Organ Donation & Transplant Matters Resources
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'Heart in a box': Pioneering device keeps donor organs alive OUTSIDE the body

'Heart in a box': Pioneering device keeps donor organs alive OUTSIDE the body | Organ Donation & Transplant Matters Resources | Scoop.it


Traditionally, all donor organs are placed in a cool-box and surrounded by ice to prevent them deteriorating on their journey between hospitals.

 

However new technology in the form of transportable machines is

leading to changes in how some organs are maintained following their removal from the donor.

 

This report focuses on the preliminary experience with the use of normothermic machine preservation in the Harefield heart transplant programme in the United Kingdom

Deborah Verran's insight:

Another report on the preliminary use of machine preservation in heart transplantation. Further data from the prospective clinical trials that are currently being undertaken is now awaited

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Organ Donation & Transplant Matters Resources
Combining reports, research findings and topic reviews
Curated by Deborah Verran
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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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Dutch Bill Would Make Everyone an Organ Donor Unless They Opt Out

Dutch Bill Would Make Everyone an Organ Donor Unless They Opt Out | Organ Donation & Transplant Matters Resources | Scoop.it

Dutch lawmakers have taken a step forward on a "yes unless" (opt out) system of organ donation in that country, hoping to make more organs available for transplant.


The first stage of passing the legislation has now occurred following a close vote in the lower house of the Netherlands parliament.


Now it remains to be seen as to whether the legislation passes the upper house.

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Nobel Prize judges fired in scandal surrounding trachea transplant surgeon

Nobel Prize judges fired in scandal surrounding trachea transplant surgeon | Organ Donation & Transplant Matters Resources | Scoop.it
Two members of the group that awards the Nobel Prize in Physiology for Medicine at Sweden’s Karolinska Institute have now been asked to resign over their involvement in a scandal over the work of now disgraced surgeon Dr Paolo Macchiarini.

This latest development follows the release of an external review into the trachea transplant programme. It seems that important red flags were either not acted upon or were ignored.

For another online media report from Sweden click on the following link-


Deborah Verran's insight:
The latest development following an external review of the trachea transplant programme at the Karolinska Institute in Sweden
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Culture of silence protected disgraced trachea surgeon

Culture of silence protected disgraced trachea surgeon | Organ Donation & Transplant Matters Resources | Scoop.it

An independent report has found both serious medical inadequacies and an uncritical environment surrounding Dr Paolo Macchiarini whilst he was heading the trachea transplant programme at the Karolinska Institute in Sweden.


In the final chapter of a story that has been attracting media attention for several years the report of the external review has now been released.


The lack of appropriate governance for this particular research programme combined with a lack of medical leadership is clearly  evident.


For the full story click on the banner headline..

Deborah Verran's insight:
Sobering report which shines a light on the inadequate governance processes which surrounded this particular clinical research programme. 
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Iran’s cash-for-kidney programme not without controversy

Iran’s cash-for-kidney programme not without controversy | Organ Donation & Transplant Matters Resources | Scoop.it

Iran’s kidney  transplant programme stands apart from other organ donation systems around the world by openly allowing payments, typically of several thousand dollars to live kidney donors.


Although there is some oversight of the relevant processes including at the level of the hospitals, where this particular programme attracts international concern is whether the financial payment acts as an inducement to live kidney donors.


For more on this story click on the banner headline.

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Hiranandani Hospital's CEO, 4 other doctors arrested in kidney racket case

Hiranandani Hospital's CEO, 4 other doctors arrested in kidney racket case | Organ Donation & Transplant Matters Resources | Scoop.it
Read more about the Hiranandani Hospital's CEO, and 4 other doctors who were all arrested this last week in Mumbai India as the result of an ongoing investigation into organ trafficking.

It is also becoming evident that some of the live kidney donors involved in this may be poor villagers from rural India-

One of the drivers for organ trafficking is the low deceased donor rate in India, the reasons for which are summarisedIm in this online article-

Under Indian law organ trafficking is now illegal. Should it be proven that any of these individuals broke the law, the penalties will be severe. Meanwhile there continue to be ongoing campaigns (including via social media) to try and raise public awareness about the importance of organ donation.
Deborah Verran's insight:
The authorities in India continue to have to grapple with the consequences of organ trafficking whilst ongoing efforts to promote organ donation via legitimate avenues continue.
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Rabies cases probably linked to kidney donor in China: Study | Outbreak News Today

Rabies cases probably linked to kidney donor in China: Study | Outbreak News Today | Organ Donation & Transplant Matters Resources | Scoop.it
It appears that two renal transplant recipients have been diagnosed with rabies which appears to have been transmitted by a deceased donor in Southern China.

More on the case can be viewed via this link  - https://t.co/qtRj4wyksm
Deborah Verran's insight:
Encephalitis in a potential organ donor can be due to an infectious agent and hence is usually a contraindication to organ donation proceeding.
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Deceased-Donor Age Affects Kidney Transplant Outcomes 

Deceased-Donor Age Affects Kidney Transplant Outcomes  | Organ Donation & Transplant Matters Resources | Scoop.it
In this recently reported analysis of Registry data, recipients of kidneys from individuals who donated the organs after circulatory death are more likely to experience graft loss and delayed graft function. This is particularly the case of the donor was aged over 50 years.

This data adds to the knowledge pertaining to renal allograft outcomes according to the type of donor as well as the age of the donor.
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The First Successful Kidney Transplant in Dubai From a Deceased Donor Has Just Happened

The First Successful  Kidney Transplant in Dubai From a Deceased Donor Has Just Happened | Organ Donation & Transplant Matters Resources | Scoop.it

Dubai Healthcare City Authority (DHCA) today announced that the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) has successfully carried out the first organ transplant surgery in Dubai in collaboration with Mediclinic City Hospital.


The deceased donor kidney from Saudi Arabia was successfully transplanted into a woman who was requiring dialysis for end stage kidney disease.


For more on the story including information on the co-operation required between authorities in both Saudi Arabia and the United Arab Emirates click on the following link-

http://mediaoffice.ae/en/media-center/news/15/6/2016/dubai-healthcare-city.aspx


Interviews with some of the healthcare professionals who were involved in this particular case can be found by clicking on this link-

http://gulfnews.com/news/uae/health/how-dubai-achieved-its-first-cadaver-kidney-transplant-1.1847549


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Dialysis Patients Trial Wearable Artificial Kidney: Proof of concept study

Dialysis Patients Trial Wearable Artificial Kidney: Proof of concept study | Organ Donation & Transplant Matters Resources | Scoop.it

A couple of years ago the news broke about a new wearable dialysis machine about to go into clinical trial that is essentially an artificial kidney for cleansing and regulating levels of uraemic toxins in the blood. The device is worn on a belt around the patient's waist (as pictured).


Now the results of the pilot study undertaken in the United States have been made available. Although the portable artificial kidney functioned reasonably well, the limitations of the current device became apparent during the trial.


The full results of this important proof of concept study are published in the journal JCI Insight and make for interesting reading-


https://insight.jci.org/articles/view/86397


It is also now understood what are the limitations of the current dialysis modalities with respect to the clearance of uraemic toxins and how bioengineered solutions may make the process more efficient on the future. The following research has been published in the journal Nature-


http://www.nature.com/articles/srep26715





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BPoD | Colourful Cornea

BPoD | Colourful Cornea | Organ Donation & Transplant Matters Resources | Scoop.it
Colourful Cornea - Biomedical pictures for May 2016.

This close up image is of a mouse cornea with the cell nuclei colored blue. Scientists are studying lymphangiogenesis which can contribute to abnormalities of the cornea, including after corneal transplantation. 
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Dead could be brought 'back to life' in groundbreaking project - via the use of stem cells

Dead could be brought 'back to life' in groundbreaking project - via the use of stem cells | Organ Donation & Transplant Matters Resources | Scoop.it
Stem cells have been used to try and treat a number of neurological disorders including Parkinsons disease as well as damage to the spinal cord leading to paralysis.

However in what may be currently considered a giant leap of faith a United States biotech company (Bioquark), has gone through the initial stages of seeking regulatory approval for a trial utilizing stem cells to treat patients following the declaration of brain death. The aim is to restore neurological function via a combination of supportive medical treatments along with the injection of stem cells into the spinal cord.

The initial proof of concept study titled the 'Reanima project' will be carried out in India. The study protocol can be viewed via the following link-

https://clinicaltrials.gov/ct2/show/NCT02742857?term=stem+cells+AND+brain+injury&rank=11 ;

More on the story can be viewed by clicking on the following link- 


In addition an ethicist asks the question as to whether this planned trial can truly deliver acceptable results-



Deborah Verran's insight:
It seems highly unlikely that any patient in whom a sound diagnosis of brain death has been made, will have their brain function restored to any significant degree via this approach in the near future.
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Improved Detection for Deadly Prion Diseases

Improved Detection for Deadly Prion Diseases | Organ Donation & Transplant Matters Resources | Scoop.it
A new assay now offers the potential for there to be an improved sensitivity in practice compared to current tests for transmissible spongiform encephalopathies, researchers report.

Up to now the diagnosis of these types of conditions has required that tissue taken via biopsies be processed in the laboratory. This newly developed assay may be the first of a new generation of laboratory based tests that can be performed on blood, saliva or urine for these types of disorders. Further data from the prospective use of this particular test in clinical practice is now awaited.
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Head transplant team’s new animal tests fail to convince critics

Head transplant team’s new animal tests fail to convince critics | Organ Donation & Transplant Matters Resources | Scoop.it

The latest report of research performed on animals in preparation for the first possible so called head transplant has not convinced critics of the procedure. A dog has reportedly recovered the ability to walk after an injection into its damaged spinal cord, but some have criticized the standard of the study as outlined in this online report.


Although there are plans for the first head transplant to be performed in China in 2017, concerns continue to be expressed around both the safety and efficacy of the procedure. Of note the patient will actually undergo a body transplant, that is their body will be replaced.


There are significant barriers to this procedure being successful in practice, of which 5 are identified in this online article posted via Business Insider-

http://www.businessinsider.com.au/italian-surgeon-head-transplant-dog-experiment-2016-9?r=UK&IR=T




Deborah Verran's insight:
The latest news on the so called head transplant which may be performed in China in 2017
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Paolo Macchiarini: A surgeon’s downfall - BBC News

Paolo Macchiarini: A surgeon’s downfall - BBC News | Organ Donation & Transplant Matters Resources | Scoop.it

Ground-breaking work on synthetic tissue transplants made Paolo Macchiarini one of the most famous doctors in the world. Now his reputation lies in tatters.


This is the most comprehensive online article to date on this matter. It provides a summary on the chain of events which ultimately led to an external investigation of the research carried out at the Karolinska Institute in Sweden into trachea transplantation.


For anyone with an interest in the governance of organ and tissue transplantation this is a must read.

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What Happens When A Living Kidney Donor Needs A Transplant in the United States?

What Happens When A Living Kidney Donor Needs A Transplant in the United States? | Organ Donation & Transplant Matters Resources | Scoop.it
A new study from the United States examines how well the system works to prioritize the needs of previous live kidney donors if they end up needing a kidney transplant of their own.

Live kidney donors can receive priority for a kidney transplant if it is determined that their remaining kidney is failing. However it seems that this information may not be fully understood across the healthcare system within the United States.


Hence the importance of this retrospective review of just over 200 live kidney donors. For more information click on the banner headline.
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Does China still harvest organs of executed? Doctors divided (not really!)

Does China still harvest organs of executed? Doctors divided (not really!) | Organ Donation & Transplant Matters Resources | Scoop.it

A Canadian patient's receipt of a kidney transplant recently after waiting just three days during a recent visit to China raised an immediate red flag among surgeons at the Montreal-based Transplantation Society. A turnaround that quick indicates the organ likely came from the body of an executed prisoner. 


The case adds to doubts among many doctors internationally about whether China has met its pledge to stop harvesting the organs of executed inmates. The practice is widely condemned by the World Health Organization and others because of concerns over coercive practices and fears it could encourage executions. China officially claims it ended the harvesting of executed inmates' organs in January 2015. 


China sought to use the Transplantation Society's decision to hold its annual meeting in Hong Kong this last month as validation of its organ donation system. 


But Dr. Philip O'Connell, the society's president, rejected that interpretation, even if it appeared some reforms had been successful. In a country that routinely suppresses discussions of human-rights issues and cracks down on lawyers and independent groups, government officials and state media have been relatively open about China's problems with organ donation. 


Dr. Huang Jiefu, head of the system that supervises transplants in Chinese hospitals, has been the public face of the country's attempts to change its transplant practices. Huang publicly admitted in 2005 that doctors used executed prisoners' organs. In 2011, Huang and other officials estimated that 65 percent of transplanted organs from the deceased came from executed prisoners. In an interview Friday with The Associated Press, Huang said he was confident hospitals under his purview were moving to donated organs, but that black-market surgeries still persist. "We still have a long way to go," Huang said. According to the government, Chinese doctors performed 10,057 organ transplants in 2015.  


To read the full story click on the banner headline

Deborah Verran's insight:
Nb the word harvest in the title of this story needs to be replaced by either organ recovery or organ retrieval in 2016. Nevertheless this latest online post provides some additional detail on the current issues with organ donation in China along with confirmation from a senior official that there are still unresolved problems,
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The Chinese Claim That The World Accepts Its Organ Transplant System Are Rebutted

The Chinese Claim That The World Accepts Its Organ Transplant System Are Rebutted | Organ Donation & Transplant Matters Resources | Scoop.it

After it was revealed in the media that delegates from China were speaking at the Transplantation Society meeting in HongKong, concern was raised as to the veracity of their claims that the use of organs from executed prisoners within China has largely subsided. This followed publication of an article in the American Journal of Transplantation where further concerns were raised about organ donation in China. The previous article from the New York Times can be viewed via this link-

http://www.nytimes.com/2016/08/18/world/asia/debate-flares-on-chinas-use-of-prisoners-organs-as-experts-meet-in-hong-kong.html


The head of the Transplantation Society Professor Philip O'Connell (pictured), stated that the decades-long practice of using the organs of executed prisoners, which China claims it has stopped, had horrified the rest of the world.


There now seems to be ongoing uncertainty over whether the claims being made by Chinese officials can actually be supported by accurate data. Whatever the outcome it is clear that the majority of transplant professionals around the world are not supportive of unscrupulous organ donation practices. 

Deborah Verran's insight:
Important issue which will not go away until the appropriate management and governance practices are both adopted and promulgated within China
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How Snapchat is recruiting bone marrow donors

How Snapchat is recruiting bone marrow donors | Organ Donation & Transplant Matters Resources | Scoop.it
A nonprofit organization is now utilizing the Snapchat social media platform in order to reach millennials and help find bone marrow donors for blood cancer patients.

This innovative approach to expanding the potential pool of bone marrow donors has been implemented by Be the Match. More information  on their campaign can be accessed via the following link-


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Exposure To Industrial Printing Chemical Raises Risk Of Bile Duct Cancer

Exposure To Industrial Printing Chemical Raises Risk Of Bile Duct Cancer | Organ Donation & Transplant Matters Resources | Scoop.it
1,2-dichloropropane, a chemical used in the printing industry, turns carcinogenic when it is metabolized by the liver and then excreted into bile.

This finding has been confirmed in research which has now been published in the Journal Nature-


This important research was undertaken following confirmation of there being an increased incidence of cholangiocarcinoma, particularly  in individuals who had worked in the printing industry in Japan. Hence the attention of the researchers was directed towards elucidating the possible underlying mechanism as well as establishing which chemicals were most likely involved.
Deborah Verran's insight:
This important research now establishes that there is a link between chemicals that have been used in some industrial processes and the risk of development of this particular rare form of bile duct/liver cancer.
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U.S. To Invest $200 Million To Shorten Organ Transplant Wait Lists

U.S. To Invest $200 Million To Shorten Organ Transplant Wait Lists | Organ Donation & Transplant Matters Resources | Scoop.it
The U.S. government announced plans this last week to invest $200 million to help shorten the waiting list for patients waiting for organ transplants.

With the per annum costs of dialysis now topping $34 billion per annum and with the majority of patients on the waiting list for an organ needing kidneys, there is a real need explore all possible options as well as optimize organ donation within the United States.

Although a significant component of the funding will go to Defense a number of new projects will now be undertaken. For more on this story click on the banner headline.

One project will involve initiating kidney transplant chains via the use of altruistic live donors at the Walter Reed hospital-


A collaborative research initiative between two academic medical centres and UNOS will seek to undertake prospective research into optimizing the management of deceased donors. This is in order to maximize the numbers of organs that are suitable for transplantation purposes- 


In addition UNOS is looking to optimize the use of electronic donor records in order to facilitate organ allocation as well as provide quarterly feedback to transplant programs-


The American Society of Nephrology has committed $7 million towards the development of an artificial implantable kidney via the XPRIZE initiative-


Finally in what may be termed a 'moonshot' NASA has announced a prize for the three most successful organizations who wish to attempt to grow tissues and or organs in space-





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CMS liver transplant policy may be denying some patients the opportunity to undergo an organ transplant

CMS liver transplant policy may be denying some patients the opportunity to undergo an organ transplant | Organ Donation & Transplant Matters Resources | Scoop.it
An examination of how patients are being managed on liver transplant waiting lists in the United States has revealed that sicker patients may end up being delisted.

One of the drivers for this type of decision making is the requirements for programmes to continue to meet set post transplant patient outcome criteria that have been established by the Centre for Medicaid Services (CMS). This is in order for programmes to be able to maintain federal approval to continue to deliver the requisite clinical programme service . The implications of this research are explored further in the online article
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The UAE may soon allow organ donation from deceased donors

The UAE may soon allow organ donation from deceased donors | Organ Donation & Transplant Matters Resources | Scoop.it
Steps are being undertaken within the United Arab Emirates (UAE), to explore whether it is feasible to establish processes and procedures in order to facilitate organ donation from deceased donors.

The results of a survey have now been available publicly. Some 68% of respondents on a UAE national survey said they were willing to donate organs if they were brain-dead.

Surgeon Dr Farhad Janahi (pictured) who is the senior researcher responsible for this survey, is now optimistic that progress can be made within the UAE for organ donation from deceased donors to become a reality.


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U.S. trial tests machine that 'reconditions' lungs outside of the body

U.S. trial tests machine that 'reconditions' lungs outside of the body | Organ Donation & Transplant Matters Resources | Scoop.it
ST. LOUIS (Reuters) - A machine that 'reconditions' a donor's lungs outside the body before they are transplanted into a recipient is undergoing tests in the United States in the hope that it can radically improve survival rates for people with lung disease.

The XVIVO machine preservation device will be used to recondition marginal deceased donor lungs in 16 centers lead to an increase in the number of donor lungs that can be successfully transplanted.

In another recent article posted online a short video also contains information on the XPS XVIVO device-


Deborah Verran's insight:
The results of this important prospective clinical trial are now awaited with interest.
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Scientists Learn to Detect Zika Virus Using Nuclear-Derived Technique

Scientists Learn to Detect Zika Virus Using Nuclear-Derived Technique | Organ Donation & Transplant Matters Resources | Scoop.it
More than thirty doctors, epidemiologists, microbiologists and laboratory technicians from Latin America, the Caribbean and Africa learned how to use a nuclear-derived technique to detect the Zika virus during IAEA training courses this month.

These courses are being run in order to assist with the scaling up of reliable laboratory testing which is now required in a number of countries in order to detect this particular virus in affected patients.
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