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Gao C, Dai Y, Chai Y, Wang Y, Wu J, Ye M, Yi X, Jiang X, Jia Q. Knowledge, Attitudes, Willingness, and Associated Factors to Organ Donation Among Intensive Care Unit Health Care Workers: Findings of a Cross-Sectional Study. Transplant Proc 2024; 56:469-478. [PMID: 38365513 DOI: 10.1016/j.transproceed.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/18/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND The lack of donor organs is a major barrier to the advancement of organ transplantation. This study aimed to understand the current status of knowledge, attitudes, and willingness to donate organs among intensive care unit (ICU) health care workers and analyzed the influencing factors to provide a scientific basis for improving the situation of a serious imbalance between the ratio of organ supply and demand. METHODS From November 2021 to March 2022, 160 ICU health care workers from 3 level 3A hospitals in Huzhou City, Zhejiang Province, China were chosen as subjects by the cluster sampling method. A cross-sectional study of the participants was carried out using a general information questionnaire, Organ Donation Knowledge Scale, Organ Donation Attitude Scale, and Organ Donation Willingness Scale. The determinants of ICU health care workers' knowledge, attitudes, and willingness toward organ donation were examined using multiple linear regression analysis. RESULTS A total of 150 ICU health care workers completed the survey within the prescribed time, and the recovery rate of this questionnaire was 93.75%. The score on the Organ Donation Knowledge Scale was 7 (5, 7) points, and the full score was 10 points. The score on the Organ Donation Attitude Scale was (3.87 ± 0.93), and the full score was 7. The Organ Donation Willingness Scale score was 2 (2, 3) out of 5. The results of the multiple linear regression analysis revealed that several factors significantly influenced the score of organ donation knowledge. These factors were identified as the professional title and persuasive experience related to organ donation. Additionally, the score of organ donation attitude was found to be influenced primarily by the persuasive experience of organ donation. Furthermore, the score of organ donation willingness was influenced by 3 main factors: marital status, professional title, and persuasive experience in the context of organ donation. CONCLUSIONS Although the level of ICU health care workers' knowledge and attitudes toward organ donation was above the median level, they still needed to be improved. The current status of ICU health care workers' desire to donate organs is not optimistic; thus, relevant departments should take specific actions to improve the situation.
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Affiliation(s)
- Chu Gao
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yaqin Dai
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Yufei Chai
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yingying Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jiayun Wu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Mengyuan Ye
- School of Nursing, Huzhou Teachers College, Huzhou, Zhejiang, China
| | - Xiaoyan Yi
- School of Nursing, Huzhou Teachers College, Huzhou, Zhejiang, China
| | - Xiurong Jiang
- School of Nursing, Huzhou Teachers College, Huzhou, Zhejiang, China.
| | - Qin Jia
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
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Wang D, Ma Y, Gu B, Li X, Yu Y, Zhang Y, Chen H. Preliminary study of donor volume changes after dual-graft liver transplantation in rats. Front Immunol 2023; 14:1183426. [PMID: 37908343 PMCID: PMC10613707 DOI: 10.3389/fimmu.2023.1183426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/27/2023] [Indexed: 11/02/2023] Open
Abstract
Dual-graft liver transplantation (DGLT) expands the pool of donors, ensures the safety of the donors, and treats a potential small for size syndrome (SFSS). However, some of the recipient graft showed atrophy. The cause and mechanism of the unbalanced proliferation and atrophy of dual grafts after clinical DGLT have not been clarified. We established and optimized the rat model of DGLT to explore the causes of growth unbalance. Continuously and dynamically observed bilateral graft volume and portal vein blood flow change by magnetic resonance imaging (MRI) and ultrasound (US). We detected liver function indexes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL). Liver samples from receptors were obtained for morphology, and apoptosis was measured by RT-PCR and western blot. Optimization of the model improved the 7-day survival rate from former 58.3% to 87.5%, and the 30-day survival rate was 68.8%. The volume of the right graft gradually increased, and the left graft atrophied during the 30-day observation period. The portal blood flow of the left graft gradually decreased until the 30th day (0.13 ± 0.01 ml/s) compared with the sham group (0.63 ± 0.05 ml/s), and the right graft significantly increased on the 30th day (0.75 ± 0.11ml/s). The liver function initially increased and then recovered. The total volume (12.52 ± 1.60 ml vs 4.47 ± 0.08 ml) and weight (12.09 ± 1 g vs 4.91 ± 0.18 g) of the graft increased significantly compared to pre-transplantation and reached the level of the sham operation group on the 30th day. The volume and weight of the right graft increased more than those of the left graft (P < 0.05). There was more inflammatory cell infiltration in the left graft, and the right graft had obvious proliferation of hepatocytes and mature bile duct cells. Left grafts were more prone to apoptosis than right grafts (P < 0.05). In conclusion, growth of the right graft is superior to the left; after double liver transplantation, perfusion blood flow and apoptosis may be the reason contributing to the volume differences in dual grafts.
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Affiliation(s)
- Dan Wang
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yanling Ma
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Baohong Gu
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Xuemei Li
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yang Yu
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Ying Zhang
- Department of Laboratory Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Hao Chen
- The Department of Tumor Surgery, Second Hospital of Lanzhou University, Lanzhou, China
- The Key Laboratory of The Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
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Ullah K, Dogar AW, Rehman IU, Abbas SH, Ullah I, Nisar H, Lee KY. Expanding the living liver donor pool in countries having limited deceased donor activity: Pakistani perspective. Transpl Immunol 2022; 75:101683. [PMID: 35952941 DOI: 10.1016/j.trim.2022.101683] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/23/2022] [Accepted: 07/30/2022] [Indexed: 01/10/2023]
Abstract
Over the last decades, liver transplantation (LT) has evolved into a life-saving procedure. Due to limited deceased donor activities in the eastern world, living donor liver transplantation (LDLT) had flourished tremendously in most Asian countries. Yet, these LDLT activities fall short of meeting the expected demands. Pakistan, a developing country, bears a major burden of liver diseases. Currently, only few centers offer LDLT services in the country. On the other hand, deceased donor liver transplantation (DDLT) activities have not started due to social, cultural, and religious beliefs. Various strategies can be adopted successfully to overcome the scarcity of live liver donors (LLDs) and to expand the donor pool, keeping in view donor safety and recipient outcome. These include consideration of LLDs with underlying clinical conditions like G6PD deficiency and Hepatitis B core positivity. Extended donor criteria can also be utilized and relaxation can be made in various donors' parameters including upper age and body mass index after approval from the multidisciplinary board. Also, left lobe grafts, grafts with various anatomical variations, and a low graft-to-recipient ratio can be considered in appropriate situations. ABO-incompatible LT and donor swapping at times may help in expanding the LLDs pool. Similarly, legislation is needed to allow live non-blood-related donors for organ donations. Finally, community education and awareness through various social media flat forms are needed to promote deceased organ donation.
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Affiliation(s)
- Kaleem Ullah
- Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan
| | - Abdul Wahab Dogar
- Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan
| | | | - Syed Hasnain Abbas
- Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan; Institute of Public Health and Social Science (IPH&SS), Khyber Medical University, Peshawar, Pakistan
| | - Husna Nisar
- Mehboob School of Physiotherapy, Hayatabad, Peshawar, Pakistan
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
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Sim JH, Kwon HM, Jun IG, Kim SH, Kim KS, Moon YJ, Song JG, Hwang GS. Association of skeletal muscle index with postoperative acute kidney injury in living donor hepatectomy: A retrospective single-centre cohort study. Liver Int 2022; 42:425-434. [PMID: 34817911 DOI: 10.1111/liv.15109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/27/2021] [Accepted: 11/21/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although living donor liver transplantation (LDLT) is the standard treatment option for patients with end-stage liver disease, it always entails ethical concerns about the risk of living donors. Recent studies have reported a correlation between sarcopenia and surgical prognosis in recipients. However, there are few studies of donor sarcopenia and the surgical prognosis of donors. This study investigated the association between sarcopenia and postoperative acute kidney injury in liver donors. METHODS This retrospective study analysed 2892 donors who underwent donor hepatectomy for LDLT between January 2008 and January 2018. Sarcopenia was classified into pre-sarcopenia and severe sarcopenia, which were determined to be -1 standard deviation (SD), and -2 SD from the mean baseline of the skeletal muscle index, respectively. Multivariate regression analysis was performed to evaluate the association between donor sarcopenia and postoperative AKI. Additionally, we assessed the association between donor sarcopenia and delayed recovery of liver function (DRHF). RESULTS In the multivariate analysis, donor sarcopenia was significantly associated a higher incidence of postoperative AKI (adjusted odds ratio [OR]: 2.65, 95% confidence interval [CI]: 1.15-6.11, P = .022 in pre-sarcopenia, OR: 5.59, 95% CI: 1.11-28.15, P = .037 in severe sarcopenia, respectively). Additionally, hypertension and synthetic colloid use were significantly associated with postoperative AKI. In the multivariate analysis, risk factors of DRHF were male gender, indocyanine green retention rate at 15 minutes, and graft type, however, donor sarcopenia was not a risk factor. CONCLUSIONS Donor sarcopenia is associated with postoperative AKI following donor hepatectomy.
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Affiliation(s)
- Ji-Hoon Sim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye-Mee Kwon
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In-Gu Jun
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Hoon Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Sun Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Jin Moon
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun-Gol Song
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Gyu-Sam Hwang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Carbonnel M, Revaux A, Menzhulina E, Karpel L, Snanoudj R, Le Guen M, De Ziegler D, Ayoubi JM. Uterus Transplantation with Live Donors: Screening Candidates in One French Center. J Clin Med 2020; 9:jcm9062001. [PMID: 32630524 PMCID: PMC7356518 DOI: 10.3390/jcm9062001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022] Open
Abstract
We report our experience regarding the profile and screening process of potential recipients (R) and their live donors (D) in our Uterus transplantation (UTx) trial from 2014 to 2020. The initial screening was performed using medical questionnaires and consultations. The second step of the screening consisted of two individual interviews with an independent multidisciplinary committee. Then, a complete medical, biological and imaging assessment of the directed living D, the R, and her partner was performed over a two-day hospitalization. A total of 239 women contacted our department: 165 potentials R and 74 potentials D. During the first step of screening, 141 R and 45 D were excluded. Only 12 R/D pairs were pursued. During inclusion, 10 R/D pairs were excluded. One R/D pair is still under evaluation. Finally, only 1 R/D pair was definitively included (0.6%), which led us to perform the first French UTx in March 2019 with a successful graft. The primary limiting factors of inclusion were due to very strict criteria and difficulty of having a suitable directed living D. The International Society of UTx (ISUTx) guidelines based on worldwide results of trials can help ease our inclusion criteria in the future while remaining safe for patients.
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Affiliation(s)
- Marie Carbonnel
- Department of Obstetrics and Gynecology, Hospital Foch, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France; (A.R.); (E.M.); (L.K.); (D.D.Z.); (J.M.A.)
- Correspondence:
| | - Aurelie Revaux
- Department of Obstetrics and Gynecology, Hospital Foch, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France; (A.R.); (E.M.); (L.K.); (D.D.Z.); (J.M.A.)
| | - Elena Menzhulina
- Department of Obstetrics and Gynecology, Hospital Foch, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France; (A.R.); (E.M.); (L.K.); (D.D.Z.); (J.M.A.)
| | - Lea Karpel
- Department of Obstetrics and Gynecology, Hospital Foch, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France; (A.R.); (E.M.); (L.K.); (D.D.Z.); (J.M.A.)
| | - Renaud Snanoudj
- Department of Nephrology and Transplantation, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France;
| | - Morgan Le Guen
- Department of Anesthesiology, Hospital Foch, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France;
| | - Dominique De Ziegler
- Department of Obstetrics and Gynecology, Hospital Foch, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France; (A.R.); (E.M.); (L.K.); (D.D.Z.); (J.M.A.)
| | - Jean Marc Ayoubi
- Department of Obstetrics and Gynecology, Hospital Foch, University of Versailles, Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France; (A.R.); (E.M.); (L.K.); (D.D.Z.); (J.M.A.)
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How far can we go with hepatocellular carcinoma in living donor liver transplantation? Curr Opin Organ Transplant 2019; 24:644-650. [DOI: 10.1097/mot.0000000000000692] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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