ABSTRACT
BACKGROUND: The biological recovery of human skin allografts is the gold standard for preservation in Skin Banks. However, there is no worldwide consensus about specific allocation criteria for preserved human skin allografts with living cells. A report is presented on the results of 5 years of experience of using human skin allografts in burned patient in the Skin and Tissue Bank at the "Instituto Nacional de Rehabilitacion" MATERIAL AND METHODS: The human skin allografts were obtained from multi-organ donors. processed and preserved at -80 °C for 12 months. Allocation criteria were performed according to blood type match, clinical history, and burned body surface. RESULTS: Up to now, the Skin and Tissue Bank at 'Instituto Nacional de Rehabilitacion" has processed and recovered 125,000 cm(2) of human skin allografts. It has performed 34 surgical implants on 21 burned patients. The average of burn body surface was 59.2%. More than two-thirds (67.7%) of recipients of skin allografts were matched of the same to type blood of the donor, and 66.6% survived after 126 days hospital stay. CONCLUSION: It is proposed to consider recipient's blood group as allocation criteria to assign tissue; and use human skin allografts on patiens affected with burns over 30% of body surface (according the "rule of the 9").
Subject(s)
Cryopreservation , Organ Preservation , Skin Transplantation/methods , Skin , Adolescent , Adult , Allografts , Burns/microbiology , Burns/mortality , Burns/surgery , Child , Child, Preschool , Female , Graft Survival , Histocompatibility , Humans , Infant , Length of Stay , Male , Mexico , Middle Aged , Skin Diseases, Infectious/epidemiology , Skin Diseases, Infectious/microbiology , Skin Transplantation/statistics & numerical data , Tissue Banks , Tissue Donors , Tissue and Organ Harvesting , Treatment Outcome , Wound Infection/epidemiology , Wound Infection/microbiology , Young AdultABSTRACT
The cadaveric or donor-related transplant is a worldwide priority program. In Mexico, the human hospitalary resources primarily assigned to issues about donation and transplant are scarce. In our country, recent legal changes permit that undergraduate medicine students under University linking programs can be integrated in activities that guarantee a social profit, for example, the hospitalary donation coordination of the Mexican Institute of Social Security. This is a proposal with a legal framework, based in experiences of the Barcelona Provincial Hospital Clínic, that integrate undergraduate medicine students as monitors in the Hospitalary Donation Coordination area of the Mexican Institute of Social Security who are available 24 hours. During this social service stage, undergraduate medical students can benefit their community by optimizing potential for transplants via hospital organ donations.
Subject(s)
Tissue and Organ Procurement/organization & administration , Education, Medical, Undergraduate , Humans , Mexico , Social Medicine , Students, Medical , Tissue and Organ Procurement/legislation & jurisprudenceABSTRACT
El programa de donación de órganos y tejidos con fines de trasplante debe ser fortalecido y tener como objetivo principal incrementar la donación cadavérica, suceso que elevará el número de trasplantes y como consecuencia reducirá la cantidad de personas en lista de espera. En México las bajas tasas de donación son resultado de múltiples causas y los factores a modificar son también abundantes, entre lo que sobresale la negativa al solicitar el consentimiento familiar. La Coordinación de Donación de Órganos y Tejidos con Fines de Trasplante (CODOyT) recomienda una serie de puntos a desarrollar y afinar en cada hospital así como la elaboración de proyectos a corto, mediano y largo plazo para lograr el objetivo.
The Organ and Tissue Donation Program must be strengthened to increase the number of cadaveric donors, which will raise the number of transplantations and, therefore, decrease the national recipient waiting list. There are many reasons for the low rates of donation in Mexicol, and the factors that must be modified are also abundant, being the most prominent the lack of family authorization. The Coordination for Organ and Tissues Donation and Transplantation recommends some points to be developed and refined in every hospital, as well as the making of short-medium-and longterm projects to achieve the objective.
ABSTRACT
The cadaveric donation is not a programmed event. In the critical areas where exist a potential donating patient of organs and tissues initiate a cascade of actions in which medical, legal and social aspects are involved. The Program of Obtaining-Transplant organs and tissues began in 2004 with the creation of the Department of Coordination Donation for the training of personnel to lead this process. The diffusion of strategies used in these processes is the aim of this publication, as well as to describe the current difficulties to achieve an improvement in donation according to needs.
Subject(s)
Corneal Transplantation , Tissue and Organ Procurement , Humans , Tissue and Organ Procurement/methods , Tissue and Organ Procurement/organization & administration , Tissue and Organ Procurement/standardsABSTRACT
La insuficiencia renal aguda severa, es uno de los mayores componentes del síndrome de insuficiencia orgánica múltiple y es muy común en la UCI. Hasta hace poco, la falla renal aguda severa se trataba exclusivamente con terapias de reemplazo convencional de la función renal (hemodiálisis intermitente y/o diálisis peritoneal). El manejo de este problema con estas técnicas tiene varias limitaciones que pueden tener repercusiones negativas graves en el paciente crítico. La diálisis peritoneal por ejemplo, no permite un control adecuado de la azotemia o de la ultrafiltración, y a menudo causa pérdida de proteínas, hiperglucemia y peritonitis. La hemodiálisis intermitente se asocia a hipotensión, hipoxemia, hipoventilación, arritmias y agravamiento del edema cerebral. Recientemente, se ha introducido una amplia variedad de tratamientos continuos de reemplazo renal (TCRR), que se realizan con un circuito extracorpóreo sanguíneo y cierto tipo de hemofiltros. Estas técnicas son adecuadas como terapia substitutiva de la función renal del paciente crítico. Sus ventajas son: a) mantienen la estabilidad cardiovascular; b) el control hidroelectrolítico es fácil y flexible; c) permiten disponer de un espacio para la nutrición parenteral (sin requerir de recursos y unidades especializadas y personal experto en técnicas dialíticas). El uso de TCRR coincide con una reducción notable de la mortalidad. En este artículo se revisan las diferentes modalidades de TCRR
