Effect of Interviews Done by Intensive Care Physicians on Organ Donation

PubMed ID: 28340798In this study, we examined the correspondence between intensive care unit physicians and the relatives of potential brain-dead donors regarding the decision to donate or the reasons for refusing organ donation. A total of 12 consecutive cases of potential brain-dead patients treated in intensive care units of Marmara University Pendik Education and Research Hospital in 2013 were evaluated. For each of the cases, the Potential Donor Questionnaire, and Family Notification, Brain Death Criteria Fulfilment and Organ Donation Conversation Questionnaires were used to collect the required data. Statistically, descriptive analyses were performed. We concluded that honestly, regularly, and sufficiently informed relatives of the potential brain-dead donor more readily donate organs, with a positive contribution from the intensive care physician. © 2017 Elsevier Inc

Donor Contraindications to Living Kidney Donation: A Single-Center Experience

Objective Kidney transplantation is the treatment of choice in end-stage renal disease. In Turkey, the inadequate cadaveric donor supply has resulted in transplantation from living kidney donors (LKD) in 80% of transplant operations. LKD candidates undergo a thorough general medical evaluation and are approved to donate their kidneys only if no contraindication is found. In our study we aimed to investigate the reasons and rate of denial for living kidney donation in our center. Methods We included all LKD candidates who applied to our center between June 2012 to June 2014. Demographic data, rate of rejection, and the reasons for denial to organ donation were analyzed retrospectively. Results Of the 97 LKD candidates included in the study, 60 (62%) were unable to donate their kidneys. Among the reasons for denial were hypertension with target organ damage in 30% (n = 18), immunologic reasons in 23% (n = 14), impaired renal function in 20% (n = 12) cardiovascular reasons 13.3% (n = 8), diabetes mellitus in 10% (n = 6), malignity in 10% (n = 6), obesity (body mass index > 35 kg/m2) in 5% (n = 3), and miscellaneous in 18.3% (n = 11). There were >1 reasons in 13 candidates. Conclusions The problems detected in donor candidates offer a possibility for early detection of disorders and increased awareness. © 2015 Elsevier Inc. All rights reserved

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P < 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients