The role and problems of post-mortem donations
DOI:
https://doi.org/10.11603/2414-4533.2022.4.13618Keywords:
organ donation, explantation, brain death, organ transplantationAbstract
The aim of the work : to determine the dependence of the number of organ explantations in effective post-mortem donors on age and laboratory results and to study the proportion of organs suitable for transplantation in the latter.
Materials and Methods. The study included 14 post-mortem donors who underwent organ explantation from May 2021 to December 2021 at the KNP KOCL, of which 56.3 % were men and 43.7 % were women. By age, the patients were divided into 2 groups: group 1 – under 50 years old, group 2–50 years and older.
Results and Discussion. According to the results of statistical processing of data, it can be argued that the groups did not differ significantly for the article, body mass index, duration of stay in HRIT, and such laboratory parameters as the average level of creatinine, sodium, ALT and AST, at the same time there was a significant difference in the content of urea and directly after age, p = 0.03 and p = 0.000034, respectively. There was no significant statistical difference in the number of explantations.
The modern development of transplantation in our country has made it possible to significantly improve the results in the fight for the lives of patients. Posthumous donation saves the life of at least 4 people at the same time. In Ukraine, there are no criteria for marginal donation, extended criteria for donation, and there is no unified protocol for conditioning a potential donor. The age of the post-mortem donor is not a critical criterion for organ donation. Despite laboratory indicators of donor safety, some organs are not suitable for further transplantation; in this study, these are 36 % of hearts, 43 % of livers and 7 % of kidneys. Follow-up studies in a larger cohort of patients are needed to further explore the effectiveness of donor use and post-transplant long-term outcomes.
References
Heldal, K., Hartmann, A., Leivestad, T., Lien, B., Foss, A.E., & Midtvedt, K. (2011). Renal transplantation is also an option for patients over 70. Tidsskr Nor Laegeforen., 131(20), 2004-2007. English, Norwegian. DOI: 10.4045/tidsskr.10.1391. PMID: 22016126.
Yilmaz, G., Ozdemir, E., Yildar, M., Karayagiz, H., Berber, I., & Cakir, U. (2022). Graft and Patient Survival in Kidney Transplant Recipients Over the Age of Sıxty-Five. Cureus, 14(1), e20913. DOI: 10.7759/cureus.20913. PMID: 35154914; PMCID: PMC8815706.
Ruggenenti, P., Cravedi, P., Gotti, E., Plati, A., Marasà, M., Sandrini, S., Bossini, N., … Remuzzi, G. (2021). Mycophenolate mofetil versus azathioprine in kidney transplant recipients on steroid-free, low-dose cyclosporine immunosuppression (ATHENA): A pragmatic randomized trial. PLoS Med., 18(6), e1003668. DOI: 10.1371/journal.pmed.1003668. PMID: 34166370; PMCID: PMC8224852.
Vathsala, A., & Woo, K.T. (1999). Renal transplantation in cyclosporine-treated recipients at the Singapore General Hospital. Clin. Transpl., 189-197. PMID: 11038637.
Ong, S.C., & Gaston, R.S. (2021). Thirty Years of Tacrolimus in Clinical Practice. Transplantation, 105(3), 484-495. DOI: 10.1097/TP.0000000000003350. PMID: 32541562.
Stephan, A. (2017). Organ Shortage: Can We Decrease the Demand? Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation, 15(1), 6-9. DOI: 10.6002/ect.mesot2016.l27. PMID: 28260423.
Levitt, M. (2015). Could the organ shortage ever be met? Life Sci. Soc. Policy 11, 6. DOI: 10.1186/s40504-015-0023-1.
Saidi, R.F., & Hejazii Kenari, S.K. (2014). Challenges of organ shortage for transplantation: solutions and opportunities. Int. J. Organ Transplant. Med., 5(3), 87-96. PMID: 25184029; PMCID: PMC4149736.
Messina, M., Diena, D., Dellepiane, S., Guzzo, G., Lo Sardo L., Fop, Fabrizio G., P. … Biancone, L. (2017). Long-Term Outcomes and Discard Rate of Kidneys by Decade of Extended Criteria Donor Age. CJASN, 12(2), 323-331. DOI: 10.2215/CJN.06550616.
Bozkurt, B., & Kılıç, M., (2015). Marginal Donors in Renal Transplantation. Transplantation Proceedings, 47(5), 1273-1281.ISSN 0041-1345. DOI: 10.1016/j.transproceed.2015.04.006.
Bae, S., Massie, A.B., Thomas, A.G., Bahn, G., Luo, X., Jackson, K.R., … Garonzik Wang, J.M. (2018). Who can tolerate a marginal kidney? Predicting survival after deceased donor kidney transplant by donor-recipient combination. American Journal of Transplantation. DOI:10.1111/ajt.14978.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Hospital Surgery. Journal named by L.Ya. Kovalchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
