On the morning of 23 December 2024,the Panda Pack and Bike Donation Ceremony in Cambodia under the Action Plan on Silk Road People-to-People Connectivity was held at Balaing Khang Lech Primary School in Kampong Thom P...On the morning of 23 December 2024,the Panda Pack and Bike Donation Ceremony in Cambodia under the Action Plan on Silk Road People-to-People Connectivity was held at Balaing Khang Lech Primary School in Kampong Thom Province.Over 150 participants including Kemreat Viseth,Deputy Director of the Council of Ministers of Cambodia and President of Civil Society Alliance Forum(CSAF),Nhek Ban Kheng,Deputy Governor of Kampong Thom Province.展开更多
The reform stems from honesty and determination. Since 2005, organ donation and transplantation in China has undergone thorough reform, which complies with legislation requirements and ethical principles established b...The reform stems from honesty and determination. Since 2005, organ donation and transplantation in China has undergone thorough reform, which complies with legislation requirements and ethical principles established by the World Health Organization(WHO). Reform in China has demonstrated the unwavering confidence and utmost determination of the Chinese government and the Chinese transplantation community. The year 2015 marked a historic turning point when voluntary donations from Chinese citizens became the sole legitimate source for organ transplantation. Since 2015, China has gradually established and refined the “Chinese Mode” and “China System” for organ donation and transplantation, fulfilling its political pledge of reform, and has garnered international recognition, and fostered a social culture which promotes organ donation. This article reviewed the history of reform on organ donation and transplantation in China, presented a new pattern of establishment of organ donation system in the new era of the country, and the direction of advances in the future.展开更多
China’s rice donation to Uganda’s drought-stricken Karamoja sub-region saves thousands from starvation.Afriend in need is a friend indeed,said Thomas Lokirut,an elder from Uganda’s Karamojong people after learning ...China’s rice donation to Uganda’s drought-stricken Karamoja sub-region saves thousands from starvation.Afriend in need is a friend indeed,said Thomas Lokirut,an elder from Uganda’s Karamojong people after learning that China had donated 1,610 tonnes of rice to his people.展开更多
BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes...BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes and barriers toward organ donation.METHODSA cross-sectional study was adopted and included 607 samples consisting ofstudents, faculty, and staff who were selected from three universities in Ajmanand who had signed consent forms. A validated self-administered questionnairethat included 13 attitudes and 14 barrier items was used as a tool. The reliabilityof the tool was 0.89 (Cronbach's alpha). In the analysis of attitude scores, responseswere rated on a scale from 0 to 4, with 0 representing 'strongly disagree'and 4 representing 'strongly agree' for supportive attitudes towards organdonation. Participants with a total attitude score of 39 or higher indicated agreementor strong agreement with all items, reflecting a generally supportiveattitude toward organ donation. Lower scores suggested that the respondent wasneutral or disagreed with one or more items, indicating a less supportive attitudetoward organ donation. Knowledge about organ donation was assessed by selfadministeredquestionnaire that included 13 items. Analysis was done using SPSSversion 29. χ2 was used to assess associations between variables.RESULTSMost participants were young (≤ 30 years old, 83.7%), female (79.2%), from World Health Organization Eastern Mediterranean Region countries (69.5%), Muslim (82.4%), students (80.6%), single(83.9%), and from a nursing college (33.1%). The majority had no personal or family history of organ donation(93.2% and 93.9%, respectively). Supportive attitudes toward organ donation were significantly associated withreligion (P = 0.003), working status (P = 0.009), university (P = 0.019), and knowledge (P < 0.001). Additionally,those with a personal or family history of organ donation were significantly more supportive (56.8% vs 33.3%, P =0.004). Lack of awareness was the most reported barrier for organ donation (64.1%) followed by being afraid oforgan donation due to medical procedures required (51.9%).CONCLUSIONThe findings suggest that supportive attitudes toward organ donation are influenced by demographic factors,personal experiences, and knowledge levels. Lack of awareness and fear of medical procedures were the mostreported barriers to organ donation. These results highlight the need for targeted educational programs to increaseawareness and promote positive attitudes toward organ donation.展开更多
BACKGROUND Opioids are commonly used for management of post-operative pain in living kidney donors.Reducing exposure to opioids is desirable to minimize risk of dependence and potential side effects such as nausea,vom...BACKGROUND Opioids are commonly used for management of post-operative pain in living kidney donors.Reducing exposure to opioids is desirable to minimize risk of dependence and potential side effects such as nausea,vomiting,and constipation which may delay discharge.Liposomal bupivacaine,ketorolac,and scheduled acetaminophen have all demonstrated efficacy for management of post-operative pain in this population.AIM To assess the efficacy and safety of an opioid-sparing protocol utilizing a multimodal pain management approach in living kidney donors post-nephrectomy.METHODS Single-center,retrospective chart review study examining 52 living kidney donors(26 pre-protocol implementation,26 post-protocol implementation)from May 24th,2019 to September 27th,2023.Patients in the post-protocol group received intraoperative liposomal bupivacaine,hydromorphone PCA(until able to tolerate oral medications),15 mg of intravenous ketorolac every 6 hours for 3 doses,and scheduled oral acetaminophen,in addition to oxycodone as needed for moderate to severe pain.The primary endpoint was oral morphine equivalent(OME)use within 48 hours post-surgery.Secondary endpoints include average daily pain scale within 48 hours post-surgery,length of stay(LOS)(days),and incidence of new acute kidney injury(AKI)or gastrointestinal(GI)bleed during admission per provider.Differences between the pre-and post-protocol implementation groups were compared utilizing the exact Wilcoxon test for continuous variables and either the Fisher’s Exact orχ^(2) test for categorical variables.RESULTS Patients in the pre-protocol implementation group received more OME(mg)within 48 hours post-surgery when compared to the post-protocol group(median:84.5 vs 69.0).The median of total OME over the course of admission was numerically greater the pre-protocol group(105.0 vs 69.0),and was significantly more per LOS(41.3 vs 25.7,P=0.02).Average daily pain score was not statistically significantly different between the two groups on postoperative day 1(median:5.3 vs 4.4;P=0.43)and post-operative day 2(median:4.7 vs 5.2;P=0.96).No significant differences were found in provider-identified incidences of AKI or GI bleeding during admission.There was no difference in serum creatinine at the time of discharge between the two groups.CONCLUSION A multimodal,opioid-sparing pain management protocol was as effective for pain control and resulted in significantly less opioid daily exposure over LOS.No adverse events were found related to use of ketorolac in patients undergoing donor nephrectomy.Our findings suggest that an opioid-sparing protocol is both safe and effective at minimizing opioid exposure and managing post-operative pain within the first 48 hours post-surgery.展开更多
BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-ma...BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-making,are crucial factors in promoting awareness.Understanding their relationship can guide efforts to increase participation in organ donation.AIM To investigate the effect of health literacy on organ donation and transplantation awareness,with self-control acting as a mediator,and to emphasize its importance.METHODS The study comprised 345 adults recruited from five different cities in Türkiye.The sample included 208 women(60.29%)and 137 men(39.71%).The age range of the sample group varies between 18 and 49(median age=24.13;SD=8.81).Selfreport data were collected including psychometric measures assessing organ donation and transplantation awareness,health literacy,and self-control.Reliability analysis,descriptive statistics,correlational analysis,and mediational analysis of the data were carried.RESULTS The analysis showed that health literacy was positively correlated with organ donation and transplantation awareness(r=0.340)and self-control(r=0.376).Self-control was positively related to organ donation and transplantation awareness(r=0.531).Mediating analysis supported a mediation model where health literacy was found to influence organ donation and transplantation awareness via self-control(bootstrap=0.158,95%confidence interval=0.105-0.215).CONCLUSION The results indicate that self-control mediates the positive relationship between health literacy and organ donation and transplantation awareness.Enhancing individuals’health literacy may therefore increase awareness of organ donation and transplantation through improvements in self-control.展开更多
BACKGROUND Marginal donation after circulatory death(DCD)liver grafts are carefully used to combat the constant shortage of donors.Clinically,the worst outcomes are mainly related to severe ischemia-reperfusion-injury...BACKGROUND Marginal donation after circulatory death(DCD)liver grafts are carefully used to combat the constant shortage of donors.Clinically,the worst outcomes are mainly related to severe ischemia-reperfusion-injury and the dangerous effect of various inflammatory cytokines(CK).The machine perfusion(MP)is a promising device to rescue these grafts.AIM To analyze the role of MP connected to a sorbent cartridge(PerSorb®)and used for very damaged DCD pig livers.METHODS Seven grafts were procured from pigs from a slaughterhouse.Grafts were made very marginal with at least 60 minutes of donor warm ischemia time and 24 hours of static-cold ischemia time:(1)3 grafts were perfused in hypothermic MP with PerSorb(Sorb);(2)2 other grafts in hypothermic MP(HMP)without the cartridge(NoSorb);and(3)The other 2 livers stored in the ice box(NoTreat).The CK were measured at HMP start(T0)and at the end(Tend).Biopsies were taken at T0 and Tend.RESULTS All 5 grafts treated with HMP had a negative lactate trend after 3 hours of treatment(8.83 at T0 vs 6.4 at Tend of Sorb;15 at T0 vs 5.45 at Tend for NoSorb,P value>0.05).At Tend,both Sorb and NoSorb groups had better hemodynamic parameters,comparable between the two groups.Enzyme-linked immunosorbent assay analysis showed a reduction of monocyte chemotactic protein-1,tumor necrosis factor-alpha and interleukin-1βfor NoSorb group at Tend and a complete downregulation to physiological levels of the same CK in Sorb livers after 3 hours of treatment.Biopsies showed a reduction of the perisinusoidal edema for the Sorb grafts compared with the NoSorb livers.CONCLUSION These data suggest a potential protective role of treatment of grafts with MP and sorbent cartridge in reducing the inflammatory response after a severe ischemic injury.展开更多
Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of dat...Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of data on this topic so far.In the present review, we assessed available evidence on quality metrics in solidorgan procurement in the United States and in Europe by means of a PubMedsearch. Evidence was summarized according to countries, considering that thedonation and transplantation systems differ from country to country. In UnitedStates, the assessment of these indicators is periodically performed by the nationalnetwork for organ sharing to evaluate the performance of each Organ ProcurementOrganization (OPO). Quality metrics consider several factors, in primispopulation characteristics (i.e. race/ethnicity, age, socio-economic status). That iswhy the assessment of each OPO performance relies on several quality metrics,not only one single indicator. In Europe, quality improvement programs representa structural element of organ and transplant system in several countries, but fewpapers have to date addressed the results obtained by a quality improvementprogram based on indicators. In Poland, the use of quality indicators and improvementprocedures were associated with better results in those hospitals whichimplemented these programs in respect to hospitals who did not. In TuscanyRegion (Italy) the implementation of a monitoring and reporting approach basedon indicators by the Regional Transplant Center was associated with an increasedin transplant and donation activity (especially in cDCD donors). According toavailable evidence, the development of a method for quality assessment andquality improvement has been recognized as pivotal for donation and transplantauthorities to identify key interventions either at national and/or hospital levels.展开更多
BACKGROUND Knowledge about organ donation and transplantation plays a crucial role in shaping individuals'health behaviors and perceptions,potentially impacting their health-related quality of life(HRQoL).Future a...BACKGROUND Knowledge about organ donation and transplantation plays a crucial role in shaping individuals'health behaviors and perceptions,potentially impacting their health-related quality of life(HRQoL).Future anxiety,defined as the anticipatory worry individuals experience regarding potential negative events and outcomes in their future,may further influence these outcomes.AIM To investigate the effect of such knowledge on HRQoL and to examine whether future anxiety mediates this relationship.METHODS A cross-sectional study was conducted with 659 participants aged 18 to 65 years.Participants completed the Organ Tissue Donation and Transplantation Knowledge Scale,the Dark Future Scale,and the European Health Interview Survey-Quality of Life 8.Correlation analyses were performed,followed by Structural Equation Modeling to test the proposed mediation model.RESULTS The findings indicated that greater knowledge about organ donation and transplantation was positively associated with higher HRQoL and negatively associated with future anxiety.Future anxiety was negatively correlated with HRQoL.Structural Equation Modeling analysis indicated that knowledge directly enhanced HRQoL and reduced future anxiety.Additionally,future anxiety negatively affected HRQoL,mediating the relationship between knowledge and HRQoL.The mediation effect was significant,as confirmed by bootstrapping(bootstrap coefficient=0.068,95%CI:0.046-0.093).CONCLUSION The study concludes that future anxiety partially mediates the positive impact of knowledge about organ donation and transplantation on HRQoL.These results suggest that increasing public knowledge in this area may reduce future anxieties and enhance quality of life.展开更多
BACKGROUND The normothermic machine perfusion pump(NMPP)could shape the future of transplantation.Providing ex-vivo optimization,NMPP attenuates ischemic insult while replenishing energy.An understanding of machine pe...BACKGROUND The normothermic machine perfusion pump(NMPP)could shape the future of transplantation.Providing ex-vivo optimization,NMPP attenuates ischemic insult while replenishing energy.An understanding of machine perfusion time(MPT)impact and potential clinical benefits is paramount and necessitates exploration.AIM To investigate the relationship between MPT and post-transplant graft function.METHODS Retrospective review of the first 50 donation after circulatory death(DCD)grafts preserved using NMPP in a tertiary institution was performed.Essential preser-vation time points,graft parameters,recipient information,and postoperative outcomes were prospectively recorded.Early allograft dysfunction(EAD),L-Graft7 score and 90-day outcomes were collected for all grafts.The first 20 re-cipients were allocated into the early group,considered the learning curve population for the center.The subsequent 30 were allocated into the late group.Recipients were also stratified into cohorts depending on MPT,i.e.,short(<8 hours),medium(8-16 hours)and long(>16 hours).RESULTS NMPP operational parameters were not predictive of EAD,L-GrAFT7 or 90-day outcomes.The early group had significantly less MPT and cold ischemia time than the late group(553 minutes vs 850 minutes,P<0.001)and(127.5 minutes vs 154 minutes,P=0.025),respectively.MPT had no impact in either group.CONCLUSION Increased MPT of DCD liver grafts had no adverse recipient results for the times utilized in this population,indicating its upper limits,likely beyond 24 hours,are not demonstrated within this study.Future studies are necessary to determine whether longer MPT is beneficial or detrimental to graft function and,if the latter,what is the maximum safe duration.Further studies of the effect of normothermic machine perfusion pump duration on long-term outcomes are also needed.展开更多
There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way...There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to con-trolled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function （DGF） and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that signifcantly infuences the outcome of allografts, for example, limiting it to 〈 12 h markedly reduces DGF. DCD kidneys from donors 〈 50 function like stan-dard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled dona-tion, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kid-neys from DCD include： implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.展开更多
BACKGROUND The most important factors affecting attitudes on organ donation are socioeconomic, educational, cultural, and religious factors in many countries.AIM To evaluate the attitudes, awareness, and knowledge lev...BACKGROUND The most important factors affecting attitudes on organ donation are socioeconomic, educational, cultural, and religious factors in many countries.AIM To evaluate the attitudes, awareness, and knowledge levels of the Turkish adult population toward organ donation.METHODS This nationwide study surveyed 3000 adults(≥ 18 years) in Turkey. To ensure a representative sample, the Nomenclature of Territorial Units for Statistics-Ⅱ(modified for Turkey) was used. Turkey was divided into 26 regions based on social, economic, and geographic criteria as identified by the Turkish Statistical Institute. A stratified sampling method was used with an even distribution of adults across cities and towns based on population data. Data were collected by the PRP Research and Consultancy Company using computer-assisted personal interviews.RESULTS Out of 3000 individuals represented in the study population, 1465(48.8%) were male and 1535(51.2%) female. The results showed that most participants were under 45 years(59.0%) and married(72.1%), some had a bachelor’s degree or higher(21.9%), and very few(1.5%) had any direct experience with organ transplantation-whether in the family, or a family member on a transplantation waiting list. Most of the study population(88.3%) had not considered donating an organ, however, most(87.9%) said that they would accept an organ from a donor if they needed one. Among the individuals surveyed, 67% were willing to donate an organ to a close relative, while 26.8% would donate an organ to an unrelated person. Only 47.2% said they had adequate information about brain death, and 85.2% refused to consent to donating organs of family members declared brain dead. Only 33.9% thought they had adequate information about organ donation. The main source of information was the television. The two main reasons for refusing organ donation were that it was too soon to think about organ donation and the importance of retaining the integrity of the dead person’s body.CONCLUSION This study showed that Turkey’s adult population has inadequate knowledge about organ donation. The study advocates for public education programs to increase awareness among the general population about legislation related to organ donation.展开更多
AIM: To analyze the attitude of Spanish medical students toward living liver donation(LLD) and to establish which factors have an influence on this attitude.METHODS: Study type: A sociological, interdisciplinary, mult...AIM: To analyze the attitude of Spanish medical students toward living liver donation(LLD) and to establish which factors have an influence on this attitude.METHODS: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain(n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire(PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student′s t test, χ^(2 )test and logistic regression analysis.RESULTS: The completion rate was 95.7%(n = 9275). 89%(n = 8258) were in favor of related LLD, and 32%(n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude:(1) age(P = 0.008);(2) sex(P < 0.001);(3) academic year(P < 0.001);(4) geographical area(P = 0.013);(5) believing in the possibility of needing a transplant oneself in the future(P < 0.001);(6) attitude toward deceased donation(P < 0.001);(7) attitude toward living kidney donation(P < 0.001);(8) acceptance of a donated liver segment from a family member if one were needed(P < 0.001);(9) having discussed the subject with one's family(P < 0.001) and friends(P < 0.001);(10) a partner's opinion about the subject(P < 0.001);(11) carrying out activities of an altruistic nature; and(12) fear of the possible mutilation of the body after donation(P < 0.001).CONCLUSION: Spanish medical students have a favorable attitude toward LLD.展开更多
At present, the huge problem that China’s Non-profit Organizations are facing is the low efficiency of public fundraising. However, the newly appeared Online Fundraising Platform indicates some possibilities in ove...At present, the huge problem that China’s Non-profit Organizations are facing is the low efficiency of public fundraising. However, the newly appeared Online Fundraising Platform indicates some possibilities in overcoming the obstacle for public fundraising. Among which Tencent Online Fundraising Platform becomes the typical and the point cut of exploring Online Fundraising Platform Improving Efficiency Mechanism of public donation. Online Fundraising Platform is similar to the online United Way, relying on the advantages of the Internet and the united fundraising to build a ecosystem of public donation which has professional fundraising system, good charity atmosphere, excellent policy environment and crossover cooperation resources. And in which, many factors get improved in pubic donation influence factors system. For one thing, Charity atmosphere and policy environment can be shaped better. For another, the charities can transmit fundraising information in inexpensive and high-efficiency way, and must ensure the transparency of project and donation. Finally, it will be more convenient for donors to get charitable information, make donations and supervise the nonprofit organizations.展开更多
<b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:""><span style="font-family:Verdana;">This article is aiming...<b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:""><span style="font-family:Verdana;">This article is aiming to give an essential informative principle about the development of blood donation activities in Kyrgyzstan. </span><b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">The sequence of blood donation procedure steps before donation, during donation, and after donation w</span></span><span style="font-family:Verdana;">as</span><span style="font-family:""><span style="font-family:Verdana;"> shown and discussed. </span><b><span style="font-family:Verdana;">Methods/Materials: </span></b><span style="font-family:Verdana;">Rhesus factor determination in donors was achieved by </span></span><span style="font-family:Verdana;">“</span><span style="font-family:""><span style="font-family:Verdana;">COLICO” method which is based on the use of monoclonal antibodies solution. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">According to the</span><b> </b><span style="font-family:Verdana;">blood donation activity of donors in Osh, Kyrgyzstan for the 2018 year, it was found that gratuitous donors who donated blood in 6 months were 269, in 9 months were 366, and in 1 year were 499 people. Relative donors who donated blood in 6 months were 3480, in 9 months were 5100, and in 1 year were 6701 people. Active donors donated blood in 6 months were 12, in 9 months were 14 and in 1 year were 17 people. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">No agglutination was observed in any of the plates for the first blood group;agglutination was observed with anti-A monoclonal antibody solution for the second blood group;agglutination was observed with anti-B monoclonal antibody solution for the third blood group;agglutination was observed with both of anti-A and anti-B monoclonal antibody solutions for the fourth blood group.展开更多
Introduction: Despite the progress recorded at the level of transfusion safety in Côte d’Ivoire, much remains to be done, particularly at the level of the medical selection of blood donors. The objective of the ...Introduction: Despite the progress recorded at the level of transfusion safety in Côte d’Ivoire, much remains to be done, particularly at the level of the medical selection of blood donors. The objective of the study was to make an assessment of the pre-donation capillary hemoglobin dosage for the year 2020 of the fixed collection, of the Blood Transfusion Center of Yamoussoukro. Method: This is a retrospective study that took place at the Yamoussoukro Blood Transfusion Center. The data collection related to all old and new blood donors were deemed suitable for the fixed collection of the year 2020. The method chosen for the pre-donation control is that of the portable hemoglobinometer of the HémoCue<sup>®</sup> type, more precisely 201+. Results: Of the 1160 blood donors in the study, the pre-donation hemoglobin level was not measured in 787 (67.8%) subjects of either sex. Of the subjects who had a pre-donation hemoglobin level performed, 97 (26%) blood donors had a sub-standard hemoglobin level, including 15 females and 82 males. Conclusion: Pre-donation hemoglobin testing of blood donors is effective in Yamoussoukro. However, efforts must still be made to improve the quality of the blood collected and to protect blood donors.展开更多
AIM To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients.METHODS We retrospectively studied the results of blood cultures among ...AIM To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients.METHODS We retrospectively studied the results of blood cultures among our donation after cardiac death(DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors' and patients' characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections.RESULTS Head trauma was the most common origin of death among our 67 DCD donors(46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria(70.6%). Only three(4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections,with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donorderived infections showed relation to higher crude mortality and graft loss rates(33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections(9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy.CONCLUSION Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given.展开更多
Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered ...Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered： limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In China's Mainland, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.展开更多
BACKGROUND:An updated definition of early allograft dysfunction(EAD) was recently validated in a multicenter study of 300 deceased donor liver transplant recipients.This analysis did not differentiate between donation...BACKGROUND:An updated definition of early allograft dysfunction(EAD) was recently validated in a multicenter study of 300 deceased donor liver transplant recipients.This analysis did not differentiate between donation after brain death(DBD) and donation after cardiac death(DCD) allograft recipients.METHODS:We reviewed our prospectively entered database for all DBD(n=377) and DCD(n=38) liver transplantations between January 1,2006 and October 30,2011.The incidence of EAD as well as its ability to predict graft failure and survival was compared between DBD and DCD groups.RESULTS:EAD was a valid predictor of both graft and patient survival at six months in DBD allograft recipients,but in DCD allograft recipients there was no significant difference in the rate of graft failure in those with EAD(11.5%) compared with those without EAD(16.7%)(P=0.664) or in the rate of death in recipients with EAD(3.8%) compared with those without EAD(8.3%)(P=0.565).The graft failure rate in the first 6 months in those with international normalized ratio ≥1.6 on day 7 who received a DCD allograft was 37.5% compared with 6.7% for those with international normalized ratio <1.6 on day 7(P=0.022).CONCLUSIONS:The recently validated definition of EAD is a valid predictor of patient and graft survival in recipients of DBD allografts.On initial assessment,it does not appear to be a useful predictor of patient and graft survival in recipients of DCD allografts,however a study with a larger sample size of DCD allografts is needed to confirm these findings.The high ALT/AST levels in most recipients of DCD livers as well as the predisposition to biliary complications and early cholestasis make these parameters as poor predictors of graft failure.An alternative definition of EAD that gives greater weight to the INR on day 7 may be more relevant in this population.展开更多
Sperm donation in China is different from that in other countries due to cultural, social and political factors. This research presents the current status of sperm donation in China's Mainland and highlights some ...Sperm donation in China is different from that in other countries due to cultural, social and political factors. This research presents the current status of sperm donation in China's Mainland and highlights some problems. Between January 2003 and December 2009, 19 471 sperm donors were screened totally and 6467 donors （33.2%） were recruited. The primary reasons for non-recruitment were either inadequate semen parameters （55.0%） or positive results for sexually transmitted diseases （7.9%）. There were 327 （1.7%） qualified donors who withdrew from the program because of frustration related to failed semen parameters, participation merely for free medical tests or job transfer. A questionnaire investigating donor intention, as well as other concerns associated with sperm donation, was distributed to 516 potential donors. All potential donors indicated their primary motivation as altruism, while 90.9% mentioned monetary reward as a second motivating factor. Approximately 93.4% of donors expressed some apprehension about the risk of consanguineous mating and the protection of their identity. Over the past 7 years, 488 389 vials of donors＇ semen have been cryopreserved. In 36 438 artificial insemination with donor sperm （AID） cycles, the clinical pregnancy rate was 23.9% and the live birth rate was 16.6%, In 7148 in vitro fertilization cycles, the clinical pregnancy rate was 45.8% and the live birth rate was 35.2%. Human sperm banks have been strictly monitored to ensure that each sperm donor can only impregnate five women nationwide. There is still a large gap between the supply and demand for sperm donation which may be solved by updated guidelines.展开更多
文摘On the morning of 23 December 2024,the Panda Pack and Bike Donation Ceremony in Cambodia under the Action Plan on Silk Road People-to-People Connectivity was held at Balaing Khang Lech Primary School in Kampong Thom Province.Over 150 participants including Kemreat Viseth,Deputy Director of the Council of Ministers of Cambodia and President of Civil Society Alliance Forum(CSAF),Nhek Ban Kheng,Deputy Governor of Kampong Thom Province.
文摘The reform stems from honesty and determination. Since 2005, organ donation and transplantation in China has undergone thorough reform, which complies with legislation requirements and ethical principles established by the World Health Organization(WHO). Reform in China has demonstrated the unwavering confidence and utmost determination of the Chinese government and the Chinese transplantation community. The year 2015 marked a historic turning point when voluntary donations from Chinese citizens became the sole legitimate source for organ transplantation. Since 2015, China has gradually established and refined the “Chinese Mode” and “China System” for organ donation and transplantation, fulfilling its political pledge of reform, and has garnered international recognition, and fostered a social culture which promotes organ donation. This article reviewed the history of reform on organ donation and transplantation in China, presented a new pattern of establishment of organ donation system in the new era of the country, and the direction of advances in the future.
文摘China’s rice donation to Uganda’s drought-stricken Karamoja sub-region saves thousands from starvation.Afriend in need is a friend indeed,said Thomas Lokirut,an elder from Uganda’s Karamojong people after learning that China had donated 1,610 tonnes of rice to his people.
文摘BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes and barriers toward organ donation.METHODSA cross-sectional study was adopted and included 607 samples consisting ofstudents, faculty, and staff who were selected from three universities in Ajmanand who had signed consent forms. A validated self-administered questionnairethat included 13 attitudes and 14 barrier items was used as a tool. The reliabilityof the tool was 0.89 (Cronbach's alpha). In the analysis of attitude scores, responseswere rated on a scale from 0 to 4, with 0 representing 'strongly disagree'and 4 representing 'strongly agree' for supportive attitudes towards organdonation. Participants with a total attitude score of 39 or higher indicated agreementor strong agreement with all items, reflecting a generally supportiveattitude toward organ donation. Lower scores suggested that the respondent wasneutral or disagreed with one or more items, indicating a less supportive attitudetoward organ donation. Knowledge about organ donation was assessed by selfadministeredquestionnaire that included 13 items. Analysis was done using SPSSversion 29. χ2 was used to assess associations between variables.RESULTSMost participants were young (≤ 30 years old, 83.7%), female (79.2%), from World Health Organization Eastern Mediterranean Region countries (69.5%), Muslim (82.4%), students (80.6%), single(83.9%), and from a nursing college (33.1%). The majority had no personal or family history of organ donation(93.2% and 93.9%, respectively). Supportive attitudes toward organ donation were significantly associated withreligion (P = 0.003), working status (P = 0.009), university (P = 0.019), and knowledge (P < 0.001). Additionally,those with a personal or family history of organ donation were significantly more supportive (56.8% vs 33.3%, P =0.004). Lack of awareness was the most reported barrier for organ donation (64.1%) followed by being afraid oforgan donation due to medical procedures required (51.9%).CONCLUSIONThe findings suggest that supportive attitudes toward organ donation are influenced by demographic factors,personal experiences, and knowledge levels. Lack of awareness and fear of medical procedures were the mostreported barriers to organ donation. These results highlight the need for targeted educational programs to increaseawareness and promote positive attitudes toward organ donation.
文摘BACKGROUND Opioids are commonly used for management of post-operative pain in living kidney donors.Reducing exposure to opioids is desirable to minimize risk of dependence and potential side effects such as nausea,vomiting,and constipation which may delay discharge.Liposomal bupivacaine,ketorolac,and scheduled acetaminophen have all demonstrated efficacy for management of post-operative pain in this population.AIM To assess the efficacy and safety of an opioid-sparing protocol utilizing a multimodal pain management approach in living kidney donors post-nephrectomy.METHODS Single-center,retrospective chart review study examining 52 living kidney donors(26 pre-protocol implementation,26 post-protocol implementation)from May 24th,2019 to September 27th,2023.Patients in the post-protocol group received intraoperative liposomal bupivacaine,hydromorphone PCA(until able to tolerate oral medications),15 mg of intravenous ketorolac every 6 hours for 3 doses,and scheduled oral acetaminophen,in addition to oxycodone as needed for moderate to severe pain.The primary endpoint was oral morphine equivalent(OME)use within 48 hours post-surgery.Secondary endpoints include average daily pain scale within 48 hours post-surgery,length of stay(LOS)(days),and incidence of new acute kidney injury(AKI)or gastrointestinal(GI)bleed during admission per provider.Differences between the pre-and post-protocol implementation groups were compared utilizing the exact Wilcoxon test for continuous variables and either the Fisher’s Exact orχ^(2) test for categorical variables.RESULTS Patients in the pre-protocol implementation group received more OME(mg)within 48 hours post-surgery when compared to the post-protocol group(median:84.5 vs 69.0).The median of total OME over the course of admission was numerically greater the pre-protocol group(105.0 vs 69.0),and was significantly more per LOS(41.3 vs 25.7,P=0.02).Average daily pain score was not statistically significantly different between the two groups on postoperative day 1(median:5.3 vs 4.4;P=0.43)and post-operative day 2(median:4.7 vs 5.2;P=0.96).No significant differences were found in provider-identified incidences of AKI or GI bleeding during admission.There was no difference in serum creatinine at the time of discharge between the two groups.CONCLUSION A multimodal,opioid-sparing pain management protocol was as effective for pain control and resulted in significantly less opioid daily exposure over LOS.No adverse events were found related to use of ketorolac in patients undergoing donor nephrectomy.Our findings suggest that an opioid-sparing protocol is both safe and effective at minimizing opioid exposure and managing post-operative pain within the first 48 hours post-surgery.
文摘BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-making,are crucial factors in promoting awareness.Understanding their relationship can guide efforts to increase participation in organ donation.AIM To investigate the effect of health literacy on organ donation and transplantation awareness,with self-control acting as a mediator,and to emphasize its importance.METHODS The study comprised 345 adults recruited from five different cities in Türkiye.The sample included 208 women(60.29%)and 137 men(39.71%).The age range of the sample group varies between 18 and 49(median age=24.13;SD=8.81).Selfreport data were collected including psychometric measures assessing organ donation and transplantation awareness,health literacy,and self-control.Reliability analysis,descriptive statistics,correlational analysis,and mediational analysis of the data were carried.RESULTS The analysis showed that health literacy was positively correlated with organ donation and transplantation awareness(r=0.340)and self-control(r=0.376).Self-control was positively related to organ donation and transplantation awareness(r=0.531).Mediating analysis supported a mediation model where health literacy was found to influence organ donation and transplantation awareness via self-control(bootstrap=0.158,95%confidence interval=0.105-0.215).CONCLUSION The results indicate that self-control mediates the positive relationship between health literacy and organ donation and transplantation awareness.Enhancing individuals’health literacy may therefore increase awareness of organ donation and transplantation through improvements in self-control.
文摘BACKGROUND Marginal donation after circulatory death(DCD)liver grafts are carefully used to combat the constant shortage of donors.Clinically,the worst outcomes are mainly related to severe ischemia-reperfusion-injury and the dangerous effect of various inflammatory cytokines(CK).The machine perfusion(MP)is a promising device to rescue these grafts.AIM To analyze the role of MP connected to a sorbent cartridge(PerSorb®)and used for very damaged DCD pig livers.METHODS Seven grafts were procured from pigs from a slaughterhouse.Grafts were made very marginal with at least 60 minutes of donor warm ischemia time and 24 hours of static-cold ischemia time:(1)3 grafts were perfused in hypothermic MP with PerSorb(Sorb);(2)2 other grafts in hypothermic MP(HMP)without the cartridge(NoSorb);and(3)The other 2 livers stored in the ice box(NoTreat).The CK were measured at HMP start(T0)and at the end(Tend).Biopsies were taken at T0 and Tend.RESULTS All 5 grafts treated with HMP had a negative lactate trend after 3 hours of treatment(8.83 at T0 vs 6.4 at Tend of Sorb;15 at T0 vs 5.45 at Tend for NoSorb,P value>0.05).At Tend,both Sorb and NoSorb groups had better hemodynamic parameters,comparable between the two groups.Enzyme-linked immunosorbent assay analysis showed a reduction of monocyte chemotactic protein-1,tumor necrosis factor-alpha and interleukin-1βfor NoSorb group at Tend and a complete downregulation to physiological levels of the same CK in Sorb livers after 3 hours of treatment.Biopsies showed a reduction of the perisinusoidal edema for the Sorb grafts compared with the NoSorb livers.CONCLUSION These data suggest a potential protective role of treatment of grafts with MP and sorbent cartridge in reducing the inflammatory response after a severe ischemic injury.
文摘Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of data on this topic so far.In the present review, we assessed available evidence on quality metrics in solidorgan procurement in the United States and in Europe by means of a PubMedsearch. Evidence was summarized according to countries, considering that thedonation and transplantation systems differ from country to country. In UnitedStates, the assessment of these indicators is periodically performed by the nationalnetwork for organ sharing to evaluate the performance of each Organ ProcurementOrganization (OPO). Quality metrics consider several factors, in primispopulation characteristics (i.e. race/ethnicity, age, socio-economic status). That iswhy the assessment of each OPO performance relies on several quality metrics,not only one single indicator. In Europe, quality improvement programs representa structural element of organ and transplant system in several countries, but fewpapers have to date addressed the results obtained by a quality improvementprogram based on indicators. In Poland, the use of quality indicators and improvementprocedures were associated with better results in those hospitals whichimplemented these programs in respect to hospitals who did not. In TuscanyRegion (Italy) the implementation of a monitoring and reporting approach basedon indicators by the Regional Transplant Center was associated with an increasedin transplant and donation activity (especially in cDCD donors). According toavailable evidence, the development of a method for quality assessment andquality improvement has been recognized as pivotal for donation and transplantauthorities to identify key interventions either at national and/or hospital levels.
文摘BACKGROUND Knowledge about organ donation and transplantation plays a crucial role in shaping individuals'health behaviors and perceptions,potentially impacting their health-related quality of life(HRQoL).Future anxiety,defined as the anticipatory worry individuals experience regarding potential negative events and outcomes in their future,may further influence these outcomes.AIM To investigate the effect of such knowledge on HRQoL and to examine whether future anxiety mediates this relationship.METHODS A cross-sectional study was conducted with 659 participants aged 18 to 65 years.Participants completed the Organ Tissue Donation and Transplantation Knowledge Scale,the Dark Future Scale,and the European Health Interview Survey-Quality of Life 8.Correlation analyses were performed,followed by Structural Equation Modeling to test the proposed mediation model.RESULTS The findings indicated that greater knowledge about organ donation and transplantation was positively associated with higher HRQoL and negatively associated with future anxiety.Future anxiety was negatively correlated with HRQoL.Structural Equation Modeling analysis indicated that knowledge directly enhanced HRQoL and reduced future anxiety.Additionally,future anxiety negatively affected HRQoL,mediating the relationship between knowledge and HRQoL.The mediation effect was significant,as confirmed by bootstrapping(bootstrap coefficient=0.068,95%CI:0.046-0.093).CONCLUSION The study concludes that future anxiety partially mediates the positive impact of knowledge about organ donation and transplantation on HRQoL.These results suggest that increasing public knowledge in this area may reduce future anxieties and enhance quality of life.
文摘BACKGROUND The normothermic machine perfusion pump(NMPP)could shape the future of transplantation.Providing ex-vivo optimization,NMPP attenuates ischemic insult while replenishing energy.An understanding of machine perfusion time(MPT)impact and potential clinical benefits is paramount and necessitates exploration.AIM To investigate the relationship between MPT and post-transplant graft function.METHODS Retrospective review of the first 50 donation after circulatory death(DCD)grafts preserved using NMPP in a tertiary institution was performed.Essential preser-vation time points,graft parameters,recipient information,and postoperative outcomes were prospectively recorded.Early allograft dysfunction(EAD),L-Graft7 score and 90-day outcomes were collected for all grafts.The first 20 re-cipients were allocated into the early group,considered the learning curve population for the center.The subsequent 30 were allocated into the late group.Recipients were also stratified into cohorts depending on MPT,i.e.,short(<8 hours),medium(8-16 hours)and long(>16 hours).RESULTS NMPP operational parameters were not predictive of EAD,L-GrAFT7 or 90-day outcomes.The early group had significantly less MPT and cold ischemia time than the late group(553 minutes vs 850 minutes,P<0.001)and(127.5 minutes vs 154 minutes,P=0.025),respectively.MPT had no impact in either group.CONCLUSION Increased MPT of DCD liver grafts had no adverse recipient results for the times utilized in this population,indicating its upper limits,likely beyond 24 hours,are not demonstrated within this study.Future studies are necessary to determine whether longer MPT is beneficial or detrimental to graft function and,if the latter,what is the maximum safe duration.Further studies of the effect of normothermic machine perfusion pump duration on long-term outcomes are also needed.
文摘There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to con-trolled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function （DGF） and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that signifcantly infuences the outcome of allografts, for example, limiting it to 〈 12 h markedly reduces DGF. DCD kidneys from donors 〈 50 function like stan-dard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled dona-tion, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kid-neys from DCD include： implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.
基金Supported by Inonu University Scientific Research Projects Coordination Unit,No.2018/976.
文摘BACKGROUND The most important factors affecting attitudes on organ donation are socioeconomic, educational, cultural, and religious factors in many countries.AIM To evaluate the attitudes, awareness, and knowledge levels of the Turkish adult population toward organ donation.METHODS This nationwide study surveyed 3000 adults(≥ 18 years) in Turkey. To ensure a representative sample, the Nomenclature of Territorial Units for Statistics-Ⅱ(modified for Turkey) was used. Turkey was divided into 26 regions based on social, economic, and geographic criteria as identified by the Turkish Statistical Institute. A stratified sampling method was used with an even distribution of adults across cities and towns based on population data. Data were collected by the PRP Research and Consultancy Company using computer-assisted personal interviews.RESULTS Out of 3000 individuals represented in the study population, 1465(48.8%) were male and 1535(51.2%) female. The results showed that most participants were under 45 years(59.0%) and married(72.1%), some had a bachelor’s degree or higher(21.9%), and very few(1.5%) had any direct experience with organ transplantation-whether in the family, or a family member on a transplantation waiting list. Most of the study population(88.3%) had not considered donating an organ, however, most(87.9%) said that they would accept an organ from a donor if they needed one. Among the individuals surveyed, 67% were willing to donate an organ to a close relative, while 26.8% would donate an organ to an unrelated person. Only 47.2% said they had adequate information about brain death, and 85.2% refused to consent to donating organs of family members declared brain dead. Only 33.9% thought they had adequate information about organ donation. The main source of information was the television. The two main reasons for refusing organ donation were that it was too soon to think about organ donation and the importance of retaining the integrity of the dead person’s body.CONCLUSION This study showed that Turkey’s adult population has inadequate knowledge about organ donation. The study advocates for public education programs to increase awareness among the general population about legislation related to organ donation.
文摘AIM: To analyze the attitude of Spanish medical students toward living liver donation(LLD) and to establish which factors have an influence on this attitude.METHODS: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain(n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire(PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student′s t test, χ^(2 )test and logistic regression analysis.RESULTS: The completion rate was 95.7%(n = 9275). 89%(n = 8258) were in favor of related LLD, and 32%(n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude:(1) age(P = 0.008);(2) sex(P < 0.001);(3) academic year(P < 0.001);(4) geographical area(P = 0.013);(5) believing in the possibility of needing a transplant oneself in the future(P < 0.001);(6) attitude toward deceased donation(P < 0.001);(7) attitude toward living kidney donation(P < 0.001);(8) acceptance of a donated liver segment from a family member if one were needed(P < 0.001);(9) having discussed the subject with one's family(P < 0.001) and friends(P < 0.001);(10) a partner's opinion about the subject(P < 0.001);(11) carrying out activities of an altruistic nature; and(12) fear of the possible mutilation of the body after donation(P < 0.001).CONCLUSION: Spanish medical students have a favorable attitude toward LLD.
文摘At present, the huge problem that China’s Non-profit Organizations are facing is the low efficiency of public fundraising. However, the newly appeared Online Fundraising Platform indicates some possibilities in overcoming the obstacle for public fundraising. Among which Tencent Online Fundraising Platform becomes the typical and the point cut of exploring Online Fundraising Platform Improving Efficiency Mechanism of public donation. Online Fundraising Platform is similar to the online United Way, relying on the advantages of the Internet and the united fundraising to build a ecosystem of public donation which has professional fundraising system, good charity atmosphere, excellent policy environment and crossover cooperation resources. And in which, many factors get improved in pubic donation influence factors system. For one thing, Charity atmosphere and policy environment can be shaped better. For another, the charities can transmit fundraising information in inexpensive and high-efficiency way, and must ensure the transparency of project and donation. Finally, it will be more convenient for donors to get charitable information, make donations and supervise the nonprofit organizations.
文摘<b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:""><span style="font-family:Verdana;">This article is aiming to give an essential informative principle about the development of blood donation activities in Kyrgyzstan. </span><b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">The sequence of blood donation procedure steps before donation, during donation, and after donation w</span></span><span style="font-family:Verdana;">as</span><span style="font-family:""><span style="font-family:Verdana;"> shown and discussed. </span><b><span style="font-family:Verdana;">Methods/Materials: </span></b><span style="font-family:Verdana;">Rhesus factor determination in donors was achieved by </span></span><span style="font-family:Verdana;">“</span><span style="font-family:""><span style="font-family:Verdana;">COLICO” method which is based on the use of monoclonal antibodies solution. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">According to the</span><b> </b><span style="font-family:Verdana;">blood donation activity of donors in Osh, Kyrgyzstan for the 2018 year, it was found that gratuitous donors who donated blood in 6 months were 269, in 9 months were 366, and in 1 year were 499 people. Relative donors who donated blood in 6 months were 3480, in 9 months were 5100, and in 1 year were 6701 people. Active donors donated blood in 6 months were 12, in 9 months were 14 and in 1 year were 17 people. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">No agglutination was observed in any of the plates for the first blood group;agglutination was observed with anti-A monoclonal antibody solution for the second blood group;agglutination was observed with anti-B monoclonal antibody solution for the third blood group;agglutination was observed with both of anti-A and anti-B monoclonal antibody solutions for the fourth blood group.
文摘Introduction: Despite the progress recorded at the level of transfusion safety in Côte d’Ivoire, much remains to be done, particularly at the level of the medical selection of blood donors. The objective of the study was to make an assessment of the pre-donation capillary hemoglobin dosage for the year 2020 of the fixed collection, of the Blood Transfusion Center of Yamoussoukro. Method: This is a retrospective study that took place at the Yamoussoukro Blood Transfusion Center. The data collection related to all old and new blood donors were deemed suitable for the fixed collection of the year 2020. The method chosen for the pre-donation control is that of the portable hemoglobinometer of the HémoCue<sup>®</sup> type, more precisely 201+. Results: Of the 1160 blood donors in the study, the pre-donation hemoglobin level was not measured in 787 (67.8%) subjects of either sex. Of the subjects who had a pre-donation hemoglobin level performed, 97 (26%) blood donors had a sub-standard hemoglobin level, including 15 females and 82 males. Conclusion: Pre-donation hemoglobin testing of blood donors is effective in Yamoussoukro. However, efforts must still be made to improve the quality of the blood collected and to protect blood donors.
基金Supported by the New Xiangya Talent Project of The Third Xiangya Hospital of Central South University,No.20170311
文摘AIM To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients.METHODS We retrospectively studied the results of blood cultures among our donation after cardiac death(DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors' and patients' characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections.RESULTS Head trauma was the most common origin of death among our 67 DCD donors(46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria(70.6%). Only three(4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections,with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donorderived infections showed relation to higher crude mortality and graft loss rates(33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections(9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy.CONCLUSION Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given.
文摘Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered： limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In China's Mainland, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.
文摘BACKGROUND:An updated definition of early allograft dysfunction(EAD) was recently validated in a multicenter study of 300 deceased donor liver transplant recipients.This analysis did not differentiate between donation after brain death(DBD) and donation after cardiac death(DCD) allograft recipients.METHODS:We reviewed our prospectively entered database for all DBD(n=377) and DCD(n=38) liver transplantations between January 1,2006 and October 30,2011.The incidence of EAD as well as its ability to predict graft failure and survival was compared between DBD and DCD groups.RESULTS:EAD was a valid predictor of both graft and patient survival at six months in DBD allograft recipients,but in DCD allograft recipients there was no significant difference in the rate of graft failure in those with EAD(11.5%) compared with those without EAD(16.7%)(P=0.664) or in the rate of death in recipients with EAD(3.8%) compared with those without EAD(8.3%)(P=0.565).The graft failure rate in the first 6 months in those with international normalized ratio ≥1.6 on day 7 who received a DCD allograft was 37.5% compared with 6.7% for those with international normalized ratio <1.6 on day 7(P=0.022).CONCLUSIONS:The recently validated definition of EAD is a valid predictor of patient and graft survival in recipients of DBD allografts.On initial assessment,it does not appear to be a useful predictor of patient and graft survival in recipients of DCD allografts,however a study with a larger sample size of DCD allografts is needed to confirm these findings.The high ALT/AST levels in most recipients of DCD livers as well as the predisposition to biliary complications and early cholestasis make these parameters as poor predictors of graft failure.An alternative definition of EAD that gives greater weight to the INR on day 7 may be more relevant in this population.
文摘Sperm donation in China is different from that in other countries due to cultural, social and political factors. This research presents the current status of sperm donation in China's Mainland and highlights some problems. Between January 2003 and December 2009, 19 471 sperm donors were screened totally and 6467 donors （33.2%） were recruited. The primary reasons for non-recruitment were either inadequate semen parameters （55.0%） or positive results for sexually transmitted diseases （7.9%）. There were 327 （1.7%） qualified donors who withdrew from the program because of frustration related to failed semen parameters, participation merely for free medical tests or job transfer. A questionnaire investigating donor intention, as well as other concerns associated with sperm donation, was distributed to 516 potential donors. All potential donors indicated their primary motivation as altruism, while 90.9% mentioned monetary reward as a second motivating factor. Approximately 93.4% of donors expressed some apprehension about the risk of consanguineous mating and the protection of their identity. Over the past 7 years, 488 389 vials of donors＇ semen have been cryopreserved. In 36 438 artificial insemination with donor sperm （AID） cycles, the clinical pregnancy rate was 23.9% and the live birth rate was 16.6%, In 7148 in vitro fertilization cycles, the clinical pregnancy rate was 45.8% and the live birth rate was 35.2%. Human sperm banks have been strictly monitored to ensure that each sperm donor can only impregnate five women nationwide. There is still a large gap between the supply and demand for sperm donation which may be solved by updated guidelines.
