Anti-factor B autoantibody in dense deposit disease

Dense deposit disease (DDD), also known as membranoproliferative glomerulonephritis type II, is a rare kidney disorder that is associated with dysregulation of the alternative pathway of complement. Autoantibodies against the C3bBb convertase termed C3 nephritic factor are common in DDD patients. Here we report an autoantibody that binds to complement factor B in a DDD patient who was negative for C3 nephritic factor. This anti-factor B autoantibody recognized an epitope within the Bb fragment and was able to bind to the C3bBb convertase. Upon binding, the anti-factor B autoantibody stabilized the convertase against both intrinsic and factor H-mediated extrinsic decay and thus enhanced C3 consumption. Functional analyses demonstrated that, in contrast to C3 nephritic factor, the anti-factor B autoantibody inhibited complement-mediated lysis in vitro due to inhibition of the C5 convertase and the terminal complement pathway. Analysis of C5a plasma levels indicated that not all C5 convertases are inhibited by the autoantibodies in the patient in vivo. Antigen array experiments confirmed the presence of anti-factor B autoantibodies and also revealed complement activating anti-C1q antibodies in the patient's plasma. In summary, the present report describes a new autoantibody in DDD that binds to factor B and to the alternative pathway C3 convertase and alters the kinetics of complement activation and regulation. (C) 2010 Elsevier Ltd. All rights reserved

Efficacy of long-term oral telmisartan treatment in cats with hypertension: Results of a prospective European clinical trial

BACKGROUND: Efficacy of telmisartan in treating hypertension (HT) in cats has not been largely investigated. OBJECTIVE: Telmisartan oral solution effectively controls systolic arterial blood pressure (SABP) in hypertensive cats. ANIMALS: Two-hundred eighty-five client-owned cats with systemic HT. METHODS: Prospective, multicenter, placebo-controlled, randomized, double-blinded study. Hypertensive cats diagnosed with SABP ≥160 mmHg and ≤200 mmHg without target-organ-damage were randomized (2 : 1 ratio) to receive 2 mg/kg telmisartan or placebo q24 PO. A 28-day efficacy phase was followed by a 120-day extended use phase. Efficacy was defined as significant difference in mean SABP reduction between telmisartan and placebo on Day 14 and group mean reduction in SABP of > 20 mmHg by telmisartan on Day 28 compared to baseline. RESULTS: Two-hundred fifty-two cats completed the efficacy and 144 cats the extended use phases. Mean SABP reduction at Day 14 differed significantly between groups (P < .001). Telmisartan reduced baseline SABP of 179 mmHg by 19.2 (95% confidence interval [CI]: 15.92-22.52) and 24.6 (95% CI: 21.11-28.14) mmHg at Days 14 and 28. The placebo group baseline SABP of 177 mmHg was reduced by 9.0 (95% CI: 5.30-12.80) and 11.4 (95% CI: 7.94-14.95) mmHg, respectively. Of note, 52% of telmisartan-treated cats had SABP <150 mmHg at Day 28. Mean SABP reduction by telmisartan in severe (≥180 mmHg) and moderate HT (160-179 mmHg) was comparable and persistent over time. CONCLUSIONS AND CLINICAL IMPORTANCE: Telmisartan solution (PO) was effective in reducing SABP in hypertensive cats with SABP ≥160 mmHg and ≤200 mmHg

Profibrotic effects of angiotensin II and transforming growth factor beta on feline kidney epithelial cells

OBJECTIVES: The aim of this study was to evaluate the role of angiotensin II (AT-II) and its main mediator, transforming growth factor beta 1 (TGF-β1), in the development of feline renal fibrosis. METHODS: Expression of marker genes indicating epithelial-to-mesenchymal transition (EMT), profibrotic mediators and matricellular proteins was measured in feline kidney epithelial cells (Crandell Rees feline kidney [CRFK] cells) after incubation with AT-II and/or TGF-β1. RESULTS: Cells incubated with TGF-β1 or the combination of TGF-β1 with AT-II showed clear EMT with more stretched fibroblastic cells, whereas the cells incubated without TGF-β1 and AT-II (control) showed more epithelial cells. Gene expression of collagen type I ( COL1), tenascin-C ( TNC), trombospondin-1 ( TSP-1), connective tissue growth factor ( CTGF) and alpha-smooth muscle actin ( α-SMA) increased significantly after incubation of the CRFK cells with TGF-β1 or TGF-β1 in combination with AT-II for 12 h. As incubation of the CRFK cells with only AT-II did not show any significant rise in gene expression of the above-mentioned genes, this was further investigated. In contrast to healthy feline kidney tissue, CRFK cells showed almost no expression of the AT-II type 1 (AT1) receptor. CONCLUSIONS AND RELEVANCE: TGF-β1 significantly induced expression of the EMT marker gene α-SMA, profibrotic mediator CTGF, and fibrogenic proteins COL1, TNC and TSP-1 in CRFK cells. The effect of TGF-β1 on myofibroblast formation was also observed by the stretched appearance of the CRFK cells. As CRFK cells expressed almost no AT1 receptors, this cell line proved not suitable for testing the efficacy of drugs that interact with the AT1 receptor. As AT-II stimulates the effects of TGF-β1 in mammals, the results of this study suggest an indirect profibrotic effect of AT-II besides the demonstrated profibrotic effect of TGF-β1 and thus the development of feline renal fibrosis. Modulation of EMT or proliferation of myofibroblasts could serve as a diagnostic tool and a novel therapeutic target to inhibit renal fibrogenesis, and could possibly serve in the therapy of feline renal fibrosis

Comparison of Efficacy of Long-term Oral Treatment with Telmisartan and Benazepril in Cats with Chronic Kidney Disease

Background: The efficacy and benefits of telmisartan in cats with chronic kidney disease (CKD) have not previously been reported. Hypothesis: Long-term treatment of cats with CKD using telmisartan decreases urine protein-to-creatinine ratio (UP/C) similar to benazepril. Animals: Two-hundred and twenty-four client-owned adult cats with CKD. Methods: Prospective, multicenter, controlled, randomized, parallel group, blinded clinical trial with noninferiority design. Cats were allocated in a 1 : 1 ratio to either telmisartan (1 mg/kg; n = 112) or benazepril (0.5-1.0 mg/kg; n = 112) PO q24 h. The primary endpoint was prospectively defined as the change in proteinuria (benazepril:telmisartan) based on a log transformed weighted average of UP/C change from baseline (AUC 0?t/t) as a percentage compared using a confidence interval (CI) approach. Changes of UP/C from baseline were assessed on all study days and corrected for multiple comparisons. Results: Telmisartan proved noninferior to benazepril in controlling proteinuria (CI, À0.035 to 0.268). At Day 180, UP/C compared to baseline in the telmisartan group was significantly lower (À0.05 AE 0.31; P = .016), whereas in the benazepril group the change (À0.02 AE 0.48) was not statistically significant (P = .136). Similar results were obtained at all assessment points with significant decrease in UP/C occurring with telmisartan but not benazepril. Conclusion and Clinical Importance: Both telmisartan and benazepril were well tolerated and safe. Telmisartan proved to be noninferior to benazepril and significantly decreased proteinuria relative to baseline at all assessment points whereas benazepril did not

The Drosophila Zinc Finger Protein Trade Embargo Is Required for Double Strand Break Formation in Meiosis

Homologous recombination in meiosis is initiated by the programmed induction of double strand breaks (DSBs). Although the Drosophila Spo11 ortholog Mei-W68 is required for the induction of DSBs during meiotic prophase, only one other protein (Mei-P22) has been shown to be required for Mei-W68 to exert this function. We show here that the chromatin-associated protein Trade Embargo (Trem), a C2H2 zinc finger protein, is required to localize Mei-P22 to discrete foci on meiotic chromosomes, and thus to promote the formation of DSBs, making Trem the earliest known function in the process of DSB formation in Drosophila oocytes. We speculate that Trem may act by either directing the binding of Mei-P22 to preferred sites of DSB formation or by altering chromatin structure in a manner that allows Mei-P22 to form foci

Post-meiotic transcription in mouse testes detected with spermatid cDNA clones

cDNA clones to poly(A) + mRNA from spermatids have been obtained to study gene transcription in post-meiotic germ cells. Four cDNA clones detect mRNAs that increase in abundance in post-meiotic germ cells. One clone, pPM459, was shown to correspond to an mRNA that is transcribed after meiosis. Pulse-labelling experiments demonstrate transcription o5 the message in spermatids. These data constitute further evidence for post-meiotic gene transcription in spermatids.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44190/1/10540_2005_Article_BF01116696.pd

Opinions and Attitudes towards Organ and Tissue Donation 2018

Knowledge, information and attitudes about organ and tissue donation. Dealing with the topic of organ donation in the family and circle of friends. Experiences with organ and tissue donation. Topics: 1. Trust in the German health system. 2. Knowledge and attitudes towards organ and tissue donation: determination of the willingness to donate (by entry in a donation register, completion of an organ donation card, notification of the decision to the relatives, notification to the family doctor, notification to the health insurance company, by a living will); knowledge of the contents of the organ donation card (consent to the removal of organs without exception, exclusion of certain organs from the donation, only removal of certain organs, general objection to the removal of organs or tissue, certain person should decide on the removal of organs); withdrawal of the decision to donate organs and tissue; other donation behaviour: respondent has already donated blood; has donated blood in the last 12 months; personal reasons against blood donation; registered bone marrow donor or stem cell donor; generally rather positive or rather negative opinion on organ and tissue donation; own willingness to donate organs after death; willingness to accept a donated organ. Documentation of the willingness to donate organs in the organ donor card: possession of an organ donation card; personal statement of intention on the organ donation card (consent to organ removal, objection or designation of a person to take a decision); consent to the removal of organs and tissues without restriction, except for certain organs and tissues or only for certain organs and tissues; organs and tissues excluded from donation, as well as organs and tissues whose removal has been approved (heart, lungs, liver, kidneys, pancreas, intestines, heart valves, cornea of the eyes, eyes, skin, bones, only organs, no tissue, only tissues, no organs, cartilage, blood vessels, tendons, ligaments, fasciae, amniotic sac membranes, other, open mentions); personal reasons for consenting to organ donation in the organ donor card (altruism, own organs are no longer needed, reciprocity, family members and friends affected who could be helped with organ donation, relevance of organ donations known from the professional environment, great need, long waiting lists, science or research, religious, ethical, spiritual reasons, organ donation meaningful, functioning organ donation system, relatives should not be burdened with decision, other, open mentions); personal reasons why the organ donation was objected to (too old, too young, for health reasons, fear of abuse / lack of trust, fear of organ trade, negative media coverage, fear of inadequate medical care, fear or uncertainty regarding the determination of brain death, fear of disfigurement of the body, organs removed from living persons, fear of pain, generally against organ donation, religious, ethical, spiritual reasons, general insecurity/ scepticism/ anxiety, generally against life-prolonging measures, experiences and knowledge from professional or social life, other, open mentions); intention to obtain and complete an organ donor card within the next 12 months; personal reasons against an organ donor card (too old, too young, for health reasons, uncertainty about suitability as a donor, not relevant, undecided, not yet or not enough concerned with it, comfort or carelessness, avoidance of the subject, fear of misuse/ lack of trust, fear of organ trafficking, negative media coverage, fear of inadequate medical care, uncertainty with regard to the determination of brain death, fear of disfigurement of the body, fear of pain during organ removal, rejection of organ donation, rejection of life-prolonging measures, general uncertainty/ scepticism anxiety, personal bad experiences, religious, ethical, spiritual reasons, relatives/ friends/ acquaintances know personal attitude, living will, decision set out in another document, lost organ donor card, ignorance of documentation possibilities, no time or opportunity to obtain an organ donor card, no organ donor card received, missing information, no special reason, other, open mentions); person who is to decide on organ or tissue donation in the event of death (spouse, partner, relatives, friends, doctor, clergyman, other, open mentions); reasons why other person should decide on organ donation (trust, cannot decide, person has medical expertise, should ensure death, will decide correctly, reciprocity, other, open mentions); source of supply for organ donation card (e.g. Bundeszentrale für gesundheitliche Aufklärung, health insurance, action of the Apothekenumschau, pharmacist, doctor, hospital, self-help associations, German Foundation Organ Transplantation, information stand, newspaper/ magazine, website on the Internet, etc., open mentions); time when the organ donation card was sent by the health insurance company or health insurance; website on the Internet where the organ donation card was obtained (Organspende-info.de, organpaten.de, bmg.bund.de, other, open mentions). Documentation of the willingness to donate organs in the living will: possession of a living will; statement on organ and tissue donation in the living will; consent to organ removal in the living will; open mentions of consent; consent to complete organ removal in the living will; organs and tissues excluded from donation in the living will and organs and tissues whose removal was consent; reasons for consent to organ donation in the living will; reasons why organ donation was rejected in the living will. Undocumented or alternatively documented decisions on organ and tissue donation (respondents who do not have an organ donor card or a living will with comments on organ donation): decision on organ readiness to donate already taken; reasons why no decision was taken; basic consent to organ and tissue donation; complete consent to organ removal; organs and tissues excluded from donation and organs and tissues whose removal is approved; personal reasons for consenting to organ donation; personal reasons for refusing organ donation; reasons why the decision on organ donation was not recorded in writing; change of opinion on organ and tissue donation; frequency of change of opinion; change of opinion towards consent to organ and tissue removal; refusal or determination of which organs and tissues may be removed or are excluded from the donation; reasons for the now given consent to the organ donation, the rejection of the organ donation or the determination of which organs are to be donated; own decision communicated to someone; person who was informed of the decision; reasons why the decision was not communicated to anyone (not relevant, too little involved, convenience, unpleasant subject, subject has not yet come up, decision is private matter, no suitable contact person, does not want to burden anyone with it, dissenting opinions in the social environment, not necessary, since decision documents, relatives or friends know attitude, refusal of the organ donation, for health reasons, too old, no special reason, other, open denominations); agreement to the removal of organs of family members with unclear decision of the deceased. 3. Dealing with the topic of organ donation in the family and circle of friends: discussions with family and friends about organ and tissue donation; preferred contact persons about organ and tissue donation; people in the social environment have informed about their decision to donate organs and tissue; people who have communicated their decision (spouse, partner, relatives, friends, colleagues, other, open mentions); decision of close persons for or against organ and tissue donation; majority decision of these persons for or against organ donation; rather positive or negative attitude of relatives and friends towards organ and tissue donation; self-assessment of information about organ and tissue donation; already dealt with own death. 4. Knowledge of legal requirements and medical knowledge: tissues that can be donated (corneas of the eyes, eyes, skin, bone tissue, cartilage, heart valves, blood vessels, tendons, ligaments and fasciae, amniotic sac membranes, blood/ blood plasma, muscle/ muscular tissue, spinal cord/ bone marrow/ stem cells, mucous membranes, hair/ hair roots, everything, mention of organs, other, open mentions); reasons against donor suitability (illness, HIV/AIDS, cancer, too old, too young, taking medication, addictions, unhealthy lifestyle, religious, moral, ethical reasons, fear of abuse or lack of trust, uncertainty about the determination of death, generally in the case of damaged organs, tolerance of the blood group or of organs and tissue, circumstances of death, lack of information, refusal of organ donation, anxiety or fear, uncertainty in general, other, open mentions); age limit for organ and tissue removal; definition of the term brain death; organ donation to certain persons; organ donation from living persons (living donation); organs eligible for living donation; opinion on living organ donation; willingness to donate living organs to a close person; mediation of organs removed in Germany (to persons living in Germany, worldwide or within the European association Eurotransplant); criterion for possible organ and tissue removal (presence of cardiac death, brain death or coma); reawakening of a brain-dead person; pain sensation of a brain-dead person; available quantity of organs and tissue in Germany; personal definition of brain death as the final death of a human being; fair distribution of donor organs in Germany; legal regulation of organ and tissue donation in Germany; regulation on organ and tissue removal in Germany (consent of the donor, consent of relatives in the absence of a personal decision, automatic organ and tissue donor in the absence of an objection, general registration of decisions on organ and tissue donation); organ and tissue trade in Germany; willingness to store personal decisions on organ and tissue donation on the health card; trust in doctors to save lives before receiving donated organs; knowledge of irregularities in organ allocation; negative effects of these incidents on trust in the German organ donation system. 5. Being informed about the issue of organ and tissue donation and the need for information: information sources on organ donation in the last six months (magazines, posters, Internet, cinema, television, radio and brochures/ flyers); websites visited on organ donation (www.organspende-info.de, www.organpaten.de, www.dso.de); awareness of contact persons for organ and tissue donation (Bundeszentrale für gesundheitliche Aufklärung (BZgA), Deutsche Stiftung Organtransplantation (DSO), Stiftung ´Fürs Leben´, transplantation centre, self-help associations, Deutsche Gesellschaft für Gewebetransplantation (DGFG), doctor, pharmacies, DRK, DKMS, Eurotransplant, hospital, health insurance companies, media, other authorities, research, other, none known, open entries); awareness of the info telephone organ donation; info telephone organ donation already once used; awareness of slogans to the topic organ and tissue donation (organ donation gives life, for life, be future, your organ can save lives, become organ sponsor, correct, important, vital, one carries that today: the organ donor card, I decide, My card, My decision, No matter how you carry it..., chopsticks pure, be a donor, Born on...., reborn on..., organ donation saves lives, others, no slogan known, open mentions); sufficient information or desire for further information. Demography: sex; age; marital status; household size; household composition: number of persons in the household aged 14 to 75 and children under 18; highest school or university degree; desired school degree; gainful employment or employment situation; work in the health service; occupation in the health service; German citizenship, citizenship of another EU country or a non-EU country; denomination; will; net household income; number of telephone numbers at home. Additionally coded: respondent ID; weighting factors; region; federal state; city size (political community size class); level of knowledge survey: total score over the entire objective level of knowledge on organ and tissue donation, knowledge dimension decision and knowledge dimension donation (in points and in categories); cumulative documented decisions in the organ donation card or in the living will (and which ones); cumulated documented and undocumented decisions (and which ones); interview date; interview start; length of the respective question blocks 1 to 6 in seconds; total length of the interview in seconds; interruption of the interview.Wissen, Informiertheit und Einstellungen zum Thema Organ- und Gewebespende. Umgang mit dem Thema Organspende im Familien- und Freundeskreis. Erfahrungen mit der Organ- und Gewebespende. Themen: 1. Vertrauen in das deutsche Gesundheitssystem. 2. Wissen und Einstellungen zur Organ- und Gewebespende: Festlegung der Spendenbereitschaft (durch Eintrag in ein Spendenregister, Ausfüllen eines Organspendeausweises, Mitteilung der Entscheidung an die Angehörigen, Mitteilung an den Hausarzt, Mitteilung an die Krankenkasse, durch eine Patientenverfügung); Kenntnis des Inhalts des Organspendeausweises (Zustimmung zur Entnahme von Organen ohne Ausnahme, Ausschließen bestimmter Organe von der Spende, nur Entnahme bestimmter Organe, generelles Widersprechen einer Entnahme von Organen oder Gewebe, bestimmte Person soll über Entnahme von Organen entscheiden); Rücknahme des Entschlusses zur Organ- und Gewebespende; anderes Spendeverhalten: Befragter hat selbst schon einmal Blut gespendet; in den letzten 12 Monaten Blut gespendet; persönliche Gründe gegen Blutspende; registrierter Knochenmarkspender bzw. Stammzellenspender; generell eher positive oder eher negative Meinung zur Organ- und Gewebespende; eigene Organspendebereitschaft nach dem Tod; Bereitschaft, selbst ein gespendetes Organ anzunehmen. Dokumentation der Organspendebereitschaft im Organspendeausweis: Besitz eines Organspendeausweises; persönliche Willensbekundung auf dem Organspendeausweis (Zustimmung zur Organentnahme, Widerspruch oder Benennung einer Person, die Entscheidung treffen soll); Zustimmung zur Entnahme von Organen und Gewebe ohne Beschränkung, mit Ausnahme bestimmter Organe und Gewebe oder nur für bestimmte Organe und Gewebe; von der Spende ausgeschlossene Organe und Gewebe sowie Organe und Gewebe, deren Entnahme zugestimmt wurde (Herz, Lunge, Leber, Nieren, Bauchspeicheldrüse, Darm, Herzklappen, Hornhaut der Augen, Augen, Haut, Knochen, nur Organe, kein Gewebe, nur Gewebe, keine Organe, Knorpel, Blutgefäße, Sehnen, Bänder, Faszien, Eihaut der Fruchtblase, sonstige, offene Nennungen); persönliche Gründe für die Zustimmung zur Organspende im Organspendeausweis (Altruismus, eigene Organe werden nicht mehr benötigt, Gegenseitigkeit, Betroffene im Familien- und Bekanntenkreis, denen mit einer Organspende geholfen werden könnte, Relevanz von Organspenden aus dem beruflichen Umfeld heraus bekannt, großer Bedarf, lange Wartelisten, der Wissenschaft bzw. Forschung dienen, religiöse, ethische, spirituelle Gründe, Organspende sinnvoll, funktionierendes Organspendesystem, Angehörige sollen mit Entscheidung nicht belastet werden, sonstiges, offene Nennungen); persönliche Gründe, warum der Organspende widersprochen wurde (zu alt, zu jung, aus gesundheitlichen Gründen, Angst vor Missbrauch/ mangelndes Vertrauen, Angst vor Organhandel, negative Medienberichterstattung, Angst vor unzureichender medizinischer Versorgung, Angst bzw. Unsicherheit in Bezug auf die Feststellung des Hirntods, Angst vor Entstellung des Körpers, Organe an lebenden Personen entnommen, Angst vor Schmerzen, generell gegen Organspende, religiöse, ethische, spirituelle Gründe, allgemeine Unsicherheit/ Skepsis/ Angst, generell gegen lebensverlängernde Maßnahmen, Erfahrungen und Wissen aus dem beruflichen bzw. privaten Bereich, sonstiges, offene Nennungen); Absicht, sich in den nächsten 12 Monaten einen Organspendeausweis zu besorgen und auszufüllen; persönliche Gründe gegen einen Organspendeausweis (zu alt, zu jung, aus gesundheitlichen Gründen, Unsicherheit über die Eignung als Spender, nicht relevant, unentschlossen, noch nicht bzw. zu wenig damit beschäftigt, Bequemlichkeit bzw. Nachlässigkeit, Vermeidung des Themas, Angst vor Missbrauch/ mangelndes Vertrauen, Angst vor Organhandel, negative Medienberichterstattung, Angst vor unzureichender medizinischer Versorgung, Angst bzw. Unsicherheit in Bezug auf die Feststellung des Hirntods, Angst vor Entstellung des Körpers, Angst vor Schmerzen bei der Organentnahme, ablehnende Haltung gegenüber Organspende, ablehnende Haltung gegen lebensverlängernde Maßnahmen, allgemeine Unsicherheit/ Skepsis/ Angst, persönliche schlechte Erfahrungen, religiöse, ethische, spirituelle Gründe, Angehörige/ Freunde/ Bekannte kennen persönliche Einstellung, Patientenverfügung, Entscheidung in einem anderen Dokument festgelegt, Ausweis abhandengekommen, Unwissenheit über Dokumentationsmöglichkeiten, keine Zeit bzw. Gelegenheit einen Organspendeausweis zu besorgen, keinen Organspendeausweis erhalten, fehlende Informationen, kein spezieller Grund, sonstiges, offene Nennungen); Person, die im Falle des Todes über eine Organ- oder Gewebespende entscheiden soll (Ehepartner, Partner, Angehörige, Freunde, Arzt, Geistlicher, sonstige, offene Nennungen); Gründe, warum andere Person über Organspende entscheiden soll (Vertrauen, kann dann nicht entscheiden, Person hat medizinisches Fachwissen, soll Tod sicherstellen, wird richtig entscheiden, Gegenseitigkeit, sonstiges, offene Nennungen); Bezugsquelle für den Organspendeausweis (z.B. Bundeszentrale für gesundheitliche Aufklärung, Krankenkasse bzw. Krankenversicherung, Aktion der Apothekenumschau, Apotheker, Arzt, Krankenhaus, Selbsthilfeverbände, Deutsche Stiftung Organtransplantation, Informationsstand, Zeitung/ Zeitschrift, Webseite im Internet, etc., offene Nennungen); Zeitpunkt der Zusendung des Organspendeausweises durch die Krankenkasse bzw. Krankenversicherung; Webseite im Internet, über die Organspendeausweis bezogen wurde (Organspende-info.de, organpaten.de, bmg.bund.de, sonstige, offene Nennungen); Dokumentation der Organspendebereitschaft in der Patientenverfügung: Besitz einer Patientenverfügung; Äußerung zur Organ- und Gewebespende in der Patientenverfügung; Zustimmung zur Organentnahme in der Patientenverfügung; offene Nennungen zur Zustimmung; der vollständigen Organentnahme in der Patientenverfügung zugestimmt; von der Spende ausgeschlossene Organe und Gewebe in der Patientenverfügung sowie Organe und Gewebe, deren Entnahme zugestimmt wurde; Gründe für die Zustimmung zur Organspende in der Patientenverfügung; Gründe, warum der Organspende in der Patientenverfügung widersprochen wurde. Undokumentierte oder alternativ dokumentierte Entscheidungen zur Organ- und Gewebespende (Befragte, die weder einen Organspendeausweis noch eine Patientenverfügung mit Äußerungen zur Organspende besitzen): Entscheidung über Organspendebereitschaft bereits getroffen; Gründe, warum keine Entscheidung getroffen wurde; grundsätzliche Zustimmung zu einer Organ- und Gewebespende; der Organentnahme vollständig zugestimmt; von der Spende ausgeschlossene Organe und Gewebe sowie Organe und Gewebe, deren Entnahme zugestimmt wird; persönliche Gründe für die Zustimmung zur Organspende; persönliche Gründe für die Ablehnung der Organspende; Gründe, warum die Entscheidung zur Organspende nicht schriftlich festgehalten wurde; Meinungsänderung zur Organ- und Gewebespende; Häufigkeit der Meinungsänderung; Meinungsänderung in Richtung Zustimmung zur Organ- und Gewebeentnahme, Ablehnung oder Festlegung, welche Organe und Gewebe entnommen werden dürfen bzw. von der Spende ausgeschlossen sind; Gründe für die jetzt erteilte Zustimmung zur Organspende, die Ablehnung der Organspende bzw. die Festlegung welche Organe gespendet werden; eigene Entscheidung jemandem mitgeteilt; Person, der die Entscheidung mitgeteilt wurde; Gründe, warum Entscheidung niemandem mitgeteilt wurde (nicht relevant, zu wenig damit beschäftigt, Bequemlichkeit, unangenehmes Thema, Thema kam noch nicht auf, Entscheidung ist Privatsache, kein geeigneter Ansprechpartner, will niemanden damit belasten, abweichende Meinungen im sozialen Umfeld, nicht notwendig, da Entscheidung dokumentiert, Angehörige bzw. Freunde kennen Einstellung, Ablehnung der Organspende, aus gesundheitlichen Gründen, zu alt, kein spezieller Grund, sonstiges, offene Nennungen); Zustimmung zur Organentnahme bei Angehörigen bei unklarer Entscheidung des Verstorbenen. 3. Umgang mit dem Thema Organspende im Familien- und Freundeskreis: Gespräche mit der Familie und Freunden über das Thema Organ- und Gewebespende; präferierte Ansprechpartner zum Thema Organ-und Gewebespende; Personen im sozialen Umfeld haben über ihre Entscheidung zur Organ- und Gewebespende informiert; Personen, die ihre Entscheidung mitgeteilt haben (Ehepartner, Partner, Angehörige, Freunde, Kollegen, sonstige, offene Nennungen); Entscheidung nahestehender Personen für oder gegen eine Organ- und Gewebespende; mehrheitliche Entscheidung dieser Personen für oder gegen eine Organspende; eher positive oder negative Haltung der Angehörigen und Freunde zum Thema Organ- und Gewebespenden; Selbsteinschätzung der Informiertheit zum Thema Organ- und Gewebespende; schon einmal mit dem eigenen Tod auseinandergesetzt. 4. Kenntnis der gesetzlichen Bestimmungen und medizinische Wissensfragen: Gewebe, die gespendet werden können (Hornhaut der Augen, Augen, Haut, Knochengewebe, Knorpel, Herzklappen, Blutgefäße, Sehnen, Bänder und Faszie