Transplantation proceedings
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The use of pretransplantation extracorporeal membrane oxygenation (ECMO) has been considered to be a relative contraindication and a risk factor associated with poor outcomes in lung transplantation. However, with a donor shortage, use of ECMO before transplantation is often unavoidable. This study aimed to review our experiences of lung transplantation outcome with regards to the use of pretransplantation ECMO. ⋯ Use of pretransplantation ECMO did not jeopardize survival-to-discharge and short-term survival rates in our experience. Our result suggests pretransplantation ECMO can provide a chance of receiving lung transplantation to those who were classified as "too sick to be transplanted."
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Observational Study
Non-Heart-Beating Donor Program: Results After 3 Years of Experience.
Non-heart-beating donation (NHBD) is a useful way to obtain organs and tissues. Therefore, since 2012 we have had an NHBD protocol in the metropolitan area of Seville. The aim of this work was to present the results obtained after 3 years of program. ⋯ NHBD is a useful program in our city with a low refusal rate (8%), an average of 1.45 organs per donor, and kidney the most frequent organ.
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Living donor liver transplantation reduces time and mortality on the waiting list. Bleeding is a serious complication; however, "overcorrection" of coagulopathy may lead to hepatic artery thrombosis. ⋯ After 1 dose of DDAVP, bleeding improved significantly and the recipient had an unremarkable recovery. DDAVP should be considered for persisting bleeding after correcting common coagulation abnormalities where complexity of the anastomosis may preclude the use of more aggressive procoagulant drugs in liver transplantation.
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Multicenter Study Observational Study
Severe Supratentorial Intracerebral Hemorrhage: Factors Related to Brain Death Development.
This study sought to identify clinical variables that may contribute to the development of brain death (BD) in patients with severe supratentorial intracerebral hemorrhage (ICH). ⋯ Certain clinical variables are predictive of an increased risk for BD development after supratentorial ICH. This information would be useful for transplant coordinators, permitting early identification of at-risk patients and increasing the availability of potential donors.
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Observational Study
Mortality of Oncohematological Patients Undergoing Hematopoietic Stem Cell Transplantation Admitted to the Intensive Care Unit.
Both autologous and allogenic hematopoietic stem cell transplantation (HSCT) are potentially curative treatments for hematological malignancies. Patients with related complications may need admission to the intensive care unit (ICU) for specific therapy and organ support. A consensus on treatment between hematologists and intensive care specialists is essential. ⋯ Of recipient patients of allogenic HSCT, 21.8% were admitted to the ICU, presenting a mortality rate of >95%. The main reason for admission was respiratory failure with requirement of invasive mechanical ventilation. Patients with autologous HSCT presented very few complications needing organ support.