmidt, Alexander H.

    2016-02-01

    The heterogeneous nature of HLA information in real-life stem cell donor registries may hamper unrelated donor searches. It is even possible that fully HLA-matched donors with incomplete HLA information are not identified. In our simulation study, we estimated the probability of these unnecessarily failed donor searches. For that purpose, we carried out donor searches in several virtual donor registries. The registries differed by size, composition with respect to HLA typing levels, and genetic diversity. When up to three virtual HLA typing requests were allowed within donor searches, the share of unnecessarily failed donor searches ranged from 1.19% to 4.13%, thus indicating that non-identification of completely HLA-matched stem cell donors is a problem of practical relevance. The following donor registry characteristics were positively correlated with the share of unnecessarily failed donor searches: large registry size, high genetic diversity, and, most strongly correlated, large fraction of registered donors with incomplete HLA typing. Increasing the number of virtual HLA typing requests within donor searches up to ten had a smaller effect. It follows that the problem of donor non-identification can be substantially reduced by complete high-resolution HLA typing of potential donors.

  10. Iron deficiency in Canadian blood donors.

    PubMed

    Goldman, Mindy; Uzicanin, Samra; Scalia, Vito; O'Brien, Sheila F

    2014-03-01

    The adequacy of communication and knowledge of donors and physicians regarding iron needs and the relationship between hemoglobin (Hb) and iron stores require evaluation to address donor iron deficiency. A prospective cohort study was performed on 550 successful donors and 50 donors deferred for low Hb (<125 g/L on repeat fingerstick). Donors participated in an on-clinic interview and had serum ferritin measured. They were mailed their results and recontacted regarding follow-up. Most donors are unaware of possible health impacts of donation and do not discuss donation with their physician. In successful donors, mean ferritin levels were 37 and 131 μg/L in first-time and reactivated (no donation for 2 years) females and males and 19 and 29 μg/L in frequent repeat females and males, respectively (p < 0.0001), with infrequent donors having intermediate results. Mean ferritin was 12 μg/L in donors deferred for low Hb. Twenty of 22 donors failing initial Hb testing and passing on repeat testing had ferritin below 25 μg/L. On follow-up, 63 of 164 donors (38%) with low ferritin were taking iron supplements 2 months postdonation. Iron deficiency is frequent, particularly in female donors and frequent donors. A fail on initial Hb testing followed by a pass on repeat testing is likely to be due to iron deficiency and borderline anemia. Donors and physicians need to be more aware of iron needs associated with blood donation and appropriate treatment for low iron stores. © 2013 American Association of Blood Banks.

  11. Criteria for structural test

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The results of a study to define criteria and techniques of design, analysis and test which permit the use of a single major structural test article for performing dynamic, fatigue, and static testing are presented. The criteria developed is applicable to both space vehicles and aircraft structures operating in the subsonic or supersonic regime. The feasibility of such an approach was demonstrated by defining test interactions, compatibilities and incompatibilities between the three different types of tests. The results of the study indicate that the single test article concept is feasible with a testing sequence of dynamic test followed by a fatigue and static test.

  12. Stabilization of estimated glomerular filtration rate in kidney transplantation from deceased donors with acute kidney injuries

    PubMed Central

    Wiwattanathum, Punlop; Ingsathit, Atiporn; Kantachuvesiri, Surasak; Arpornsujaritkun, Nuttapon; Tirapanich, Wiwat; Sumethkul, Vasant

    2016-01-01

    AIM To evaluate and compare the outcomes of kidney transplant (KT) from deceased donors among standard criteria, acute kidney injury (AKI) and expanded criteria donors (ECDs). METHODS This retrospective study included 111 deceased donor kidney transplant recipients (DDKT). Deceased donors were classified as standard criteria donor (SCD), AKI donor and ECD. AKI was diagnosed and classified based on change of serum Cr by acute kidney injury network (AKIN) criteria. Primary outcome was one-year estimated glomerular filtration rate (eGFR) calculated from Cr by CKD-EPI. Multivariate regression analysis was done by adjusting factors such as type of DDKT, %Panel-reactive antibodies, cold ischemic time, the presence of delayed graft function and the use of induction therapy. Significant factors that can affect the primary outcomes were then identified. RESULTS ECD group had a significantly lower eGFR at one year (33.9 ± 17.3 mL/min) when compared with AKI group (56.6 ± 23.9) and SCD group (63.6 ± 19.9) (P < 0.001). For AKI group, one-year eGFR was also indifferent among AKIN stage 1, 2 or 3. Patients with AKIN stage 3 had progressive increase of eGFR from 49.6 ± 27.2 at discharge to 61.9 ± 29.0 mL/min at one year. From Kaplan-Meier analysis, AKI donor showed better two-year graft survival than ECD (100% vs 88.5%, P = 0.006). Interestingly, AKI group had a stable eGFR at one and two year. The two-year eGFR of AKI group was not significantly different from SCD group (56.6 ± 24.5 mL/min vs 58.6 ± 23.2 mL/min, P = 0.65). CONCLUSION Kidney transplantations from deceased donors with variable stage of acute kidney injuries were associated with favorable two-year allograft function. The outcomes were comparable with KT from SCD. This information supports the option that deceased donors with AKI are an important source of organ for kidney transplantation even in the presence of stage 3 AKI. PMID:28058222

  13. Donor free radical explosive composition

    DOEpatents

    Walker, Franklin E. [15 Way Points Rd., Danville, CA 94526; Wasley, Richard J. [4290 Colgate Way, Livermore, CA 94550

    1980-04-01

    An improved explosive composition is disclosed and comprises a major portion of an explosive having a detonation velocity between about 1500 and 10,000 meters per second and a minor amount of a donor additive comprising an organic compound or mixture of organic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and which is not an explosive, or an inorganic compound or mixture of inorganic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and selected from ammonium or alkali metal persulfates.

  14. Donor insemination: the secret experiment.

    PubMed

    Rushbrooke, Rupert

    2004-03-01

    This paper gives an overview of the research that has been done into people created by donor insemination (DI) (note 1), shows how the secretive way DI is carried out makes objective knowledge of their situation impossible to obtain and describes how doctors support this secrecy. It argues that DI is a social experiment whose potential justifications are implicit theories that have either been falsified or are unfalsifiable, and that consequently DI is conducted unscientifically and unethically. In conclusion, it questions the integrity of the industry and the institutions that support it, and considers where we should go from here.

  15. Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors: Systematic Review and Meta-Analysis

    PubMed Central

    Kucirka, Lauren M.; Sarathy, Harini; Govindan, Priyanka; Wolf, Joshua H.; Ellison, Trevor A.; Hart, Leah J.; Montgomery, Robert A.; Ros, R. Lorie; Segev, Dorry L.

    2011-01-01

    The OPTN classifies high infectious risk donors (HRDs) based on criteria originally intended to identify people at risk for HIV infection. These donors are sometimes referred to as "CDC high risk donors" in reference to the CDC-published guidelines adopted by the OPTN. However, these guidelines are also being used to identify deceased donors at increased risk of window period (WP) hepatitis C virus (HCV) infection, although not designed for this purpose. The actual risk of WP HCV infection in HRDs is unknown.We performed a systematic review of 3,476 abstracts and identified 37 eligible estimates of HCV incidence in HRD populations in the United States/Canada. Pooled HCV incidence was derived and used to estimate the risk of WP infection for each HRD category. Risks ranged from 0.26–300.6 per 10,000 donors based on WP for ELISA and 0.027–32.4 based on nucleic acid testing (NAT). Injection drug users were at highest risk (32.4 per 10,000 donors by NAT WP), followed by commercial sex workersand donors exhibiting high risk sexual behavior (12.3:10,000),men who have sex with men (3.5:10,000), incarcerated donors (0.8:10,000), donors exposed to HIV infected blood (0.4:10,000), and hemophiliacs (0.027:10,000). NAT reduced WP risk by approximately 10-fold in each category. PMID:21401874

  16. Training techniques in laparoscopic donor nephrectomy: a systematic review.

    PubMed

    Raque, Jessica; Billeter, Adrian T; Lucich, Elizabeth; Marvin, Michael M; Sutton, Erica

    2015-10-01

    The learning curve to achieve competency in laparoscopic donor nephrectomy (LDN) is poorly outlined. Online databases were searched for training in LDN. Abstracts and manuscripts were excluded if they did not address introduction of a laparoscopic technique for donor nephrectomy. Relevant manuscripts were reviewed for surgical technique, use of animal models, co-surgeons, surgeon specialty and training, institution type/volume, and assessment of training method. Forty-four met inclusion criteria, with 75% describing the evolution from open to LDN. Eighty-two percent were from academic centers, and 36% were from centers performing <25 donor nephrectomies each year. The learner was an attending surgeon 80% of the time, mostly urologists with prior laparoscopy or open nephrectomy experience. The learning curve, defined by decreased operating time, averaged 35 cases. Improved intra-operative, patient, and recipient outcomes were observed for centers performing ≥50 LDNs annually. The United Network of Organ Sharing requires 15 cases as surgeon or assistant to be certified as the primary LDN surgeon. This falls below the described learning curve for LDN. The assessment of training and competency for LDN is heterogeneous, and objective learner-based metrics could help surgeons and institutions reach a quality standard for performing this operation.

  17. Kidney Transplantation From a Donor With Sickle Cell Disease.

    PubMed

    Rossidis, A; Lim, M A; Palmer, M; Levine, M H; Naji, A; Bloom, R D; Abt, P L

    2017-02-01

    In the United States, >100 000 patients are waiting for a kidney transplant. Given the paucity of organs available for transplant, expansion of eligibility criteria for deceased donation is of substantial interest. Sickle cell disease (SCD) is viewed as a contraindication to kidney donation, perhaps because SCD substantially alters renal structure and function and thus has the potential to adversely affect multiple physiological processes of the kidney. To our knowledge, transplantation from a donor with SCD has never been described in the literature. In this paper, we report the successful transplantation of two kidneys from a 37-year-old woman with SCD who died from an intracranial hemorrhage. Nearly 4 mo after transplant, both recipients are doing well and are off dialysis. The extent to which kidneys from donors with SCD can be safely transplanted with acceptable outcomes is unknown; however, this report should provide support for the careful expansion of kidneys from donors with SCD without evidence of renal dysfunction and with normal tissue architecture on preimplantation biopsies.

  18. Revisiting Bioaccumulation Criteria

    EPA Science Inventory

    The objective of workgroup 5 was to revisit the B(ioaccumulation) criteria that are currently being used to identify POPs under the Stockholm Convention and PBTs under CEPA, TSCA, REACh and other programs. Despite the lack of a recognized definition for a B substance, we defined ...

  19. Revisiting Bioaccumulation Criteria

    EPA Science Inventory

    The objective of workgroup 5 was to revisit the B(ioaccumulation) criteria that are currently being used to identify POPs under the Stockholm Convention and PBTs under CEPA, TSCA, REACh and other programs. Despite the lack of a recognized definition for a B substance, we defined ...

  20. Laparoscopic donor nephrectomy versus open donor nephrectomy: recipient's perspective.

    PubMed

    Jamale, Tukaram E; Hase, Niwrutti K; Iqbal, Anwar M

    2012-11-01

    Effects of laparoscopic donor nephrectomy (LDN) on graft function, especially early post-transplant, have been controversial. To assess and compare early and late graft function in kidneys procured by open and laparoscopic methods, a retrospective observational study was carried out on 37 recipients-donors who underwent LDN after introduction of this technique in February 2007 at our center, a tertiary care nephrology referral center. Demographic, immunological and intraoperative variables as well as immunosuppressive protocols and number of human leukocyte antigen (HLA) mismatches were noted. Early graft function was assessed by serum creatinine on Days two, five, seven, 14 and 28 and at the time of discharge. Serum creatinine values at three months and at one year post-transplant were considered as the surrogates of late graft function. Data obtained were compared with the data from 33 randomly selected kidney transplants performed after January 2000 by the same surgical team, in whom open donor nephrectomy was used. Pearson's chi square test, Student's t test and Mann-Whitney U test were used for statistical analysis. Early graft function (serum creatinine on Day five 2.15 mg/dL vs 1.49 mg/dL, P = 0.027) was poorer in the LDN group. Late graft function as assessed by serum creatinine at three months (1.45 mg/dL vs 1.31 mg/dL, P = 0.335) and one year (1.56 mg/dL vs 1.34 mg/dL, P = 0.275) was equivalent in the two groups. Episodes of early acute graft dysfunction due to acute tubular necrosis were significantly higher in the LDN group (37.8% vs 12.1%, Z score 2.457, P = 0.014). Warm ischemia time was significantly prolonged in the LDN group (255 s vs 132.5 s, P = 0.002). LDN is associated with slower recovery of graft function and higher incidence of early acute graft dysfunction due to acute tubular necrosis. Late graft function at one year is however comparable.

  1. Gamete donors' expectations and experiences of contact with their donor offspring

    PubMed Central

    Kirkman, Maggie; Bourne, Kate; Fisher, Jane; Johnson, Louise; Hammarberg, Karin

    2014-01-01

    STUDY QUESTION What are the expectations and experiences of anonymous gamete donors about contact with their donor offspring? SUMMARY ANSWER Rather than consistently wanting to remain distant from their donor offspring, donors' expectations and experiences of contact with donor offspring ranged from none to a close personal relationship. WHAT IS KNOWN ALREADY Donor conception is part of assisted reproduction in many countries, but little is known about its continuing influence on gamete donors' lives. STUDY DESIGN, SIZE, DURATION A qualitative research model appropriate for understanding participants' views was employed; semi-structured interviews were conducted during January–March 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS Before 1998, gamete donors in Victoria, Australia, were subject to evolving legislation that allowed them to remain anonymous or (from 1988) to consent to the release of identifying information. An opportunity to increase knowledge of donors' expectations and experiences of contact with their donor offspring recently arose in Victoria when a recommendation was made to introduce mandatory identification of donors on request from their donor offspring, with retrospective effect. Pre-1998 donors were invited through an advertising campaign to be interviewed about their views, experiences and expectations; 36 sperm donors and 6 egg donors participated. MAIN RESULTS AND THE ROLE OF CHANCE This research is unusual in achieving participation by donors who would not normally identify themselves to researchers or government inquiries. Qualitative thematic analysis revealed that most donors did not characterize themselves as parents of their donor offspring. Donors' expectations and experiences of contact with donor offspring ranged from none to a close personal relationship. LIMITATIONS, REASONS FOR CAUTION It is not possible to establish whether participants were representative of all pre-1998 donors. WIDER IMPLICATIONS OF THE FINDINGS Anonymous

  2. Hydroperoxides as Hydrogen Bond Donors

    NASA Astrophysics Data System (ADS)

    Møller, Kristian H.; Tram, Camilla M.; Hansen, Anne S.; Kjaergaard, Henrik G.

    2016-06-01

    Hydroperoxides are formed in the atmosphere following autooxidation of a wide variety of volatile organics emitted from both natural and anthropogenic sources. This raises the question of whether they can form hydrogen bonds that facilitate aerosol formation and growth. Using a combination of Fourier transform infrared spectroscopy, FT-IR, and ab initio calculations, we have compared the gas phase hydrogen bonding ability of tert-butylhydroperoxide (tBuOOH) to that of tert-butanol (tBuOH) for a series of bimolecular complexes with different acceptors. The hydrogen bond acceptor atoms studied are nitrogen, oxygen, phosphorus and sulphur. Both in terms of calculated redshifts and binding energies (BE), our results suggest that hydroperoxides are better hydrogen bond donors than the corresponding alcohols. In terms of hydrogen bond acceptor ability, we find that nitrogen is a significantly better acceptor than the other three atoms, which are of similar strength. We observe a similar trend in hydrogen bond acceptor ability with other hydrogen bond donors including methanol and dimethylamine.

  3. Donor dominance cures CHILD nevus.

    PubMed

    König, Arne; Skrzypek, Jan; Löffler, Harald; Oeffner, Frank; Grzeschik, Karl-Heinz; Happle, Rudolf

    2010-01-01

    Congenital hemidysplasia with ichthyosiform nevus and limb defects (MIM 308050, CHILD) syndrome is an X-linked dominant, male-lethal, multisystem birth defect. Patients suffer from an inflammatory nevus that covers large areas, predominantly of one side of the body, with a sharp midline demarcation. Treatment of CHILD nevus is notoriously difficult. The aim of this study was to develop a novel surgical approach for this disorder. In 2 patients, the CHILD nevus was dermabraded, and the area was covered with split skin grafts obtained from a contralateral unaffected donor region. In a third patient, papillomatous, strawberry-like lesions on fingers and toes were excised, and the defects were covered with full-thickness grafts obtained from the unaffected left, gluteal area. Highly satisfying functional and cosmetic results were documented during a follow-up period ranging from 3 to 8 years. The favorable outcome, superior to that obtained by simple dermabrasion or extensive plastic surgery, can best be explained by the donor dominance of the grafted skin samples that carried, in all or most cells, the mutant X chromosome in an inactivated form. Copyright (c) 2010 S. Karger AG, Basel.

  4. [Clinical selection of blood donors].

    PubMed

    Danic, B

    2003-06-01

    For 20 years, the organization set up to insure the blood transfusion safety has never stopped strengthening. It is based on clinical and epidemiological selection of the blood donation candidates, biologic selection of blood donations and different physico-chemical techniques for pathogens reduction or inactivation in blood products. In France, this organization is optimized by the assertion of the voluntary and non-remunerated character of blood donation registered in the law of January 4th, 1993. The blood donors selection is structured in three successive stages. The first stage is the pre-donation information. The second stage begins with reading and filling out an info-questionnaire which prepare for an interview with a physician. This interview is specially directed to prevention of transfusion-transmitted infections and the prevention of adverse reactions after a 400 to 600 mL collection of whole blood or components. Finally, the third stage is the delivery of a post-donation information which invites the donor to contact the "établissement français du sang" (EFS) in case of a new event arisen after the donation or in case of reviewing of its own answers during the medical interview.

  5. First Danish experience with ex vivo lung perfusion of donor lungs before transplantation.

    PubMed

    Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold; Zemtsovski, Mikhail; Nilsson, Jens Christian; Seidelin, Casper Tobias; Perch, Michael; Iversen, Martin; Steinbrüchel, Daniel

    2014-03-01

    The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction. The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively. In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs. no funding was granted for the present paper. not relevant.

  6. Adverse events and retention of donors of double red cell units by apheresis

    PubMed Central

    Keshelashvili, Ketevan; O’Meara, Alix; Stern, Martin; Jirout, Zuzana; Pehlic, Vildana; Holbro, Andreas; Buser, Andreas; Sigle, Jörg; Infanti, Laura

    2016-01-01

    Background Safety of double-erythrocyte (2RBC) collection and reasons for ceasing 2RBC donation were retrospectively analysed in the blood donor population of Basel, Switzerland. Methods Donors with at least 1 2RBC apheresis were included in the study. Minimal requirements were Hb ≥140 g/L and body weight ≥70 kg; serum ferritin (SF) values were measured routinely, but were not part of the selection criteria. 2RBC collections were performed with ALYX devices at 6-month intervals. Adverse events (AEs) were systematically recorded and classified according to the ISBT EHN 2008 criteria. Data of procedures were retrieved from the ALYX software. Demographics, apheresis data and AEs were analysed with descriptive statistics. Results Data of 4,377 2RBC aphereses performed in 793 donors (779 males) between 1st January 2003 and 31st May 2015 were evaluated. Mean donor age at first 2RBC donation was 44 years (standard deviation [SD] 21), median number of donations was 4 (interquartile range [IQR] 8); 32% of the donors underwent a single procedure. There were 161 AEs, mostly local haematomas (55%) and vasovagal reactions (20%); fatigue was reported in 6% of the cases and was more frequent than citrate toxicity. Two severe AEs were observed. The most frequent reasons for abandoning 2RBC donation were low SF levels and donor choice (both 11%), but most donors simply did not reply to invitations (16%). Overall, procedure-related causes (AEs, low SF levels, no time for apheresis, inadequate venous access) were observed in 14% of the cases. At the end of the observation period, 40% of the donors were still active blood donors, but only 20% were donating 2RBC. Discussion 2RBC donation is overall safe. Donor retention was low over a period of 11 years. An important reason for abandoning 2RBC was the detection of low SF levels. The impact of fatigue on donor retention and the course of iron stores after repeated 6-monthly 2RBC apheresis require further investigation. PMID:27136442

  7. [HTLV examination of Norwegian blood donors].

    PubMed

    Samdal, H H; Skaug, K; Stigum, H; Hervig, T; Kjeldsen-Kragh, J; Skar, A G

    1999-01-20

    Approximately one third of the Norwegian blood donor population has been tested for infection with human T-lymphotropic virus type I and II (HTLV-I/II). This study was initiated to provide an indication as to whether or not the Norwegian transfusion service should screen the entire donor population for HTLV I/II. No HTLV-I infections were found among the blood donors. One new donor was confirmed HTLV-II positive. This individual had previously used drugs intravenously. HTLV-I/II infection can be regarded as a marker for risk behaviour, and testing can be of significance in the quality assurance of the transfusion service. We recommend that the entire blood donor population be tested for HTLV-I/II infections, and thereafter only new donors. The benefit of this scheme should be evaluated in the future.

  8. Donor Considerations in Fecal Microbiota Transplantation.

    PubMed

    Barnes, Danielle; Park, K T

    2017-03-01

    Tremendous acceleration has been made in understanding the gut microbiota in the past decade and, with it, further understanding of the pathologic role of dysbiosis and the use of fecal microbiota transplantation (FMT) as therapy. FMT has been studied in many disease states including the most common indication of Clostridium difficile infection (CDI), though many questions regarding stool donor selection remain. Though traditionally, one donor has provided stool for one patient, research is underway to explore many donor selection considerations from the use of pooled donor stool to selection of a high diversity donor. It is well-known that dietary intake shapes the gut microbiota and the potential implications of this on FMT donor selection are being explored. Though further high-quality research is needed, optimizing the fecal microbiota inoculum holds great promise.

  9. Risk Stratification for 25-Year Cardiovascular Disease Incidence in Type 1 Diabetes: Tree-Structured Survival Analysis of the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study

    PubMed Central

    Miller, Rachel G.; Anderson, Stewart J.; Costacou, Tina; Sekikawa, Akira; Orchard, Trevor J.

    2017-01-01

    Background The formal identification of subgroups with varying levels of risk is uncommon in observational studies of cardiovascular disease (CVD), although such insight might be useful for clinical management. Methods Tree-structured survival analysis (TSSA) was utilized to determine whether there are meaningful subgroups at varying levels of CVD risk in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study, a prospective cohort study of childhood-onset (<17 years old) type 1 diabetes. Results Of the 561 participants free of CVD (coronary artery disease, stroke, or lower extremity arterial disease) at baseline, 263 (46.9%) had an incident CVD event over the 25-year follow-up. TSSA revealed a range of risk groups, from 24 to 85%, which demonstrate that those with short diabetes duration and elevated non-HDL cholesterol have similar CVD risk to those with long diabetes duration and that renal disease is a better discriminator of risk in men than in women. Conclusions Our findings suggest that subgroups with major CVD risk differences exist in this type 1 diabetes cohort. Using TSSA may help to identify these groups and the interrelationships between their associated risk factors. This approach may improve our understanding of various clinical pathways to CVD and help target intervention strategies. PMID:27190081

  10. Considering Tangible Benefit for Interdependent Donors: Extending a Risk-Benefit Framework in Donor Selection.

    PubMed

    Van Pilsum Rasmussen, S E; Henderson, M L; Kahn, J; Segev, D

    2017-10-01

    From its infancy, live donor transplantation has operated within a framework of acceptable risk to donors. Such a framework presumes that risks of living donation are experienced by the donor while all benefits are realized by the recipient, creating an inequitable distribution that demands minimization of donor risk. We suggest that this risk-tolerance framework ignores tangible benefits to the donor. A previously proposed framework more fully considers potential benefits to the donor and argues that risks and benefits must be balanced. We expand on this approach, and posit that donors sharing a household with and/or caring for a potential transplant patient may realize tangible benefits that are absent in a more distantly related donation (e.g. cousin, nondirected). We term these donors, whose well-being is closely tied to their recipient, "interdependent donors." A flexible risk-benefit model that combines risk assessment with benefits to interdependent donors will contribute to donor evaluation and selection that more accurately reflects what is at stake for donors. In so doing, a risk-benefit framework may allow some donors to accept greater risk in donation decisions. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. Lobar lung transplantation from deceased donors: A systematic review

    PubMed Central

    Eberlein, Michael; Reed, Robert M; Chahla, Mayy; Bolukbas, Servet; Blevins, Amy; Van Raemdonck, Dirk; Stanzi, Alessia; Inci, Ilhan; Marasco, Silvana; Shigemura, Norihisa; Aigner, Clemens; Deuse, Tobias

    2017-01-01

    AIM To systematically review reports on deceased-donor-lobar lung transplantation (ddLLTx) and uniformly describe size matching using the donor-to-recipient predicted-total lung-capacity (pTLC) ratio. METHODS We set out to systematically review reports on ddLLTx and uniformly describe size matching using the donor-to-recipient pTLC ratio and to summarize reported one-year survival data of ddLLTx and conventional-LTx. We searched in PubMed, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley (CDSR), Database of Abstracts of Reviews of Effects via Wiley (DARE), Cochrane Central Register of Controlled Trials via Wiley (CENTRAL), Scopus (which includes EMBASE abstracts), and Web of Science for original reports on ddLLTx. RESULTS Nine observational cohort studies reporting on 301 ddLLTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The ddLLTx-group was often characterized by high acuity; however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pTLC ratio was available for 242 ddLLTx (80%). The mean pTLCratio before lobar resection was 1.25 ± 0.3 and the transplanted pTLCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddLLTx-group ranged from 50%-100%, compared to 72%-88% in the conventional-LTx group. In the largest study ddLLTx (n = 138) was associated with a lower one-year-survival compared to conventional-LTx (n = 539) (65.1% vs 84.1%, P < 0.001). CONCLUSION Further investigations of optimal donor-to-recipient size matching parameters for ddLLTx could improve outcomes of this important surgical option. PMID:28280698

  12. Nitrogen related shallow thermal donors in silicon

    NASA Astrophysics Data System (ADS)

    Fujita, N.; Jones, R.; Öberg, S.; Briddon, P. R.

    2007-07-01

    In this letter, the authors investigate the electrical properties of nitrogen related shallow thermal donor (STD) candidates and their concentrations under different doping conditions by means of density functional theory. Experimentally, the existence of STDs containing one nitrogen atom and both even and odd numbers of oxygen atoms has been proposed. However, so far first principles studies have not presented a candidate for the latter. Here, they show that the NO defect possesses a shallow donor level. Adding one or two more oxygen atoms results in the donor level to become shallower. The fraction of shallow nitrogen related donors to N dimers increases in material with low concentration of nitrogen.

  13. Historical perspective of living donor liver transplantation

    PubMed Central

    Chan, See Ching; Fan, Sheung Tat

    2008-01-01

    Living donor liver transplantation (LDLT) has gone through its formative years and established as a legitimate treatment when a deceased donor liver graft is not timely or simply not available at all. Nevertheless, LDLT is characterized by its technical complexity and ethical controversy. These are the consequences of a single organ having to serve two subjects, the donor and the recipient, instantaneously. The transplant community has a common ground on assuring donor safety while achieving predictable recipient success. With this background, a reflection of the development of LDLT may be appropriate to direct future research and patient-care efforts on this life-saving treatment alternative. PMID:18176956

  14. Adult to adult right lobe living donor liver transplantation: does biological relationship matter?

    PubMed Central

    Zhang, Wei; Tan, Yifei; Shen, Shu; Jiang, Li; Yan, Lunan; Yang, Jiayin; Li, Bo; Wen, Tianfu; Zeng, Yong; Wang, WenTao; Xu, Mingqing

    2017-01-01

    Abstract The influence of the biological relationship between the donor and the recipient is rarely discussed in living donor liver transplantation (LDLT), although it is believed to be an important risk factor in other types of organ transplantations. A total of 272 consecutive patients undergoing adult to adult right lobe LDLT were retrospectively analyzed and stratified into a nonbiologically related (NBR) group (69 patients) and a biologically related (BR) group (203 patients). The preoperative data and postoperative outcomes of both recipients and donors were evaluated. More than two-thirds of the recipients had histories of HBV infection, and hepatocellular carcinoma (HCC) was the main reason for the patients undergoing LDLT in both groups. The percentage of female donors in the NBR group was more than the percentage in the BR group (P = 0.000). There were no differences between the groups in postoperative laboratory testing or daily immunosuppression dose, and the complication rates in both the recipient and donor surgeries showed no significant differences. For patients with benign diseases, the cumulative 1-, 3-, 5-, and 10-year survival rate were 92.9% in the 4 periods in the NBR group and 89.1%, 87.6%, 83.7%, and 83.7%, respectively, in BR group, while for the patients diagnosed as HCC, if patients exceeding the Milan criteria were involved, the 5-year survival rate was 41.2%, compared to 82% for patients within the Milan criteria, which was nearly the same as for those with the benign disease. In conclusion, our findings suggested that the biological relationship between the donor and the recipient in adult to adult LDLT was not associated with the short- and long-term outcomes of recipients diagnosed with benign liver diseases and early stage HCC. Moreover, the criteria for patients diagnosed with HCC to undergo LDLT should be restrictively selected. PMID:28121912

  15. Criteria for submitting photos.

    PubMed

    Vallarelli, Andrelou Fralete Ayres

    2011-01-01

    Dermatological photography is used as a supplement to dermatological examination with the function of providing additional knowledge and information. Its quality depends on the expertise of the photographer-dermatologist in recording the relevant elements present. Therefore, the dermatologist should know basic principles of photography and the journal editors should ensure that the articles have high-quality images. This article suggests criteria to improve the quality of photographs submitted to journals for publication.

  16. Space Tethers: Design Criteria

    NASA Technical Reports Server (NTRS)

    Tomlin, D. D.; Faile, G. C.; Hayashida, K. B.; Frost, C. L.; Wagner, C. Y.; Mitchell, M. L.; Vaughn, J. A.; Galuska, M. J.

    1997-01-01

    This document is prepared to provide a systematic process for the selection of tethers for space applications. Criteria arc provided for determining the strength requirement for tether missions and for mission success from tether severing due to micrometeoroids and orbital debris particle impacts. Background information of materials for use in space tethers is provided, including electricity-conducting tethers. Dynamic considerations for tether selection is also provided. Safety, quality, and reliability considerations are provided for a tether project.

  17. Differences in social representation of blood donation between donors and non-donors: an empirical study.

    PubMed

    Guarnaccia, Cinzia; Giannone, Francesca; Falgares, Giorgio; Caligaris, Aldo Ozino; Sales-Wuillemin, Edith

    2015-11-04

    Both donors and non-donors have a positive image of blood donation, so donors and non-donors do not differ regarding their views on donation but do differ in converting their opinion into an active deed of donation. Several studies have identified altruism and empathy as the main factors underlying blood donation. However, a mixture of various motivational factors mould the complex behaviour of donation. This paper presents an exploratory study on differences of social representations of blood donation between blood donors and non-donors, in order to understand the reasons that bring someone to take the decision to become a blood donor. Participants filled in the Adapted Self-Report Altruism Scale, Toronto Empathy Questionnaire and answered a test of verbal association. Descriptive and correlation analyses were carried out on quantitative data, while a prototypic analysis was used for qualitative data. The study was carried out on a convenience sample of 786 individuals, 583 donors (mean age: 35.40 years, SD: 13.01 years; 39.3% female) and 203 non-donors (mean age: 35.10 years, SD: 13.30 years; 67.5% female). Social representations of donors seem to be more complex and articulated than those of non-donors. The terms that appear to be central were more specific in donors (life, needle, blood, help, altruism were the words most associated by non-donors; life, aid, altruism, solidarity, health, love, gift, generosity, voluntary, control, needed, useful, needle were the words most associated by donors). Furthermore, non-donors associated a larger number of terms referring to negative aspects of blood donation. Aspects related to training and the accuracy of any information on blood donation seem to be important in the decision to become a donor and stabilise the behaviour of donation over time, thus ensuring the highest levels of quality and safety in blood establishments.

  18. Differences in social representation of blood donation between donors and non-donors: an empirical study

    PubMed Central

    Guarnaccia, Cinzia; Giannone, Francesca; Falgares, Giorgio; Caligaris, Aldo Ozino; Sales-Wuillemin, Edith

    2016-01-01

    Background Both donors and non-donors have a positive image of blood donation, so donors and non-donors do not differ regarding their views on donation but do differ in converting their opinion into an active deed of donation. Several studies have identified altruism and empathy as the main factors underlying blood donation. However, a mixture of various motivational factors mould the complex behaviour of donation. This paper presents an exploratory study on differences of social representations of blood donation between blood donors and non-donors, in order to understand the reasons that bring someone to take the decision to become a blood donor. Materials and methods Participants filled in the Adapted Self-Report Altruism Scale, Toronto Empathy Questionnaire and answered a test of verbal association. Descriptive and correlation analyses were carried out on quantitative data, while a prototypic analysis was used for qualitative data. Results The study was carried out on a convenience sample of 786 individuals, 583 donors (mean age: 35.40 years, SD: 13.01 years; 39.3% female) and 203 non-donors (mean age: 35.10 years, SD: 13.30 years; 67.5% female). Social representations of donors seem to be more complex and articulated than those of non-donors. The terms that appear to be central were more specific in donors (life, needle, blood, help, altruism were the words most associated by non-donors; life, aid, altruism, solidarity, health, love, gift, generosity, voluntary, control, needed, useful, needle were the words most associated by donors). Furthermore, non-donors associated a larger number of terms referring to negative aspects of blood donation. Discussion Aspects related to training and the accuracy of any information on blood donation seem to be important in the decision to become a donor and stabilise the behaviour of donation over time, thus ensuring the highest levels of quality and safety in blood establishments. PMID:26674814

  19. Limbal Stem Cells from Aged Donors Are a Suitable Source for Clinical Application

    PubMed Central

    Martínez-Conesa, Eva M.

    2016-01-01

    Limbal stem cells (LSC) are the progenitor cells that maintain the transparency of the cornea. Limbal stem cell deficiency (LSCD) leads to corneal opacity, inflammation, scarring, and blindness. A clinical approach to treat this condition consists in LSC transplantation (LSCT) after ex vivo expansion of LSC. In unilateral LSCD, an autologous transplant is possible, but cases of bilateral LSCD require allogenic LSCT. Cadaveric donors represent the most important source of LSC allografts for treatment of bilateral LSCD when living relative donors are not available. To evaluate the suitability of aged cadaveric donors for LSCT, we compared three pools of LSC from donors of different ages (<60 years, 60–75 years, and >75 years). We evaluated graft quality in terms of percent of p63-positive (p63+) cells by immunofluorescence, colony forming efficiency, and mRNA and protein expression of p63, PAX6, Wnt7a, E-cadherin, and cytokeratin (CK) 12, CK3, and CK19. The results showed that LSC cultures from aged donors can express ≥3% of p63+ cells—considered as the minimum value for predicting favorable clinical outcomes after LSCT—suggesting that these cells could be a suitable source of LSC for transplantation. Our results also indicate the need to evaluate LSC graft quality criteria for each donor. PMID:28042298

  20. Landscape of Deceased Donors Labeled Increased Risk for Disease Transmission Under New Guidelines.

    PubMed

    Kucirka, L M; Bowring, M G; Massie, A B; Luo, X; Nicholas, L H; Segev, D L

    2015-12-01

    Deceased donors are labeled increased risk for disease transmission (IRD) if they meet certain criteria. New PHS guidelines were recently implemented; the impact of these changes remains unknown. We aimed to quantify the impact of the new guidelines on the proportion of deceased donors labeled IRD, as well as demographic and clinical characteristics. We used Poisson regression with an interaction term for era (new vs. old guidelines) to quantify changes. Under the new guidelines, 19.5% donors were labeled IRD, compared to 10.4%, 12.2%, and 12.3% in the 3 most recent years under the old guidelines (IRR = 1.45, p < 0.001). Increases were consistent across OPOs: 44/59 had an increase in the percent of donors labeled IRD, and 14 OPOs labeled 25% of their donors IRD under the new guidelines (vs. 5 OPOs under the old). African-Americans were 52% more likely to be labeled IRD under the new guidelines (RR = 1.52, p = 0.01). There has been a substantial increase in donors labeled IRD under the new PHS guidelines; it is important to understand the mechanism and consequences to ensure an optimal balance of patient safety and organ utilization is achieved.

  1. Establishing Criteria for Human Mesenchymal Stem Cell Potency

    PubMed Central

    Samsonraj, Rebekah M.; Rai, Bina; Sathiyanathan, Padmapriya; Puan, Kia Joo; Rötzschke, Olaf; Hui, James H.; Raghunath, Michael; Stanton, Lawrence W.; Nurcombe, Victor

    2015-01-01

    Abstract This study sought to identify critical determinants of mesenchymal stem cell (MSC) potency using in vitro and in vivo attributes of cells isolated from the bone marrow of age‐ and sex‐matched donors. Adherence to plastic was not indicative of potency, yet capacity for long‐term expansion in vitro varied considerably between donors, allowing the grouping of MSCs from the donors into either those with high‐growth capacity or low‐growth capacity. Using this grouping strategy, high‐growth capacity MSCs were smaller in size, had greater colony‐forming efficiency, and had longer telomeres. Cell‐surface biomarker analysis revealed that the International Society for Cellular Therapy (ISCT) criteria did not distinguish between high‐growth capacity and low‐growth capacity MSCs, whereas STRO‐1 and platelet‐derived growth factor receptor alpha were preferentially expressed on high‐growth capacity MSCs. These cells also had the highest mean expression of the mRNA transcripts TWIST‐1 and DERMO‐1. Irrespective of these differences, both groups of donor MSCs produced similar levels of key growth factors and cytokines involved in tissue regeneration and were capable of multilineage differentiation. However, high‐growth capacity MSCs produced approximately double the volume of mineralized tissue compared to low‐growth capacity MSCs when assessed for ectopic bone‐forming ability. The additional phenotypic criteria presented in this study when combined with the existing ISCT minimum criteria and working proposal will permit an improved assessment of MSC potency and provide a basis for establishing the quality of MSCs prior to their therapeutic application. Stem Cells 2015;33:1878–1891 PMID:25752682

  2. The carboxyl modifier 1-ethyl-3-(3-(dimethylamino)propyl)carbodiimide (EDC) inhibits half of the high-affinity Mn-binding site in photosystem II membrane fragments

    SciTech Connect

    Preston, C.; Seibert, M. )

    1991-10-08

    The diphenylcarbazide (DPC)/Mn{sup 2+} assay was used to assess the amount of the high-affinity Mn-binding site in manganese-depleted photosystem II (PS II) membrane fragments from spinach and Scenedesmus obliquus. The assay mechanism at high DPC concentration was shown to involve noncompetitive inhibition of only half of the control level of DPC donation to PS II by micromolar concentrations of Mn at pH 6.5. At low DPC concentration both DPC and Mn{sup 2+} donate to PS II additively. Treatment with the carboxyl amino acid modifier 1-ethyl-3-(3(dimethylamino) propyl) carbodiimide (EDC) inhibited half of the high affinity Mn-binding site in spinach and Scenedesmus WT PS II membranes and all of the available site in Scenedesmus LF-1 mutant PS II membranes. A similar EDC concentration dependence was observed in all cases. This protection was specific for Mn{sup 2+}; six other divalent cations were ineffective. The authors conclude that EDC modifies that half of the high-affinity Mn-binding site that is insensitive to the histidine modifier diethyl pyrocarbonate (DEPC) and directly affects ligands that bind Mn. The effects of EDC and DEPC that influence the high-affinity site are mutually exclusive and are specific to the lumenal side of the PS II membrane. They suggest that carboxyl residues on reaction center proteins are associated with half of the high-affinity Mn-binding site in PS II and are involved along with histidine residues in binding Mn functional in the O{sub 2}-evolving process.

  3. Intention of future donations: a study of donors versus non-donors.

    PubMed

    Martín-Santana, J D; Beerli-Palacio, A

    2013-04-01

    Recent years have seen the level of blood donation at a world level come to a standstill or even decline. This situation requires blood donation services to make efforts to increase donor recruitment and retention, as well as to increase the frequency of donations among current donors. In order to obtain good results, it is essential to understand the factors that affect intention to donate. To determine the explanatory power of a set of factors on intention to donate blood, as well as evaluating the ability of current donors to motivate others. A questionnaire was administered to a sample of 1015 Spanish individuals. Results indicate that (i) motivations and hindering factors have the greatest explanatory power on intention to donate, (ii) experience as a donor is the most explanatory factor on future intention and (iii) there are significant behavioural and sociodemographic differences between donors and non-donors. These findings suggest that it is necessary (i) to enhance the donor retention for maintaining the donation system using a personal and frequent communication with donors not only to remind them to schedule their next donation, but also to attract more donors; (ii) to recapture temporarily deferred donors, as they are less reluctant towards donation; (iii) to describe in detail how donation affects donors and clarify the importance of donation for society and (iv) to develop member get member programs in which current donors act as motivators amongst friends, coworkers and family. © 2012 The Authors. Transfusion Medicine © 2012 British Blood Transfusion Society.

  4. Exchange living-donor kidney transplantation: diminution of donor organ shortage.

    PubMed

    Park, K; Lee, J H; Huh, K H; Kim, S I; Kim, Y S

    2004-12-01

    To alleviate the organ shortage, the use of more living donors is strongly recommended world wide. A living donor exchange (swap) program was launched in Korea. After the success of a direct swap program between two families, we have developed the swap-around program to expand the donor pool by enrolling many kinds of unrelated donors. Herein, we report our results of a living donor exchange program. This retrospectively review of 978 recipients of kidney transplants from living donors, included analysis of donor-recipient relationships, mode of donor recruitment, episodes of acute rejection, and 5-year patient/graft survivals. Transplantation was performed in 101 patients (10.3%) by way of the swap program. The proportion of swap patients among the number of unrelated donor renal transplants has been increasing from 4.2% to 46.6%. The incidence of acute rejection and 5-year patient/graft survival rates were comparable between the groups. We have achieved some success in reducing the organ shortage with a swap program in addition to our current unrelated living donor programs without jeopardizing graft survival. Potentially exchangeable donors should undergo strict medical evaluation by physicians and social evaluation by social workers and coordinators as a pre-requisite for kidney transplantation. Expanding the swap around program to a regional or national pool could be an option to reduce the organ donor shortage in the future.

  5. 21 CFR 630.6 - Donor notification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification. (a) Notification of donors. You, an establishment that collects blood or blood components, must make reasonable... tests for evidence of infection with a communicable disease agent(s) as required by § 610.41 of this...

  6. 42 CFR 35.64 - Donors.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Donors. 35.64 Section 35.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.64 Donors. Authorized contributions...

  7. 42 CFR 35.64 - Donors.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Donors. 35.64 Section 35.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.64 Donors. Authorized contributions...

  8. 42 CFR 35.64 - Donors.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Donors. 35.64 Section 35.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.64 Donors. Authorized contributions...

  9. The Experience of Living Kidney Donors

    ERIC Educational Resources Information Center

    Brown, Judith Belle; Karley, Mary Lou; Boudville, Neil; Bullas, Ruth; Garg, Amit X.; Muirhead, Norman

    2008-01-01

    This article describes the experiences, feelings, and ideas of living kidney donors. Using a phenomenological, qualitative research approach, the authors interviewed 12 purposefully selected living kidney donors (eight men and four women), who were between four and 29 years since donation. Interviews were audiotaped, and transcribed verbatim, and…

  10. Negotiating boundaries: Accessing donor gametes in India

    PubMed Central

    Widge, A.; Cleland, J.

    2011-01-01

    Background: This paper documents how couples and providers access donor materials for conception in the Indian context and perceptions about using them. The objective is to facilitate understanding of critical issues and relevant concerns. Methods: A postal survey was conducted with a sample of 6000 gynaecologists and in-depth interviews were conducted with 39 gynaecologists in four cities. Results: Donor gametes are relatively more acceptable than a few years ago, especially if confidentiality can be maintained, though lack of availability of donor materials is sometimes an impediment to infertility treatment. Donor sperms are usually accessed from in-house or commercial sperm banks, pathology laboratories, IVF centres, professional donors, relatives or friends. There is scepticism about screening procedures of sperm banks. Donor eggs are usually accessed from voluntary donors, friends, relatives, egg sharing programmes, donation from other patients, advertising and commercial donors. There are several concerns regarding informed consent for using donated gametes, using relatives and friends gametes, the unregulated use of gametes and embryos, record keeping and documentation, unethical and corrupt practices and commercialisation. Conclusion: These issues need to be addressed by patients, providers and regulatory authorities by providing information, counselling, ensuring informed consent, addressing exploitation and commercialisation, ensuring monitoring, proper documentation and transparency. PMID:24753849

  11. Low hemoglobin deferral in blood donors

    PubMed Central

    Mast, Alan E.

    2013-01-01

    Low hemoglobin deferral occurs in about 10% of attempted whole blood donations and commonly is a consequence of iron deficiency anemia. Pre-menopausal women often have iron deficiency anemia caused by menstruation and pregnancy and have low hemoglobin deferral on their first donation attempt. Frequent donors also develop iron deficiency and iron deficiency anemia because blood donation removes a large amount of iron from the donor and the 56-day minimum inter-donation interval for donors in the United States is not sufficient for recovery of hemoglobin and iron stores. Other causes for low hemoglobin deferral range from a medically insignificant deferral of a woman with hemoglobin between 12.0 and 12.4 g/dL, which is within the normal reference range but below the 12.5 g/dL needed to donate blood, to anemia caused by an unrecognized malignancy in a “healthy” individual attempting to donate blood. The diverse causes of anemia in blood donors make it difficult to provide accurate information to donors about the cause of their low hemoglobin deferral and complicate implementation of programs to prevent them by blood collecting agencies. This article reviews how hemoglobin is measured and the demographics and causes of low hemoglobin deferral in blood donors. It provides recommendations for how blood collection agencies can provide donors with accurate information about the cause of their deferral and discusses programs that can be implemented to decrease these deferrals in regular donors. PMID:24332843

  12. 21 CFR 630.6 - Donor notification.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the reason for that decision; (ii) Where appropriate, the types of donation of blood or blood... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification. (a) Notification of donors. You, an establishment that collects blood or blood components, must make...

  13. 21 CFR 630.6 - Donor notification.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the reason for that decision; (ii) Where appropriate, the types of donation of blood or blood... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification. (a) Notification of donors. You, an establishment that collects blood or blood components, must make...

  14. Payment for donor kidneys: pros and cons.

    PubMed

    Friedman, E A; Friedman, A L

    2006-03-01

    Continuous growth of the end stage renal disease population treated by dialysis, outpaces deceased donor kidneys available, lengthens the waiting time for a deceased donor transplant. As estimated by the United States Department of Health & Human Services: '17 people die each day waiting for transplants that can't take place because of the shortage of donated organs.' Strategies to expand the donor pool--public relations campaigns and Drivers' license designation--have been mainly unsuccessful. Although illegal in most nations, and viewed as unethical by professional medical organizations, the voluntary sale of purchased donor kidneys now accounts for thousands of black market transplants. The case for legalizing kidney purchase hinges on the key premise that individuals are entitled to control of their body parts even to the point of inducing risk of life. One approach to expanding the pool of kidney donors is to legalize payment of a fair market price of about 40,000 dollars to donors. Establishing a federal agency to manage marketing and purchase of donor kidneys in collaboration with the United Network for Organ Sharing might be financially self-sustaining as reduction in costs of dialysis balances the expense of payment to donors.

  15. The Experience of Living Kidney Donors

    ERIC Educational Resources Information Center

    Brown, Judith Belle; Karley, Mary Lou; Boudville, Neil; Bullas, Ruth; Garg, Amit X.; Muirhead, Norman

    2008-01-01

    This article describes the experiences, feelings, and ideas of living kidney donors. Using a phenomenological, qualitative research approach, the authors interviewed 12 purposefully selected living kidney donors (eight men and four women), who were between four and 29 years since donation. Interviews were audiotaped, and transcribed verbatim, and…

  16. 21 CFR 630.6 - Donor notification.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... of donation of blood or blood components that the donor should not donate in the future; (3) Where... the reason for that decision; (ii) Where appropriate, the types of donation of blood or blood... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification....

  17. Fecal microbiota transplantation and donor standardization.

    PubMed

    Owens, Casey; Broussard, Elizabeth; Surawicz, Christina

    2013-09-01

    Clostridium difficile diarrhea is a common and severe infectious disease. Antibiotics, which are standard initial treatment, are less effective for treating refractory or recurrent infection. Fecal microbiota transplantation, where healthy donor stool is transplanted into a patient, is an alternative to antibiotic therapy that requires standardization for donors and patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Does situs inversus totalis preclude liver donation in living donor liver transplantation? A series of 3 cases from single institution

    PubMed Central

    N., Selvakumar; Goyal, Neerav; Nayeem, Mohammed; Vohra, Sandeep; Gupta, Subash

    2016-01-01

    Introduction Liver transplantation (LT) is the gold standard for decompensated Chronic Liver Disease (CLD) in individuals satisfying the selection criteria. Organ scarcity is the rate limiting step in liver transplantation across the globe. Expanding the donor pool is practiced by transplant surgeons across the globe in view of perennial donor organ scarcity and ever increasing organ demand. Presentation of case We have presented series of 3 cases of liver transplantation (LT) with modified left lobe (conventional right) graft from a situs inversus donor and implanting it as a conventional right lobe with a modified technique. The grafts had Type 1, Type 2 and Type 3 biliary anatomies. One graft had inferior hepatic veins also. All three patients had uneventful recoveries. The follow up period range is 4 years to 8 months. Discussion There are multiple case reports in the literature involving situs inversus donors in liver transplantation. Various techniques have also been described. We describe simple and effective technique which has proved successful to our patients. Conclusion SIT donors can be safely accepted for living donor liver transplantation. It is a technically challenging procedure both for donor liver harvesting and implantation in recipient. This is the first case series of LT using modified left lobe graft (conventional right) from a SIT donor with 2 different techniques. Biliary anastomosis is the tricky part of the operation. PMID:26895114

  19. Impact of donor and recipient sex and parity on outcomes of HLA-identical sibling allogeneic hematopoietic stem cell transplantation.

    PubMed

    Loren, Alison W; Bunin, Greta R; Boudreau, Christian; Champlin, Richard E; Cnaan, Avital; Horowitz, Mary M; Loberiza, Fausto R; Porter, David L

    2006-07-01

    Allogeneic hematopoietic stem cell transplantation (SCT) may cure patients with hematologic malignancies, but it carries significant risks. Careful donor selection is an important component of the clinical transplantation decision-making process and includes evaluation of HLA typing and other criteria, the most controversial of which is parity. We examined the effect of donor sex and parity on outcomes of HLA-identical sibling SCT. Because the effect of recipient sex/parity has never been explicitly evaluated, we also analyzed the effect of recipient sex/parity on outcomes of transplantation. We found that (1) parous female donors result in an increased risk of chronic graft-versus-host disease (GVHD) in all recipients, (2) the magnitude of this increased risk is similar in male and female recipients, and (3) nulliparous female donors increase the risk of chronic GVHD in male recipients to a degree comparable to that from parous donors. A decrease in the risk of relapse was not observed, and there was no effect on overall survival, acute GVHD, or transplant-related mortality. Recipient parity had no independent effect on any endpoint. Until the effects of pregnancy on the maternal immune system are better understood, it is appropriate whenever possible to avoid parous female donors and to choose male donors for male recipients in HLA-identical related donor SCT.

  20. On material fracture criteria

    NASA Astrophysics Data System (ADS)

    Kremnev, L. S.

    2017-01-01

    Based on the nonlinear mechanics of material fracture, a model of the fracture of materials with actual (discrete) structures has been constructed. The model is supported by proofs that crack resistance K 1 c and fracture toughness G 1 c obtained from the energy conservation law without using the assumptions adopted in the linear material fracture mechanics serve as the force and energy criteria in the nonlinear fracture mechanics. It has been shown that energy criterion G 1 c in the nonlinear mechanics is much greater than G 1 c in the linear fracture mechanics.

  1. Kinetics of thermal donor generation in silicon

    NASA Technical Reports Server (NTRS)

    Mao, B.-Y.; Lagowski, J.; Gatos, H. C.

    1984-01-01

    The generation kinetics of thermal donors at 450 C in Czochralski-grown silicon was found to be altered by high-temperature preannealing (e.g., 1100 C for 30 min). Thus, when compared with as-grown Si, high-temperature preannealed material exhibits a smaller concentration of generated thermal donors and a faster thermal donor saturation. A unified mechanism of nucleation and oxygen diffusion-controlled growth (based on solid-state plate transformation theory) is proposed to account for generation kinetics of thermal donors at 450 C, in as-grown and high-temperature preannealed Czochralski silicon crystals. This mechanism is consistent with the main features of the models which have been proposed to explain the formation of oxygen thermal donors in silicon.

  2. Non Heart-Beating Donors in England

    PubMed Central

    Chaib, Eleazar

    2008-01-01

    When transplantation started all organs were retrieved from patients immediately after cardio-respiratory arrest, i.e. from non-heart-beating donors. After the recognition that death resulted from irreversible damage to the brainstem, organ retrieval rapidly switched to patients certified dead after brainstem testing. These heart-beating-donors have become the principal source of organs for transplantation for the last 30 years. The number of heart-beating-donors are declining and this is likely to continue, therefore cadaveric organs from non-heart-beating donor offers a large potential of resources for organ transplantation. The aim of this study is to examine clinical outcomes of non-heart-beating donors in the past 10 years in the UK as an way of decreasing pressure in the huge waiting list for organs transplantation. PMID:18297216

  3. Citrate Anticoagulation: Are Blood Donors Donating Bone?

    PubMed Central

    Bialkowski, Walter; Bruhn, Roberta; Edgren, Gustaf; Papanek, Paula

    2015-01-01

    An estimated 2.4 million volunteer apheresis blood donation procedures were performed in the United States in 2010 and increases in the proportion of transfused blood products derived from apheresis blood collections have been consistently reported. Anticoagulation is required during apheresis and is achieved with citrate. Donor exposure to citrate causes an acute physiological response in the donor maintaining serum mineral homeostasis. Some data are available on the sequelae of this acute response in the days and weeks following exposure, raising questions about bone mineral density in regular apheresis donors. New research is emerging that addresses the potential long term health outcomes of repeated citrate exposure. This article reviews the acute physiological response to citrate anticoagulation in volunteer blood donors, presents contrasting perspectives on the potential effects of citrate exposure on bone density, and identifies key knowledge gaps in our understanding of long term health outcomes in apheresis donors. PMID:26607494

  4. Development of Organ-Specific Donor Risk Indices

    PubMed Central

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.

    2012-01-01

    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C-positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease disproportionately. Use of livers with high donor risk index is associated with increased hospital costs independent of recipient risk factors, and transplanting livers with high donor risk index into patients with Model for End-Stage Liver Disease scores < 15 is associated with lower allograft survival; use of the Liver Donor Risk Index has limited this practice. Significant regional variation in donor quality, as measured by the Liver Donor Risk Index, remains in the United States. We also review other potential indices for liver transplant, including donor-recipient matching and the retransplant donor risk index. While substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. PMID:22287036

  5. Evaluation of blood donor deferral causes in the Trinidad and Tobago National Blood Transfusion Service.

    PubMed

    Charles, K S; Hughes, P; Gadd, R; Bodkyn, C J; Rodriguez, M

    2010-02-01

    The majority of blood donations in Trinidad and Tobago are made as replacement by family members or friends. National Blood Transfusion Policy was drafted in 2007 to promote voluntary, repeated donation. The objective of this study is to assess the current rate and reasons for donor deferral, and the aim is to guide the proposed donor education and recruitment programme. A retrospective study of pre-donation deferral of prospective blood donors at the National Blood Transfusion Centre, Port of Spain, Trinidad and Tobago, was conducted. Records of all pre-donation deferrals over a 12-month period were studied. As many as 11,346 pre-donation screening interviews were conducted. There were 4043 (35.6%) deferrals. The most common reasons for donor deferral were exposure to high-risk sexual activity (27.6%), low haemoglobin 22.2% and hypertension 17.5%. Other reasons such as medication, chronic medical illness, tattoos, travel history, recent pregnancy, surgery or presentation outside the accepted age limit caused 33.8% of all deferrals and the majority (34.7%) of male deferrals. Low haemoglobin (44.5%) was the most common reason among females. The rate of deferral of voluntary donors was not significantly different from that for replacement donors (31.7 vs. 35.4%, P = 0.25). This study exposed a lack of public awareness as the principal reason for an unacceptably high rate of donor deferral. Donor education about selection criteria needs to be urgently addressed as an objective of the National Policy. Monitoring and evaluation of deferral rates and reasons could be used as one indicator of the effectiveness of the Policy.

  6. Pancreas Transplantation From Living Donors: A Single Center Experience of 20 Cases.

    PubMed

    Choi, J Y; Jung, J H; Kwon, H; Shin, S; Kim, Y H; Han, D J

    2016-08-01

    Living donor pancreas transplantation (LDPT) has several advantages over deceased donor pancreas transplantation (DDPT), including better HLA matching, shorter ischemic time, and shorter waiting time. It remains an attractive option for diabetes mellitus (DM) patients with end stage renal disease. We reviewed 20 cases of LDPT performed in Asan Medical Center between October 1992 and March 2015. Six cases (30%) were pancreas transplantation alone (PTA), and the rest (70%) were simultaneous pancreas and kidney transplantation (SPK). Relations of donor and recipient were parents in 7 (35%), siblings in 6 (30%), spouse in 6 (30%), and cousin in 1 (5%). Graft survival in SPK at 1, 3, 5, and 10 years was 91.7%, 83.3%, 83.3%, and 83.3%, respectively, and that in PTA recipients was 50%, 33.3%, 16.7%, and 16.7%, respectively (p = 0.005). Causes of graft failure in SPK were thrombosis (one case), and rejection (one case), whereas those in PTA were noncompliance (two cases), thrombosis (one case), reflux pancreatitis (one case), and chronic rejection (one case). In terms of pancreas exocrine drainage, two grafts (25%) maintained their function in bladder drainage, while all grafts maintained in enteric drainage p < 0.05). Seven (35%) donors experienced minor pancreatic juice leakage and one underwent reoperation due to postoperative hematoma. Most donors maintained normoglycemia and normal renal function. However, two donors developed DM (at 1 and 90 months postdonation), and were treated with oral hypoglycemic agents. Graft survival in PTA recipients was poorer than in SPK due to poor compliance and bladder drainage-related problems. The surgical and metabolic complication rates of donors can be minimized by applying strict donor criteria. Therefore, LDPT with enteric drainage is an acceptable treatment for SPK. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  7. New method and characterization of self-assembled gelatin-oleic nanoparticles using a desolvation method via carbodiimide/N-hydroxysuccinimide (EDC/NHS) reaction.

    PubMed

    Park, Chulhun; Vo, Chau Le-Ngoc; Kang, Taehee; Oh, Euichaul; Lee, Beom-Jin

    2015-01-01

    In this study, we investigated a new method for the preparation of gelatin-oleic conjugate (GOC) as an amphiphilic biomaterial to load model anti-cancer drugs into self-assembled nanoparticles (NPs). Oleic acid (OA) was covalently bound to gelatin via carbodiimide/N-hydroxysuccinimide (EDC/NHS) reaction in water-ethanol cosolvent to form a GOC. Fourier transform infrared (FT-IR) spectroscopy and proton nuclear magnetic resonance ((1)H NMR) clearly indicated the successful synthesis of GOC. The percentage of gelatin amino groups reacted with OA was up to 50% as determined using the 2,4,6-trinitrobenzene sulfonic acid (TNBS) method. Subsequently, gelatin-oleic nanoparticles (GONs) were prepared using a desolvation method with glutaraldehyde or genipin used as a crosslinker for comparison. Irinotecan hydrochloride (IRT) was used as a model drug to load into GONs using incubation or an in-process adding method for comparison. Dynamic light scattering (DLS) and transmission electron microscopy (TEM) data showed that the sizes of GONs and IRT-loaded GONs (IRT-GONs) were below 250 nm. The zeta potentials of the GONs and irinotecan-loaded IRT-GONs were below -20 mV, which was found to be stable in suspension against the aggregation process. The incubation method was more suitable for drug loading because it did not affect the process of GON formation and thus did not increase their size much compared to the change in size with the in-process adding method. The lipophilic property of the oleic moiety in the GOC increased the affinity between GOC molecules, thus reducing the amount of crosslinking agents needed to stabilize GONs compared to gelatin nanoparticles (GNs). As novel approaches for the synthesis of protein-fatty acid complexes, chemical reaction has been suggested for the synthesis of GOC. The above results show that GOC synthesized via new method is a promising biomaterial based upon preparation of nanoparticles.

  8. Donor Conception and "Passing," or; Why Australian Parents of Donor-Conceived Children Want Donors Who Look Like Them.

    PubMed

    Wong, Karen-Anne

    2017-03-01

    This article explores the processes through which Australian recipients select unknown donors for use in assisted reproductive technologies and speculates on how those processes may affect the future life of the donor-conceived person. I will suggest that trust is an integral part of the exchange between donors, recipients, and gamete agencies in donor conception and heavily informs concepts of relatedness, race, ethnicity, kinship, class, and visibility. The decision to be transparent (or not) about a child's genetic parentage affects recipient parents' choices of donor, about who is allowed to "know" children's genetic backgrounds, and how important it is to be able to "pass" as an unassisted conception. In this way, recipients must trust the process, institutions, and individuals involved in their treatment, as well as place trust in the future they imagine for their child. The current market for donor gametes reproduces normative conceptions of the nuclear family, kinship, and relatedness by facilitating "matching" donors to recipients by phenotype and cultural affinities. Recipient parents who choose not to prioritize "matching," and actively disclose the process of children's conceptions, may embark on a project of queering heteronormative family structures and place great trust in both their own children and changing social attitudes to reduce stigma and generate acceptance for non-traditional families.

  9. Donor, dad, or…? Young adults with lesbian parents' experiences with known donors.

    PubMed

    Goldberg, Abbie E; Allen, Katherine R

    2013-06-01

    In this exploratory qualitative study of 11 young adults, ages 19-29 years, we examine how young people who were raised by lesbian parents make meaning out of and construct their relationships with known donors. In-depth interviews were conducted to examine how participants defined their family composition, how they perceived the role of their donors in their lives, and how they negotiated their relationships with their donors. Findings indicate that mothers typically chose known donors who were family friends, that the majority of participants always knew who their donors were, and that their contact with donors ranged from minimal to involved. Further, participants perceived their donors in one of three ways: as strictly donors and not members of their family; as extended family members but not as parents; and as fathers. The more limited role of donors in participants' construction of family relationships sheds light on how children raised in lesbian, gay, and bisexual families are contributing to the redefinition and reconstruction of complex kinship arrangements. Our findings hold implications for clinicians who work with lesbian-mother families, and suggest that young adulthood is an important developmental phase during which interest in and contact with the donor may shift, warranting a transfer of responsibility from mother to offspring in terms of managing the donor-child relationship.

  10. Donor phosphorus levels and recipient outcomes in living-donor kidney transplantation.

    PubMed

    Chang, Peter C; Saha, Sharmeela; Gomes, Amanda M; Padiyar, Aparna; Bodziak, Kenneth A; Poggio, Emilio D; Hricik, Donald E; Augustine, Joshua J

    2011-05-01

    In living-donor kidney transplantation, various donor factors, including gender, age, and baseline kidney function, predict allograft function and recipient outcomes after transplantation. Because higher phosphorus is predictive of vascular injury in healthy adults, the effect of donor phosphorus levels on recipient renal function after transplantation was investigated. Phosphorus levels in 241 living donors were analyzed from a 7-year period, and recipient renal function and acute rejection at 1 year posttransplantation were examined controlling for other influencing factors, including multiple donor variables, HLA matching, and acute rejection. Female and African-American donors had significantly higher phosphorus levels predonation. By multivariable analysis, higher donor phosphorus correlated with higher recipient serum creatinine (slope=0.087, 95% confidence interval [CI]: 0.004 to 0.169, P=0.041) and lower recipient estimated GFR (slope=-4.321, 95% CI: -8.165 to -0.476, P=0.028) at 12 months. Higher donor phosphorus also displayed an independent correlation with biopsy-proven acute rejection and delayed or slow graft function after transplantation. In a cohort of living kidney donors, higher donor phosphorus correlated with female gender and African-American ethnicity and was an independent risk factor for early allograft dysfunction after living-donor kidney transplantation. Copyright © 2011 by the American Society of Nephrology

  11. The influence of the donor-recipient relationship on related donor reactions to stem cell donation.

    PubMed

    Labott, S; Pfammatter, A

    2014-06-01

    Previous research has begun to delineate the complicated reactions experienced by bone marrow and stem cell donors. The purpose of this study was to examine the influence of the donor-recipient relationship on the related donor's emotional reactions. Twenty-eight adult stem cell donors completed questionnaires before donation, 30 days post stem cell infusion, and 1 year after infusion. Questionnaires addressed the donor-recipient relationship, depression, mood, guilt and responsibility, self-esteem, ambivalence about donation and reactions to the donation itself. Results indicated that most donors reported little ambivalence about donation, and their reactions to the donation itself were generally positive. Closer and more positive donor-recipient relationships were associated with less anticipated guilt and responsibility if the transplant did not work. The relationships between the donor and the recipient did not change over time. Mood disturbance and depression were low overall, not related to the donor-recipient relationship, and did not significantly change over time. These results indicate that related stem cell donors are generally without significant emotional distress, and are comfortable with the donation process. Further, a more positive relationship with the recipient may help donors to avoid feeling guilty and responsible if the transplant does not work.

  12. Admissions Criteria in Teacher Education.

    ERIC Educational Resources Information Center

    Schwanke, Dean

    1981-01-01

    A review of the literature on the topic of admissions criteria in teacher education is presented. Bibliographic annotations review surveys, studies, models, and guidelines on various aspects of admissions criteria, as well as attracting and retaining quality students. (JN)

  13. Admissions Criteria in Teacher Education.

    ERIC Educational Resources Information Center

    Schwanke, Dean

    1981-01-01

    A review of the literature on the topic of admissions criteria in teacher education is presented. Bibliographic annotations review surveys, studies, models, and guidelines on various aspects of admissions criteria, as well as attracting and retaining quality students. (JN)

  14. Bright Solid-State Emission of Disilane-Bridged Donor-Acceptor-Donor and Acceptor-Donor-Acceptor Chromophores.

    PubMed

    Shimada, Masaki; Tsuchiya, Mizuho; Sakamoto, Ryota; Yamanoi, Yoshinori; Nishibori, Eiji; Sugimoto, Kunihisa; Nishihara, Hiroshi

    2016-02-24

    The development of disilane-bridged donor-acceptor-donor (D-Si-Si-A-Si-Si-D) and acceptor-donor-acceptor (A-Si-Si-D-Si-Si-A) compounds is described. Both types of compound showed strong emission (λem =ca. 500 and ca. 400 nm, respectively) in the solid state with high quantum yields (Φ: up to 0.85). Compound 4 exhibited aggregation-induced emission enhancement in solution. X-ray diffraction revealed that the crystal structures of 2, 4, and 12 had no intermolecular π-π interactions to suppress the nonradiative transition in the solid state.

  15. Nordic criteria for reproductive toxicity.

    PubMed

    Taskinen, H K

    1995-08-01

    Scientific criteria for assessment of the reproductive toxicity of chemicals have been proposed by a Nordic group of experts and regulatory representatives. The criteria take into account the results of clinical studies as well as of experimental research. The criteria should be useful in, for example, product control and labeling and planning of a safe work environment. The proposed Nordic criteria and examples of the assessment of the reproductive toxicity of some chemicals are presented.

  16. Criteria for Assessing Naturalistic Inquiries as Reports.

    ERIC Educational Resources Information Center

    Lincoln, Yvonna S.; Guba, Egon G.

    Research on the assessment of naturalistic inquiries is reviewed, and criteria for assessment are outlined. Criteria reviewed include early foundational and non-foundational criteria, trustworthiness criteria, axiomatic criteria, rhetorical criteria, action criteria, and application/transferability criteria. Case studies that are reports of…

  17. Improving the waiting list by using 75-year-old donors for recipients with hepatocellular carcinoma.

    PubMed

    Cascales Campos, P A; Romero, P R; Gonzalez, R; Zambudio, A R; Martinez Frutos, I M; de la Peña, J; Bueno, F S; Robles Campos, R; Miras, M; Pons Miñano, J A; Sanmartin Monzo, A; Domingo, J; Bixquert Montagud, V; Parrilla Paricio, P

    2010-03-01

    The best treatment for hepatocellular carcinoma (HCC) associated with liver cirrhosis is liver transplantation and the best results are obtained when the tumors fulfill the Milan criteria. However, although the number of transplants is increasing, the organ deficit is growing, which lengthens time on the waiting list, increasing the risk of tumor progression of and exclusion from the list. The use of elderly donors is a valid option for patients on the transplant waiting list with HCC, reducing time on the waiting list. We report our experience with patients transplanted for HCC associated with hepatic cirrhosis using livers from donors >75 years of age. Our preliminary results supported the use of elderly suboptimal donors making it possible to give priority to these patients. All patients in the series achieved good graft function after a follow-up of 2 years with a 100% disease-free survival rate. More extensive long-term studies are needed to confirm these findings.

  18. When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists.

    PubMed

    Long, Kristin; Talley, Cynthia; Yarrison, Rebecca B; Bernard, Andrew

    2015-01-01

    Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible.

  19. Laser Safety Inspection Criteria

    SciTech Connect

    Barat, K

    2005-02-11

    A responsibility of the Laser Safety Officer (LSO) is to perform laser safety audits. The American National Standard Z136.1 Safe use of Lasers references this requirement in several sections: (1) Section 1.3.2 LSO Specific Responsibilities states under Hazard Evaluation, ''The LSO shall be responsible for hazards evaluation of laser work areas''; (2) Section 1.3.2.8, Safety Features Audits, ''The LSO shall ensure that the safety features of the laser installation facilities and laser equipment are audited periodically to assure proper operation''; and (3) Appendix D, under Survey and Inspections, it states, ''the LSO will survey by inspection, as considered necessary, all areas where laser equipment is used''. Therefore, for facilities using Class 3B and or Class 4 lasers, audits for laser safety compliance are expected to be conducted. The composition, frequency and rigueur of that inspection/audit rests in the hands of the LSO. A common practice for institutions is to develop laser audit checklists or survey forms. In many institutions, a sole Laser Safety Officer (LSO) or a number of Deputy LSO's perform these audits. For that matter, there are institutions that request users to perform a self-assessment audit. Many items on the common audit list and the associated findings are subjective because they are based on the experience and interest of the LSO or auditor in particular items on the checklist. Beam block usage is an example; to one set of eyes a particular arrangement might be completely adequate, while to another the installation may be inadequate. In order to provide more consistency, the National Ignition Facility Directorate at Lawrence Livermore National Laboratory (NIF-LLNL) has established criteria for a number of items found on the typical laser safety audit form. These criteria are distributed to laser users, and they serve two broad purposes: first, it gives the user an expectation of what will be reviewed by an auditor, and second, it is an

  20. National Recommended Water Quality Criteria

    EPA Pesticide Factsheets

    The National Recommended Water Quality Criteria is a compilation of national recommended water quality criteria for the protection of aquatic life and human health in surface water for approximately 150 pollutants. These criteria provide guidance for states and tribes to use in adopting water quality standards.

  1. Donor-estimated GFR as an appropriate criterion for allocation of ECD kidneys into single or dual kidney transplantation.

    PubMed

    Snanoudj, R; Rabant, M; Timsit, M O; Karras, A; Savoye, E; Tricot, L; Loupy, A; Hiesse, C; Zuber, J; Kreis, H; Martinez, F; Thervet, E; Méjean, A; Lebret, T; Legendre, C; Delahousse, M

    2009-11-01

    It has been suggested that dual kidney transplantation (DKT) improves outcomes for expanded criteria donor (ECD) kidneys. However, no criteria for allocation to single or dual transplantation have been assessed prospectively. The strategy of DKT remains underused and potentially eligible kidneys are frequently discarded. We prospectively compared 81 DKT and 70 single kidney transplant (SKT) receiving grafts from ECD donors aged >65 years, allocated according to donor estimated glomerular filtration rate (eGFR): DKT if eGFR between 30 and 60 mL/min, SKT if eGFR greater than 60 mL/min. Patient and graft survival were similar in the two groups. In the DKT group, 13/81 patients lost one of their two kidneys due to hemorrhage, arterial or venous thrombosis. Mean eGFR at month 12 was similar in the DKT and SKT groups (47.8 mL/min and 46.4 mL/min, respectively). Simulated allocation of kidneys according to criteria based on day 0 donor parameters such as those described by Remuzzi et al., Andres et al. and UNOS, did not indicate an improvement in 12-month eGFR compared to our allocation based on donor eGFR.

  2. Making the case for directed organ donation to registered donors in Israel.

    PubMed

    Siegal, Gil

    2014-01-23

    The number of deceased donor organ donations in Israel is lower than average when compared to other Western World countries. To address the organ gap, the 2008 Organ Transplantation Law provides new interventions, including important incentives to donors (and their families). The most notable of these was granting priority to registered donors (i.e., people on the waiting list who signed a donor card). The current study presents the normative arguments as well as the first documentation of public attitudes in Israel towards another possible incentive - allowing individuals to influence the allocation of their organs by permitting them to designate, to direct their donated organs [DD] to other registered donors, instead of the current allocation based primarily on medical criteria. A structured phone survey of 695 Israelis was conducted during Feb-March 2012. The sample is representative of the Israeli society in terms of age mix and gender, with adequate representation of the Arab and ultra-orthodox Jewish subgroups. Among all Israelis, 68% stated a willingness to donate their organs, but only 16% reported to have already signed a donor card. 85% stated their interest in receiving an organ if the need arises. Overall, 64% of respondents felt that DD to a group of others who have registered as donors is justified, and the rate was remarkably higher in the Arab group (84%), and lower in the religious and ultraorthodox Jewish groups (52% and 50% respectively). The majority of the Israeli public supports organ donation and its proven benefits. Thus, organ recovery policy should be grounded in a strong communitarian strategy as we all stand to benefit from cooperation. However, current legislation and practices are modeled on individual disposition based on an opt-in legal framework. DD allows personal choices of to-be donors that might interfere with social interests, principles, and values such as equal access to care (i.e. organs) or justice. However, based on the

  3. Validation of tissue quality parameters for donor corneas, designated for emergency cases: corneal graft survival.

    PubMed

    Rijneveld, Wilhelmina J; Wolff, Rachel; Völker-Dieben, Hennie J M; Pels, Elisabeth

    2011-12-01

    To validate tissue quality parameters for donor corneas designated for emergency grafting for corneal graft survival. In a longitudinal cohort follow-up study, 131 emergency penetrating grafts were studied. Grafts were performed with a pool of organ-cultured donor corneas designated for emergency grafting and prepared for immediate use with all safety tests performed. Assignation criteria were: corneas with a small superficial stromal opacity but meeting all selection criteria for PKP tissue and corneas without stromal opacity, but an endothelial cell density from 1800 to 2300 cells/mm(2) or mild polymegathism or pleomorphism. Cox multivariate regression analysis, Kaplan-Meier survival and log rank test were applied. Of the 131 keratoplasties, 115 could be followed. One eye was lost during surgery because of an expulsive bleeding. In 15 cases, a conjunctival transplantation finished off the penetrating graft. Corneal graft survival was not significantly related to the presence of PKP quality of the donor endothelium, neither with a cloudy graft nor with endothelial decompensation as the cause of failure. Main risk factors for a failed graft were vascularization of the host cornea (p=0.0001), the presence of a systemic auto immune disease in the recipient (p=0.003) and the disease leading to the (imminent) perforation and emergency graft (p=0.021). A selected pool of donor corneas designated for emergency grafting that does not interfere with the scheduled procedures allows more efficient and safe use of donor tissue in case of a(n) (imminent) perforation. Corneal graft survival rates justify the criteria for selection. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

  4. Living donor liver transplantation in Egypt

    PubMed Central

    Marwan, Ibrahim

    2016-01-01

    In Egypt there is no doubt that chronic liver diseases are a major health concern. Hepatitis C virus (HCV) prevalence among the 15−59 years age group is estimated to be 14.7%. The high prevalence of chronic liver diseases has led to increasing numbers of Egyptian patients suffering from end stage liver disease (ESLD), necessitating liver transplantation (LT). We reviewed the evolution of LT in Egypt and the current status. A single center was chosen as an example to review the survival and mortality rates. To date, deceased donor liver transplantation (DDLT) has not been implemented in any program though Egyptian Parliament approved the law in 2010. Living donor liver transplantation (LDLT) seemed to be the only logical choice to save many patients who are in desperate need for LT. By that time, there was increase in number of centers doing LDLT (13 centers) and increase in number of LDLT cases [2,400] with improvement of the results. Donor mortality rate is 1.66 per 1,000 donors; this comprised four donors in the Egyptian series. The exact recipient survival is not accurately known however, and the one-year, three-year and five-year survival were 73.17%, 70.83% and 64.16% respectively in the International Medical Center (IMC) in a series of 145 adult to adult living donor liver transplantation (AALDLT) cases. There was no donor mortality in this series. LDLT are now routinely and successfully performed in Egypt with reasonable donor and recipient outcomes. Organ shortage remains the biggest hurdle facing the increasing need for LT. Although LDLT had reasonable outcomes, it carries considerable risks to healthy donors. For example, it lacks cadaveric back up, and is not feasible for all patients. The initial success in LDLT should drive efforts to increase the people awareness about deceased organ donation in Egypt. PMID:27115003

  5. Living donor liver transplantation in Egypt.

    PubMed

    Amer, Khaled E; Marwan, Ibrahim

    2016-04-01

    In Egypt there is no doubt that chronic liver diseases are a major health concern. Hepatitis C virus (HCV) prevalence among the 15-59 years age group is estimated to be 14.7%. The high prevalence of chronic liver diseases has led to increasing numbers of Egyptian patients suffering from end stage liver disease (ESLD), necessitating liver transplantation (LT). We reviewed the evolution of LT in Egypt and the current status. A single center was chosen as an example to review the survival and mortality rates. To date, deceased donor liver transplantation (DDLT) has not been implemented in any program though Egyptian Parliament approved the law in 2010. Living donor liver transplantation (LDLT) seemed to be the only logical choice to save many patients who are in desperate need for LT. By that time, there was increase in number of centers doing LDLT (13 centers) and increase in number of LDLT cases [2,400] with improvement of the results. Donor mortality rate is 1.66 per 1,000 donors; this comprised four donors in the Egyptian series. The exact recipient survival is not accurately known however, and the one-year, three-year and five-year survival were 73.17%, 70.83% and 64.16% respectively in the International Medical Center (IMC) in a series of 145 adult to adult living donor liver transplantation (AALDLT) cases. There was no donor mortality in this series. LDLT are now routinely and successfully performed in Egypt with reasonable donor and recipient outcomes. Organ shortage remains the biggest hurdle facing the increasing need for LT. Although LDLT had reasonable outcomes, it carries considerable risks to healthy donors. For example, it lacks cadaveric back up, and is not feasible for all patients. The initial success in LDLT should drive efforts to increase the people awareness about deceased organ donation in Egypt.

  6. Laser Safety Inspection Criteria

    SciTech Connect

    Barat, K

    2005-06-13

    A responsibility of the Laser Safety Officer (LSO) is to perform laser audits. The American National Standard Z136.1 Safe Use of Lasers references this requirement through several sections. One such reference is Section 1.3.2.8, Safety Features Audits, ''The LSO shall ensure that the safety features of the laser installation facilities and laser equipment are audited periodically to assure proper operation''. The composition, frequency and rigor of that inspection/audit rests in the hands of the LSO. A common practice for institutions is to develop laser audit checklists or survey forms It is common for audit findings from one inspector or inspection to the next to vary even when reviewing the same material. How often has one heard a comment, ''well this area has been inspected several times over the years and no one ever said this or that was a problem before''. A great number of audit items, and therefore findings, are subjective because they are based on the experience and interest of the auditor to particular items on the checklist. Beam block usage, to one set of eyes might be completely adequate, while to another, inadequate. In order to provide consistency, the Laser Safety Office of the National Ignition Facility Directorate has established criteria for a number of items found on the typical laser safety audit form. The criteria are distributed to laser users. It serves two broad purposes; first, it gives the user an expectation of what will be reviewed by an auditor. Second, it is an opportunity to explain audit items to the laser user and thus the reasons for some of these items, such as labelling of beam blocks.

  7. Sample quality criteria.

    PubMed

    Ramsey, Charles A; Wagner, Claas

    2015-01-01

    The concept of Sample Quality Criteria (SQC) is the initial step in the scientific approach to representative sampling. It includes the establishment of sampling objectives, Decision Unit (DU), and confidence. Once fully defined, these criteria serve as input, in addition to material properties, to the Theory of Sampling for developing a representative sampling protocol. The first component of the SQC establishes these questions: What is the analyte(s) of concern? What is the concentration level of interest of the analyte(s)? How will inference(s) be made from the analytical data to the DU? The second component of the SQC establishes the DU, i.e., the scale at which decisions are to be made. On a large scale, a DU could be a ship or rail car; examples for small-scale DUs are individual beans, seeds, or kernels. A well-defined DU is critical because it defines the spatial and temporal boundaries of sample collection. SQC are not limited to a single DU; they can also include multiple DUs. The third SQC component, the confidence, establishes the desired probability that a correct inference (decision) can be made. The confidence level should typically correlate to the potential consequences of an incorrect decision (e.g., health or economic). The magnitude of combined errors in the sampling, sample processing and analytical protocols determines the likelihood of an incorrect decision. Thus, controlling error to a greater extent increases the probability of a correct decision. The required confidence level directly affects the sampling effort and QC measures.

  8. Proportion of glomerulosclerosis in procurement wedge renal biopsy cannot alone discriminate for acceptance of marginal donors.

    PubMed

    Pokorná, E; Vítko, S; Chadimová, M; Schück, O; Ekberg, H

    2000-01-15

    The shortage of available kidneys for renal transplantation could be addressed, to some extent, by expanding the criteria for acceptance of marginal donors. The study of these criteria is limited by the selection of grafts actually retrieved and transplanted, therefore reduced to a study of risk factors. We have evaluated the potential of procurement renal biopies as an instrument for acceptance or refusal of donor kidneys for transplantation. This was a prospective study of a consecutive series of 200 donors. Biopsies were performed by wedge technique at the donor operation and were evaluated for proportion of glomerulosclerosis, vascular and tubular changes, and interstitial fibrosis. The study included 387 renal grafts with a representative biopsy, transplanted, and followed-up for survival and functional evaluation; 24 hr creatinine clearance at 1 and 3 weeks, and 3, 6, 12, 18, and 24 months. Factors associated with initial graft function included cold ischemia time, number of DR mismatches, tubular changes, although donor age showed the strongest correlation with short- and long-term level of graft function. DR mismatches and retransplantation appeared to be the only significant risk factors for graft loss. The proportion of glomerulosclerosis (mean 8%, range 0-48%) correlated with graft function in the simple regression analysis. However, when age was taken into account glomerulosclerosis did not correlate significantly with graft function. Furthermore, glomerulosclerosis as high as 25% or more had an acceptable 3-year graft survival rate of 74.7%. Procurement biopsy provides only limited information for the decision whether or not to accept a kidney donor.

  9. Interventional radiology in living donor liver transplant.

    PubMed

    Cheng, Yu-Fan; Ou, Hsin-You; Yu, Chun-Yen; Tsang, Leo Leung-Chit; Huang, Tung-Liang; Chen, Tai-Yi; Hsu, Hsien-Wen; Concerjero, Allan M; Wang, Chih-Chi; Wang, Shih-Ho; Lin, Tsan-Shiun; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Yu-Hung; Lin, Chih-Che; Chiu, King-Wah; Jawan, Bruno; Eng, Hock-Liew; Chen, Chao-Long

    2014-05-28

    The shortage of deceased donor liver grafts led to the use of living donor liver transplant (LDLT). Patients who undergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation (LT). Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplant. The aim of this paper is to review indications, diagnostic modalities, technical considerations, achievements and potential complications of interventional radiology procedures after LDLT.

  10. Donor Retention in Online Crowdfunding Communities: A Case Study of DonorsChoose.org

    PubMed Central

    Althoff, Tim; Leskovec, Jure

    2016-01-01

    Online crowdfunding platforms like DonorsChoose.org and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on DonorsChoose.org, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations. PMID:27077139

  11. The Kupffer Cell Number Affects the Outcome of Living Donor Liver Transplantation from Elderly Donors

    PubMed Central

    Hidaka, Masaaki; Eguchi, Susumu; Takatsuki, Mitsuhisa; Soyama, Akihiko; Ono, Shinichiro; Adachi, Tomohiko; Natsuda, Koji; Kugiyama, Tota; Hara, Takanobu; Okada, Satomi; Imamura, Hajime; Miuma, Satoshi; Miyaaki, Hisamitsu

    2016-01-01

    Background There have been no previous reports how Kupffer cells affect the outcome of living donor liver transplantation (LDLT) with an elderly donor. The aim of this study was to elucidate the influence of Kupffer cells on LDLT. Methods A total of 161 adult recipients underwent LDLT. The graft survival, prognostic factors for survival, and graft failure after LDLT were examined between cases with a young donor (<50, n = 112) and an elderly donor (≥50, N = 49). The Kupffer cells, represented by CD68-positive cell in the graft, were examined in the young and elderly donors. Results In a multivariable analysis, a donor older than 50 years, sepsis, and diabetes mellitus were significant predictors of graft failure after LDLT. The CD68 in younger donors was significantly more expressed than that in elderly donors. The group with a less number of CD68-positive cells in the graft had a significantly poor survival in the elderly donor group and prognostic factor for graft failure. Conclusions The worse outcome of LDLT with elderly donors might be related to the lower number of Kupffer cells in the graft, which can lead to impaired recovery of the liver function and may predispose patients to infectious diseases after LDLT. PMID:27819035

  12. Phonon induced spin relaxation times of single donors and donor clusters in silicon

    NASA Astrophysics Data System (ADS)

    Hsueh, Yuling; Buch, Holger; Hollenberg, Lloyd; Simmons, Michelle; Klimeck, Gerhard; Rahman, Rajib

    2014-03-01

    The phonon induced relaxation times (T1) of electron spins bound to single phosphorous (P) donors and P donor clusters in silicon is computed using the atomistic tight-binding method. The electron-phonon Hamiltonian is directly computed from the strain dependent tight-binding Hamiltonian, and the relaxation time is computed from Fermi's Golden Rule using the donor states and the electron-phonon Hamiltonian. The self-consistent Hartree method is used to compute the multi-electron wavefunctions in donor clusters. The method takes into account the full band structure of silicon including the spin-orbit interaction, and captures both valley repopulation and single valley g-factor shifts in a unified framework. The single donor relaxation rate varies proportionally to B5, and is of the order of seconds at B =2T, both in good agreement with experimental single donor data (A. Morello et. al., Nature 467, 687 (2010)). T1 calculations in donor clusters show variations for different electron numbers and donor numbers and locations. The computed T1 in a 4P:5e donor cluster match well with a scanning tunneling microscope patterned P donor cluster (H. Buch et. al., Nature Communications 4, 2017 (2013)).

  13. Donor Retention in Online Crowdfunding Communities: A Case Study of DonorsChoose.org.

    PubMed

    Althoff, Tim; Leskovec, Jure

    2015-05-01

    Online crowdfunding platforms like DonorsChoose.org and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on DonorsChoose.org, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations.

  14. Remuneration of hematopoietic stem cell donors: principles and perspective of the World Marrow Donor Association.

    PubMed

    Boo, Michael; van Walraven, Suzanna M; Chapman, Jeremy; Lindberg, Brian; Schmidt, Alexander H; Shaw, Bronwen E; Switzer, Galen E; Yang, Edward; Egeland, Torstein

    2011-01-06

    Hematopoietic stem cell transplantation is a curative procedure for life-threatening hematologic diseases. Donation of hematopoietic stem cells (HSCs) from an unrelated donor, frequently residing in another country, may be the only option for 70% of those in need of unrelated hematopoietic stem cell transplantation. To maximize the opportunity to find the best available donor, individual donor registries collaborate internationally. To provide homogeneity of practice among registries, the World Marrow Donor Association (WMDA) sets standards against which registries are accredited and provides guidance and regulations about unrelated donor safety and care. A basic tenet of the donor registries is that unrelated HSC donation is an altruistic act; nonpayment of donors is entrenched in the WMDA standards and in international practice. In the United States, the prohibition against remuneration of donors has recently been challenged. Here, we describe the reasons that the WMDA continues to believe that HSC donors should not be paid because of ethical concerns raised by remuneration, potential to damage the public will to act altruistically, the potential for coercion and exploitation of donors, increased risk to patients, harm to local transplantation programs and international stem cell exchange, and the possibility of benefiting some patients while disadvantaging others.

  15. Donor safety in living donor liver transplantation: a single-center analysis of 300 cases.

    PubMed

    Lei, Jianyong; Yan, Lunan; Wang, Wentao

    2013-01-01

    To evaluate the safety to donors of living-donor liver transplantation. This study included 300 consecutive living liver tissue donors who underwent operations at our center from July 2002 to December 2012. We evaluated the safety of donors with regard to three aspects complications were recorded prospectively and stratified by grade according to Clavien's classification, and the data were compared in two stages (the first 5 years' experience (pre-January 2008) and the latter 5 years' experience (post-January 2008); laboratory tests such as liver function and blood biochemistry were performed; and the health-related quality of life was evaluated. There was no donor mortality at our center, and the overall morbidity rate was 25.3%. Most of the complications of living donors were either grade I or II. There were significantly fewer complications in the latter period of our study than in the initial period (19.9% vs 32.6%, P<0.001), and biliary complications were the most common complications, with an incidence of 9%. All of the liver dysfunction was temporary; however, the post-operative suppression of platelet count lasted for years. Although within the normal range, eight years after operation, 22 donors showed lower platelet levels (189 × 10(9)/L) compared with the pre-operative levels (267 × 10(9)/L) (P<0.05). A total of 98.4% of donors had returned to their previous levels of social activity and work, and 99.2% of donors would donate again if it was required and feasible. With the exception of two donors who experienced grade III complications (whose recipients died) and a few cases of abdominal discomfort, fatigue, chronic pain and scar itching, none of the living donors were affected by physical problems. With careful donor selection and specialized patient care, low morbidity rates and satisfactory long-term recovery can be achieved after hepatectomy for living-donor liver transplantation.

  16. The effect of donor characteristics on survival after unrelated donor transplantation for hematologic malignancy

    PubMed Central

    Kollman, Craig; Spellman, Stephen R.; Zhang, Mei-Jie; Hassebroek, Anna; Anasetti, Claudio; Antin, Joseph H.; Champlin, Richard E.; Confer, Dennis L.; DiPersio, John F.; Fernandez-Viña, Marcelo; Hartzman, Robert J.; Horowitz, Mary M.; Hurley, Carolyn K.; Karanes, Chatchada; Maiers, Martin; Mueller, Carlheinz R.; Perales, Miguel-Angel; Setterholm, Michelle; Woolfrey, Ann E.; Yu, Neng

    2016-01-01

    There are >24 million registered adult donors, and the numbers of unrelated donor transplantations are increasing. The optimal strategy for prioritizing among comparably HLA-matched potential donors has not been established. Therefore, the objective of the current analyses was to study the association between donor characteristics (age, sex, parity, cytomegalovirus serostatus, HLA match, and blood group ABO match) and survival after transplantation for hematologic malignancy. The association of donor characteristics with transplantation outcomes was examined using either logistic or Cox regression models, adjusting for patient disease and transplantation characteristics associated with outcomes in 2 independent datasets: 1988 to 2006 (N = 6349; training cohort) and 2007 to 2011 (N = 4690; validation cohort). All donor-recipient pairs had allele-level HLA typing at HLA-A, -B, -C, and -DRB1, which is the current standard for selecting donors. Adjusting for patient disease and transplantation characteristics, survival was better after transplantation of grafts from young donors (aged 18-32 years) who were HLA matched to recipients (P < .001). These findings were validated for transplantations that occurred between 2007 and 2011. For every 10-year increment in donor age, there is a 5.5% increase in the hazard ratio for overall mortality. Increasing HLA disparity was also associated with worsening survival. Donor age and donor-recipient HLA match are important when selecting adult unrelated donors. Other donor characteristics such as sex, parity, and cytomegalovirus serostatus were not associated with survival. The effect of ABO matching on survival is modest and must be studied further before definitive recommendations can be offered. PMID:26527675

  17. Travel behavior and deferral of Dutch blood donors: consequences for donor availability.

    PubMed

    Lieshout-Krikke, Ryanne W; Oei, Welling; Habets, Karin; Pasker-de Jong, Pieternel C M

    2015-01-01

    Donors returning from areas with outbreaks of infectious diseases may donate infectious blood back home. Geographic donor deferral is an effective measure to ensure the blood safety, but donor deferral may pose a threat for the blood supply especially after holiday seasons. Insight into the travel behavior of blood donors is a first step to define appropriate deferral strategies. This study describes the travel behavior of Dutch donors, the actual deferral, and the consequences of deferral strategies on donor availability. A questionnaire designed to assess travel behavior (destination, frequency, and duration of travels) was sent to 2000 Dutch donors. The impact of travel deferral policies on donor availability was calculated, expressed as proportionate decrease in donor availability. The deferral policies considered were 1) deferral based on entire countries instead of affected regions where an infection is prevalent and 2) deferral after any travel outside Europe ("universal deferral"). Of the 1340 respondents, 790 (58.9%) donors traveled within Europe only, 61 (4.6%) outside Europe only, and 250 (18.7%) within and outside Europe. The deferral for entire countries and universal deferral would lead to 11.1 and 11.4% decrease in donor availability, respectively. Most Dutch donors traveled outside the Netherlands, while 23.2% traveled outside Europe. Universal deferral resulted in an additional decrease in donor availability of 0.3% compared with deferral for entire countries instead of affected regions where an infection is prevalent. Thus, the universal deferral could be considered as a simpler and safer measure. © 2014 AABB.

  18. Utilization of the organ care system - a game-changer in combating donor organ shortage.

    PubMed

    Popov, Aron-Frederik; García Sáez, Diana; Sabashnikov, Anton; Patil, Nikhil P; Zeriouh, Mohamed; Mohite, Prashant N; Zych, Bartlomiej; Schmack, Bastian; Ruhparwar, Arjang; Kallenbach, Klaus; Dohmen, Pascal M; Karck, Matthias; Simon, Andre R; Weymann, Alexander

    2015-03-12

    For patients with end-stage heart failure, cardiac transplantation persists to be the gold standard. Nevertheless, the availability of organs remains a main constraint to the treatment. Through mounting usage of ex vivo heart perfusion an increase in organ availability was achieved by reconditioning of organs formerly not regarded as appropriate for transplantation. We propose the future standard application of this state-of-the-art technology to improve the pool of donor organs by evaluating hearts outside standard acceptability criteria.

  19. Estimation of the potential eye and tissue donor pool in an Australian emergency department.

    PubMed

    Johnson, Damian; Dutch, Martin; Knott, Jonathan

    2016-06-01

    EDs have long been considered a potential source of eye and tissue donors, but no specific evidence to support this was identified in the Australian setting. The present study aims to bridge that knowledge gap, by analysing medical and social histories of those who have died over a 5 year period so as to determine donation eligibility in this population. A retrospective audit was undertaken of all patients who died within the Royal Melbourne Hospital ED between 2010 and 2014. ED records, pharmacy records and electronic medical histories were audited for the presence of eye and tissue donation exclusion criteria and the distribution of these criteria within the target population. Over the 5 year period, of 326 deaths that occurred in the ED, one third was suitable for eye donation (n = 106) and one in seven (n = 45) for tissue donation. Of the age appropriate patients, five criteria were identified that excluded up to 85% of the population not eligible to donate. These were: haematological malignancies, neurodegenerative conditions, non-haematological malignancies, chronic renal failure and eye disease. The present study has identified a large pool of potential eye and tissue donors; a pool mostly unrecognised by emergency clinicians. An extensive list of exclusion criteria restricts donor potential. However, the present study has identified that only five fundamentally limit donation in the ED population. Utilisation of this knowledge will allow for the development of clinical triggers that will improve identification, and increase realisation, of potential donors. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  20. Location of in-house organ procurement organization staff in level I trauma centers increases conversion of potential donors to actual donors.

    PubMed

    Shafer, Teresa J; Davis, Kimberly D; Holtzman, Samuel M; Van Buren, Charles T; Crafts, Nicholas J; Durand, Roger

    2003-04-27

    Of 5810 acute care hospitals in the United States, only 3.9% (231) are Level 1 Trauma Centers (L1TCs). L1TCs have a significant number of potential organ donors (PODs). Placement of Organ Procurement Organization (OPO) staff, In House Coordinators (IHCs), directly within the L1TC to increase the number of families who consent to donate and to provide system management for the trauma center's donation program, was evaluated. Four OPO staff, IHCs, were placed in offices inside two L1TCs in Houston, Texas. The IHCs were responsible for development of a donation system, donor surveillance, management, and most importantly, family support. Calendar year 2000 data on conversion of PODs to actual donors were compared between the L1TCs with IHCs (IHC-L1TC) (n=2) and trauma centers without IHCs (n=4) within the OPO's service area. IHC-L1TCs converted 44% more of the PODs to actual donors. Furthermore, the IHC-L1TCs were compared with 85 L1TCs (37% of U.S. L1TCs) without IHCs. IHC-L1TCs had a 28% greater donor consent rate and a 48% greater conversion rate of PODs to actual donors than the national L1TCs. L1TC status is the America College of Surgeons' highest level of verification for trauma care. To be certified as a L1TC, hospitals must meet strict criteria in both services and patient care. The donation process is often profoundly affected by the burden of demands made on the resources of these institutions and from divergent responsibilities between specialty services within the facility. Dedicated IHCs (OPO staff) are needed to provide early family intervention and to orchestrate the donation process to maximize organ recovery.

  1. The incidence of potential missed organ donors in intensive care units and emergency rooms: a retrospective cohort.

    PubMed

    Kutsogiannis, Demetrios J; Asthana, Sonal; Townsend, Derek R; Singh, Gurmeet; Karvellas, Constantine J

    2013-08-01

    There is a shortage of organ donors in Canada. The number of potential organ donors that are not referred to organ procurement organizations in Canada is unknown. We conducted a retrospective cohort study of all deaths in ICUs and emergency rooms not referred to the Human Organ Procurement and Exchange Program in four hospitals between 1 January 2008 and 31 December 2010. The primary outcome was the number of normal and expanded criteria heart-beating donors and circulatory death (DCD) donors. Of 2,931 deaths, 64 patients were identified as having a high probability for progression to heart-beating donation (Glasgow Coma Score of 3 and three or more absent brainstem reflexes) and 130 patients were assessed for possible DCD donation. The number of potential abdominal and lung heart-beating donors ranged from 3.2 to 7.5 and 0.5 to 2.7 per million population. The number of potential DCD abdominal and lung donors ranged from 3.9 to 6.5 and 2.7 to 4.3 per million population. Potential heart-beating abdominal (p = 0.04) and lung (p = 0.06) donors increased after legislation mandating donation discussion. Non-pupillary brainstem reflexes were documented in fewer than 60 % of records. Life-sustaining treatment was withdrawn in 19 of 46 (41.3 %) cardiac arrest patients not requiring high doses of vasoactive drugs within 24 h. The number of heart-beating or DCD organ donors represented by missed referrals may represent up to 7.5 donors per million population. Improved documentation of brainstem reflexes and encouraging referral of patients suffering cardiac arrest to ICU specialists may improve donor numbers.

  2. Prediction of occult hepatitis B virus infection in liver transplant donors through hepatitis B virus blood markers.

    PubMed

    Tandoi, Francesco; Caviglia, Gian Paolo; Pittaluga, Fabrizia; Abate, Maria Lorena; Smedile, Antonina; Romagnoli, Renato; Salizzoni, Mauro

    2014-11-01

    Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation. we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors. In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe. In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (p<0.0001). All anti-HBc-positive donors with detectable HBV-DNA in plasma (n=5) or anti-HBs>1,000 mIU/mL (n=5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBs<58 mIU/mL. In deceased donors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Diagnostic criteria of antibody-mediated rejection in kidney transplants.

    PubMed

    Mosquera Reboredo, J M; Vázquez Martul, E

    2011-01-01

    The diagnosis and treatment of anti-donor antibody-mediated rejection or humoral rejection (ABMR) is one of the main discussions at the moment in kidney transplantation. The search for histopathological markers that help us to diagnose ABMR has been more problematic, in contrast to the histological expression of cellular or tubulointerstitial rejection. Although the relationship between post-transplant anti-donor antibodies and the allograft's prognosis has been a topic of discussion for a long time, led in the main by P.Terasaki, it was not until the beginning of 1990s when P. Halloran studied the humoral mechanisms of rejection in greater depth. Feutch described the importance of C4d deposits as a marker that shows a humoral mechanism of allograft rejection in 1993. As a result of many studies carried out, the Banff consensus group established some diagnostic histopathological criteria of acute (ABMR) in 2003. These have been modified slightly in later meetings of the group. Furthermore, in 2005 this same working group looked at the physiopathological mechanisms causing chronic allograft failure in more detail and established the criteria defining chronic humoral rejection. In this review, we are trying to update any useful histopathological criteria for diagnosing acute and chronic ABMR.

  4. Living donor liver transplantation in the USA

    PubMed Central

    Testa, Giuliano

    2016-01-01

    Living donor liver transplant (LDLT) accounts for a small volume of the transplants in the USA. Due to the current liver allocation system based on the model for end-stage liver disease (MELD), LDLT has a unique role in providing life-saving transplantation for patients with low MELD scores and significant complications from portal hypertension, as well as select patients with hepatocellular carcinoma (HCC). Donor safety is paramount and has been a topic of much discussion in the transplant community as well as the general media. The donor risk appears to be low overall, with a favorable long-term quality of life. The latest trend has been a gradual shift from right-lobe grafts to left-lobe grafts to reduce donor risk, provided that the left lobe can provide adequate liver volume for the recipient. PMID:27115007

  5. Solicited kidney donors: Are they coerced?

    PubMed Central

    SERUR, DAVID; BRETZLAFF, GRETCHEN; CHRISTOS, PAUL; DESROSIERS, FARRAH; CHARLTON, MARIAN

    2016-01-01

    Most non-directed donors (NDDs) decide to donate on their own and contact the transplant centre directly. Some NDDs decide to donate in response to community solicitation such as newspaper ads or donor drives. We wished to explore whether subtle coercion might be occurring in such NDDs who are part of a larger community. One successful organization in a community in Brooklyn, NY, provides about 50 NDDs per year for recipients within that community. The donors answer ads in local papers and attend donor drives. Herein, we evaluated the physical and emotional outcomes of community-solicited NDDs in comparison to traditional NDDs who come from varied communities and are not responding to a specific call for donation. An assessment of coercion was used as well. PMID:26511772

  6. Solicited kidney donors: Are they coerced?

    PubMed

    Serur, David; Bretzlaff, Gretchen; Christos, Paul; Desrosiers, Farrah; Charlton, Marian

    2015-12-01

    Most non-directed donors (NDDs) decide to donate on their own and contact the transplant centre directly. Some NDDs decide to donate in response to community solicitation such as newspaper ads or donor drives. We wished to explore whether subtle coercion might be occurring in such NDDs who are part of a larger community. One successful organization in a community in Brooklyn, NY, provides about 50 NDDs per year for recipients within that community. The donors answer ads in local papers and attend donor drives. Herein, we evaluated the physical and emotional outcomes of community-solicited NDDs in comparison to traditional NDDs who come from varied communities and are not responding to a specific call for donation. An assessment of coercion was used as well. © 2015 Asian Pacific Society of Nephrology.

  7. A Time for Flexible Donor Agreements.

    ERIC Educational Resources Information Center

    Fischer, Gerald B.

    2003-01-01

    Discusses why volatile markets and new donor expectations make now a good time to rework payout rates and gift agreements to bolster financial and strategic performance. Suggests seven options for action. (EV)

  8. The dead donor rule: a defense.

    PubMed

    Birch, Samuel C M

    2013-08-01

    Miller, Truog, and Brock have recently argued that the "dead donor rule," the requirement that donors be determined to be dead before vital organs are procured for transplantation, cannot withstand ethical scrutiny. In their view, the dead donor rule is inconsistent with existing life-saving practices of organ transplantation, lacks a cogent ethical rationale, and is not necessary for maintenance of public trust in organ transplantation. In this paper, the second of these claims will be evaluated. (The first and third are not addressed.) The claim that the dead donor rule lacks a cogent ethical rationale will be shown to be an expression of the contemporary rejection of the moral significance of the traditional distinction between killing and allowing to die. The moral significance of this traditional distinction, and the associated norm that doctors should not kill their patients, will be defended, and this critique of it shown to be unsuccessful.

  9. Donor-Derived Myeloid Sarcoma in Two Kidney Transplant Recipients from a Single Donor

    PubMed Central

    Palanisamy, Amudha; Persad, Paul; Koty, Patrick P.; Douglas, Laurie L.; Stratta, Robert J.; Rogers, Jeffrey; Reeves-Daniel, Amber M.; Orlando, Giuseppe; Farney, Alan C.; Beaty, Michael W.; Pettenati, Mark J.; Iskandar, Samy S.; Grier, David D.; Kaczmorski, Scott A.; Doares, William H.; Gautreaux, Michael D.; Freedman, Barry I.; Powell, Bayard L.

    2015-01-01

    We report the rare occurrence of donor-derived myeloid sarcoma in two kidney transplant patients who received organs from a single deceased donor. There was no evidence of preexisting hematologic malignancy in the donor at the time of organ recovery. Both recipients developed leukemic involvement that appeared to be limited to the transplanted organ. Fluorescence in situ hybridization (FISH) and molecular genotyping analyses confirmed that the malignant cells were of donor origin in each patient. Allograft nephrectomy and immediate withdrawal of immunosuppression were performed in both cases; systemic chemotherapy was subsequently administered to one patient. Both recipients were in remission at least one year following the diagnosis of donor-derived myeloid sarcoma. These cases suggest that restoration of the immune system after withdrawal of immunosuppressive therapy and allograft nephrectomy may be sufficient to control HLA-mismatched donor-derived myeloid sarcoma without systemic involvement. PMID:25977825

  10. Donor-derived myeloid sarcoma in two kidney transplant recipients from a single donor.

    PubMed

    Palanisamy, Amudha; Persad, Paul; Koty, Patrick P; Douglas, Laurie L; Stratta, Robert J; Rogers, Jeffrey; Reeves-Daniel, Amber M; Orlando, Giuseppe; Farney, Alan C; Beaty, Michael W; Pettenati, Mark J; Iskandar, Samy S; Grier, David D; Kaczmorski, Scott A; Doares, William H; Gautreaux, Michael D; Freedman, Barry I; Powell, Bayard L

    2015-01-01

    We report the rare occurrence of donor-derived myeloid sarcoma in two kidney transplant patients who received organs from a single deceased donor. There was no evidence of preexisting hematologic malignancy in the donor at the time of organ recovery. Both recipients developed leukemic involvement that appeared to be limited to the transplanted organ. Fluorescence in situ hybridization (FISH) and molecular genotyping analyses confirmed that the malignant cells were of donor origin in each patient. Allograft nephrectomy and immediate withdrawal of immunosuppression were performed in both cases; systemic chemotherapy was subsequently administered to one patient. Both recipients were in remission at least one year following the diagnosis of donor-derived myeloid sarcoma. These cases suggest that restoration of the immune system after withdrawal of immunosuppressive therapy and allograft nephrectomy may be sufficient to control HLA-mismatched donor-derived myeloid sarcoma without systemic involvement.

  11. Pre-banking microbial contamination of donor conjunctiva and storage medium for penetrating keratoplasty.

    PubMed

    Inomata, Takenori; Ono, Koichi; Matsuba, Tsuyoshi; Shiang, Tina; Di Zazzo, Antonio; Nakatani, Satoru; Yamaguchi, Masahiro; Ebihara, Nobuyuki; Murakami, Akira

    2017-06-08

    The aims of this study were to investigate the incidence of positive donor tissue cultures before transfer to preservation medium (Optisol™-GS) for penetrating keratoplasty, to verify the efficacy of antibiotics contained in Optisol™-GS by examining the drug susceptibility and to assess the relationship between the results of our microbial assessments as well as donor factors and the incidence of contamination. We conducted a retrospective, cross-sectional study using Juntendo Eye Bank records for all corneal transplantations. Two hundred donor conjunctiva harvestings and storage medium (EP-II(®)) cultures were performed between July 2008 and June 2011. We analyzed the associations between donor factors (age, gender, history of cataract surgery, death-to-preservation interval, cause of death) and contamination rates using multivariate analysis by the generalized estimating equation model. We obtained positive bacterial cultures from 154 of the 200 eyes (77.0%). The isolated bacteria were indigenous, such as coagulase-negative Staphylococci, Corynebacterium sp., and methicillin-resistant Staphylococcus aureus (MRSA). There was significant resistance to levofloxacin (18 eyes, 9.0%) and gentamicin (12 eyes, 6.0%), and no vancomycin-resistant bacteria were detected. The donor factors did not correlate with the prevalence of bacterial contamination in our criteria. Pre-banking microbial assessment allows for microbial detection, bacterial susceptibility and resistance testing. This is useful for developing preservation mediums containing effective spectrum antibiotic agents for high quality control of corneal banking.

  12. Nucleic acid-amplification testing for hepatitis B in cornea donors.

    PubMed

    Fornés, Maria Gema; Jiménez, Maria Angustias; Eisman, Marcela; Gómez Villagrán, Jose Luis; Villalba, Rafael

    2016-06-01

    Careful donor selection and implementation of tests of appropriate sensitivity and specificity are of paramount importance for minimizing the risk of transmitting infectious diseases from donors to corneal allograft recipients. Reported cases of viral transmission with corneal grafts are very unusual. Nevertheless potential virus transmission through the engraftment cannot be ruled out. According to European Guideline 2006/17/EC, screening for antibodies for Hepatitis B core antigen (anti HBc) is mandatory, and when this test is positive, some criteria must be established before using corneas. Despite the continuous progress in screening tests, donors carrying an occult hepatitis B infection (OBI) can cause transplant-transmitted hepatitis B. To date, Nucleic Acid Testing (NAT) is not an obligatory assay in corneal tissue setting neither in our country nor in the rest of European countries. Herein, we report three cornea donors that were rejected with the diagnosis of OBI through the testing of sensitive NAT and the serological profile of Hepatitis B virus. The aim of this report is to emphasize the need to include NAT in new reviews of EU Tissues and Cells Directives in order to increase level of security in tissue donation as well as not to reject a high number of donors with isolated profile of anti HBc in geographical areas with high prevalence of Hepatitis B, that could be rejected without a true criterion of Hepatitis B infection.

  13. How I manage the adult potential organ donor: donation after cardiac death (part 2).

    PubMed

    Frontera, Jennifer A

    2010-02-01

    To address the gap between organs available for transplant and the number of patients on the transplant waiting list, the Joint Commission on the Accreditation of Healthcare Organizations, Institute of Medicine, United Network for Organ Sharing and the federal government have recommended the increased used of donation after cardiac death (DCD) (JCAHOnline http://www.jointcommission.org/Library/JCAHOnline/jo_06.06.htm ; UNOS, Highlights of the June Board Meeting, 2006). DCD is defined as organ donation once death is declared after irreversible cessation of circulatory and respiratory functions, as opposed to brain death (donation after neurological death). Though DCD is one of the fastest growing categories of organ donors, it comprises only 8% of all deceased donors (Steinbrook in N Engl J Med 357:209-213, 2007). Prior to 1968, when the Ad Hoc Committee of Harvard Medical School proposed a neurological definition of death based on brain-death criteria, organs from deceased donors came from patients who had suffered cardio-pulmonary demise (IOM, Non-heart-beating organ transplantation: practice and protocols, 2000). Early transplantation from DCD donors met with limited success and most transplant surgeons turned to brain-dead donors. Consequently, DCD fell out of vogue and, until recently, has not been the focus of transplant initiatives.

  14. Does Lung Donation by Heart Donors Have an Impact on Survival in Heart Transplant Recipients?

    PubMed

    Xia, Y; Friedmann, P; Bello, R; Goldstein, D; D'Alessandro, D

    2017-02-01

    Lung procurement is increasing during multiorgan recovery and substantially alters the explant process. This study evaluated whether lung donation by a heart donor affects survival in heart transplant recipients. Retrospective analysis of United Network for Organ Sharing (UNOS) adult heart transplantation data from 1998 to 2012 was performed. Lung donors (LDs) were defined as those having at least one lung procured and transplanted. Non-LDs had neither lung transplanted. Heart transplant recipients who had previous transplants, who had heterotopic transplants, who were waitlisted for other organs or who were temporarily delisted were excluded from the analysis. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed. Of 23 590 heart transplant recipients meeting criteria during the study period, 8638 (36.6%) transplants were from LDs. Donors in the LD group had less history of cigarette use (15.5% vs. 29.5%, p < 0.001). On univariate analysis, LDs were associated with improved patient survival (p < 0.001). On multivariate analysis, LDs were not significantly associated with patient survival (adjusted hazard ratio 0.98, 95% confidence interval 0.94-1.03). Analysis of the UNOS registry suggested that donor pulmonary status and lung procurement had no detrimental effect on survival in heart transplant recipients, supporting the present practice of using donor lungs whenever possible.

  15. Selection of unrelated bone marrow donors: does the current procedure warrant complete MHC class II identity?

    PubMed

    Eiermann, T H; Ballas, M; Fakler, J; Müller, C; Wölpl, A; Goldmann, S F

    1992-01-01

    Bone marrow transplantation from unrelated donors is being used increasingly for the treatment of patients with leukemia and several other hematologic disorders. Selection of unrelated bone marrow donors currently relies on serological HLA identity and negative mixed lymphocyte reactions between donor/recipient pairs. As serological HLA-DP typing is not feasible, we used the HLA-DPB1 oligonucleotide typing method to investigate whether the current selection procedure can guarantee complete MHC class II identity. In 40 consecutive patients, one third (62/193) serologically HLA-A, -B, -C, -DR and -DQ identical donors were found to be MLC-negative with a relative response below 5%. HLA-DPB1 oligonucleotide typing of these MLC-negative donors revealed that again only one third (20/62) was also identical for DP with their presumptive recipients. In the majority of pairs a disparity in graft-versus-host direction or in host-versus-graft direction of at least one allele was seen. These data indicate that, in spite of the strict MLC criteria used, the current procedure did not warrant complete MHC class II identity. This implies that oligotyping for DPB1 can improve matching and should be introduced for typing of volunteers.

  16. Baseline donor chronic renal injury confers the same transplant survival disadvantage for DCD and DBD kidneys.

    PubMed

    Kosmoliaptsis, V; Salji, M; Bardsley, V; Chen, Y; Thiru, S; Griffiths, M H; Copley, H C; Saeb-Parsy, K; Bradley, J A; Torpey, N; Pettigrew, G J

    2015-03-01

    Histological assessment of baseline chronic kidney injury may discriminate kidneys that are suitable for transplantation, but has not been validated for appraisal of donation after circulatory death (DCD) kidneys. 'Time-zero' biopsies for 371 consecutive, solitary, deceased-donor kidneys transplanted at our center between 2006 and 2010 (65.5% DCD, 34.5% donation after brain death [DBD]) were reviewed and baseline chronic degenerative injury scored using Remuzzi's classification. High scores correlated with donor age and extended criteria donors (42% of donors), but the spectrum of scores was similar for DCD and DBD kidneys. Transplant outcomes for kidneys scoring from 0 to 4 were comparable (1 and 3 year graft survival 95% and 92%), but were much poorer for kidneys scoring ≥5, with 1 year graft survival only 73%, and 12.5% suffering primary nonfunction. Critically, high Remuzzi scores conferred the same survival disadvantage for DCD and DBD kidneys. On multi-variable regression analysis, time-zero biopsy score was the only independent predictor for graft survival, whereas one-year graft estimated glomerular filtration rate (eGFR) correlated with donor age and biopsy score. In conclusion, the relationship between severity of chronic kidney injury and transplant outcome is similar for DCD and DBD kidneys. Kidneys with Remuzzi scores of ≤4 can be implanted singly with acceptable results.

  17. The development of organic super electron donors.

    PubMed

    Zhou, Shengze; Farwaha, Hardeep; Murphy, John A

    2012-01-01

    In the past decade, a host of exceptionally strong organic electron donors has been designed and prepared; their redox potentials are more negative than any previous neutral organic donors and extend beyond E(1/2) = -1 V vs. the saturated calomel electrode (SCE). Their ability to reduce a wide range of organic functional groups has been demonstrated and this article provides an overview of the main advances in the area and the guiding principles for the design of these reagents.

  18. Stimulated emission from donor transitions in silicon

    PubMed

    Pavlov; Zhukavin; Orlova; Shastin; Kirsanov; Hubers; Auen; Riemann

    2000-05-29

    The observation of far-infrared stimulated emission from shallow donor transitions in silicon is reported. Lasing with a wavelength of 59 &mgr;m due to the neutral donor intracenter 2p(0)-->1s(E) transition in Si:P pumped by CO2 laser radiation is obtained. Populations of D0 and D- center states and the balance of the radiation absorption and amplification are theoretically analyzed.

  19. Blood donation mobile applications: are donors ready?

    PubMed

    Yuan, Shan; Chang, Shelley; Uyeno, Kasie; Almquist, Gay; Wang, Shirong

    2016-03-01

    The rapid rise of mobile communication technologies has the potential to dramatically change and improve blood donor recruitment and retention efforts. E-mail invitations were sent to blood donors in a large metropolitan area to participate in a Web-based survey designed to gauge their readiness and interest level for a blood donation mobile application ("app"). A total of 982 ethnically diverse respondents of various age groups and prior donation experiences were surveyed. Among the respondents, 87.3% had ready access to smart phones. E-mail was chosen by 62.1% as the currently preferred method when contacted by the blood center, followed by texting (10.1%). App features desired by most respondents were the abilities to request appointments 24/7 (76.8%) and to receive appointment confirmations quickly (81.3%). Many were concerned about receiving too many alerts or messages (64.1%) or insufficient protection for personal information (53.5%). Overall, 67.7% of respondents indicated that they were likely to use a blood donation mobile app. Likelihood was not significantly different by sex or ethnicity, and the impact of education level was limited. Donors who currently made donation appointments via telephone or a website were equally likely to use such an app. However, donors older than 45 years were less likely than younger donors (p = 0.001), and donors with more than five lifetime donations were more likely than less frequent donors to use such an app (p = 0.02). In a metropolitan area, donors are very receptive to using a mobile app to manage their donations. © 2015 AABB.

  20. Comprehensive banking of sibling donor cord blood for children with malignant and nonmalignant disease.

    PubMed

    Reed, William; Smith, Renée; Dekovic, Florinna; Lee, Joanna Y; Saba, Julie D; Trachtenberg, Elizabeth; Epstein, Joanna; Haaz, Steffany; Walters, Mark C; Lubin, Bertram H

    2003-01-01

    Banking of cord blood (CB) for unrelated hematopoietic stem cell (HSC) transplantation is well established. However, directed-donor banking of CB for siblings in a current good tissue practices (cGTP) environment has not previously been investigated. Families were eligible for the present study if they were caring for a child with a disorder treatable by HSC transplantation and expecting the birth of a full sibling. We devised standard operating procedures and policies to address eligibility, donor recruitment, donor and recipient evaluation, CB collection, shipping, graft characterization, storage, and release of CB from quarantine. Many of these policies are distinctly different from those established for unrelated-donor CB banks. We enrolled 540 families from 42 states. Collections occurred at several hundred different hospitals. No family was deferred on the basis of health history or infectious disease testing, but departures from standard donor suitability criteria were documented. Disease categories for sibling recipients included malignancy, sickle cell anemia, thalassemia major, nonmalignant hematological conditions, and metabolic errors. Mean CB volume (including anticoagulant) was 103.1 mL; mean nucleated cell count was 8.9 x 10(8). Cell dose exceeded 1.5 x 10(7) nucleated cells per kilogram for 90% of banked units. Seventeen units (3.4%) have been transplanted. Sixteen of the 17 CB allograft recipients had stable engraftment of donor cells. Remote-site collection of sibling donor CB can be accomplished with a high success rate and in a cGTP-guided environment. The cellular products have been used successfully for transplantation; their number and characteristics should be adequate to support the first prospective clinical investigations of sibling CB transplantation.

  1. Obesity increases the risk of end-stage renal disease among living kidney donors.

    PubMed

    Locke, Jayme E; Reed, Rhiannon D; Massie, Allan; MacLennan, Paul A; Sawinski, Deirdre; Kumar, Vineeta; Mehta, Shikha; Mannon, Roslyn B; Gaston, Robert; Lewis, Cora E; Segev, Dorry L

    2017-03-01

    Determining candidacy for live kidney donation among obese individuals remains challenging. Among healthy non-donors, body mass index (BMI) above 30 is associated with a 16% increase in risk of end-stage renal disease (ESRD). However, the impact on the ESRD risk attributable to donation and living with only one kidney remains unknown. Here we studied the risk of ESRD associated with obesity at the time of donation among 119 769 live kidney donors in the United States. Maximum follow-up was 20 years. Obese (BMI above 30) live kidney donors were more likely male, African American, and had higher blood pressure. Estimated risk of ESRD 20 years after donation was 93.9 per 10 000 for obese; significantly greater than the 39.7 per 10 000 for non-obese live kidney donors. Adjusted for age, sex, ethnicity, blood pressure, baseline estimated glomerular filtration rate, and relationship to recipient, obese live kidney donors had a significant 86% increased risk of ESRD compared to their non-obese counterparts (adjusted hazard ratio 1.86; 95% confidence interval 1.05-3.30). For each unit increase in BMI above 27 kg/m(2) there was an associated significant 7% increase in ESRD risk (1.07, 1.02-1.12). The impact of obesity on ESRD risk was similar for male and female donors, African American and Caucasian donors, and across the baseline estimated glomerular filtration rate spectrum. These findings may help to inform selection criteria and discussions with persons considering living kidney donation.

  2. Transplantation of Kidneys From Donors With Acute Kidney Injury: Friend or Foe?

    PubMed

    Boffa, C; van de Leemkolk, F; Curnow, E; Homan van der Heide, J; Gilbert, J; Sharples, E; Ploeg, R J

    2017-02-01

    The gap between supply and demand in kidney transplantation has led to increased use of marginal kidneys; however, kidneys with acute kidney injury are often declined/discarded. To determine whether this policy is justified, we analyzed outcomes of donor kidneys with acute kidney injury (AKI) in a large UK cohort. A retrospective analysis of the UK Transplant Registry evaluated deceased donors between 2003 and 2013. Donors were classified as no AKI, or AKI stage 1-3 according to Acute Kidney Injury Network (AKIN) criteria. Relationship of AKI with delayed graft function/primary nonfunction (DGF/PNF), estimated glomerular filtration rate (eGFR), and graft-survival at 90 days and 1 year was analyzed. There were 11 219 kidneys (1869 [17%] with AKI) included. Graft failure at 1 year is greater for donors with AKI than for those without (graft survival 89% vs. 91%, p = 0.02; odds ratio (OR) 1.20 [95% confidence interval (CI): 1.03-1.41]). DGF rates increase with donor AKI stage (p < 0.005), and PNF rates are significantly higher for AKIN stage 3 kidneys (9% vs. 4%, p = 0.04) Analysis of association between AKI and recipient eGFR suggests a risk of inferior eGFR with AKI versus no AKI (p < 0.005; OR 1.25 [95% CI: 1.08-1.31]). We report a small reduction in 1-year graft-survival of kidneys from donors with AKI. We conclude that AKI stage 1 or 2 kidneys should be used; however, caution is advised for AKI stage 3 donors.

  3. CDTI target selection criteria

    NASA Technical Reports Server (NTRS)

    Britt, C. L.; Davis, C. M.; Jackson, C. B.; Mcclellan, V. A.

    1984-01-01

    A Cockpit Display of Traffic Information (CDTI) is a cockpit instrument which provides information to the aircrew on the relative location of aircraft traffic in the vicinity of their aircraft (township). In addition, the CDTI may provide information to assist in navigation and in aircraft control. It is usually anticipated that the CDTI will be integrated with a horizontal situation indicator used for navigational purposes and/or with a weather radar display. In this study, several sets of aircraft traffic data are analyzed to determine statistics on the number of targets that will be displayed on a CDTI using various target selection criteria. Traffic data were obtained from an Atlanta Terminal Area Simulation and from radar tapes recorded at the Atlanta and Miami terminal areas. Results are given in the form of plots showing the average percentage of time (or probability) that an aircraft equipped with a CDTI would observe from 0 to 10 other aircraft on the display for range settings on the CDTI up to 30 n. mi. and using various target discrimination techniques.

  4. FHR Generic Design Criteria

    SciTech Connect