Education Corner – Brain Death Pronouncement

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Brain Death Pronouncement

Summary Points:

  • State legislation provides guidance on requirements for brain death determination.
  • The AAN provides best practice recommendations for the determination process.
  • Ancillary tests are not required by legislation, but should be utilized only when the clinical examination cannot be fully performed or confounders cannot be corrected.
  • Apnea testing is not an ancillary test – it is an essential part of the clinical evaluation, testing brainstem function.

Best practices in pronouncing brain death include following state legislative requirements and the American ...

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DAAs prove effective for HCV-infected heart transplant patients

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Direct-acting antiviral (DAA) drugs proved safe and effective for hepatitis C (HCV) patients who had undergone heart transplants, according to new research.

Jia-Horng Kao, MD, PhD, FAASLD, and a team from the National Taiwan University Hospital in Taipei, found that 12 individuals given sofosbuvir combined with ledipasvir (Harvoni) or sofosbuvir (Sovaldi) combined with daclatasvir (Daklinza) achieved a sustained virologic response rate of 100% after 12 weeks.

Interferon-free DAAs have shown excellent efficacy and safety for ordinary patients with chronic HCV infection, the researchers ...

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High-dose influenza vaccine better for solid organ transplant recipients

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A high-dose influenza vaccine is preferable to a standard-dose vaccine in adult solid organ transplant recipients, according to study findings presented at IDWeek.

Yoichiro Natori, MD, clinical fellow of transplant infectious diseases at the University Health Network, University of Toronto, summarized results showing that a high-dose influenza vaccine (Fluzone High-Dose, Sanofi Pasteur; HD) demonstrated “significantly better immunogenicity” when compared with a standard-dose vaccine (Fluviral, GlaxoSmithKline; SD) in adult solid organ transplant recipients.

Transplant recipients are on lifelong immunosuppression and a particularly ...

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In some patients, hepatitis C best treated after transplant

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Direct-acting antiviral drugs can eradicate the hepatitis C virus, even in patients with advanced liver decompensation. But their outcomes may be better if treatment occurs after transplant, according to a recent study looking at this issue.

The goal of the study was to determine when life expectancy was improved with DAA treatment, before or after liver transplant. One reason these may differ is that the trade-off for improved liver function with early treatment is the risk for delay—or even delisting for ...

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UNOS searches for a fairer way to distribute donor livers

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More than 16,000 Americans are waiting for a liver transplant because of conditions such as hepatitis, cancer or cirrhosis. But only about 7,000 livers are donated each year. Most patients know their odds aren’t great.

And their chances also vary based on where they live.

“In some areas of the country, patients have to wait a lot longer than in other areas,” says Julie Heimbach, a transplant surgeon at the Mayo Clinic. “They have to get much sicker before they can access a liver ...

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How first “kidney vouchers” led to 25 lifesaving transplants

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In 2014 a former judge from San Diego County approached the UCLA Kidney Transplant Program with an unusual request: If the judge donated a kidney to a stranger now, could his then 4-year-old grandson, who suffered from chronic kidney disease, receive priority for a future kidney transplant if needed later in life?

The suggestion from Howard Broadman, then 64 years old, initiated the kidney “voucher” program, an innovative system allowing living donors to donate a kidney now, or at some time in the ...

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Selena Gomez reveals she received a kidney transplant

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Selena Gomez took to Instagram this morning to reveal that she received the ultimate gift of life from her best friend, Francia Raisa. The actress and award-winning artist announced she received a kidney transplant over the summer due to complications from Lupus, an autoimmune disease that causes harm to organs and tissues. She said, “It was what I needed to do for my overall health.”

Although the leading causes of chronic kidney disease are mainly diabetes or high blood pressure, other related conditions, such ...

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World’s First 3-D Printed Tibia Transplanted

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Surgeons in Australia have successfully performed a world-first transplant surgery, installing a 3D printed tibia into the leg of Reuben Lichter, who faced losing his leg above the knee to amputation. The 3D printed tibia was wrapped in blood vessels and leg tissue from both of his legs. Just over two weeks ago, in the last in a series of five surgeries, the procedure was declared a success. For the next nine months at least, the doctors hope to observe ...

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Education Corner – Developing Advances in Organ Transplantation: Organ Banking – What is it?

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Developing Advances in Organ Transplantation: Organ Banking – What is it?

A New World?

Imagine a world where no one who needs an organ transplant has to wait for an organ to become available. A transplant in this new world would be a scheduled surgery. Families who want the donation process to occur quickly could easily be accommodated, as the organs can be recovered and banked until the right ...

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Virtual Journal Club: To Presume Consent or Not to Presume Consent?

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To Presume Consent or Not to Presume Consent? What does the data show? Comparing Organ Donation Rates in “Opt-In” vs. “Opt-Out” Systems

Thomas Mone, MS; CEO OneLegacy, Los Angeles, 2017

Introduction:
Almost every day, somewhere in the world, a news headline calls for countries to adopt Opt-Out organ donation policies. Accompanying the call-to-action, is often a heart-wrenching story of a young child desperately awaiting a lifesaving transplant, or recipients seeking the help of their legislators to modify laws ...

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