This document outlines tasks and responsible roles for developing consensus recommendations on maximizing the use of organs recovered from cadaver donors. It proposes that each participant suggest two choices for each task to identify two individuals responsible for each task. Each task description would be made available online for editing by all participants. The draft divides tasks into areas like donor assessment, management, monitoring, organ preservation techniques, allocation protocols, and considerations for pediatric transplantations. Responsible roles would include clinicians, anesthesiologists, surgeons, and procurement agencies.
Cardiac Allograft Vasculopathy in Redo-Transplants- Is It More or Less (or) t...Anya Ragnhildstveit
This study examined the relationship between the MELD-XI score and mortality in patients who received an orthotopic heart transplant (OHT). The researchers analyzed data from over 27,000 OHT patients between 2002-2012 from the United Network for Organ Sharing database. They found that 22% of patients had a MELD-XI score over 17 at the time of transplant. Higher MELD-XI scores were associated with significantly lower 30-day, 1-year, and 5-year survival rates compared to those with lower scores. After adjusting for other factors, a high MELD-XI score remained an independent predictor of increased mortality at 30 days, 1 year, and 5 years following OHT. This large study demonstrates
Advancing Dialysis - Mineral and Bone Diseasenxstage
This document summarizes key findings from studies on intensive hemodialysis and its impact on mineral and bone disorder and phosphate binder use. It reports that intensive hemodialysis through daily or nocturnal treatment reduced serum phosphorus levels compared to conventional hemodialysis, where levels increased over time. Intensive hemodialysis also significantly reduced the need for and dosage of phosphate binders. In one study, the percentage of patients using any phosphate binders decreased from 97% at baseline to 27% after 10-12 months of intensive nocturnal hemodialysis.
Set di slides divulgative per la manifestazione della Regione Campania organizzata dal Monaldi- Azienda dei Colli- in supporto alla donazione di Organi in occasione della settimana della donazione 2018. #partenopedona
Corso formativo della Società italiana trapianti di organo.
Principi base ed evoluzione degli schemi immunosoppressivi nel trapianto di cuore dagli albori ad oggi: dai protocolli di centro alla medicina personalizzata.
A rapid overview of indications to Mechanical Circulatory Support in the Acute and Chronic Setting of Heart Failure concluding with the new horizons in LVAD therapy and Heart Replacement.
Slides from the first meeting of ECTTA held in Budapest. The presentation focused on the role of EUROMACS data in the expansion of knowledge on Mechanical Circulatory Support.
Cardiac Allograft Vasculopathy in Redo-Transplants- Is It More or Less (or) t...Anya Ragnhildstveit
This study examined the relationship between the MELD-XI score and mortality in patients who received an orthotopic heart transplant (OHT). The researchers analyzed data from over 27,000 OHT patients between 2002-2012 from the United Network for Organ Sharing database. They found that 22% of patients had a MELD-XI score over 17 at the time of transplant. Higher MELD-XI scores were associated with significantly lower 30-day, 1-year, and 5-year survival rates compared to those with lower scores. After adjusting for other factors, a high MELD-XI score remained an independent predictor of increased mortality at 30 days, 1 year, and 5 years following OHT. This large study demonstrates
Advancing Dialysis - Mineral and Bone Diseasenxstage
This document summarizes key findings from studies on intensive hemodialysis and its impact on mineral and bone disorder and phosphate binder use. It reports that intensive hemodialysis through daily or nocturnal treatment reduced serum phosphorus levels compared to conventional hemodialysis, where levels increased over time. Intensive hemodialysis also significantly reduced the need for and dosage of phosphate binders. In one study, the percentage of patients using any phosphate binders decreased from 97% at baseline to 27% after 10-12 months of intensive nocturnal hemodialysis.
Set di slides divulgative per la manifestazione della Regione Campania organizzata dal Monaldi- Azienda dei Colli- in supporto alla donazione di Organi in occasione della settimana della donazione 2018. #partenopedona
Corso formativo della Società italiana trapianti di organo.
Principi base ed evoluzione degli schemi immunosoppressivi nel trapianto di cuore dagli albori ad oggi: dai protocolli di centro alla medicina personalizzata.
A rapid overview of indications to Mechanical Circulatory Support in the Acute and Chronic Setting of Heart Failure concluding with the new horizons in LVAD therapy and Heart Replacement.
Slides from the first meeting of ECTTA held in Budapest. The presentation focused on the role of EUROMACS data in the expansion of knowledge on Mechanical Circulatory Support.
Asaio 2017: Predicting Right Ventricular Failure in CF-LVAD Era.Cristiano Amarelli
The ALMA score from Loforte et al. presented at the ASAIO meeting in Chicago on June 24th. An Useful Decision Supporting Tool available bedside to predict right ventricular failure and even to modify the surgical planning to support/protect right heart and warranting better outcome.
The document discusses short-term mechanical circulatory support devices like extracorporeal membrane oxygenation (ECMO) and the Impella pump. ECMO can be used to provide both cardiac and respiratory support through peripheral or central cannulation. It discusses indications, configurations, complications and management of ECMO. The Impella is an axial flow pump that is placed via catheter into the heart to unload the left ventricle and increase cardiac output, protecting the myocardium with less invasive placement compared to other devices.
Amarelli 313 Transplantation Ii Early Graft Failure After Heart Transplant Le...Cristiano Amarelli
The document discusses a study examining risk factors for early graft failure (EGF) within 24 hours of heart transplantation. The study analyzed 317 transplant recipients and identified factors significantly associated with EGF, including male sex, redo surgery, high donor inotrope use, weight mismatch over 20%, and longer ischemic time. EGF occurred in 32 patients (10.1%) and was associated with high mortality of 52.9%.
A 60-year-old female presented with an interventricular septum rupture following a myocardial infarction. Immediate surgical repair carried too high of a risk. She was stabilized with an extracorporeal membrane oxygenation (ECMO) device, which supported her cardiovascularly and allowed time for planning. After four days on ECMO, her condition worsened and she received a heart transplant. She recovered well and was discharged after one month with no complications at her six-month follow-up. The conclusion was that ECMO can effectively bridge high-risk patients with septal ruptures to surgery or transplantation.
This document discusses rehabilitation in heart transplant patients. It provides statistics on heart transplants performed from 1988-2006, including the most common causes of heart disease. It also discusses treatment at the time of transplant, trends in recipient characteristics, and survival rates post-transplant. Complications after transplant like hypertension, renal dysfunction, hyperlipidemia, diabetes and coronary altery disease are common. Exercise intolerance is also discussed. Rehabilitation including exercise training can help increase VO2 max and reduce complications like osteoporosis and obesity. Safety precautions during rehabilitation are also recommended.
This document discusses various topics related to heart transplantation including:
1. Older donor hearts exhibit a higher risk of developing coronary allograft vasculopathy (CAV) and worse long-term outcomes.
2. Hearts from older donors also show increased risk of renal dysfunction in recipients.
3. The use of everolimus in heart transplant recipients may provide benefits such as reduced risk of acute rejection and CMV infection while also being less nephrotoxic than calcineurin inhibitors. However, everolimus use can also increase risks like hyperlipidemia and impaired wound healing.
3. Recipient age is an important factor, as older recipients have higher risks of developing
The document summarizes the experience with extracorporeal membrane oxygenation (ECMO) and mechanical circulatory support (MCS) at the Department of Cardiothoracic Surgery and Transplants at Monaldi Hospital in Naples, Italy from 1988-2010. It provides statistics on heart transplants performed, details on 22 cases of ECMO support in 15 patients from 2007-2010, and discusses complications in 9 cases of ventricular assist devices implanted from 1995-2007. Surgical techniques for ECMO cannulation are also described.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Asaio 2017: Predicting Right Ventricular Failure in CF-LVAD Era.Cristiano Amarelli
The ALMA score from Loforte et al. presented at the ASAIO meeting in Chicago on June 24th. An Useful Decision Supporting Tool available bedside to predict right ventricular failure and even to modify the surgical planning to support/protect right heart and warranting better outcome.
The document discusses short-term mechanical circulatory support devices like extracorporeal membrane oxygenation (ECMO) and the Impella pump. ECMO can be used to provide both cardiac and respiratory support through peripheral or central cannulation. It discusses indications, configurations, complications and management of ECMO. The Impella is an axial flow pump that is placed via catheter into the heart to unload the left ventricle and increase cardiac output, protecting the myocardium with less invasive placement compared to other devices.
Amarelli 313 Transplantation Ii Early Graft Failure After Heart Transplant Le...Cristiano Amarelli
The document discusses a study examining risk factors for early graft failure (EGF) within 24 hours of heart transplantation. The study analyzed 317 transplant recipients and identified factors significantly associated with EGF, including male sex, redo surgery, high donor inotrope use, weight mismatch over 20%, and longer ischemic time. EGF occurred in 32 patients (10.1%) and was associated with high mortality of 52.9%.
A 60-year-old female presented with an interventricular septum rupture following a myocardial infarction. Immediate surgical repair carried too high of a risk. She was stabilized with an extracorporeal membrane oxygenation (ECMO) device, which supported her cardiovascularly and allowed time for planning. After four days on ECMO, her condition worsened and she received a heart transplant. She recovered well and was discharged after one month with no complications at her six-month follow-up. The conclusion was that ECMO can effectively bridge high-risk patients with septal ruptures to surgery or transplantation.
This document discusses rehabilitation in heart transplant patients. It provides statistics on heart transplants performed from 1988-2006, including the most common causes of heart disease. It also discusses treatment at the time of transplant, trends in recipient characteristics, and survival rates post-transplant. Complications after transplant like hypertension, renal dysfunction, hyperlipidemia, diabetes and coronary altery disease are common. Exercise intolerance is also discussed. Rehabilitation including exercise training can help increase VO2 max and reduce complications like osteoporosis and obesity. Safety precautions during rehabilitation are also recommended.
This document discusses various topics related to heart transplantation including:
1. Older donor hearts exhibit a higher risk of developing coronary allograft vasculopathy (CAV) and worse long-term outcomes.
2. Hearts from older donors also show increased risk of renal dysfunction in recipients.
3. The use of everolimus in heart transplant recipients may provide benefits such as reduced risk of acute rejection and CMV infection while also being less nephrotoxic than calcineurin inhibitors. However, everolimus use can also increase risks like hyperlipidemia and impaired wound healing.
3. Recipient age is an important factor, as older recipients have higher risks of developing
The document summarizes the experience with extracorporeal membrane oxygenation (ECMO) and mechanical circulatory support (MCS) at the Department of Cardiothoracic Surgery and Transplants at Monaldi Hospital in Naples, Italy from 1988-2010. It provides statistics on heart transplants performed, details on 22 cases of ECMO support in 15 patients from 2007-2010, and discusses complications in 9 cases of ventricular assist devices implanted from 1995-2007. Surgical techniques for ECMO cannulation are also described.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
9. Possible causes of so low extraction of heart donors:
• PERCEIVED INCREASE OF PGF RATES IN THE LAST DECADE (role of recipient profile)
• INCREASE OF THE HAZARD FOR PGF WITH THE INCREASE OF DONOR AGE
• IF LONG ISCHEMIC TIME ARE PROJECTED
• IF HIGH DOSAGE OF INOTROPES
• INADEQUATE AVAILABILITY OF DATA (ANGIOGRAPHY, FUNCTIONAL DATA ETC.)
• PERCEIVED CLINICAL STABILITY OF OUTPATIENT RECIPIENT
• PERCEIVED AVAILABILITY OF A SURGICAL BACKUP TO TRANSPLANT (MCS)
• NOT FOR ALL
• COMPLEX USE FOR BIVENTRICULAR FAILURE
27. DonorAssessment
At Harvesting Time
• Ischemic Time
• Age (in absence of coronaric lesions)
• Inotropic dosage
Are risk factors related to the actual gold
standard of myocardial preservation: Cold
Static Cardioplegic Solutions.
28.
29.
30. Donor Preservation
How:
• Cold Static
• Hypotermic Ex vivo
perfusion
• Normotermic Ex vivo
perfusion
When:
?
Physiopathology
of Brain Death
Who:
• Donor Agencies
• Transplant Centers
31. Methods
• Each of the partecipants to the Core Group should
purpose 2 choices for every task so to identify 2
responsibles for every task.
• Every task should be online on the dropbox open to
modifications by everyone (word revision mode) so the
responsibles of the tasks can accept or not modification
of each of the component of the consensus.
• Every task may be developed indipendently but
bibliographic service may be updated from every
partecipants at the best of his knowledge.
32. Draft of Tasks and Responsible Role
Tasks:
• Donor Assessment
• Donor Management
• Manage Modifiable Risk factors
• Donor Monitoring
• Brain Death Pathophysiology
and timing for harvesting
• Scouting Programs
• Organ Preservation (DBD/DCD)
• Donor Allocation Protocols
• Proposal of logistic models to
increase the rate of thoracic
Organs
• Specific Considerations about
pediatric transplantations
Who:
• Clinicians (cardiologist/pneumologists)
• Anesthesiologist
• Anesthesiologist/Surgeon
• Clinicians/Anesthesiologist
• Anesthesiologists
• Cardiologist/Anesthesiologist
• Surgeons/Anesthesiologist
• Procurement/Surgeons
• Procurement Agencies
• Surgeons