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ImportancePolicy makers, transplant professionals, and patient organizations agree that there is a need to increase the number of kidney transplants by facilitating living donation. Vouchers for future transplant provide a means of overcoming the chronological incompatibility that occurs when the ideal time for living donation differs from the time at which the intended recipient actually needs a transplant. However, uncertainty remains regarding the actual change in the number of living kidney donors associated with voucher programs and the capability of voucher redemptions to produce timely transplants.ObjectiveTo examine the consequences of voucher-based kidney donation and the capability of voucher redemptions to provide timely kidney allografts.Design, setting, and participantsThis multicenter cohort study of 79 transplant centers across the US used data from the National Kidney Registry from January 1, 2014, to January 31, 2021, to identify all family vouchers and patterns in downstream kidney-paired donations. The analysis included living kidney donors and recipients participating in the National Kidney Registry family voucher program.ExposuresA voucher was provided to the intended recipient at the time of donation. Vouchers had no cash value and could not be sold, bartered, or transferred to another person. When a voucher was redeemed, a living donation chain was used to return a kidney to the voucher holder.Main outcomes and measuresDeidentified demographic and clinical data from each kidney donation were evaluated, including the downstream patterns in kidney-paired donation. Voucher redemptions were separately evaluated and analyzed.ResultsBetween 2014 and 2021, 250 family voucher-based donations were facilitated. Each donation precipitated a transplant chain with a mean (SD) length of 2.3 (1.6) downstream kidney transplants, facilitating 573 total transplants. Of those, 111 transplants (19.4%) were performed in highly sensitized recipients. Among 250 voucher donors, the median age was 46 years (range, 19-78 years), and 157 donors (62.8%) were female, 241 (96.4%) were White, and 104 (41.6%) had blood type O. Over a 7-year period, the waiting time for those in the National Kidney Registry exchange pool decreased by more than 3 months. Six vouchers were redeemed, and 3 of those redemptions were among individuals with blood type O. The time from voucher redemption to kidney transplant ranged from 36 to 155 days.Conclusions and relevanceIn this study, the family voucher program appeared to mitigate a major disincentive to living kidney donation, namely the reluctance to donate a kidney in the present that could be redeemed in the future if needed. The program facilitated kidney donations that may not otherwise have occurred. All 6 of the redeemed vouchers produced timely kidney transplants, indicating the capability of the voucher program.

Background/Aim. There is a constant increase in the need to use third-party reproductive cells among couples who are unable to conceive with their own reproductive cells or in order to prevent the passing of an existing hereditary genetic disorder to the child. The aim of the study was to present a theoretical overview and perform a practical analysis of the use of social marketing strategies using the first technique of analyzing the attitudes of potential donors of reproductive cells in the Republic of Serbia (RS) in the interest of adapting to the target group. Methods. Empirical research in this study, in which both women and men from the RS participated, was based on a questionnaire about people’s willingness to be potential reproductive cell donors and about having information on the donation of reproductive cells. The data in this paper were obtained during 2021, and the questionnaire was focused on a particular population group. The questionnaire was sent to people aged 20 to 34 years who could become potential donors of reproductive cells. In the research, 201 women and men from the RS participated. The first part of the questionnaire was tested for internal consistency, which was tested by Cronbach’s alpha coefficient calculation (α). Values of α lower than 0.5 indicate that the questionnaire possesses unacceptable consistency. Results. A total of 57% of participants were informed about reproductive cell donation through the Internet, 29% by friends and family, and 11% of them were informed by doctors. Only 32% of participants were fully informed, and 25.1% were partially informed about the donation of reproductive material in the RS. Forty-three percent of participants were not informed about the donation of reproductive material. Most of the participants (54%) said they would maybe donate their reproductive material if they had more information, 20% would donate in any case, and 26% would refuse to donate reproductive material. Conclusion. The target group of potential donors of reproductive cells is present in the RS. In addition to the analysis of attitudes, further planning and implementation measures for the promotion of donation could have an influence on raising awareness about the lack of reproductive material and increase the recruitment of gamete donors. [ABSTRACT FROM AUTHOR]

Background/Aim. There is a constant increase in the need to use third-party reproductive cells among couples who are unable to conceive with their own reproductive cells or in order to prevent the passing of an existing hereditary genetic disorder to the child. The aim of the study was to present a theoretical overview and perform a practical analysis of the use of social marketing strategies using the first technique of analyzing the attitudes of potential donors of reproductive cells in the Republic of Serbia (RS) in the interest of adapting to the target group. Methods. Empirical research in this study, in which both women and men from the RS participated, was based on a questionnaire about people’s willingness to be potential reproductive cell donors and about having information on the donation of reproductive cells. The data in this paper were obtained during 2021, and the questionnaire was focused on a particular population group. The questionnaire was sent to people aged 20 to 34 years who could become potential donors of reproductive cells. In the research, 201 women and men from the RS participated. The first part of the questionnaire was tested for internal consistency, which was tested by Cronbach’s alpha coefficient calculation (α). Values of α lower than 0.5 indicate that the questionnaire possesses unacceptable conistency. Results. A total of 57% of participants were in-formed about reproductive cell donation through the Internet, 29% by friends and family, and 11% of them were informed by doctors. Only 32% of participants were fully informed, and 25.1% were partially informed about the donation of reproductive material in the RS. Forty-three percent of participants were not informed about the donation of re-productive material. Most of the participants (54%) said they would maybe donate their reproductive material if they had more information, 20% would donate in any case, and 26% would refuse to donate reproductive material. Conclusion. The target group of potential donors of reproductive cells is present in the RS. In addition to the analysis of attitudes, further planning and implementation measures for the promotion of donation could have an influence on raising awareness about the lack of reproductive material and increase the recruitment of gamete donors.

BackgroundThe waiting list for kidney transplantation is long. The creation of "vouchers" for future kidney transplants enables living donation to occur when optimal for the donor and transplantation to occur later, when and if needed by the recipient.MethodsThe donation of a kidney at a time that is optimal for the donor generates a "voucher" that only a specified recipient may redeem later when needed. The voucher provides the recipient with priority in being matched with a living donor from the end of a future transplantation chain. Besides its use in persons of advancing age with a limited window for donation, vouchers remove a disincentive to kidney donation, namely, a reluctance to donate now lest one's family member should need a transplant in the future.ResultsWe describe the first three voucher cases, in which advancing age might otherwise have deprived the donors the opportunity to provide a kidney to a family member. These 3 voucher donations functioned in a nondirected fashion and triggered 25 transplants through kidney paired donation across the United States.ConclusionsThe provision of a voucher to potential recipients whose need for a transplant makes them "chronologically incompatible" with their donors may increase the number of living donor transplants.

Background and Objectives: Nowadays, with the development of medical science, the coupleschr('39') infertility problem has been resolved; however, this issue has presented some challenges. This study was conducted to explain the psychological challenges of infertile men seeking alternative infertility treatments. Methods: This qualitative research with phenomenological design (n=9) was carried out on infertile males seeking alternative infertility treatments. The subjects were selected using purposive and criterion sampling methods with maximum variation until reaching saturation. The necessary data were collected through a semi-structured interview method and coded and analyzed using the Dickelman method. The coding process was analyzed in the form of primary codes, concepts, and categories. Results: Based on the findings, the psychological challenges of infertile men seeking alternative reproductive therapies included 4 main themes (precedent challenges, process challenges, contextual challenges, and approaching challenges) and 13 sub-themes (problems in decision-making and acceptance of treatment, challenges related to childless life, intellectual and emotional challenges of couples through the treatment, challenges affecting marital life, concerns related to the course of treatment, challenges related to the actions and reactions of family and relatives, concerns about cultural and social rejection and religious issues, concerns due to the possibility of physical, mental, and behavioral defects of the child, and challenges related to the parental role). Conclusion: In general, reviewing the categories and concepts obtained from this study and summarizing them could well reveal the concerns and difficulties experienced by infertile males and provide a clear picture of their problems to experts and authorities.

In liver transplantation, the primary concern is to ensure an adequate future liver remnant (FLR) volume for the donor, while selecting a graft of sufficient size for the recipient. The living donor-resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (LD-RAPID) procedure offers a potential solution to expand the donor pool for living donor liver transplantation (LDLT). We report the first case involving a cirrhotic patient with autoimmune hepatitis and hepatocellular carcinoma, who underwent left lobe LDLT using the LD-RAPID procedure. The living liver donor (LLD) underwent a laparoscopic left hepatectomy, including middle hepatic vein. The resection on the recipient side was an extended left hepatectomy, including the middle hepatic vein orifice and caudate lobe. At postoperative day 7, a computed tomography scan showed hypertrophy of the left graft from 320 g to 465 mL (i.e., a 45.3% increase in graft volume body weight ratio from 0.60% to 0.77%). After a 7-day interval, the diseased right lobe was removed in the second stage surgery. The LD-RAPID procedure using left lobe graft allows for the use of a small liver graft or small FLR volume in LLD in LDLT, which expands the donor pool to minimize the risk to LLD by enabling the donation of a smaller liver portion.

Living kidney donations in Israel come from 2 sources: family members and individuals who volunteer to donate their kidney to patients with whom they do not have personal acquaintance. We refer to the first group as directed living donors (DLDs) and the second as semidirected living donors (SDLDs). The incidence of SDLD in Israel is ∼60%, the highest in the world. We introduce results of a survey among 749 living donors (349 SDLDs and 400 DLDs). Our data illustrate the sociodemographic profile of the 2 groups and their answers to a series of questions regarding spirituality and social tolerance. We find SDLDs to be sectorial: they are mainly married middle-class religious men who reside in small communities. However, we found no significant difference between SDLDs and DLDs in their social tolerance. Both groups ranked high and expressed tolerance toward different social groups. Semidirected living donation enables donors to express general preferences as to the sociodemographic features of their respected recipients. This stirs a heated debate on the ethics of semidirected living donation. Our study discloses a comprehensive picture of the profile and attitudes of SDLDs in Israel, which adds valuable data to the ongoing debate on the legitimacy of semidirected living donation., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

With the growing challenge of abandoned surplus embryos in the ART arena, and the limited traction of embryo donation as a viable embryo disposition choice, it is important to better understand barriers to wider adoption of this opportunity. We aim to learn about perspectives and experience of participants in directed and non-identified embryo donation programmes. This was a longitudinal cohort survey study, of all participants in an embryo donation programme in a single university affiliated clinic between 2016 and 2020. Clinical data were extracted from counselling reports. Based on these data, non-identified online questionnaires were constructed and refined via Delphi procedure for face and content validity. Sixty-five online questionnaires were emailed between March-April 2021. Descriptive statistics, cross-tabulation, Fisher's exact test and t-test were used for analyses. Source of patient awareness, factors influencing the decision-making process, patient perspective and satisfaction were explored. The response rate was 67.2%. Most participants in the non-identified programme learned of it through their treating physicians, whereas most participants in the directed programme learned of it online. The main driver to donate across both cohorts was wanting to give others the opportunity to experience the joy of parenthood. Overall, 45% described moderate to marked difficulty in decision making related to donating their embryos, and this did not differ between cohorts. Non-identified donors reported feeling highly attached to the donated embryos more often than directed donors. Level of satisfaction was higher in the directed donation programme. Participants were more satisfied following directed than non-identified donation, and some even consider their counterparts as extended family. Our findings should be validated in various settings, and on larger samples.

Introduction: Organ donation is one of the surviving procedures which can increase the life expectancy of end-stage patients. Inappropriate beliefs and attitude of individuals to organ donation, their poor knowledge, and the socio-economic level are one of the most important barriers for organ donation. Therefore, here knowledge and attitude levels among relatives of trauma patients regarding organ donation were evaluated. Methods: This cross-sectional study was done on relatives of trauma patients referred to the emergency department of Sina Hospital, Tabriz, Iran, through 2013 to 2014. The questionnaire included parts of demographic data and socio-economic situations as well as status of knowledge and attitude regarding organ donation. A score between 0-7 was belonged to each person based on his/her level of knowledge. Attitude level had a score between 0-12. Chi- square, Fisher, and Mann–Whitney U test were performed to assess the relation between demographic variables and the level of knowledge and attitude. P

Objetive: Identify the factors associated with unfavorable organ donation in Chiclayo during 2014. Material and Methods: cross-sectional study. We interviewed 330 families of patients admitted to the Hospital Almanzor Aguinaga Asenjo, selected by consecutive sampling. Avalidated instrument was used. Absolute and relative frequencies and exploratory bivariate and multivariate inferential analysis were calculated. Prevalence ratios, 95% confidence intervals and p values were calculated. Results: There were 176 women (53.33%) and 154 men (46.67%); mean age was 35.1 +/- 11.6 in men and 35.9 +/- 11.1 in women; 47.27 % were single; 45.45 % had secondary education and there were 73.03% catholics; The predominant family bond was son (a): 45.75 %, 71.81 % were from Lambayeque and 59.09 % from the district of Chiclayo. The frequency of an unfavorable attitude toward organ donation was 72.3%, 69.8% in women and 74.6% in man. In the multivariate analysis being catholic as opossed as being evangelic and witness of Jehova, was associated with an unfavorable attitude toward organ donation: RP: 0,47 CI95%: 0,25-0,88 p:0,02 y RP: 0,09 CI95%: 0,01- 0,62 p:0,015. Conclusions: The frequency of an unfavorable attitude toward organ donation was 72.3%. Association was found between being Catholic and an unfavorable attitude toward organ donation. [ABSTRACT FROM AUTHOR]

Introduction: Organ donation is one of the surviving procedures which can increase the life expectancy of end-stage patients. Inappropriate beliefs and attitude of individuals to organ donation, their poor knowledge, and the socio-economic level are one of the most important barriers for organ donation. Therefore, here knowledge and attitude levels among relatives of trauma patients regarding organ donation were evaluated. Methods: This cross-sectional study was done on relatives of trauma patients referred to the emergency department of Sina Hospital, Tabriz, Iran, through 2013 to 2014. The questionnaire included parts of demographic data and socio-economic situations as well as status of knowledge and attitude regarding organ donation. A score between 0-7 was belonged to each person based on his/her level of knowledge. Attitude level had a score between 0-12. Chi- square, Fisher, and Mann–Whitney U test were performed to assess the relation between demographic variables and the level of knowledge and attitude. PResults: 79 persons (57.1% male) with the mean age of 31.3±11.3 years were evaluated. 57 (73.1%) of subjects agreed with organ transplant. The main causes of disagreement among relatives regarding organ donation were dissatisfaction of the donor's relatives (25%) and religious issues (15%). 49 (62.02%) studied people had inappropriate attitude and 27 (34.2%) ones had good knowledge. male gender (OR=5.87; 95%CI: 3.32-8.42; p=0.001) and self-employed job (OR=7.78; 95%CI: 4.64-10.92; p=0.001) are independent factors associated with poor knowledge about organ donation. Self-employed job (OR=3.86; 95%CI: 1.41-6.11; p=0.009) and poor knowledge (OR=15.3; 95%CI: 9.03-21.57; pConclusion: The present study showed that 73.1% of participants agreed with organ donation. The major causes of disagreements were dissatisfaction of other relatives and religious beliefs. 62.0% of the studied people had positive view regarding organ donation and 34.2% of them well-informed about. The most important causative factors for poor knowledge in this context were male gender and self-employed occupation. In addition, poor knowledge and self-employed job were two factors associated with inappropriate attitude toward organ donation.

Competing Interests: A. Gérard déclare n'avoir aucun lien d'intérêts. A. Sicard déclare des interventions ponctuelles pour Astellas, Novartis et avoir été pris en charge, à l’occasion de déplacements pour congrès, par Alexion. C. Chauvet et E. Morelon n’ont pas fourni de déclaration d’intérêts.

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Corneal diseases account for about 4 to 5% of reversible blindness in the world. Corneal transplantation is the most transplanted tissue in the world and the only widely accepted treatment to promote corneal transparency and restore vision. Monitoring was incorporated into the field of Public Health, with the objective of systematically monitoring teams' performance and production data, through the creation of norms, periodic evaluation inspections and monitoring of quality indicators. The critical analyzes of the results aim to point out flaws and risks involved in the process, and to undertake actions capable of modifying the negative findings, in order to improve the quality of the services provided to the population. In Brazil, there are different sources of data on corneal transplants and ocular tissue banks. In this review, the accuracy of the data and the reliability of the information disclosed by the National Transplant System by the Brazilian Organ Transplant Association and the National Sanitary Surveillance Agency on the situation of corneal transplantation in Brazil were evaluated in order to guide governments, public health managers and researchers. [ABSTRACT FROM AUTHOR]

Corneal diseases account for about 4 to 5% of reversible blindness in the world. Corneal transplantation is the most transplanted tissue in the world and the only widely accepted treatment to promote corneal transparency and restore vision. Monitoring was incorporated into the field of Public Health, with the objective of systematically monitoring teams' performance and production data, through the creation of norms, periodic evaluation inspections and monitoring of quality indicators. The critical analyzes of the results aim to point out flaws and risks involved in the process, and to undertake actions capable of modifying the negative findings, in order to improve the quality of the services provided to the population. In Brazil, there are different sources of data on corneal transplants and ocular tissue banks. In this review, the accuracy of the data and the reliability of the information disclosed by the National Transplant System by the Brazilian Organ Transplant Association and the National Sanitary Surveillance Agency on the situation of corneal transplantation in Brazil were evaluated in order to guide governments, public health managers and researchers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chinese citizens have a high approbation to organ donation, but few take action. Besides the restriction of policies and regulations, there are still many hidden factors, among which the cultural elements should never be neglected. OBJECTIVE: To analyze the cultural and psychological factor affecting the willingness of donors under Chinese cultural background through the phenomenological study on the organ donation simulation in college students, and to explore the strategies for promoting organ donation. METHODS: Totally 50 junior students majored in applied psychology were selected from one university in Guangdong Province, including 19 males and 31 females, and an in-depth interview was performed in 8 students (2 males and 6 females). The participants were interviewed using qualitative research methods and phenomenological approaches after simulating the dilemma of organ donation, to explore the cultural and psychological factors that affect the willingness of college students to donate their organs. RESULTS AND CONCLUSION: The donation situation will affect the willingness to donate, among which, cognition, sentiment and emotional connections are the psychological factors, and death, loss, taboo, meaning and respect are the cultural factors. Cultural psychological factors contributing to the willingness of organ donation included maximum the organ value, positive mentality, pleasure to help others and life extension. The cultural and psychological factors that bad for the willingness to donate include fear of death, traditional thinking, and uncertainty. To encourage donation, it is necessary to conduct death education, cultural guidance, and strengthen social support, as well as respect the opinions of important families and improve the relevant regulations as quickly as possible. [ABSTRACT FROM AUTHOR]

Background: Currently, the Nepalese law permits organ donation by an individual who falls into the category of a “close relative” of the recipient. There is a need for expansion of the live organ donor pool beside close relatives. Different systems of organ transplantation are followed by several countries and the professional opinions that underpin these systems need to be studied. Objective: To generate a questionnaire related to different organ transplant systems and validate it so that it can be used to collect mass professional opinions. Methods: Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire. The final version of the questionnaire was reviewed by experts for its content validity and then was used twice for participants at a 20-day interval to calculate Cronbach’s alpha for testing its internal consistency and Intra-class correlation for testing its test and retest reliability. Results: The questionnaire was found to be valid and reliable with an overall Cronbach’s alpha of 0.701. Intra-class correlation scores for each question in both test and retest were correlated. Conclusion: A valid and reliable questionnaire was developed that can be used to collect mass professional opinions to assist policy makers to establish a better organ transplant system.

Background: Currently, the Nepalese law permits organ donation by an individual who falls into the category of a "close relative" of the recipient. There is a need for expansion of the live organ donor pool beside close relatives. Different systems of organ transplantation are followed by several countries and the professional opinions that underpin these systems need to be studied. Objective: To generate a questionnaire related to different organ transplant systems and validate it so that it can be used to collect mass professional opinions. Methods: Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire. The final version of the questionnaire was reviewed by experts for its content validity and then was used twice for participants at a 20-day interval to calculate Cronbach's alpha for testing its internal consistency and Intra-class correlation for testing its test and retest reliability. Results: The questionnaire was found to be valid and reliable with an overall Cronbach's alpha of 0.701. Intra-class correlation scores for each question in both test and retest were correlated. Conclusion: A valid and reliable questionnaire was developed that can be used to collect mass professional opinions to assist policy makers to establish a better organ transplant system. [ABSTRACT FROM AUTHOR]

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite the fact that the criteria for allocation of donated livers have been laid down for years, these criteria may not help to select a potential recipient from those with the same medical requirements. This study used conjoint analysis method to determine the importance of certain non-medical factors from the public’s point of view. Through a population based study, a sample of 899 randomly selected persons filled a questionnaire where in each question the respondents had to choose one out of two hypothetical patients as the recipients of a donor liver considering their expressed characteristics. The collected data were analyzed by means of conjoint analysis method, and the importance of each characteristic was determined. According to the respondents the important criteria for allocation of donated livers included younger age, being married or breadwinner of the family, more than 3-year survival after transplantation, and having no role in causing the illness. Among the selected criteria, financial ability to pay post-operation costs had the least value on the selection. The findings of this study indicate that the public may values certain social and individual factors in case of multiple potential recipients with equal medical need for liver transplant. [ABSTRACT FROM AUTHOR]

Descrever a relação entre bioética, biodireito e o processo doação e transplante de órgãos no Brasil, considerando a complexidade desta temática que é responsável pela manutenção da qualidade de vida daqueles que aguardam por um novo órgão. Trata-se de um estudo qualitativo, descritivo. O Brasil possui hoje o maior programa público de transplantes de órgãos e tecidos do mundo, sendo as diretrizes da politica nacional de transplantes pautadas pela gratuidade da doação, beneficência em relação aos receptores e na não maleficência em relação aos doadores vivos, conforme os princípios norteadores da teoria principialista da bioética. O conhecimento da legislação por parte dos profissionais que atuam na área pode levar a transformações positivas no atual cenário brasileiro em que a maior barreira para a efetivação da doação de órgãos e tecidos é a recusa familiar. Nessa perspectiva, além do conhecimento técnico-científico-biológico, é preciso compreender a legislação vigente levando em consideração os princípios éticos, bioéticos e do biodireito de modo a assegurarem aos agentes envolvidos seus direitos fundamentais e o exercício pleno de sua dignidade humana.

Background: Of the overall 9.5 million deaths annually in India, nearly 100,000 are due to organ failure. To save and extend lives, organ donation and organ transplantation have become the only hope. Health care professionals (HCPs) are a key element in facilitating cadaveric organ donation process. Objective: To assess and compare the knowledge, attitude, and practice regarding organ donation among undergraduate dental students. Methods: A cross-sectional study was conducted among 298 undergraduate dental students of the Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. A 27-item self-administered questionnaire, which assessed the levels of knowledge (Q1–13), positive attitude (Q14–24) and practice habits (Q25–27) regarding organ donation with dichotomous scale (Yes/No). Results: As compared to males, females reported better mean±SD scores in knowledge (8.22±1.51) and practice (0.91±0.8); higher mean±SD attitude scores (8.55±1.56) were reported among males (p

RACIONAL: Desde que o uso de enxertos marginais é solução aceita para escassez de órgãos para transplante, ele tornou-se muito comum em todo mundo e a literatura vem mostrando efetividade desses enxertos no transplante de fígado. OBJETIVO: Apresentar a experiência do Serviço de Transplante Hepático do Hospital Universitário Oswaldo Cruz, em transplante de fígado com o uso de doadores marginais. MÉTODOS: Estudo retrospectivo em 137 transplantes ortotópicos de fígado, usando enxertos marginais entre 1999 e 2006, com acompanhamento mínimo de 180 dias. Os receptores foram classificados de acordo com a função inicial do enxerto no pós-operatório como normal (FN) e disfunção primária (DP). RESULTADOS: Não foi observada diferença estatisticamente significante entre os grupos FN e DP com os seguintes parâmetros dos doadores: idade, sódio sérico, tempo de protrombina, esteatose hepática, transaminases sérica, pressão sanguínea, drogas vasoativas, índice de massa corpórea, parada cardíaca antes da doação de órgão, doador em assistolia e tempo de isquemia quente. Análise da curva de sobrevida (Kaplan-Meier) de pacientes e de enxertos de fígado de pacientes que receberam fígado de doadores ideais versus doadores marginais não mostrou diferença com significância estatística. CONCLUSÃO: Pode ser recomendado o uso de enxertos marginais para transplantes hepáticos, inclusive os provenientes de doadores com o coração parado.BACKGROUND: Since marginal grafts are a solution to deal with the shortage of organ donors, its use became more common worldwide, and the literature had shown its effectiveness in the liver transplantation (LT) outcomes. AIM: To present a single center experience, at the Liver Transplantation Unit of Oswaldo Cruz University Hospital, with orthotopic LT using marginal organ donors. METHODS: Retrospectivety review of 137 orthotopic LT using marginal grafts between 1999 and 2006, with a minimum 180 days follow-up. The receptors were classified according to postoperative initial graft function as normal function (NF) and primary dysfunction (PD). RESULTS: No significant statistic difference was observed between groups NF and PD concerning the following donor's parameters: donor's age, serum sodium, prothrombine time, liver steatosis, serum transaminasis, blood pressure, vasoactive drugs, body mass index, heart attack prior organ donation, non-heart-beating donor and warm ischemia time. The survival curves' analysis (Kaplan-Meier) of patients or patients' grafts which received LT from ideal donors versus marginal donors showed no significant difference. CONCLUSIONS: The results permit to recommend the use of liver marginal grafts, including that ones from non-heart-beating donors.

Organ donation after euthanasia is performed in Belgium, the Netherlands, Canada and Spain. Directed deceased organ donation is currently possible under strict conditions in a limited number of countries, while it is currently not possible to opt for directed donation following euthanasia. While organ donation after euthanasia is a deceased donation procedure, directed organ donation after euthanasia could be seen as a deceased donation procedure with a living donation consent process. Therefore, directed organ donation after euthanasia is feasible on medical and ethical grounds. Strict safeguards should be in place, including the requirement of a pre-existing familial or personal relationship with the proposed recipient, without any evidence of coercion or financial gain., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 van Dijk, Shaw, Shemie, Wiebe, van Mook and Bollen.)

This Ethics Rounds presents a request for directed blood donation. Two parents feel helpless in the setting of their daughter's new leukemia diagnosis and want to directly help their child by providing their own blood for a transfusion. They express hesitancy about trusting the safety of a stranger's blood. Commentators assess this case in the setting of blood as a scarce community resource during a national blood shortage. Commentators review the child's best interest, future risks, and harm-benefit considerations. Commentators recognize the professional integrity, humility, and courage of the physician to admit his own lack of knowledge on the subject and to seek help rather than claim directed donation is not possible without further investigation into options. Shared ideals such as altruism, trust, equity, volunteerism, and solidarity are recognized as values relevant to sustainment of a community blood supply. Pediatric hematologists, a blood bank director, transfusion medicine specialists, and an ethicist conclude that directed donation is only justified by lower risks to the recipient in particular circumstances., (Copyright © 2023 by the American Academy of Pediatrics.)

Introduction: Human heart valves are used as replacement valves and have satisfactory functional results compared with conventional prostheses. Objective: Characterize the profile of effective heart donors from the Human Valve Bank of the Santa Casa de Misericórdia de Curitiba and analyze the association between the profile variables. Methods: It consists of a retrospective and quantitative study of electronic medical records from heart donors for heart valves. Every heart donation made to the Bank between January 2004 and December 2014 was studied. Results: 2,149 donations were analyzed, from donors aged 0 to 71 years old, with an average of 34.9 ± 15.03 years old. Most donors were male 65.7% (n=1,411) and 34.3% (n=738) were female. Among the most frequent causes of the donors' death are trauma at 53% (n=1,139) and cerebral vascular accident at 34.2% (n=735). There was significant statistical association between the analyzed variables. Conclusion: There has been an improvement in Brazil's donation rate, being essential that the Tissue Banks work together with the State and Federal District Centers for Notification, Procurement and Distribution of Organs in order to increase the number of donors. [ABSTRACT FROM AUTHOR]

Background: Of the overall 9.5 million deaths annually in India, nearly 100,000 are due to organ failure. To save and extend lives, organ donation and organ transplantation have become the only hope. Health care professionals (HCPs) are a key element in facilitating cadaveric organ donation process. Objective: To assess and compare the knowledge, attitude, and practice regarding organ donation among undergraduate dental students. Methods: A cross-sectional study was conducted among 298 undergraduate dental students of the Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. A 27-item self-administered questionnaire, which assessed the levels of knowledge (Q1-13), positive attitude (Q14-24) and practice habits (Q25-27) regarding organ donation with dichotomous scale (Yes/No). Results: As compared to males, females reported better mean±SD scores in knowledge (8.22±1.51) and practice (0.91±0.8); higher mean±SD attitude scores (8.55±1.56) were reported among males (p<0.001). While second year dental students had higher scores for their knowledge (8.55±1.56) and practice (1.02±0.44) compared to other year of training, third year students showed a significant higher mean attitude score (1.73±1.17) (p=0.02). Hindus and Muslims scored significantly lower mean knowledge, attitude and practice habits compared to others (Christians, Jains and Athesists) (p<0.001). There was a positive correlation between mean knowledge, attitude, and practice habits. Conclusion: There are an average level of knowledge and low levels of positive attitude and practice habits among studied dental students towards organ donation and transplantation. [ABSTRACT FROM AUTHOR]

Background: Over the past 15 years, the number of recipients waiting for a lung transplant has increased and now far exceeds the number of available donors. Liberalization of donor criteria to include the use of extended donors remains an attractive option for expanding the donor pool. Numerous centers, including the authors' own, have begun exploring this relatively unknown territory of lung transplantation. Case Report: Successful bilateral lung transplantation was performed for a patient with emphysema utilizing lungs from a donor with persistent lobar atelectasis. Conclusion: This report demonstrates that an acceptable outcome is possible from a donor with persistent lobar atelectasis if other parameters are acceptable. Larger studies would help further our understanding of the impact of donor radiographic abnormalities on outcomes following lung transplantation. [ABSTRACT FROM AUTHOR]