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1.
Minerva Anestesiol ; 82(3): 359-68, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26372113

RESUMO

Donation after circulatory death (DCD) is a valuable option for the procurement of functioning organs for transplantation. Clinical results are promising and public acceptance is quite good in most western countries. Yet, although DCD is widespread in Europe, several problems still persist in Italy as well as in some other countries. This paper aims to describe the main clinical, organisational, ethical and legal issues at stake, bearing in mind the particular situation created by Italian legislation. Currently, as regards DCD, Italy is somewhat different from other countries. Therefore, every effort should be made for the safe and effective implementation of DCD programs: uncontrolled DCD programs should be promoted and encouraged, within the framework of shared and authoritative rules. At the same time, we need to tackle the question of controlled DCD, promoting debate among all involved subjects regarding the fundamental issues of end-of-life care within protocols that best integrate the highest standard of care for the dying and the legitimate interests of those awaiting a life-saving organ.


Assuntos
Doadores de Tecidos/ética , Doadores de Tecidos/legislação & jurisprudência , Obtenção de Tecidos e Órgãos/ética , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Atitude , Morte , Humanos , Itália , Assistência Terminal , Doadores de Tecidos/psicologia
2.
G Ital Nefrol ; 27(1): 56-68, 2010.
Artigo em Italiano | MEDLINE | ID: mdl-20191461

RESUMO

A promising way to increase the number of kidneys for transplantation is to expand the donor pool by including non-heart-beating donors (NHBDs). The centers involved in NHBD transplantation programs have reported a 16-40% increase in kidney transplants. A key issue with NHBD is the significantly higher rate of delayed graft function (DGF) and primary non-function (PNF) compared with that associated with heart-beating donor (HBD) transplants. However, although transplants from NHBD are associated with a greater incidence of early adverse events, long-term graft survival appears to be similar to that observed after transplants from HBDs. In addition, the use of extracorporeal membrane oxygenation and mechanical perfusion, the careful selection of recipients and donors, and an adequate therapeutic strategy may at least partially reduce the risk of PNF and DGF and improve transplant outcome.


Assuntos
Parada Cardíaca , Transplante de Rim , Coleta de Tecidos e Órgãos , Obtenção de Tecidos e Órgãos/métodos , Morte Encefálica , Função Retardada do Enxerto , Sobrevivência de Enxerto , Humanos , Itália , Falência Renal Crônica/cirurgia , Transplante de Rim/mortalidade , Preservação de Órgãos/métodos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
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