Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)
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Advances in organ recovery and transplantation have provided us with the skills and opportunity to save, extend, and improve the quality of life for many. But with these opportunities have come challenges to redefine our practice and relationships with donor and recipient families. ⋯ In the past, communication between donor families and recipients has been anonymous and highly controlled, with much inconsistency among and within the transplant community, leaving many involved in the process confused and frustrated. Transplant professionals may wish to consider critically the common ethical values of autonomy, beneficence, salience and benefit of choice in making decisions about information shared with and contact between donor families and recipients.
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Comparative Study
Ethical assessments of brain death and organ procurement policies: a survey of transplant personnel in the United States.
The Questionnaire on Prolonging and Shortening Life was developed to assess the views of medical personnel regarding brain death, organ procurement policies, and related issues. The questionnaire was completed by 189 transplant physicians, 197 clinical coordinators, 150 medical students, and 70 nursing students. Ninety-five percent supported the so-called dead donor rule. ⋯ More than 60% supported procuring organs from anencephalic and "higher brain-dead" patients, although patients in both groups are not dead by current legal standards. Performance on items relating to so-called non-heart-beating organ donation suggested that 75% of the group do not support non-heart-beating organ donation without assurance that the donors are brain-dead before procurement begins. Given that current recommendations to increase organ donation look to non-heart-beating organ donation rather than to anencephalic patients and those in a persistent vegetative state, these findings suggest that further ethical discussion and analysis are urgently needed.
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Pressure to reduce overall transplant costs is one of the factors which has led to earlier hospital discharge and increased patient management challenges in outpatient and home care settings. Earlier discharge often contributes to decreased opportunity to provide and ensure comprehension of critical patient and family education, resulting in challenges for home care clinicians who are committed not only to patient and environmental assessments, but to helping assure patient and family understanding of and compliance with critical posttransplant responsibilities and regimens. ⋯ The tool provides patient education information that can be realistically reviewed and reinforced during the home visit. The resource focuses on key self-care issues to promote wellness and graft survival and help prevent adverse outcomes.
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Lung and heart-lung transplantation was first undertaken in Australia in the late 1980s and early 1990s. Although detailed data are available on Australian lung transplantation outcomes, little data are available regarding the utilization of donated lungs. This study examines donated lung utilization rates and considers various factors that may affect these rates. ⋯ Single-lung donors accounted for 32% of lung donors in 1997. Uniform basic donor criteria and management guidelines, simple allocation mechanisms, and cooperative retrieval have evolved during this time. Close collaboration at the time of donation between units, coordinators, and ICUs has allowed early retrieval from well-managed donors.
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Review Comparative Study
Organizational characteristics of solid-organ donor hospitals and nondonor hospitals.
Efforts to increase organ donation include serious attempts in hospital settings, where unrealized donation potential exists. Research on hospital donation must include understanding organizational as well as patient-specific influences on the donation process. ⋯ Among hospitals not currently producing organ donations, there is a sizable subgroup with donor potential. This area merits further attention.