ABSTRACT
PURPOSE: Studying the cognizance and hindrances of eye benefactors amongst relatives of post-mortem cases in an Indian tertiary referral centre. METHODS: This prospective study was executed at a tertiary hospital. In this examination, the relatives had been approached and counselled systematically. The responses had been noted in a predesigned proforma. Data regarding demographic details, socioeconomic status, prior knowledge of eye benefactor, willingness and reasons for refusing eye benefactor, literacy level, relationship with the deceased patient, and so on were collected. RESULTS: One hundred fifty-six potential donors had been identified from 845 post-mortem cases. Among these potential donors were 63 women and 93 men. Thirty-eight next of kin had been seen as already cognizant regarding eye benefactor; however, other 118 families were unaware. A total of 109 families refused to donate eyes while other 47 showed willingness for the procedure. It was seen that there was no influence on literacy status, socioeconomic status and prior knowledge regarding the concept of willingness to donate. CONCLUSION: Counselling for eye benefactor exercises a crucial role in procuring corneas. Socioeconomic status, literacy and prior understanding of eye donation had no link with donor corneal tissue procurement in our study. Even in families with no prior knowledge and poor socioeconomic status, active counselling can be successful.
ABSTRACT
Objective To investigate the conversion rate, organ procurement rate and influencing factors of organ donation in a single center from Fujian province. Methods Baseline data of 182 potential organ donors of Fujian Medical University Union Hospital from November 2018 to June 2021 were retrospectively analyzed. The conversion rate of organ donation, baseline data of successful organ donors and the causes of failure of organ donors were identified. The organ procurement rate and the influencing factors of the number of organ donations were analyzed. Results Among 182 potential organ donors, 46 cases were successful organ donors with a conversion rate of 25.3%. In addition, 136 cases failed to donate organ. The main causes included disagreement from family members (58.1%), insufficient evaluation time (24.3%) and ineligible for donation criteria (17.6%). A total of 212 large organs and tissues were donated by 46 organ donors, including 88 kidneys, 42 livers, 15 lungs, 19 hearts and 48 corneas, with 4.6 large organs and tissues, and 3.6 large organs for each donor. Age, sex, native place, organ donation area and blood type were the influencing factors of the number of large organ donations. Organ donation area was the influencing factor of the number of tissue donations. Conclusions The conversion rate of organ donation is relatively low in a single center from Fujian province. Disagreement from family members is the main cause. Suitable potential organ donors should be selected for organ donation to improve the conversion rate and organ procurement rate of organ donation.
ABSTRACT
BACKGROUND: An intensive lung donor-management protocol based on a strict protocol would increase the lung procurement rate. The aim of this study was to determine the effect of such a protocol on the rate of lung grafts available for transplant. METHODS: A lung-management protocol for donors after brain death (DBD) was implemented in 2009. Lung donors from 2009 to 2011 were the prospective cohort, and those from 2003 to 2008 formed the historical control. We analyzed the synergic effect of several measures, such as protective ventilation, ventilator recruitment maneuvers, high positive end-expiratory pressure, fluid restriction with reduced extravascular lung water values, and hormonal resuscitation therapy in multiorgan DBD. The number of lungs available for transplantation was the main outcome measure. For recipients, early survival and the rate of primary graft dysfunction (PGD) grade 3 were the main outcome measures. RESULTS: The DBD rate was more than 40 donors per 1 million population in both periods. The rate of lung donors increased from 20.1% to 50% (p < 0.001), quadrupling the number of lung donors (p < 0.001), grafts retrieved (p = 0.02), and patients who received a lung transplant (p < 0.01). No differences were observed in the survival of early recipients (p = 0.203) or in the rate of PGD grade 3 (p = 0.835). CONCLUSION: The management of multiorgan DBDs should be approached as a global treatment requiring attentive bedside management. Implementing an intensive lung donor-management protocol based on synergic measures increases lung procurement rates, negative effect on early survival of lung recipients or PGD grade 3.
