[Eligibility to a Maastricht III - type organ donation according to the protocol proposed by the French organ procurement organization (Agence de la biomedicine) among patients in a medico surgical intensive care unit]. / Potentiel de patients éligibles à un prélèvement d'organes de type Maastricht III dans le cadre du protocole de l'Agence de la biomédecine dans un service de réanimation polyvalente.

OBJECTIVE: Because of graft shortages, an experimental programme of organ donation after Maastricht 3-type circulatory death (M3) has been proposed by the French organ procurement organization (Agence de la biomedicine: ABM). The aim of the study was to estimate how many potential patients were eligible for an M3-type organ donation, amongst deceased patients who have had life-support withdrawn. PATIENTS AND METHODS: We conducted a retrospective study looking at the notes of deceased patients in a French general intensive care unit (ICU), where organ donation is arranged in DBD donors. RESULTS: Over the year 2013, 1475 patients were admitted in ICU and 215 died. One hundred and one patients were brain-injured and 26 of them died following a decision to withdrawn life-support and without contraindication to organ donation. Among them, 2 patients (8%) met the criteria for the French M3-type organ donation protocol. A 12.5% increase in organ donation activity of our team and five organ transplantations could have been considered. CONCLUSION: If M3 organ donation is considered, a significant increase in transplantation would be expected.

Treatment experience with 15 MeV fast neutrons in the oral cavity and oropharynx.

All 86 patients with squamous cell carcinoma of the oral cavity and oropharynx treated with fast neutrons at the Mid-Atlantic Neutron Therapy facility at the Naval Research Laboratory (MANTA) from its inception in 1976 until closing in 1979, are reported. Patients generally had advanced disease or have failed or were failing conventional treatment prior to being treated at MANTA. The fixed horizontal beam parameters were suboptimal. Patients were treated by either neutrons alone or various combinations of neutrons and photons. In patients with T3 or T4 primary carcinomas treated with less than 2100 neutron rad, only 37% (3/11) had a complete response at the primary compared to 57% (24/42) treated to a higher dose. However, there was a significant evidence of radiation related complication. The latter was expected in a phase I/II trial of a new modality such as fast neutrons. Isocentric hospital based cyclotrons should offer some hope of improvement in the future.

Treatment experience: locally advanced sarcomas with 15 MeV fast neutrons.

Experience with ten evaluable osseous sarcomas and ten evaluable advanced soft tissue sarcomas treated with neutrons of a mean neutron energy of 15 MeV are described. Neutron irradiation with or without conventional megavoltage radiotherapy is an effective modality in the treatment of these patients. No correlation between response rate and grade or whether fast neutrons alone or combined with megavoltage radiotherapy was noted. Those patients receiving a neutron dose of 2195 neutron plus gamma rads or greater all had a complete response.