Transplantation proceedings
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Increased cadaveric donation may be achieved by improving medical staff education to enhance consent rates. This study was designed to examine the critical items that influence nurse knowledge regarding the concepts of brain death and the attitudes toward cadaveric donor renal transplantation. These findings may be useful to evaluate future progress in education. ⋯ The legal definition of death and the medical definition of death should be uniform in the view of society. To make all medical staff favor cadaveric renal transplantation, they should agree on a definition of death. It was observed that the relatively high rate of misinterpretation of the brain-death concept among respondents negatively affected nurses attitudes toward cadaveric renal transplant. It was concluded that the "concept of brain death" and the "preferences of transplant over other treatment modalities" are the two items that need further attention in educational programs for nurses.
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Insulin is one factor responsible for hepatotrophic regeneration in animal models. This study assessed the clinical effects of intraportal administration of insulin on liver graft regeneration in adult patients undergoing right lobe living donor liver transplantation (LDLT). ⋯ The rate defined as ratio of POD 7 GV/harvested GV among group I was significantly greater than that of group NI (186.07 +/- 35.40% vs 160.61 +/- 22.11%; P < .05). The rate defined as ratio of POD 7 GRWR/operation GRWR was also significantly higher in group I than group NI (178.95 +/- 35.84% vs 156.56 +/- 18.53%; P < .05), whereas there was no significant difference in terms of regeneration rates at 1 month post-LDLT. Intraportal insulin administration may significantly downregulate POD 7 total bilirubin, aspartate aminotransferase, and alanine aminotransferase levels (P < .05). These results suggested that intraportal insulin administration augmented liver regeneration during the first postoperative week by improving hepatic function in LDLT recipients.
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The ratios of complications for living related liver donors after right hepatectomy differ widely among numerous single institutions. This study sought to use the Clavien classification system to define and graded the severity of these complications. ⋯ The Clavien grading system is useful to comparise surgical outcomes. This study demonstrated that donor right hepatectomy was a relatively safe procedure, but reducing donor complications after right hepatectomy has to be the first priority during the entire process of living related transplantation.
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We sought to determine the utility of constrat-enhanced transcranial color sonography (TCCS) in the diagnosis of cerebral circulatory arrest in cases of difficult acoustic window. ⋯ Contrast-enhanced TCCS increased the number of conclusive studies with cerebral circulatory arrest, which minimized the importance of a previous study in cases with a poor acoustic window.
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To determine public attitudes about an emergency department (ED)-based organ-donor enrollment program. ⋯ An ED organ-donation enrollment program would be acceptable to patients and effective in capturing groups who currently do not have organ-donor cards.