Prog Transplant
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Placement of central venous catheters by organ procurement coordinators to assist in obtaining blood samples or for measuring intravascular pressure is appropriate. Preparation for this role should include appropriate didactic instruction and supervised clinical experience. ⋯ Also, resources must be readily available to treat any complications. This discussion reviews methods for insertion of venous catheters placed in the femoral, internal jugular, or subclavian veins.
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Our organ procurement organization recently developed an aggressive donation after cardiac death program. Thoracic organs are rarely recovered from non-heart-beating donors. Therefore, there is concern that donation after cardiac death may affect the recovery of thoracic organs from donors not allowed to progress to brain death. ⋯ A total of 97 organs were recovered and successfully transplanted from 44 non-heart-beating donors. If all the donors who qualified to donate thoracic organs progressed to brain death and if their thoracic organs were transplantable, then 6 additional hearts and 3 pairs of lungs may have been recovered. These data demonstrate that an aggressive donation after cardiac death program contributes significantly to the organ donor pool, with a minimal impact on potential thoracic organ recovery.
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To examine attitudes toward death criteria and their relation to attitudes and behaviors regarding organ donation. ⋯ Both general and ethical education may serve to guide policy and facilitate family member requests and informed consent dialogues. Furthermore, helping families to understand and accept not only medical and legal criteria for determining death, but also ethical criteria for withdrawing life support may help them be more comfortable with their decisions.
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Although research exists examining the experiences of organ donor families, little is known about the specific needs of tissue donor families. Understanding family experiences in tissue donation is important to improve the process and potentially increase the number of families who consent to tissue donation. ⋯ Seventy-seven of 140 mailed questionnaires were returned. Almost all respondents expressed satisfaction with the approach to donate, and this did not differ with the mode of approach, that is, by phone or in person. The most common reason for agreeing to donation was that it was known to be the donor's wish. The majority of respondents felt they had sufficient time and information to decide to donate, and almost all were happy with their decision and thought they had received adequate support during and after the process.
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Family members of organ donors receive anonymous information about the transplant recipients. Also, they often receive written communication from the recipients themselves and or the recipient's family members, expressing gratitude for the generous gifts they donated. The feedback received by donor families serves to affirm that their altruistic decision to donate life-saving and life-enhancing gifts has saved or dramatically improved the lives of the recipients. ⋯ In contrast, family members of bone and soft tissue donors historically have not received the same level of feedback provided to the family members of organ donors. The tissue banking community, as an extension of the procurement community that provides care to tissue donor families, is in a unique position to facilitate meaningful feedback between bone and soft tissue donor families and their recipients. This article explores the use of tissue packaging as a communication portal to solicit and facilitate the needed feedback loop between bone and soft tissue donor families and their recipients.