Organ Donation & Transplant Matters Resources
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Rhythmic Changes in Gene Activation Power the Circadian Clock

Rhythmic Changes in Gene Activation Power the Circadian Clock | Organ Donation & Transplant Matters Resources | Scoop.it

Daily rhythms underlie most of the fundamental functions of mammals, from sleep-wake cycles to metabolic processes in the liver. The circadian clock has evolved in response to daily changes of temperature and light in the environment. At the root of circadian rhythms are daily fluctuations in gene expression, which occur in part through the process of transcription—the creation of RNA from sequences of DNA. Although past studies have uncovered how changes in transcription states relate to irreversible processes, for example when cells become more specialized, much less is known about how transcription fluctuates in synch with recurring cycles.

 

New insights into the dynamic nature of transcription are provided in a study led by Nouria Hernandez of the University of Lausanne and Felix Naef of the Ecole Polytechnique Fédérale de Lausanne. Their findings reveal the kinetics by which genes are activated in a rhythmic manner as well as the remarkable impact of daily cycles across the genome.

 

In the above-mentioned study, Hernandez and Naef used a combination of experimental and computational methods to study genome-wide transcriptional changes in the mouse liver, and how these changes relate to mRNA levels. They discovered that transcription in the liver occurs predominantly in morning and evening waves. These waves were accompanied by the rhythmic recruitment of RNA polymerase II (Pol II) — an enzyme that catalyzes transcription — to DNA strands. In addition, there were rhythmic changes in the modifications of histones — proteins that act as a scaffold for DNA and help to regulate gene expression. These rhythmic changes in transcription were driven primarily by the recruitment of Pol II to DNA.

 

The researchers also identified three classes of genes: One class showed both rhythmic transcription and mRNA fluctuations, a second class showed rhythmic transcription but flat mRNA levels, and a third class showed constant transcription but rhythmic mRNA fluctuations. The latter finding — that the levels of some mRNAs oscillated even when transcription remained constant — suggests that transcription alone does not regulate all rhythmic changes in mRNA levels. Instead, other processes, such as daily fluctuations in the rate of mRNA degradation, influence the accumulation of mRNA. These results indicate that molecular events taking place after transcription play a greater role in regulating daily fluctuations in mRNA levels than previously thought.

 

Taken together, the study reveals that many functions in the liver, such as lipid and carbohydrate metabolism as well as detoxification, are under the control of rhythmic changes in transcription. The findings could lead to insights into how the daily cycle influences genomic responses to food intake, eventually paving the way to the development of novel treatment strategies for diabetes and other metabolic diseases.


Via Sakis Koukouvis, Dr. Stefan Gruenwald
Deborah Verran's insight:

This report of basic science research reveals that many metabolic functions of the liver appear to be rhythmically controlled. It seems that even your liver may need a rest at night!

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Organ Donation & Transplant Matters Resources
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Human-embryo editing now covered by stem-cell guidelines

Human-embryo editing now covered by stem-cell guidelines | Organ Donation & Transplant Matters Resources | Scoop.it

New international guidelines have just been published by the International Society of Stem Cell Research (ISSCR), which cover all aspects of stem-cell research. This is an attempt to fend off the need for further government regulation that could impede this particular  research including the manipulation of human embryos in the laboratory setting.


To read more on this story click on the following link-


http://www.nature.com/news/human-embryo-editing-now-covered-by-stem-cell-guidelines-1.19909


In addition calls are being made for there to be more realistic and responsible reporting of stem cell research which has suffered in recent years from 'too much hype'-



http://www.bloomberg.com/news/articles/2016-05-12/stop-hyping-stem-cell-science-say-stem-cell-scientists


Deborah Verran's insight:
This will be of interest to anyone following the current research into stem cells and tissue engineering
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Busiest ever year for organ donation in Scotland

Busiest ever year for organ donation in Scotland | Organ Donation & Transplant Matters Resources | Scoop.it

In news from authorities in Scotland it has been confirmed that the organ donation rate has increased over the last year. 


With the figures for 2016/17 revealing a 34% increase in the number of organ donors in Scotland, this has led to a record number of organ transplants being performed.


One woman (Heather Marshall, pictured above) who was interviewed for this story, describes how undergoing a liver transplant has turned her life around.

Deborah Verran's insight:
Important news out of Scotland with the rate of organ donation now being close to the 25 per million mark
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IU Health’s new ‘Heart-in-a-Box’ keeping organs alive longer

IU Health’s new ‘Heart-in-a-Box’ keeping organs alive longer | Organ Donation & Transplant Matters Resources | Scoop.it

INDIANAPOLIS, Ind. -- A new medical device is keeping hearts used in transplants alive longer. The device is called a "Heart-in-a-Box" and it's on clinical trial at IU Health Methodist Hospital.


This brief article highlights the fact that ex-vivo heart preservation is now being trialled within the United States with the IU Health Methodist Hospital being involved.


Further aata are awaited

Deborah Verran's insight:
Another ongoing trial of ex-vivo preservation technology
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Thomas Starzl, pioneering transplant surgeon, dies at 90

Thomas Starzl, pioneering transplant surgeon, dies at 90 | Organ Donation & Transplant Matters Resources | Scoop.it

Dr. Thomas E. Starzl  | 1926-2017: Dr. Starzl performed the world’s first liver transplant in Denver in 1963 along with the world's first successful liver transplant before moving to Pittsburgh. 


In this comprehensive online article insights are provided into the extraordinary drive and determination that Dr Starzl possessed which led to further developments in both liver and kidney transplantation, over the next 20-30 years.


Dr Starzl understood the importance of organ donation from deceased donors for the purpose of transplantation and how organ recovery of multiple organs from the same donor was also possible. In addition he was involved in undertaking trials of some of what were the then new immunosuppressive agents in transplant recipients.


One of the true pioneers in solid organ transplantation


Via Gilbert C FAURE
Deborah Verran's insight:
This article provides a glimpse of what was required to take liver transplantation from a concept through to being a clinical reality that is now established around the world.
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The truth about organ transport and transplantation in India

The truth about organ transport and transplantation in India | Organ Donation & Transplant Matters Resources | Scoop.it

There continues to be unmet challenges with respect to increasing the numbers of both organ donors as well as organ transplants in India. With there having been only 350 heart transplants conducted in the last 24 years in the country, there is room for improvement.


The current barriers to increasing the number of organ transplants includes the lack of established transplant units, lack of access due to financial restrictions for many patients and a lack of established transport systems ensuring the rapid delivery of organs between hospitals.


This article will be of interest to healthcare professionals who have an interest in organ donation as well as transplantation.

Deborah Verran's insight:
Increasing the numbers of organ donors as well as the numbers of organ transplants in India will require that concentrated efforts are made to deal with the current barriers.
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Vatican meeting calls organ trafficking a crime against humanity

Vatican meeting calls organ trafficking a crime against humanity | Organ Donation & Transplant Matters Resources | Scoop.it

After a conference on organ trafficking at the Vatican Feb. 7-8, participants signed a statement agreeing to unite in fighting the crime of organ trafficking – submitting 11 proposals for implementation by healthcare and law enforcement professionals around the world.


For more on this story along with the formal release including the 11 proposals click on the following link-

http://en.radiovaticana.va/news/2017/02/09/vatican_organ_trafficking_summit_issues_statement/1291387


Deborah Verran's insight:
The proposals will be of interest to professionals who have an interest in this subject
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Human-Animal Hybrid: Scientists Grow Human Cells Inside Pig Embryos

Human-Animal Hybrid: Scientists Grow Human Cells Inside Pig Embryos | Organ Donation & Transplant Matters Resources | Scoop.it

Scientists injected pig embryos with human stem cells to produce animal embryos that contain human cells. What are the dangers and potential benefits of this technology? This is explored in the full article which can be accessed via clicking on the banner headline.


This online article is the result of the publication of the findings of sophisticated laboratory research into the creation of embryos which contain cells from two different animals. In the research quoted above this involved placing genetically modified human stem cells into pig blastocysts (at the pre-embryo stage). Despite evidence of the human stem cells initially surviving there was limited evidence of them being present at the pig embryo stage as outlined in the full scientific report-


http://www.cell.com/cell/fulltext/S0092-8674(16)31752-4


Despite the headlines generated in some quarters by this particular research, this does not mean that the transplantation of organs from 'humanized pigs' is just around the corner as may have been implied.



Deborah Verran's insight:
This proof of concept study will now need to be followed by more sophisticated research in order to ascertain whether this will lead to so called humanized organs in pigs.
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Air-Powered Robotic Sleeve Wraps Around Your Heart To Keep It Pumping

Air-Powered Robotic Sleeve Wraps Around Your Heart To Keep It Pumping | Organ Donation & Transplant Matters Resources | Scoop.it
Researchers from Harvard University and Boston Children's Hospital have developed an innovative robotic sleeve that fits around the heart. As outlined in this online report  the device (pictured) has been successfully trialed in large animals and hence satisfies proof of concept criteria. However in order for the device to meet stringent regulatory standards prior to then being marketed it must now undergo prospective trials in humans.

One advantage of this particular device is that it wraps around the heart and hence is not in contact with circulating blood which can lead to other problems such as excessive clotting.

The relevant research article which has now been published in Science Translational Medicine can be accessed via the following link-

Deborah Verran's insight:
This is an interesting new type of cardiac assist device which now needs to be trialed in humans
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Sgt. Darrick Kepley makes emergency organ delivery after SUV crash

Sgt. Darrick Kepley makes emergency organ delivery after SUV crash | Organ Donation & Transplant Matters Resources | Scoop.it
While patrolling in a town in Pennsylvania’s Lancaster County in the snow last Saturday, Sgt. Darrick Kepley happened across a one-car crash

Inside the crashed vehicle were an organ retrieval team who were on their way back to their base hospital (the Thomas Jefferson in Philadelphia), including with a donor liver.

In order to prevent any further delays Sgt Kepley then transported the team to the hospital so that a liver transplant procedure could continue as scheduled.
Deborah Verran's insight:
Unforseen problems with the ground transportation of donor organs can lead to alternative measures having to be adopted at short notice
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A Dying Man's Wish To Donate His Organs Gets Complicated

A Dying Man's Wish To Donate His Organs Gets Complicated | Organ Donation & Transplant Matters Resources | Scoop.it
Dying in America doesn't always go the way we plan. One terminally ill man's hope to be disconnected from his respirator and donate his organs was almost thwarted, despite his best laid plans.

Despite the wishes of David Adox to donate his organs and the agreement of physicians in a nearby hospital, the lawyers for this particular  hospital blocked the proposed organ donation. Fortunately professionals in an organ procurement organization heard about David's plight and were able to make arrangements for his wishes to be carried out in another hospital in New York.

As outlined in the article, donation after circulatory death is an established practice in many parts of the United States. Patients with progressive neurological conditions can opt to cease their treatment and then donate their organs if they go on to decease within a certain time period. There are guidelines as well as protocols in place both within organ procurement organizations as well as hospitals.

This article highlights the confusion as well as the conflict that can arise within an institution when not everyone is on the same page about modern established practices in organ donation.
Deborah Verran's insight:
Important story and a reminder that hospitals must have established protocols for DCD organ donation in the countries around the world where the practice is now established
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Is There a Better Way to Allocate Organs to Transplant Patients?

Is There a Better Way to Allocate Organs to Transplant Patients? | Organ Donation & Transplant Matters Resources | Scoop.it
This opinion piece is about one important issue patients face whilst on the waiting list for a kidney within the United States. That is whether to accept the first offer they receive of a donor kidney or to wait for a better offer. This conundrum is partly behind the current rate of discards for deceased donor kidneys within the United States.

Researchers who were interviewed for this story have come up with two more ideas for changing this system where people linger on waitlists while a significant percentage of kidneys continue to be discarded.

One option is to provide both the physicians and the patient's with a lot more data on perceived waiting times for differing organ allocation scenarios.

This article will be of interest to healthcare professionals as well as patients.
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The heavy-on-hype, light-on-substance world of drone delivery

The heavy-on-hype, light-on-substance world of drone delivery | Organ Donation & Transplant Matters Resources | Scoop.it
Companies routinely get attention for media-friendly one-off deliveries via drone, but few are currently doing any of this at scale after more than half a decade. 

There are a number of barriers to the use of drones, with meeting strict regulatory requirements being one of them. In addition the size of the drone may limit what can be carried, along with there being limits for what are the ideal and hence the safest flying conditions.

There seem to be a number of challenges that need to be worked through before the use of this type of technology can become more widespread.
Deborah Verran's insight:
There will also be a requirement to meet all of the quality, safety and regulatory requirements pertaining to the delivery of blood and/or human organs.
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Multi-drug resistant infection spreading globally among cystic fibrosis patients

Multi-drug resistant infection spreading globally among cystic fibrosis patients | Organ Donation & Transplant Matters Resources | Scoop.it
There are concerns that the pathogen mycobacterium abscessus which is notoriously difficult to treat, will prevent some patients undergoing lung transplantation. As reported this last week this pathogen tends to occur in patients with lung disease due to cystic fibrosis.

The study, led by the University of Cambridge and the Wellcome Trust Sanger Institute in the United Kingdom, also suggests that conventional cleaning will not be sufficient to eliminate this particular pathogen, which can be transmitted through contaminated surfaces or in the air.
Deborah Verran's insight:
Important information for healthcare professionals involved in caring for patients being considered for lung transplantation
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First two government funded kidney transplants have been performed in Nepal

First two government funded kidney transplants have been performed in Nepal | Organ Donation & Transplant Matters Resources | Scoop.it

It has been reported this last week that the first government funded kidney transplants have recently been performed in Nepal.

The full link to the story-
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Not enough donors, surgeons or teams for organ transplants in Malaysia

Not enough donors, surgeons or teams for organ transplants in Malaysia | Organ Donation & Transplant Matters Resources | Scoop.it

Malaysia is in critical need of more organ transplant surgeons but even if there were more available, there continues to be a lack of surgical teams to retrieve the organs from deceased donors.


This online article makes the point that until now deceased donor organ donation within Malaysia has been an infrequent activity which turns on the ability to mobilise surgical teams made up of individuals whose primary roles within the healthcare sector involve other non related activities.


Hence the absence of dedicated surgeons, along with the lack of additional requisite infra-structure including intensive care unit beds and operating room capacity are now seen to be an issue. Hence for both organ donation and organ transplantation to increase within Malaysia addressing these specific issues is now essential.



Deborah Verran's insight:
Both organ donation as well as organ transplantation require adequate resourcing. This includes resources be diverted specifically towards the requisite infra structure along with having the professionals who are required in order to facilitate this particular activity
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Desperate patients turning to social media for kidney transplants

Desperate patients turning to social media for kidney transplants | Organ Donation & Transplant Matters Resources | Scoop.it

DESPERATE patients who need a kidney transplant are resorting to social media for help because of a shortage of donors.

Transplant staff in Glasgow said there had been a rise in inquiries about Directed Altruistic Organ Donation, a controversial area in living donation, where patients make a public appeal for a donor, either online on sites such as Facebook or within transplant groups or even newspapers.

 

The British Transplantation Society say directed altruism is a “challenging and controversial area” but that more recipients are exploring the option.

Donors may have a genetic relationship to the recipient with little or no formal contact or a complete stranger with no family connection.

The Human Tissue Authority can give approval provided there is no evidence of coercion of the donor. Referrals that arise through paid advertising will also not be accepted.


To read more about the specific challenges being  faced by some of the healthcare professionals including comments made by Julie Glen, a live donor coordinator for NHSGGC, click on the banner headline.





Via Plus91
Deborah Verran's insight:
In a number of countries there are guidelines in place pertaining to altruistic live donor kidney donation in order to ensure that certain preconditions are met by the potential donors
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Iron nanoparticles could bring organs back from a deep freeze in the future

Iron nanoparticles could bring organs back from a deep freeze in the future | Organ Donation & Transplant Matters Resources | Scoop.it

While deep-freezing techniques exist to preserve organs for long periods of time, the tissue can get damaged when being reheated, hence making it an impractical solution for transplants. Researchers at the University of Minnesota believe they have solved this problem thanks to tiny microscopic particles. The full scientific report of this research can be accessed via the following link-


http://stm.sciencemag.org/content/9/379/eaah4586


However as summarized in this other online article, this new process of successfully freezing and rewarming is currently limited to small pieces of tissue which have been treated with these new nanoparticles -


http://sco.lt/8D9anR





Via ANDREAS SOFRONIOU
Deborah Verran's insight:
Currently this technique has been shown to work for only small amounts of tissue. Hence it will be quite a while before it becomes evident whether this process can be applied to organs.
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Study retraction reignites concern over China’s possible use of prisoner organs

Study retraction reignites concern over China’s possible use of prisoner organs | Organ Donation & Transplant Matters Resources | Scoop.it

The authors of liver transplant outcomes study were unable to  satisfy a journal editor (Liver International) that organs were not from obtained from executed prisoners in China.


Hence the article in question has now been retracted.


It is essential that the sources of organs that are used for the purpose of transplantation are able to be verified in order to meet agreed upon standards for the publication of scientific manuscripts.

Deborah Verran's insight:
It is essential that there be openness and transparency with respect to the reporting of data on both organ donation as well as organ transplantation activities around the world.
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Desde hoy, todos los colombianos serán donantes de órganos - New Opt out system for organ donation in Colombia

Desde hoy, todos los colombianos serán donantes de órganos - New Opt out system for organ donation in Colombia | Organ Donation & Transplant Matters Resources | Scoop.it

En Colombia hay cerca de 2.600 pacientes en lista de espera de órganos. Por eso, para Alejandra Martín, promotora en la donación de órganos en Santander, la ley que comenzará a regir mañana, que declara a todos los colombianos donantes es una noticia de vida para miles. "He visto morir a tantas personas en la lista de espera que quisiera devolver el tiempo para haber comenzado antes a promover la donación”, relata.


This media release from Colombia confirms that as from today Colombia now has an opt out system for organ donation in place. Hence all potential organ donors who are medically suitable will proceed unless they have formally registered a 'No' whilst they were alive. According to the article for individuals who wish to register a No this involves making a formal statement with a notary, whilst they are alive. These statements will then be registered with the National Health Institute.


This reflects the culmination of a 6 month implementation period following the sanctioning of Law 1805 of 2016 by President Juan Manuel Santos in August 2016-

http://confidencialcolombia.com/es/1/actualidad/28986/Desde-hoy-sus-%C3%B3rganos-ser%C3%A1n-del-Estado-tras-la-muerte-Noticias-Confidencial-Colombia-donaci%C3%B3n-de-%C3%B3rganos-ley-de-donaci%C3%B3n-obligatorio.htm?platform=hootsuite


Deborah Verran's insight:
It appears that Colombia now has an opt out system for organ donation in place
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Russia’s Shumakov center boasts record number of heart transplantations in 2016

Russia’s Shumakov center boasts record number of heart transplantations in 2016 | Organ Donation & Transplant Matters Resources | Scoop.it

In a brief report from MOSCOW, via the TASS news organization, it is confirmed that  Russia’s Shumakov Center of Transplantology and Artificial Organs performed 132 heart transplant operations last year. This makes this center an absolute leader in this sector, the Russian Healthcare Ministry said on its official website on Tuesday.


No other details are available at this point in time.

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Surgical Assistant Part of World's 1st Heart Transplant To Be Honored in SA

Surgical Assistant Part of World's 1st Heart Transplant To Be Honored in SA | Organ Donation & Transplant Matters Resources | Scoop.it
The city of Cape Town is set to honor Hamilton Naki, a Black South African surgical assistant involved in the world’s first heart transplant operation.

Although Hamilton had not undergone any formal surgical training, his skills were recognised by heart surgeon Christiaan Barnard. Hence Hamilton came to be an important member of the team that was carrying out some of the ground breaking research during this period in time.

For more on the story click on the banner headline.
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You are an organ donor in France from January 1 2017, if you do not register to opt out

You are an organ donor in France from January 1 2017, if you do not register to opt out | Organ Donation & Transplant Matters Resources | Scoop.it

In news from France comes the confirmation that an opt out system for organ donation has now been implemented effective January the 1st 2017. 


People will now be allowed to express their refusal for organ donation after their death by using the refusal register which has now been established.


Some of the background context for this change, (including statistics for the numbers of organ donors along with the numbers on transplant waiting lists in recent years), can be found in the following article from Le Monde -


http://www.lemonde.fr/les-decodeurs/article/2016/12/22/don-d-organe-quarante-ans-apres-la-loi-sur-le-consentement-presume-ou-en-est-on_5053129_4355770.html


For more information from the French Agency of Biomedicine Dondorganes subsite for organ donation click on the following link-

http://www.dondorganes.fr/

Deborah Verran's insight:
This latest development represents the culmination of the passing of the relevant legislation for opt out for organ donation by the French government in recent years.
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Pioneering surgeons recall first triple transplant operation - BBC News

Pioneering surgeons recall first triple transplant operation - BBC News | Organ Donation & Transplant Matters Resources | Scoop.it
The two surgeons who 30 years ago carried out the world's first heart, lung and liver transplant reflect on their "extraordinary" achievement.

The surgery was undertaken at the Papworth hospital in the United Kingdom and involved two surgical teams headed by Roy Calne and John Wallwork.

At the time this was groundbreaking surgery and was undertaken as the woman (pictured) was going to die without the transplant.

The article contains a lot more information on the chain of events both prior to and following the triple organ transplant procedure.
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ORGAN India and NOTTO Host First Collaborative Conclave for Organ Donation.

ORGAN India and NOTTO Host First Collaborative Conclave for Organ Donation. | Organ Donation & Transplant Matters Resources | Scoop.it

ORGAN India, an initiative of the Parashar Foundation organized a Collaborative Conclave for Organ Donation on 1st December, 2016 at India International Centre, New Delhi, along with NOTTO (National Organ & Tissue Transplant Organisation). Pictured is the team from Organ India.


For the full story click on the following link-

http://www.pocketnewsalert.com/2016/12/ORGAN-India-and-NOTTO-Host-First-Collaborative-Conclave-for-Organ-Donation.html



Via newsattitude
Deborah Verran's insight:
Important development in India, the first ever collaborative for organ donation
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Dr. Denton Cooley, famed Houston heart surgeon, dead at 96

Dr. Denton Cooley, famed Houston heart surgeon, dead at 96 | Organ Donation & Transplant Matters Resources | Scoop.it

Dr. Denton Arthur Cooley, who achieved fame for pioneering surgeries that made worldwide headlines and helped raise the profile of Houston's Texas Medical Center, has died. He was 96. 


During a career which at times was tumultuous Dr Cooley was responsible for some of the pioneering cardiac surgical procedures undertaken in Houston. This includes implanting the first artificial heart as well as performing the first heart transplant. Dr Cooley also helped establish the Texas Heart Institute. His rivalry with another famous cardiac surgeon DeBakey was well documented and is alluded to in this story which makes for fascinating reading.
 

Deborah Verran's insight:
A larger than life individual who pushed the margins in the early days of heart transplantation in the US
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U.S. Centers for Medicare and Medicaid Services report on St. Joseph's Hospital Syracuse New York

U.S. Centers for Medicare and Medicaid Services report on St. Joseph's Hospital Syracuse New York | Organ Donation & Transplant Matters Resources | Scoop.it

This is the full CMS report on St. Joseph Hospital's handling of patient Colleen Burns.


Back in time this patients was taken to the operating room for organ recovery according to the donation after circulatory death pathway. However when the patients showed signs of 'waking up' in the anaesthetic bay organ donation was immediately abandoned.


Despite a preliminary internal investigation revealing no concerns, the external investigation undertaken by CMS  revealed that there were a number of issues.


As a result a number of recommendations were made plus the hospital was fined. The full report can be accessed by clicking on the banner headline.

Deborah Verran's insight:
Failures of communication, documentation and adherence to established protocols can be costly within hospitals. This document should be on the reading list of all professionals involved in organ donation.
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