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  • González-Costello J
  • Pérez-Blanco A
  • Delgado-Jiménez J
  • González-Vílchez F
  • Mirabet S
  • et al.
Rev Esp Cardiol (Engl Ed). 2024 Jan;77(1):69-78 doi: 10.1016/j.rec.2023.11.001.

Heart transplant (HT) remains the best therapeutic option for patients with advanced heart failure (HF). The allocation criteria aim to guarantee equitable access to HT and prioritize patients with a worse clinical status. To review the HT allocation criteria, the Heart Failure Association of the Spanish Society of Cardiology (HFA-SEC), the Spanish Society of Cardiovascular and Endovascular Surgery (SECCE) and the National Transplant Organization (ONT), organized a consensus conference involving adult and pediatric cardiologists, adult and pediatric cardiac surgeons, transplant coordinators from all over Spain, and physicians and nurses from the ONT. The aims of the consensus conference were as follows: a) to analyze the organization and management of patients with advanced HF and cardiogenic shock in Spain; b) to critically review heart allocation and priority criteria in other transplant organizations; c) to analyze the outcomes of patients listed and transplanted before and after the modification of the heart allocation criteria in 2017; and d) to propose new heart allocation criteria in Spain after an analysis of the available evidence and multidisciplinary discussion. In this article, by the HFA-SEC, SECCE and the ONT we present the results of the analysis performed in the consensus conference and the rationale for the new heart allocation criteria in Spain.

  • Phillips B
  • Asgari E
  • Berry M
  • Callaghan C
  • Cerisuelo MC
  • et al.
Transplant Rev (Orlando). 2024 Jan;38(1):100801 doi: 10.1016/j.trre.2023.100801.

The British Transplantation Society (BTS) 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated and this manuscript summarises the relevant recommendations in abdominal organ transplantation from Donation after Circulatory Death (DCD) donors, encompassing the chapters on liver, kidney, pancreas and islet cell transplantation.

  • Cignarella A
  • Marshall A
  • Ranse K
  • Opdam H
  • Buckley T
  • et al.
J Bioeth Inq. 2023 Dec 7; doi: 10.1007/s11673-023-10287-y.
INTRODUCTION:

The disclosure of information that identifies deceased organ donors and/or organ transplant recipients by organ donation agencies and transplant centres is regulated in Australia by state and territory legislation, yet a significant number of donor family members and transplant recipients independently establish contact with each other.

AIM:

To describe and synthesize Australian laws and guidelines on the disclosure of identifying information.

METHOD:

Legislation and guidelines relevant to organ donation and transplantation were obtained following a search of government and DonateLife network websites. Information about the regulation of identity disclosure was extracted and synthesised using a process guided by Walt and Gilson's (1994) policy analysis framework.

FINDINGS:

Nineteen documents were examined. Six guidelines refer to and were consistent with current legislation. Four documents did not address identity disclosure. All jurisdictions prohibit healthcare professionals from disclosing identifying information. In three states, the prohibition extends to all members of the public including donor family members and transplant recipients.

CONCLUSION:

Restrictions on identity disclosure have implications for public promotion of donation and transplantation where sharing of stories and images of organ donors and transplant recipients is common. Further research is required to understand the perspective of donor family members, transplant recipients, and healthcare professionals impacted by the current laws.

  • Pai V
  • Asgari E
  • Berman M
  • Callaghan C
  • Corris P
  • et al.
Transplant Rev (Orlando). 2023 Dec;37(4):100794 doi: 10.1016/j.trre.2023.100794.

Maximising organ utilisation from donation after circulatory death (DCD) donors could help meet some of the shortfall in organ supply, but it represents a major challenge, particularly as organ donors and transplant recipients become older and more medically complex over time. Success is dependent upon establishing common practices and accepted protocols that allow the safe sharing of DCD organs and maximise the use of the DCD donor pool. The British Transplantation Society 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated. This manuscript summarises the relevant recommendations from chapters specifically related to transplantation of cardiothoracic organs.

  • O'Neill S
  • Asgari E
  • Callaghan C
  • Gardiner D
  • Hartog H
  • et al.
Transplant Rev (Orlando). 2023 Dec;37(4):100791 doi: 10.1016/j.trre.2023.100791.

Recipient outcomes after transplantation with organs from donation after circulatory death (DCD) donors can compare favourably and even match recipient outcomes after transplantation with organs from donation after brain death donors. Success is dependent upon establishing common practices and accepted protocols that allow the safe sharing of DCD organs and maximise the use of the DCD donor pool. The British Transplantation Society 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated. This manuscript summarises the relevant recommendations from chapters specifically related to organ donation.

  • Schroder JN
  • Scheuer S
  • Catarino P
  • Caplan A
  • Silvestry SC
  • et al.
J Thorac Cardiovasc Surg. 2023 Sep;166(3):856-869.e5 doi: 10.1016/j.jtcvs.2023.03.014.
  • de Luzan IF
  • Vormbrock M
  • Merkel A
  • Smith-Steinert R
AANA J. 2023 Aug;91(4):291-297.

Organ procurement is a complex and unique procedure that warrants the creation of an evidence-based practice guideline. Anesthesia care of the donor may adversely impact the fate of organs once transplanted. The following article gives a brief review of the literature, and a guideline for providing anesthesia during an organ procurement which was created for a large, level-one, academic facility. Care of the organ donor during the preoperative phase is frequently discussed in the literature; however, there remains a need for further information on the care of the organ donor intraoperatively.

  • Ferrer-Fàbrega J
  • Mesnard B
  • Messner F
  • Doppenberg JB
  • Drachenberg C
  • et al.
Transpl Int. 2023 Jul 19;36:11374 doi: 10.3389/ti.2023.11374.

The advent of Machine Perfusion (MP) as a superior form of preservation and assessment for cold storage of both high-risk kidney's and the liver presents opportunities in the field of beta-cell replacement. It is yet unknown whether such techniques, when applied to the pancreas, can increase the pool of suitable donor organs as well as ameliorating the effects of ischemia incurred during the retrieval process. Recent experimental models of pancreatic MP appear promising. Applications of MP to the pancreas, needs refinement regarding perfusion protocols and organ viability assessment criteria. To address the "Role of pancreas machine perfusion to increase the donor pool for beta cell replacement," the European Society for Organ Transplantation (ESOT) assembled a dedicated working group comprising of experts to review literature pertaining to the role of MP as a method of improving donor pancreas quality as well as quantity available for transplant, and to develop guidelines founded on evidence-based reviews in experimental and clinical settings. These were subsequently refined during the Consensus Conference when this took place in Prague.

  • Snyder JJ
  • Schaffhausen CR
  • Hart A
  • Axelrod DA
  • Dils D
  • et al.
Am J Transplant. 2023 Jul;23(7):875-890 doi: 10.1016/j.ajt.2023.03.012.

In July 2022, the Scientific Registry of Transplant Recipients (SRTR) hosted an innovative, multistakeholder consensus conference to identify information and metrics desired by stakeholders in the transplantation system, including patients, living donors, caregivers, deceased donor family members, transplant professionals, organ procurement organization professionals, payers, and regulators. Crucially, patients, caregivers, living donors, and deceased donor family members were included in all aspects of this conference, including serving on the planning committee, participating in preconference focus groups and learning sessions, speaking at the conference, moderating conference sessions and breakout groups, and shaping the conclusions. Patients constituted 24% of the meeting participants. In this report, we document the proceedings and enumerate 160 recommendations, 10 of which have been highly prioritized. SRTR will use the recommendations to develop new presentations of information and metrics requested by stakeholders to support informed decision-making.

  • Jesse MT
  • Jackson WE
  • Liapakis A
  • Ganesh S
  • Humar A
  • et al.
Clin Transplant. 2023 Jul;37(7):e14954 doi: 10.1111/ctr.14954.
INTRODUCTION:

Living donor liver transplantation (LDLT) is a promising option for mitigating the deceased donor organ shortage and reducing waitlist mortality. Despite excellent outcomes and data supporting expanding candidate indications for LDLT, broader uptake throughout the United States has yet to occur.

METHODS:

In response to this, the American Society of Transplantation hosted a virtual consensus conference (October 18-19, 2021), bringing together relevant experts with the aim of identifying barriers to broader implementation and making recommendations regarding strategies to address these barriers. In this report, we summarize the findings relevant to the selection and engagement of both the LDLT candidate and living donor. Utilizing a modified Delphi approach, barrier and strategy statements were developed, refined, and voted on for overall barrier importance and potential impact and feasibility of the strategy to address said barrier.

RESULTS:

Barriers identified fell into three general categories: 1) awareness, acceptance, and engagement across patients (potential candidates and donors), providers, and institutions, 2) data gaps and lack of standardization in candidate and donor selection, and 3) data gaps regarding post-living liver donation outcomes and resource needs.

CONCLUSIONS:

Strategies to address barriers included efforts toward education and engagement across populations, rigorous and collaborative research, and institutional commitment and resources.