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1.
Rev. panam. salud pública ; 48: e24, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1551018

ABSTRACT

ABSTRACT Objective. To obtain a comprehensive overview of organ donation, organ utilization, and discard in the entire donation process in Colombia. Methods. A retrospective study of 1 451 possible donors, distributed in three regions of Colombia, evaluated in 2022. The general characteristics, diagnosis, and causes of contraindication for potential donors were described. Results. Among the 1 451 possible donors, 441 (30.4%) fulfilled brain death criteria, constituting the potential donor pool. Families consented to organ donation in 141 medically suitable cases, while 60 instances utilized legal presumption, leading to 201 eligible donors (13.9%). Of those, 160 (11.0%) were actual donors (in whom operative incision was made with the intent of organ recovery or who had at least one organ recovered). Finally, we identified 147 utilized donors (10.1%) (from whom at least one organ was transplanted). Statistically significant differences were found between age, sex, diagnosis of brain death, and donor critical pathway between regions. A total of 411 organs were transplanted from 147 utilized donors, with kidneys being the most frequently procured and transplanted organs, accounting for 280 (68.1%) of the total. This was followed by 85 livers (20.7%), 31 hearts (7.5%), 14 lungs (3.4%), and 1 pancreas (0.2%). The discard rate of procured deceased donors was 8.1%. Conclusions. About one-tenth of donors are effectively used for transplantation purposes. Our findings highlight areas of success and challenges, providing a basis for future improvements in Colombia.


RESUMEN Objetivo. Presentar una descripción integral de la donación, utilización y descarte de órganos en todo el proceso de donación en Colombia. Métodos. Estudio retrospectivo de 1 451 donantes posibles, distribuidos en tres regiones de Colombia, que fueron evaluados en el 2022. Se describen las características generales, el diagnóstico y las causas de contraindicación de los donantes potenciales. Resultados. De los 1 451 donantes posibles, 441 (30,4%) cumplían con los criterios de muerte encefálica y constituyeron el conjunto de donantes potenciales. Las familias consintieron la donación de órganos en 141 casos aptos desde el punto de vista médico, mientras que en 60 casos se recurrió a la presunción legal, con lo que se llegó a 201 donantes aptos (13,9%). De estos, 160 (11,0%) fueron donantes reales (en los que se les practicó una incisión quirúrgica para la extracción de órganos o se obtuvo al menos un órgano). En última instancia, hubo 147 donantes utilizados (10,1%) (de los que se trasplantó al menos un órgano). Se observaron diferencias estadísticamente significativas entre las regiones en cuanto a edad, sexo, diagnóstico de muerte encefálica y vía crítica del donante. Se trasplantaron un total de 411 órganos procedentes de 147 donantes utilizados; los riñones fueron los órganos obtenidos y trasplantados con mayor frecuencia, ya que supusieron 280 (68,1%) del total de órganos, seguidos del hígado (85, 20,7%), el corazón (31 , 7,5%), los pulmones (14, 3,4%) y el páncreas (1, 0,2%). La tasa de descarte de los donantes fallecidos disponibles fue del 8,1%. Conclusiones. Aproximadamente una décima parte de los donantes son utilizados, de hecho, para realizar trasplantes. Estos datos destacan las áreas en las que se han obtenido buenos resultados y aquellas en las que se presentan desafíos, lo cual proporciona una base para futuras mejoras en Colombia.


RESUMO Objetivo. Obter uma visão geral e abrangente da doação, do aproveitamento e do descarte de órgãos em todo o processo de doação na Colômbia. Métodos. Estudo retrospectivo de 1 451 possíveis doadores em três regiões da Colômbia que foram avaliados em 2022. Foram descritas as características gerais, o diagnóstico e os motivos para a contraindicação de potenciais doadores. Resultados. Dentre os 1 451 possíveis doadores, 441 (30,4%) preencheram os critérios de morte encefálica, formando o grupo de potenciais doadores. Em 141 casos considerados clinicamente aptos, as famílias consentiram com a doação de órgãos, e em 60 casos utilizou-se o princípio da presunção legal, resultando em 201 doadores elegíveis (13,9%). Desses, 160 (11,0%) foram doadores efetivos (ou seja, doadores nos quais foi feita uma incisão cirúrgica com a intenção de remover um órgão ou pessoas com pelo menos um órgão removido). Por fim, foram identificados 147 doadores utilizados (10,1%) (ou seja, que doaram pelo menos um órgão que foi transplantado). Foram encontradas diferenças estatisticamente significantes entre idade, sexo, diagnóstico de morte encefálica e itinerário crítico de doação entre as regiões. Um total de 411 órgãos foram transplantados de 147 doadores utilizados. Os rins foram os órgãos mais frequentemente removidos e transplantados, representando 280 (68,1%) do total, seguido de 85 fígados (20,7%), 31 corações (7,5%), 14 pulmões (3,4%) e 1 pâncreas (0,2%). A taxa de descarte de doadores falecidos com órgãos removidos foi de 8,1%. Conclusões. Cerca de um décimo dos doadores são efetivamente usados para fins de transplante. Nossos achados destacam áreas de sucesso e desafios, oferecendo uma base para futuras melhorias na Colômbia.

2.
Acta Paul. Enferm. (Online) ; 37: eAPE001471, 2024. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1527577

ABSTRACT

Resumo Objetivo Analisar a recusa familiar de doação de córnea para transplante em uma Organização de Procura de Órgãos. Métodos Estudo quantitativo do tipo transversal sobre as recusas de córnea de doadores em situação de morte encefálica. A fonte de dados foi constituída pelos Termos de Autorização de Doação de Órgãos e Tecidos firmados entre janeiro de 2001 a dezembro de 2020 em uma Organização de Procura de Órgãos. Os dados foram coletados, tabulados e analisados de forma descritiva e inferencial. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados Dos 2.447 Termos de Autorização de Doação de Órgãos e Tecidos firmados no período, 620 (25.34%) recusaram a doação de córneas. Com relação à tendência temporal de recusas de doação de córneas, o único período que apresentou significância foi de 2001 a 2009, quando as faixas etárias de zero a 11 anos e 12 a 19 anos demonstraram tendência decrescente, e a faixa etária maior ou igual a 60 anos, mostrou-se crescente. No período total de 2001 a 2020, as faixas etárias dos 20 a 40 anos, 41 a 59 anos e maior ou igual a 60 anos apresentaram, 48%, 59% e 73%, respectivamente, menores chances de recusa da doação de córneas. Conclusão A faixa etária apresentou associação com a recusa, tendo em vista que os indivíduos de maior idade apresentaram maiores índices.


Resumen Objetivo Analizar la negativa familiar de donación de córneas para trasplante en una Organización de Búsqueda de Órganos. Métodos: Estudio cuantitativo tipo transversal sobre la negativa de córnea de donantes en situación de muerte encefálica. La fuente de datos estuvo compuesta por los Términos de Autorización de Donación de Órganos y Tejidos firmados entre enero de 2001 y diciembre de 2020 en una Organización de Búsqueda de Órganos. Se recopilaron los datos, luego se tabularon y se analizaron de forma descriptiva e inferencial. El presente estudio fue aprobado por el Comité de Ética en Investigación. Resultados De los 2447 Términos de Autorización de Donación de Órganos y Tejidos firmados en el período, 620 (25,34 %) negaron la donación de córneas. Con relación a la tendencia temporal de negativas de donación de córneas, el único período que presentó significación fue de 2001 a 2009, cuando los grupos de edad de 0 a 11 años y de 12 a 19 años demostraron una tendencia decreciente, y el grupo de edad mayor o igual a 60 años se mostró creciente. En el período total de 2001 a 2020, los grupos de edad de 20 a 40 años, de 41 a 59 años y mayor o igual a 60 años presentaron un 48 %, un 59 % y un 73 %, respectivamente, menor probabilidad de negativa de donación de córneas. Conclusión El grupo de edad presentó relación con la negativa, considerando que los individuos de mayor edad presentan mayores índices.


Abstract Objective To analyze family refusals to donate a cornea for transplantation in an Organ Procurement Organization. Methods This was a quantitative cross-sectional study on corneal donation refusals from potential brain-dead donors. The data source was based on the Terms of Authorization for Donation of Organs and Tissues signed from January 2001 to December 2020 in an Organ Procurement Organization. Data were collected, tabulated, and analyzed in a descriptive and inferential manner. The present study was approved by the Research Ethics Committee. Results Of the 2,447 Terms of Authorization for Donation of Organs and Tissues signed in the above period, 620 (25.34%) of them refused to donate a cornea. Regarding the time trend of corneal donation refusals, the period 2001-2009 was the only one that showed significance, when the 0-11 and 12-19 age groups showed a decreasing trend and that of 60 years or older showed an increasing trend. In the period 2001-2020, the age groups of 20-40, 41-59, and 60 years or older had lower rates of refusal to donate a cornea (48%, 59%, and 73%, respectively). Conclusion The age group is associated with refusal because older individuals had the highest refusal rates.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Tissue and Organ Procurement , Family , Cornea , Refusal to Participate , Cross-Sectional Studies
3.
Rev. enferm. UERJ ; 31: e72487, jan. -dez. 2023.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1525399

ABSTRACT

Objetivo: analisar as características epidemiológicas e causas da não efetivação do processo de doação de órgãos e tecidos de potenciais doadores em morte encefálica. Método: estudo transversal, com dados secundários do ano de 2019, obtidos de formulários de notificação de morte encefálica de pacientes com idade igual e superior a 18 anos, analisados descritiva e inferencialmente, após aprovação pelo comitê de ética. Resultados: notificadas 231 mortes encefálicas, com maior incidência de pessoas do sexo masculino, idade média de 48 anos e notificações dos hospitais públicos. Em Campo Grande, Mato grosso do Sul, observou-se maior número de notificações e o menor tempo entre a notificação e o primeiro exame clínico (RR: 4,01; IC 2,17-7,41; p<0,001). Entre os casos de não doação, 75,8% ocorreram por contraindicação médica e recusa familiar. Conclusão: houve predomínio de adultos jovens, não doadores de órgãos, cuja negativa da família deu-se pela vontade de manter o corpo íntegro.


Objective: to analyze the epidemiological characteristics and causes of non-completion of the organ and tissue donation process from potential brain-dead donors. Method: cross-sectional study, with secondary data from 2019, obtained from brain death notification forms of patients aged 18 years and over, analyzed descriptively and inferentially, after approval by the ethics committee. Results: 231 brain deaths were reported, with a higher incidence of males, average age of 48 years and notifications from public hospitals. In Campo Grande, Mato grosso do Sul, Brazil, there was a greater number of notifications and a shorter time between notification and the first clinical examination (RR: 4.01; CI 2.17-7.41; p<0.001). Among cases of non-donation, 75.8% occurred due to medical contraindication and family refusal. Conclusion: there was a predominance of young adults, non-organ donors, whose family's refusal was due to the desire to keep the body intact.


Objetivo: analizar las características epidemiológicas y las causas de la no finalización del proceso de donación de órganos y tejidos de potenciales donantes en muerte cerebral. Método: estudio transversal, con datos secundarios del año 2019, obtenidos de formularios de notificación de muerte encefálica de pacientes de 18 años y más, analizados de manera descriptiva e inferencial, previa aprobación del comité de ética. Resultados: Se reportaron 231 muertes encefálicas, con mayor incidencia de hombres, edad promedio de 48 años y notificaciones de los hospitales públicos. En Campo Grande, Mato grosso do Sul, hubo mayor número de notificaciones y menor tiempo entre la notificación y el primer examen clínico (RR: 4,01; IC 2,17-7,41; p<0,001). Entre los casos de no donación, el 75,8% se produjo por contraindicación médica y negativa familiar. Conclusión: hubo predominio de adultos jóvenes, no donantes de órganos, cuya negativa familiar se debió al deseo de mantener el cuerpo íntegro.

4.
Rev. colomb. cir ; 38(4): 689-696, 20230906. tab
Article in Spanish | LILACS | ID: biblio-1511119

ABSTRACT

Introducción. El trasplante es la mejor opción de tratamiento para los pacientes con enfermedad renal terminal, sin embargo, existe discrepancia entre las listas de espera y la disponibilidad de órganos a partir de la donación cadavérica. Buscando aumentar el número de órganos disponibles se implementó el trasplante con donante vivo. A partir de la introducción de técnicas mínimamente invasivas para la nefrectomía, el donante vivo ha logrado cifras cercanas al 50 % de los trasplantes realizados en muchas instituciones, debido a los beneficios propios del procedimiento. El objetivo de este estudio fue describir los resultados después de la incorporación del procedimiento totalmente laparoscópico en nuestra institución. Métodos. Se hizo un análisis retrospectivo de las características de los pacientes llevados a nefrectomía para obtención de injerto por técnica totalmente laparoscópica y los resultados en un solo centro en Cali, Colombia, desde noviembre de 2019 hasta octubre de 2022. Los datos fueron obtenidos mediante la revisión de las historias clínicas electrónicas. Resultados. Se realizaron 78 nefrectomías para obtención de injerto con técnica totalmente laparoscópica. El tiempo operatorio promedio fue de 152 minutos, el sangrado promedio fue de 12 ml, la estancia hospitalaria promedio del donante fue de 2,8 días. La tasa de complicaciones fue de 7,6 % (4 pacientes con complicación Clavien-Dindo I y 2 pacientes Clavien-Dindo IIIb). No se presentó ningún caso de mortalidad. Conclusiones. La técnica totalmente laparoscópica resulta ser una técnica segura con baja tasa de morbilidad y excelentes beneficios para los donantes.


Introduction. Kidney transplant is the best treatment option for end-stage renal disease. However, the discrepancy between waiting lists and the availability of organs from cadaveric donation is well known. Organ transplantation with a living donor was implemented to increase the number of organs available. Since the introduction of minimally invasive techniques for nephrectomy, living donors have achieved figures close to 50% of transplants performed in many institutions due to the procedure's benefits. In our country, the experiences described are from the hand-assisted technique. This is the first description after incorporating the laparoscopic procedure. Methods. A retrospective analysis of the characteristics and results of all patients undergoing nephrectomy to obtain a graft using a laparoscopic technique was carried at a single center in Cali, Colombia, from November 2019 to October 2022. The electronic medical records were reviewed to obtain the data. Results. Seventy-eight nephrectomies were performed to obtain a graft with a laparoscopic technique. The mean operating time was 152 minutes, the average bleeding was 12 cc, and the average hospital stay was 2.8 days. The complication rate was 7.6% (four patients with Clavien-Dindo I complication and two Clavien-Dindo IIIb patients). There were no cases of mortality. Conclusions. The laparoscopic technique is safe, with a low morbidity rate and excellent benefits.


Subject(s)
Humans , Kidney Transplantation , Laparoscopy , Nephrectomy , Transplantation , Tissue and Organ Procurement , Renal Insufficiency, Chronic
5.
Indian J Med Ethics ; 2023 Jun; 8(2): 128-133
Article | IMSEAR | ID: sea-222703

ABSTRACT

The study of the human anatomy predominantly requires the use of remains of the dead. Unclaimed bodies are easily available in India; however, there is a lack of clear ethical guidelines governing their transport and exchange. We raise pertinent questions about the ethical implications of using unclaimed bodies in teaching anatomy, their transport, transfer and storage, ethical and legal issues regarding the voluntary donation of bodies and dry human bones, as well as the commercial aspects of body donation. We also examine existing practices in anatomy departments in India, and explore the available legal safeguards. We detail practical and ethical challenges in the existing practices and safeguards and attempt to provide solutions.

6.
Article in Portuguese | LILACS, BDENF, SaludCR | ID: biblio-1430298

ABSTRACT

Introdução: O processo de doação de órgãos e tecidos é definido por ações a fim de transformar um Potencial Doador (PD) em doador efetivo e inicia-se com o diagnóstico de morte encefálica. Objetivo: Analisar o perfil clínico e sociodemográfico dos potenciais doadores de órgãos, como também os fatores que influenciam na doação de órgãos. Métodos: Trata-se de uma pesquisa quantitativa, transversal, retrospectiva e analítica realizada através da coleta de dados de 455 prontuários de pacientes com diagnóstico de Morte Encefálica, de uma Região do Nordeste brasileiro, utilizando formulário estruturado. Posteriormente realizaram-se análises descritivas e nas associações entre as variáveis independentes e dependente, utilizou-se o teste qui-quadrado de Pearson Resultados: As faixas etárias de maior incidência foram entre 21 a 40 anos e 41 a 60 anos, com 33,8% cada, prevalecendo o sexo masculino (64,1%). Em relação à causa da morte, predominou o Trauma Cranioencefálico com 36,5%. Foram entrevistados 83,3% dos familiares e desses, 53,5% autorizaram a doação. Quanto à relação das respostas das entrevistas com os familiares e o sexo dos PD o sexo masculino se destacou com 59,01% das entrevistas positivas, quanto a entrevista e faixa etária, não foram encontradas diferenças significativas. Correlacionando o resultado das entrevistas familiares e a causa da morte, 40,63% destas tinham como causa o trauma cranioencefálico, e desse total, 63,63% tiveram a doação autorizada. Conclusão: A maioria dos doadores efetivos foram jovens e do sexo masculino, com prevalência do trauma craneoencefálico como causa da morte encefálica e da aceitação familiar para a doação.


Introducción: El proceso de donación de órganos y tejidos se define por las acciones encaminadas a transformar a una persona donante potencial (DP) en donante efectiva. Este proceso comienza con el diagnóstico de muerte encefálica. Objetivo: Analizar el perfil clínico y sociodemográfico de potenciales donantes de órganos, así como los factores que influyen en la donación de órganos. Métodos: Se trata de una investigación cuantitativa, transversal, retrospectiva y analítica realizada a partir de la recopilación de datos de 455 prontuarios de pacientes con diagnóstico de muerte encefálica, en una región del Nordeste de Brasil, utilizando un formulario estructurado. Posteriormente, se realizaron análisis descriptivos y, en las asociaciones entre las variables independiente y dependiente, se utilizó la prueba chi-cuadrado de Pearson Resultados: Los grupos de edad con mayor incidencia fueron de 21 a 40 años y de 41 a 60 años, con un 33.8 % cada uno, con predominio del sexo masculino (64.1 %). En cuanto a la causa de muerte, predominó el trauma craneoencefálico con un 36.5 %. Se entrevistó al 83.3 % de familiares y, de este grupo, el 53.5 % autorizó la donación. En cuanto a la relación entre las respuestas de las entrevistas a familiares y el sexo del TP, se destacó el sexo masculino con un 59.01 % de las entrevistas positivas; en cuanto a la entrevista y grupo de edad no se encontraron diferencias significativas. Correlacionando los resultados de las entrevistas familiares y la causa de muerte, el 40.63 % fue por trauma craneoencefálico y, de ese total, el 63.63 % tenía autorizada la donación. Conclusión: Los donantes más efectivos fueron jóvenes y varones, con predominio del traumatismo craneoencefálico como causa de muerte encefálica y aceptación familiar de la donación.


Introduction: The process of organ and tissue donation is defined by actions to transform a Potential Donor (PD) into an effective donor and begins with the diagnosis of brain death. Objective: To analyze the clinical and sociodemographic profile of potential organ donors, as well as the factors that influence organ donation. Methods: This is a quantitative, cross-sectional, retrospective, and analytical research carried out in a region of Northeast Brazil by collecting data from 455 medical records of patients with brain death, who were diagnosed using a structured form. Subsequently, descriptive analyzes were carried out and for the associations between the independent and dependent variables, the Pearson's chi-square test was used. Results: The age groups with the highest incidence were between 21 to 40 years old and 41 to 60 years old, with a 33.8 % each, with a predominance of males (64.1%). Regarding the cause of death, traumatic brain injury was the most common with a 36.5% of the sample. From the 83.3% of the family members that were interviewed, 53.5% of them authorized the donation. Male potential donors constituted the 59.01% of the authorized donations (positive interviews). There was no relationship between the interview results and the age group of the PD. When correlating the results of family interviews and the cause of death, 40.63% of them were caused by traumatic brain injury and, out of this total, 63.63% had the donation authorized. Conclusion: The most effective donors were young and male whose cause of brain death was traumatic brain injury and whose families allowed the donation.


Subject(s)
Humans , Transplantation , Tissue and Organ Procurement/methods , Tissue Donors/statistics & numerical data , Brazil
7.
Cogitare Enferm. (Online) ; 28: e87978, Mar. 2023. tab
Article in Portuguese | LILACS-Express | LILACS, BDENF | ID: biblio-1520772

ABSTRACT

RESUMO Objetivo: Identificar os diagnósticos de enfermagem de potenciais doadores de órgãos em morte encefálica segundo a Taxonomia NANDA-I. Método: Estudo observacional, transversal realizado em hospital público no interior do Ceará, Brasil. Coleta de dados nos meses de outubro e novembro de 2021, em 23 prontuários de potenciais doadores de órgãos. Dados foram analisados por estatística descritiva. Resultados: Identificaram-se 22 diferentes diagnósticos, em cinco dos 13 domínios da taxonomia da NANDA-I. Prevaleceram: risco de glicemia instável; risco de função hepática prejudicada; troca de gases prejudicada; mobilidade no leito prejudicada; padrão respiratório ineficaz; risco de infecção; risco de lesão por pressão; risco de aspiração; risco de débito cardíaco diminuído; risco de quedas, eliminação urinária prejudicada; risco de desequilíbrio eletrolítico e risco de pressão arterial instável. Conclusão: A identificação dos diagnósticos poderá favorecer o aprimoramento da prática e a aplicação do processo de enfermagem diante da assistência aos potenciais doadores de órgãos.


ABSTRACT Objective: To identify the nursing diagnoses of potential organ donors in brain death according to the NANDA-I Taxonomy. Method: Observational, cross-sectional study conducted in a public hospital in the interior of Ceará, Brazil. Data collection was realized in October and November 2021 in 23 medical records of potential organ donors. Descriptive statistics analyzed data. Results: Twenty-two diagnoses were identified in five of the 13 domains of the NANDA-I taxonomy. The following were prevalent: risk of unstable blood glucose; risk of impaired liver function; impaired gas exchange; impaired bed mobility; ineffective breathing pattern; risk of infection; risk of pressure injury; risk of aspiration; risk of decreased cardiac output; risk of falls, impaired urinary elimination; risk of electrolyte imbalance and risk of unstable blood pressure. Conclusion: The identification of diagnoses may favor the improvement of practice and the application of the nursing process in the care of potential organ donors.


RESUMEN Objetivo: Identificar los diagnósticos de enfermería de los posibles donantes de órganos en muerte encefálica según la Taxonomía NANDA-I. Método: Estudio observacional, transversal, realizado en un hospital público del interior de Ceará, Brasil. Recogida de datos en octubre y noviembre de 2021, en 23 historias clínicas de posibles donantes de órganos. Los datos se analizaron mediante estadísticas descriptivas. Resultados: Se identificaron 22 diagnósticos diferentes, en cinco de los 13 dominios de la taxonomía NANDA-I. Predominaron los siguientes: riesgo de glucemia inestable; riesgo de deterioro de la función hepática; deterioro del intercambio gaseoso; deterioro de la movilidad en la cama; patrón respiratorio ineficaz; riesgo de infección; riesgo de lesión por presión; riesgo de aspiración; riesgo de disminución del gasto cardíaco; riesgo de caídas, deterioro de la eliminación urinaria; riesgo de desequilibrio electrolítico y riesgo de tensión arterial inestable. Conclusión: La identificación de diagnósticos puede favorecer la mejora de la práctica y la aplicación del proceso de enfermería en el cuidado de los donantes potenciales de órganos.

8.
Rev. colomb. cir ; 38(2): 323-329, 20230303. tab, fig
Article in Spanish | LILACS | ID: biblio-1425207

ABSTRACT

Introducción. La pandemia por COVID-19 ha causado la muerte de 6,5 millones de personas en el mundo y la donación de órganos se ha visto ampliamente afectada, reflejándose en una disminución importante en el número de trasplantes. Colombia no ha sido ajena a dicha problemática. Ante este desafío, el Instituto Nacional de Salud ha permitido tomar donantes cadavéricos con reacción en cadena de la polimerasa con transcripción reversa (RT-PCR) positiva para Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), sin enfermedad activa. El objetivo de este estudio fue describir una serie de pacientes trasplantados de riñón con donantes cadavéricos con RT-PCR SARS-CoV-2 positivo y sus principales desenlaces clínicos. Métodos. Serie de casos de pacientes que fueron llevados a trasplante renal con donante cadavérico con SARS-CoV-2 positivo, sin enfermedad activa, entre mayo y agosto de 2022. Se recolectaron las variables demográficas y clínicas y se evaluó la infección y la mortalidad asociada a SARS-CoV-2 en un mes de seguimiento. Resultados. Un total de 5 receptores de trasplante renal con 5 donantes cadavéricos SARS-CoV-2 positivos fueron evaluados. No se presentó mortalidad ni pérdida del injerto renal. Se registraron dos casos de función retardada del injerto y un caso de rechazo agudo. Ninguno de los pacientes presentó RT-PCR SARS-CoV-2 positiva en el seguimiento posterior al trasplante. Conclusión. Con nuestra serie de casos mostramos que el trasplante de riñón proveniente de donante cadavérico con prueba positiva para RT-PCR SARS-CoV-2, sin evidencia de enfermedad COVID-19 activa, es un procedimiento seguro y una estrategia eficaz para aumentar el número de donantes en pandemia


Introduction. Coronavirus Disease-2019 (COVID-19) pandemic have caused the death of 6.5 million of people worldwide. The organ donation was extremely affected reflecting in the number of transplants. Colombia has not been immune to this problem. Facing this challenge, the National Institute of Health (Instituto Nacional de Salud, INS) allowed to assign cadaveric donors with reverse transcription-polymerase chain reaction (RT-PCR) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive without COVID-19. We aim to describe a case series of kidney transplant patients with RT-PCR SARS-CoV-2 positive cadaveric donors, and their main clinical outcomes. Methods. A case series of five patients who underwent kidney transplantation of cadaveric donors with positive RT-PCR SARS-CoV-2 during the study period from May to august of 2022. Demographics and clinical characteristics were collected from the institutional medical records, and we evaluated the mortality and infection associated with SARS-CoV-2. Results. A total of five kidney transplant recipients and five cadaveric donors with positive RT-PCR SARS-CoV-2 were described in the present study. There were not mortality reported and none of the patients had graft loss. Two cases of delayed graft function and one case of acute kidney rejection were documented. None of the patients had positive RT-PCR SARS-CoV-2 in the follow-up. Conclusion. Our series demonstrated that the kidney transplant of cadaveric donors with positive RT-PCR SARS-CoV-2 without clinical evidence of active COVID-19 disease is a safe procedure and an efficient strategy to increase donors during a pandemic


Subject(s)
Humans , Kidney Transplantation , Coronavirus Infections , Donor Selection , Tissue and Organ Procurement , Pandemics
9.
Rev. adm. pública (Online) ; 57(1): 0-126, jan.-fev. 2023. tab, graf
Article in Spanish | LILACS | ID: biblio-1431419

ABSTRACT

Resumen La corrupción es un fenómeno con consecuencias desastrosas para el bienestar económico, social y político de nuestras sociedades. En particular, la contratación pública es vulnerable debido al elevado valor económico de sus transacciones. La presente investigación analiza el rol que las tecnologías de información pueden jugar en la lucha anticorrupción. Desarrollamos un caso basado en datos abiertos de contrataciones públicas en Costa Rica, con la finalidad de identificar los conceptos principales asociados al sistema de información subyacente. El caso muestra el potencial de las herramientas tecnológicas de análisis de redes sociales para contrarrestar la complejidad de las redes de corrupción. Asimismo, se evidencia la necesidad de disponer de un ecosistema rico en datos anticorrupción, preferiblemente en formato abierto.


Resumo: A corrupção é um fenômeno com consequências desastrosas para o bem-estar econômico, social e político das nossas sociedades. Em particular, a contratação pública é um fator altamente vulnerável devido ao alto valor econômico de suas transações. A pesquisa analisa o papel que as tecnologias da informação podem desempenhar no combate à corrupção. Além disso, desenvolvemos um caso baseado em dados abertos sobre compras públicas na Costa Rica, a fim de identificar os principais conceitos associados ao sistema de informação subjacente. O caso mostra o potencial das ferramentas tecnológicas de análise de redes sociais para ir de encontro a complexidade das redes de corrupção. Mostra também a necessidade de um ecossistema diversificado e sustentável de dados anticorrupção - preferencialmente em formato aberto.


Abstract Corruption has disastrous consequences for the well-being of societies. In particular, public procurement is a highly vulnerable factor due to the high value of its transactions. This research analyzes the role that information technologies can play in the fight against corruption. We developed a case based on open data on public procurement in Costa Rica to identify the main concepts associated with the underlying information system. The case shows the potential of technological tools for social network analysis to counter the complexity of corruption networks. It also shows the need for a rich ecosystem of anti-corruption data - preferably in an open format.


Subject(s)
Public Administration , Information Technology , Corruption
10.
São Paulo med. j ; 141(1): 60-66, Jan.-Feb. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1424649

ABSTRACT

ABSTRACT BACKGROUND: The coronavirus 19 (COVID-19) pandemic has reached services, systems, and world society. Despite its certified efficiency, the Brazilian National Transplant System is not exempt from the side effects of COVID-19. OBJECTIVE: To compare kidney transplantation activity registered in Brazil between the pandemic (2020) and pre-pandemic (2019) periods. DESIGN AND SETTING: A descriptive study was conducted in March 2021. The annual reports of the Brazilian Transplantation Registry for 2019 and 2020 were included in this study. METHODS: We conducted a descriptive study of kidney transplant activity in Brazil in 2019 and 2020. RESULTS: A 23.9% decrease in kidney transplants per million population was observed during the pandemic period (22.9 in 2020 versus 30.1 in 2019). Kidney transplants with a living donor (-58.8%) and in the North Region (-79.5%) experienced the greatest declines. The pandemic waiting list increased by 6.8%, and deaths during the waiting period increased by 36.8%. The number of patients on the waiting list and transplant teams decreased by 31.3% and 9.5%, respectively. CONCLUSION: The COVID-19 pandemic drastically affected Brazil and had a significant negative impact on KT activities in the country.

11.
Organ Transplantation ; (6): 485-2023.
Article in Chinese | WPRIM | ID: wpr-978489

ABSTRACT

High-quality development is the primary task of building a socialist modern country in an all-round way. Organ donation and transplantation in China are evolving from high-speed growth to high-quality development, which put forward new requirements for the safe, stable and healthy operation of Organ Procurement Organization (OPO). Safety is the foundation and prerequisite for achieving the goal of high-quality development. As an independent and comprehensive department, internal audit should create new achievements in the new era. The department should include OPO and organ donation into the scope of internal audit, shift the emphasis upon the overall development of organ donation. Besides, it should fully consider the actual situation in different places, conduct all-round, objective and fair evaluation, provide evaluation and consulting services for OPO to properly implement organ donation, and give full play to the supervision and prevention role of internal audit.

12.
Journal of Preventive Medicine ; (12): 448-451, 2023.
Article in Chinese | WPRIM | ID: wpr-973458

ABSTRACT

Abstract@#To further standardize the procurement management of reagents and consumables in disease control and prevention institutions in Zhejiang Province and facilitate incorruptible health building, the procurement management for reagents and consumables in Zhejiang disease control and prevention institutions was created by Zhejiang Provincial Center for Disease Control and Prevention in 2019. Based on three-layer architecture of SaaS, PaaS and IaaS, this platform, which is easy to perform, safe and practical, provides modular portal website services, and its main functions include procurement budget management, procurement plan management, order management, bidding management, contract management, execution-of-contract and acceptance, and payment management. This platform, which was initiated to be run on early 2020, was found to be improve the procurement efficiency, safe management costs, reduce the internal control risk, and facilitate the containment of COVID-19, which may provide the support to improving procurement management and laboratory capability in disease control and prevention institutions.

13.
China Pharmacy ; (12): 902-906, 2023.
Article in Chinese | WPRIM | ID: wpr-972257

ABSTRACT

OBJECTIVE To provide reference for the normalization of drug volume-based procurement (hereinafter referred to as “VBP”) and the establishment of local emergency management mechanism. METHODS Based on the equilibrium theory of the whole process of emergency management with Chinese conditions, referring to the “6+1” stage model, the emergency management mechanism of VBP was constructed; 21 provincial-level procurement projects in China from 2019 to 2022 were evaluated accordingly. RESULTS The emergency management mechanism of VBP including 14 measures in 7 stages of preparation, prevention, mitigation, response, recovery, learning and monitoring was successfully constructed. The total score of the 21 provincial-level procurement projects was 3 to 11 points, and the average score of each project in the past 4 years fluctuated slightly within 6 to 7 points. Among the 5 evaluated stages, the scores of the prevention and response stage were relatively high, followed by the mitigation and preparation stage, and the lowest in the recovery stage. Among the 11 rated emergency management measures, more than half had an average score greater than 0.5, but the average score of “determining alternative enterprise selection methods” was only 0.19. CONCLUSIONS Some emergency management measures of drug VBP are lacking, and the emergency management mechanism still needs to be perfected, which is not conducive to the development of emergency management work. The procurement organizer should focus on building a complete emergency management mechanism covering all stages, and clarify the specific measures at each stage, so as to ensure procurement effective and good in operation.

14.
China Pharmacy ; (12): 263-268, 2023.
Article in Chinese | WPRIM | ID: wpr-961655

ABSTRACT

OBJECTIVE To systemically sort out the main practices of local drug online procurement, so as to provide reference for national and local governments to improve drug online procurement policies and drug price formation mechanism. METHODS By searching the official websites of 31 provincial medical security bureaus and drug-centralized procurement platforms in China, the classification methods and main goals of local drug online procurement were summarized, then the main practices of local drug online procurement were analyzed based on the main goals, and corresponding suggestion was put forward. RESULTS & CONCLUSIONS There were two classification methods of online drug procurement in each province, one is based on online or purchase methods, and the other is based on drug dimensions. Five main objectives of online drug procurement in each province are to ensure reasonable drug prices, meet clinical drug demand, ensure stable drug supply, cooperate with the implementation of drug policies, and standardize the behavior of transaction subjects. In order to achieve the five goals, each province has taken some targeted measures, but the severity of the policy varies greatly. In order to further improve the online drug procurement policy and improve the market-oriented online drug price formation mechanism, it is suggested to build the top-level design of online drug procurement, strengthen the management of the price comparison relationship of similar drugs, give full play to the monitoring function of the drug-centralized procurement platform and establish a national unified drug-centralized procurement platform.

15.
Organ Transplantation ; (6): 120-2023.
Article in Chinese | WPRIM | ID: wpr-959029

ABSTRACT

Objective To explore the important factors influencing organ donation willingness and coordination effect of organ donation coordinators. Methods A questionnaire survey was conducted among 349 national organ donation coordinators by convenience sampling, including 145 males and 204 females, aged 27 (23, 36) years. Multiple linear regression and disordered logistic regression were used to investigate the important factors influencing the willingness to donate organs and coordination effects. Results Among 349 organ donation coordinators, 146 (41.8%) were willing to donate organs, including 101 (28.9%) who had signed the consent card for organ donation. Adequate awareness of organ donation laws, high education level, marital experience, and good self-perceived health status all showed positive effects on organ donation willingness of organ donation coordinators (all P < 0.05). High income, long length of service as organ donation coordinators, full-time mode of employment, high willingness to donate organs, and adequate awareness of donation conditions and donation procedures all showed positive effects on the coordination effect of organ donation coordinators (all P < 0.05). Conclusions The willingness to donate organs is increased as the higher awareness of organ donation laws of organ donation coordinators, while enhancing the willingness to donate organs of organ donation coordinators exerts positive impact upon improving the coordination effect of organ donation coordination. Therefore, an all-round organ donation coordinator training system should be established to improve the success rate of organ donation advocacy and promote the development of organ donation.

16.
Chinese Journal of Practical Nursing ; (36): 463-467, 2023.
Article in Chinese | WPRIM | ID: wpr-990203

ABSTRACT

Objective:To explore the employment experiences of coordinators of In-Hospital Organ Procurement Organization (OPO).Methods:Based on purpose sampling, 12 full-time In-Hospital OPO coordinators in Chongqing City were recruited from July to December 2020. A semi-structured and in-depth interview was performed and the data was analyzed by Colaizzi.Results:4 first-level themes were extracted, including professional identity process, negative emotional experience, improvement of professional practice competence and job expectancy. 12 second-level themes were identified including career expectations and identity confusion, professional values, shortage of respect and ratification, huge workloads, great psychological pressure, influence of the bereaved families, enhancement of the ability to communicate, improvement of problem-solving ability, improvement of team-work ability, optimization of scenario simulation, a perfection of the assessment system, a clear career path.Conclusions:In-Hospital OPO coordinators are lack of professional awareness in an initial stage. While feeling a sense of professional value, they also experience some negative emotions. Furthermore, their competences are improved in practice and they, meanwhile, express a strong desire for career development. It is suggested that the administrators could explore establishment of academic education, enhancement of psychological and social support, creation of pretty working environments and improvement of training, assessment and promotion systems to facilitate the career development of coordinators.

17.
China Pharmacy ; (12): 2278-2282, 2023.
Article in Chinese | WPRIM | ID: wpr-988791

ABSTRACT

OBJECTIVE To analyze the implementation of insulin centralized volume-based procurement policy (hereinafter referred to as “centralized procurement”) in our hospital and its effect on the use of insulin products in clinical. METHODS The manufacturer, specifications, usage, sales amount and agreed purchase volume of insulin products in our hospital before (July 4, 2021 to January 3, 2022) and after (July 4, 2022 to January 3, 2023) the centralized procurement were collected. The defined daily dose (DDD) method was used to calculate defined daily doses (DDDs), defined daily cost (DDC), the progress of procurement completion and actual cost saving. RESULTS After the centralized procurement, the number of insulin products had increased from 20 to 29 in our hospital; except for the Insulin degludec/aspart injection in our hospital’s original insulin catalog that had not been centrally purchased, all other existing varieties had been included in centralized procurement catalog. The use of Insulin aspart 30 injection produced by Novo Nordisk (China) Pharmaceutical Co., Ltd. always ranked the first place in the list of usage and DDDs before and after the centralized procurement. The sales amount of Insulin glargine injection produced by Ganli Pharmaceutical Co., Ltd. and Tonghua Dongbao Pharmaceutical Co., Ltd. increased significantly due to the significant increase in usage. The centralized procurement of Degu insulin injection from Novo Nordisk (China) Pharmaceutical Co., Ltd. had achieved a relatively high completion rate in our hospital’s original insulin catalog, while the completion rate for new varieties was low. After the centralized procurement, our hospital actually saved a total of 1 388 582.66 yuan in expenses. CONCLUSIONS After the centralized procurement, the selection and usage of insulin varieties in our hospital are reasonable, which saves patients’ insulin treatment costs, and reduces economic pressure on patients and society.

18.
China Pharmacy ; (12): 2177-2181, 2023.
Article in Chinese | WPRIM | ID: wpr-988773

ABSTRACT

OBJECTIVE To provide a reference for further improvement of the essential medicine system. METHODS Statistical analysis method and comparative analysis method were used to explain the necessity of coordination between the two systems from the direct correlation and indirect impact of centralized volume-based procurement on the essential medicine system at the present stage. The relevant suggestions were put forward for the development of the essential medicine system in the new era from the perspective of improving institutional synergy. RESULTS & CONCLUSIONS There was a direct correlation between the policy of centralized procurement and the essential medicine system in terms of policy objectives and medicines selection. However, it also indirectly affects the use of essential medicines in medical institutions through production and supply, coincidence degree between the essential medicine list and the selected variety, and the consistency evaluation of generic drugs. It is suggested that in the selection of essential medicine list in the future, priority should be given to the selection of varieties through centralized procurement, and improve the drug supply guarantee capacity under the dual policy linkage; at the same time, incentive assessments for the allocation and use of essential medicines by various entities should be further strengthened to promote the further improvement and development of the essential medicine system.

19.
China Pharmacy ; (12): 2057-2062, 2023.
Article in Chinese | WPRIM | ID: wpr-987131

ABSTRACT

Since the Guangdong alliance launched the centralized procurement of Chinese patent medicine, manufacturers have engaged in fierce price competition to obtain the qualification for selection. In order to ensure that manufacturers have lowered the price without decreasing quality, the evaluation criteria for the quality of Chinese patent medicine is constructed on the basis of the characteristics of traditional Chinese medicine. The evaluation criteria consist of the production process and therapeutic effect evaluation. The evaluation indicators involve raw materials, processing and clinical use covering the whole life cycle of Chinese patent medicine. The evaluation of production process includes 3 secondary indicators (the quality of traditional Chinese medicine, the quality of traditional Chinese medicine decoction pieces and the quality of Chinese patent medicines) and 13 tertiary indicators (standardized production, quality inspection, processing specifications, technical processes, safety risk control, etc.), which fully reflect the quality control of key links in the production of Chinese patent medicine. The therapeutic effect evaluation includes 5 secondary indicators (theoretical origin of formulation, proactive research by production enterprises, evidence-based medical evidence, clinical use, and technological embodiment) and 18 tertiary indicators (theoretical sources, post-market effectiveness re- evaluation, clinical guidelines, expert consensus, etc.) to assess the quality and efficacy of Chinese patent medicine from multiple perspectives and levels. This study is a useful supplement to the scheme of centralized procurement of Guangdong alliance, which can not only provide data support for selecting “low-cost and high-quality” Chinese patent medicine, but also provide information reference for hospitals to make procurement decisions.

20.
China Pharmacy ; (12): 769-773, 2023.
Article in Chinese | WPRIM | ID: wpr-969569

ABSTRACT

OBJECTIVE To analyze the situation and causes of the shortage of drugs in centralized volume-based procurement, and to put forward countermeasures and suggestions for optimizing centralized procurement rules and improving the drug shortage supply guarantee system. METHODS The shortage data of the first five batches of centralized purchasing drugs during January 2019 and December 2021 were collected from the Shortage Database of Chinese medicine economic information; descriptive statistical analysis was performed for shortage frequency, varieties and reasons. RESULTS & CONCLUSIONS After the first five batches of centralized volumetric procurement policy landed, the frequency of drug shortage reported for selected specifications and selected enterprises increased significantly, mainly drug shortage of selected enterprises. The shortage of some varieties from selected enterprises in the short term was obvious, and most of them were commonly used clinical drugs. The occurrence of drug shortages was affected by various links such as the production, circulation and use, and the main reasons were shortage or monopoly of raw materials. In order to ensure the drugs supply, the government should scientifically assess the risk of production interruption of enterprises, further optimize centralized procurement rules, improve the reporting system for drug shortages, and attach importance to the supply of key drugs; in addition, hospitals should take a variety of measures within the scopes of policies to flexibly respond to drug shortages so as to avoid delaying the treatment of patients.

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