RESUMO
Estatística geral de doação e transplantes de orgãos - Goiás, que tem como objetivo transcrever em números os resultados de todo o trabalho executado pela Gerência de Transplantes em Goiás
General statistics on organ donation and transplants - Goiás aims to transcribe into numbers the results of all the work carried out by the Transplant Management in Goiás
Assuntos
Humanos , Masculino , Feminino , Transplante de Órgãos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Transplante de Tecidos/estatística & dados numéricosRESUMO
OBJECTIVES: to analyze the trends and factors associated with family refusal of skin donation for transplantation. METHODS: this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance. RESULTS: 1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively. CONCLUSIONS: there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
Assuntos
Família , Obtenção de Tecidos e Órgãos , Humanos , Estudos Transversais , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Brasil , Adolescente , Criança , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/tendências , Obtenção de Tecidos e Órgãos/métodos , Família/psicologia , Pré-Escolar , Lactente , Doadores de Tecidos/psicologia , Doadores de Tecidos/estatística & dados numéricos , Transplante de Pele/estatística & dados numéricos , Transplante de Pele/tendências , Transplante de Pele/métodos , Transplante de Pele/psicologia , Idoso , Modelos LogísticosRESUMO
BACKGROUND: Thoracoabdominal normothermic regional perfusion (TA-NRP) has emerged as a powerful technique for optimizing organ procurement from donation after circulatory death donors. Despite its rapid adoption, standardized guidelines for TA-NRP implementation are lacking, prompting the need for consensus recommendations to ensure safe and effective utilization of this technique. METHODS: A working group composed of members from The American Society of Transplant Surgeons, The International Society of Heart and Lung Transplantation, The Society of Thoracic Surgeons, and The American Association for Thoracic Surgery was convened to develop technical guidelines for TA-NRP. The group systematically reviewed existing literature, consensus statements, and expert opinions to identify key areas requiring standardization, including predonation evaluation, intraoperative management, postdonation procedures, and future research directions. RESULTS: The working group formulated recommendations encompassing donor evaluation and selection criteria, premortem testing and therapeutic interventions, communication protocols, and procedural guidelines for TA-NRP implementation. These recommendations aim to facilitate coordination among transplant teams, minimize variability in practice, and promote transparency and accountability throughout the TA-NRP process. CONCLUSIONS: The consensus guidelines presented herein serve as a comprehensive framework for the successful and ethical implementation of TA-NRP programs in organ procurement from donation after circulatory death donors. By providing standardized recommendations and addressing areas of uncertainty, these guidelines aim to enhance the quality, safety, and efficiency of TA-NRP procedures, ultimately contributing to improved outcomes for transplant recipients.
Assuntos
Consenso , Preservação de Órgãos , Perfusão , Humanos , Perfusão/normas , Perfusão/métodos , Preservação de Órgãos/normas , Preservação de Órgãos/métodos , Doadores de Tecidos/provisão & distribuição , Transplante de Órgãos/normas , Transplante de Órgãos/métodos , Seleção do Doador/normas , Obtenção de Tecidos e Órgãos/normas , Obtenção de Tecidos e Órgãos/métodosAssuntos
Transplante de Rim , Doadores Vivos , Obtenção de Tecidos e Órgãos , Humanos , América Latina , Transplante de Rim/estatística & dados numéricos , Região do Caribe , Obtenção de Tecidos e Órgãos/organização & administração , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Doadores Vivos/provisão & distribuiçãoRESUMO
PURPOSE: We sought to characterize adaptive changes to the revised United Network for Organ Sharing donor heart allocation policy and estimate long-term survival trends for heart transplant (HTx) recipients. METHODS: Patients listed for HTx between October 17, 2013 and September 30, 2021 were identified from the United Network for Organ Sharing database, and stratified into pre- and postpolicy revision groups. Subanalyses were performed to examine trends in device utilization for extracorporeal membranous oxygenation (ECMO), durable left ventricular assist device (LVAD), intra-aortic balloon pump (IABP), microaxial support (Impella), and no mechanical circulatory support (non-MCS). Survival data post-HTx were fitted to parametric distributions and extrapolated to 5 years. RESULTS: We identified 27,523 HTx waitlist candidates during the study period, most of whom (n = 16,376) were waitlisted in the prepolicy change period. Overall, 19,554 patients underwent HTx during the study period (pre: 12,037 and post: 7517). Listings increased after the policy change for ECMO ( P < 0.01), Impella ( P < 0.01), and IABP ( P < 0.01) patients. Listings for LVAD ( P < 0.01) and non-MCS ( P < 0.01) patients decreased. HTx increased for ECMO ( P < 0.01), Impella ( P < 0.01), and IABP ( P < 0.01) patients after the policy change and decreased for LVAD ( P < 0.01) and non-MCS ( P < 0.01) patients. Waitlist survival increased for the overall ( P < 0.01), ECMO ( P < 0.01), IABP ( P < 0.01), and non-MCS ( P < 0.01) groups. Waitlist survival did not differ for the LVAD ( P = 0.8) and Impella ( P = 0.1) groups. Post-transplant survival decreased for the overall ( P < 0.01), LVAD ( P < 0.01), and non-MCS ( P < 0.01) populations. CONCLUSIONS: Allocation policy revisions have contributed to greater utilization of ECMO, Impella, and IABP, decreased utilization of LVADs and non-MCS, increased waitlist survival, and decreased post-HTx survival.
Assuntos
Bases de Dados Factuais , Transplante de Coração , Obtenção de Tecidos e Órgãos , Listas de Espera , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Listas de Espera/mortalidade , Adulto , Coração Auxiliar/estatística & dados numéricos , Doadores de Tecidos/provisão & distribuição , Taxa de Sobrevida/tendências , Oxigenação por Membrana Extracorpórea , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/terapia , Estudos Retrospectivos , Balão Intra-Aórtico/estatística & dados numéricosRESUMO
Introduction. The critical pathway for deceased donation offers a methodical framework for guiding the donation process. It not only serves to assess performance but also to identify areas of potential improvement. Therefore, the identification and selection of potential organ donors (POD) is a key process. This study aims to describe the critical pathway for deceased donation in a cohort of POD in three regions (CRT1, CRT2, and CRT5) of Colombia. Methods. We retrospectively reviewed data of POD assessed from January 2022 to December 2022. General characteristics of POD, diagnosis, contraindication causes, and organ procurement were described. Analysis was conducted using the Chi-squared test for categorical variables and the Mann-Whitney test for quantitative variables. Results. Within the cohort of 1451 assessed POD, 441 (30.3%) were diagnosed with brain death. Among potential donors after brain death, 198 (44.9%) were eligible donors (medically suitable). Of these, 157 donors (79.3%) became actual donors (undergoing operative incision for organ recovery), with 147 (93,6 %) having at least one organ recovered (actual donors with organ recovery). Ultimately, 411 utilized organs were utilized. Additionally, there were observed differences in the characteristics of donors from different regions. Conclusion. This study reports the critical pathway for deceased donation in a cohort of POD in three regions of Colombia. This provides useful information and helps to gain insight and understanding into the process of organ donation and organ procurement in order to take actions that could improve the donation rates.
Introducción. La ruta crítica de donantes fallecidos permite un enfoque sistemático para la donación de riñón, y, proporciona una herramienta para evaluar el rendimiento de áreas de mejora potencial. La selección de posibles donantes de órganos (PDO) es un proceso clave. El objetivo de este estudio fue describir la ruta crítica para la donación de fallecidos en una cohorte de PDO en tres regiones de Colombia. Métodos. Estudio retrospectivo de PDO evaluados durante 2022. Se describieron las características generales de los PDO, el diagnóstico y las causas de contraindicación. El análisis se llevó a cabo utilizando la prueba de Chi-cuadrado para las variables categóricas y la prueba de Mann-Whitney para las variables cuantitativas. Resultados. Entre los 1451 POD evaluados, 441 (30,3 %) fueron diagnosticados con muerte cerebral. De los posibles donantes después de la muerte cerebral, 198 (44,9 %) fueron donantes elegibles (adecuados desde el punto de vista médico). Entre ellos, 157 donantes (79,3 %) fueron donantes reales (en quienes se realizó una incisión operatoria con la intención de recuperar órganos) y 147 (93,6 %) tuvieron al menos un órgano recuperado (donantes reales con recuperación de órganos). Finalmente, se identificaron 411 órganos utilizados. Conclusión. Este estudio reporta la ruta crítica para la donación de fallecidos en una cohorte de POD en tres regiones de Colombia. Esto proporciona información útil, ayuda a obtener conocimientos y comprender el proceso de donación y obtención de órganos, para tomar medidas que puedan mejorar las tasas de donación.
Assuntos
Humanos , Doadores de Tecidos , Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Seleção do DoadorRESUMO
El presente documento propone una estrategia de comunicación para los organismos públicos de los Estados Miembros de la Organización Panamericana de la Salud, con el objetivo de contribuir a la implementación de la Estrategia y plan de acción sobre donación y acceso equitativo al trasplante de órganos, tejidos y células 2019-2030, aprobada en 2019 por los Estados Miembros, en el marco de su 57.º Consejo Directivo. Concretamente, este documento se centra en la línea de acción estratégica 2, dirigida a aumentar la disponibilidad de órganos, tejidos y células con base en la donación voluntaria no remunerada, que implica que no debe existir ningún beneficio económico a cambio de la donación y que el comercio de órganos, tejidos y células debe estar prohibido y su tráfico tipificado como delito en la legislación