The British Transplantation Society guidelines on ethics, law and consent in relation to deceased donors after circulatory death

The British Transplantation Society (BTS) 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated and this manuscript summarises the relevant recommendations from chapters specifically related to law, ethics, donor consent and informing the recipient.

British Transplantation Society guidelines on abdominal organ transplantation from deceased donors after circulatory death

The British Transplantation Society (BTS) 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated and this manuscript summarises the relevant recommendations in abdominal organ transplantation from Donation after Circulatory Death (DCD) donors, encompassing the chapters on liver, kidney, pancreas and islet cell transplantation.

The British Transplantation Society guidelines on cardiothoracic organ transplantation from deceased donors after circulatory death

Maximising organ utilisation from donation after circulatory death (DCD) donors could help meet some of the shortfall in organ supply, but it represents a major challenge, particularly as organ donors and transplant recipients become older and more medically complex over time. Success is dependent upon establishing common practices and accepted protocols that allow the safe sharing of DCD organs and maximise the use of the DCD donor pool. The British Transplantation Society 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated. This manuscript summarises the relevant recommendations from chapters specifically related to transplantation of cardiothoracic organs.

The British transplantation society guidelines on organ donation from deceased donors after circulatory death

Recipient outcomes after transplantation with organs from donation after circulatory death (DCD) donors can compare favourably and even match recipient outcomes after transplantation with organs from donation after brain death donors. Success is dependent upon establishing common practices and accepted protocols that allow the safe sharing of DCD organs and maximise the use of the DCD donor pool. The British Transplantation Society 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated. This manuscript summarises the relevant recommendations from chapters specifically related to organ donation.

COVID-19 in Kidney Transplant Patients From a Large UK Transplant Center: Exploring Risk Factors for Disease Severity

Background

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised concern for the health of immunocompromised individuals, who are potentially at higher risk of more severe infection and poorer outcomes. As a large London transplant center serving a diverse patient population, we report the outcomes of SARS-CoV-2 infection in our cohort of 2848 kidney and/or pancreas transplant patients.

Methods

Data were obtained retrospectively for all transplant patients who attended hospital during the peak of the pandemic and had a positive nasopharyngeal SARS-CoV-2 test.

Results

Sixty-six patients were found to be positive for SARS-CoV-2. Twenty percent were treated as outpatients, 59% were admitted to the general ward, and 21% required intensive care. Treatment consisted of reduced immunosuppression, antibiotics for pneumonia or sepsis, and other supportive treatments. Within our cohort, 12 patients died (18%), with an overall mortality of 0.4%. Predictive risk factors for COVID-19 severity were explored.

Conclusions

Severe disease was associated with lower hemoglobin prior to COVID-19 diagnosis and lower lymphocyte count at the time of diagnosis but not age, sex, ethnicity, or preexisting comorbidities. Lower glomerular filtration rate and higher C-reactive protein were associated with more severe disease. Despite no use of hydroxychloroquine, azithromycin, antiviral, or immunomodulatory medications, our mortality rate (kidney and pancreas transplant patients) is similar to current international rates.

Cerebral vein and dural sinus thrombosis in adults in Isfahan, Iran: frequency and seasonal variation

OBJECTIVE

To estimate the frequency of cerebral vein and dural sinus thrombosis (CVST) and its seasonal variation.

METHODS

A clinic-based prospective case-register study was conducted from 2001 to 2004. Hundred and twenty-two consecutive definite CVST patients (26 men and 96 women) treated in two major neurological centres of Isfahan, Iran, were included in the study. Part of examination included an assessment of CVST including conventional angiography and/or magnetic resonance imaging and self-reported medical history. Population data were obtained from the 1996 Iran Census. The mean (standard deviation) age of participants was 35.5 (11.9) years.

RESULTS

The annual frequency (95% confidence interval) of CVST was 12.3 (10.1, 14.5) per million in a population of 2,472,751, with higher rate in women than in men [19.9 (15.5, 23.9) women and 5.1 (3.2, 7.1) men] and with increasing age in women (up to 50 years), but not in men. The female/male ratio was 3.9 (2.5-6.0). The monthly frequency of CVST ranged from 0.6 per million (0.1, 1.1) in August to 2.1 (1.2, 3.0) in September. The seasonal CVST rate ranged from 2.2 per million (1.3, 3.2) in summer to 4.3 (3.1, 5.7) in autumn. The differences were statistically significant either for the months or season (P < 0.05).

CONCLUSION

The findings of this study show the CVST frequency in adults. More women than men are present with CVST and its frequency increased during autumn.