Transplantation proceedings
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Calcineurin inhibitors are associated with chronic allograft nephropathy. Protocols to reverse nephrotoxicity incorporate dosage reduction or withdrawal of these agents. Using ketoconazole as a sparing agent with mean cyclosporine doses of less than 50 mg/d, we have usually observed adverse cosmetic effects. One cohort of patients exhibited severe gingival hyperplasia that required gum resection; some also had hypertricosis. ⋯ Generic TAC is a good therapeutic alternative in renal transplant recipients with adverse reactions to CsA.
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Multicenter Study
Detection of potential organ donors: 2-year analysis of deaths at a German university hospital.
In 2006, inhouse coordinators were introduced in all hospitals with intensive care units in Baden-Württemberg to improve organ donation. At our university hospital with a neurosurgery and a transplantation unit, we analyzed whether brain death certification and donation requests were always initiated (if possible). ⋯ The detection of donors was not acceptable. In patients without a prognosis after resuscitation, further hemodynamic stabilization was frequently omitted, because organ donation had not been considered. In cases of donation requests the refusal rate was high. We initiated specific training.
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A positive attitude toward organ donation would be expected among health professionals from transplant centers with active donor activities. However, acceptance and knowledge about cadaveric tissue donation has been insufficiently studied. ⋯ Insufficient knowledge about cadaveric tissue was demonstrated among health professionals more exposed to the donation process. These results highlighted the importance of health professional's education to facilitate public information about organ and tissue donation.
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Orthotopic liver transplantation (OLT) in rats is frequently used as an experimental model. Numerous surgical techniques have been developed that enable the investigator to conduct clinically relevant studies. The objective of this study was to develop a rat model of acute and chronic rejection, to explicitly study technical modifications of vascular anastomoses with precision, and to examine histopathologic and functional changes in the graft. ⋯ The present model is feasible, enabling comprehensive preclinical experimental research on liver transplantation. Furthermore, we provide helpful instructions for learning this surgical technique.
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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.