Modularity and Blended Methodology on Master Education for Donation and Transplantation.

Transplant Procurement Management and the University of Barcelona has offered a Master of Donation and Transplantation degree since 2004. The aim of this study is to analyze the number of participants, their profiles, and scores to evaluate improving measures introduced since 2011, when the modular structure was stablished. The data is organized in 3 groups: number of participants, profile, and scores in each module. The variables for the profile are gender, nationality, and background. According to the number of participants, 127 professionals were trained since 2011, with a decrease in the last classes (21; 20; 15). Regarding their profiles, from 2011 until 2016 the proportion of women was higher (63.13%). The background heterogeneity was an average of 4 different backgrounds in each edition, and medicine was most frequent background for students (58.27%). Participants were from 37 countries, mostly from the United States (45.6%) and Europe (40.9%). As for the scores, participants were evaluated in 4 modules (Donation, Transplantation, Management, and Tissue Banking), an internship, and a final master dissertation. The Donation module presented the lowest score (7.45/10) and the Transplantation module the highest (8.22/10). Considering that the main characteristics of the master's degree are the participants' internationality and heterogeneity, improvement measures must continue focusing on flexibility in the module selection and promoting the online modality.

Does the Pulsatile Preservation Machine Have Any Impact in the Discard Rate of Kidneys From Older Donors After Brain Death?

BACKGROUND: Donors after brain death (DBD) older than 60 years have become 46.8% of our current activity, with higher risk of renal discard rate (RDR). Assessment of kidney suitability requires complementary strategies: macroscopic evaluation, kidney biopsy score (KBS), and renal hemodynamic evaluation with the Pulsatile Perfusion Machine (PPM). METHODS: Descriptive, cross-sectional, comparative study of kidneys procured and RDR, comparing 3 time periods: 2000 to June 2004, when only KBS were used; July 2004 to 2008 (introduction of PPM and learning period); and 2009 to 2013 (experienced use of PPM). Transplantation criteria were KBS <3 and PPM renal resistance <0.4 mm Hg/mL/min and arterial renal flow >70 mL/min. RESULTS: Between 2000 and 2013, a 59.2% reduction in DBD kidneys was observed. However, older kidneys had an increase from 33.5% to 46.8%. The RDR had increased, comparing the first to the third period from 25.4% to 38.3%. However, the RDR was lower when kidneys were evaluated with PPM than those evaluated only with KBS and preserved in cold storage (CS) (21.4% versus 43.7%). There was a significant difference in cold ischemia time, because CS kidney was grafted before PPM. During the third period, more kidneys with KBS ≥4 were assigned to PPM. CONCLUSIONS: Notwithstanding the decrease in DBD-procured kidneys and the increase in older kidneys during last period, the use of PPM allowed low DR compared with CS. A bias in the results of PPM could be generated when kidneys with higher KBS were excluded from PPM. The use of KBS only to decide acceptance could preclude the use of an additional tool to evaluate suitability.