Texas non-donor-hospital project: a program to increase organ donation in community and rural hospitals.

Identifying and recovering donors from community and rural hospitals present a challenge to organ procurement organizations. A study of non-donor hospitals in the United States was undertaken at Johns Hopkins University, which identified 31 hospitals (in one service area) with the facilities to accommodate organ donation, though an organ donor had not been produced in 3 years. The purpose of this study was to determine whether donors could be produced from these hospitals. A large, geographically dispersed OPO initiated a program consisting of (1) in-house coordinators, and (2) routine notification of all hospital deaths. Following implementation of this program, organ donation increased 387% among the targeted 25 hospitals. The number of hospitals producing at least 1 organ donor increased 133%. The number of organs recovered in the project increased 449%. In-house coordinators, by identifying potential donors and facilitating an organ donor awareness program, can increase the number of organ donors in hospitals with low, but real, donor potential.

Comparison of two prostaglandins used to terminate midtrimester pregnancy.

One of the most widely used methods of pregnancy termination has involved the use of prostaglandin drugs. Vaginal suppositories containing prostaglandin E2 (PGE2) have been used successfully by many investigators. Because of problems with a long delay between induction and abortion, as well as minor side effects, other prostaglandin agents have been tested. In our study, 17 matched patients given PGE2 vaginal suppositories to induce abortion were compared with a similar group in whom the methyl ester of prostaglandin F2 alpha ( MPGF2 alpha) was used. There was no statistically significant difference between the two groups in side effects, number of patients requiring curettage, or placental expulsion time. Patients treated with PGE2 had a shorter fetal expulsion time (P less than .001), and there were no major complications in either group. It appears from these data that multiple PGE2 vaginal suppositories are equal to or better than the newer single MPGF2a suppository followed by intramuscular injections when used for second trimester terminations.