Organ Donation Research Articles

Engraftment of wild-type alveolar type II epithelial cells in surfactant protein C deficient mice.

Childhood interstitial lung disease (chILD) secondary to pulmonary surfactant deficiency is a devastating chronic lung disease in children. Clinical presentation includes mild to severe respiratory failure and fibrosis. There is no specific treatment, except lung transplantation, which is hampered by a severe shortage of donor organs, especially for young patients. Repair of lungs with chILD represents a longstanding therapeutic challenge but cell therapy is a promising strategy. As surfactant is produced by alveolar type II epithelial (ATII) cells, engraftment with normal or gene-corrected ATII cells might provide an avenue to cure. Here we used a chILD disease-like model, Sftpc -/- mice, to provide proof-of-principle for this approach. Sftpc -/- mice developed chronic interstitial lung disease with age and were hypersensitive to bleomycin. We could engraft wild-type ATII cells after low dose bleomycin conditioning. Transplanted ATII cells produced mature SPC and attenuated bleomycin-induced lung injury up to two months post-transplant. This study demonstrates that partial replacement of mutant ATII cells can promote lung repair in a mouse model of chILD-like disease.

Why did England change its law on deceased organ donation in 2019? The dynamic interplay between evidence and values.

In the three years since the law on adult deceased organ donation consent in England changed to include an opt-out system, there has been no discernible change to donation rates. The lack of a positive impact on donation rates was predicted by many of those who took part in debates before and during the passage of the Bill through Parliament. This invites the question as to why England moved to an opt-out system for organ donation despite equivocal evidence of likely benefit and opposition from expert health professional organisations. To address this question qualitative analyses of Parliamentary debates on organ donation was undertaken. This revealed a shift from a dominant position, which gave primacy to the evidence of likely effects, towards a more normative position where a deemed consent option was viewed as the 'correct thing to do' and the limited and conflicting evidence viewed in a positive light. By 2017, following Wales's move to an opt-out system, together with continued lobbying for similar changes for England by professional and patient groups, alongside sustained public popularity for organ donation, the balance of opinion had shifted towards a system where deemed consent would become the default position for most English adults.

The Criminal Protection for Cells and Tissues Donation in the UAE Legislation

The Criminal Protection for Cells and Tissues Donation in the UAE Legislation

The subcellular distribution of miRNA isoforms, tRNA-derived fragments, and rRNA-derived fragments depends on nucleotide sequence and cell type

BackgroundMicroRNA isoforms (isomiRs), tRNA-derived fragments (tRFs), and rRNA-derived fragments (rRFs) represent most of the small non-coding RNAs (sncRNAs) found in cells. Members of these three classes modulate messenger RNA (mRNA) and protein abundance and are dysregulated in diseases. Experimental studies to date have assumed that the subcellular distribution of these molecules is well-understood, independent of cell type, and the same for all isoforms of a sncRNA.ResultsWe tested these assumptions by investigating the subcellular distribution of isomiRs, tRFs, and rRFs in biological replicates from three cell lines from the same tissue and same-sex donors that model the same cancer subtype. In each cell line, we profiled the isomiRs, tRFs, and rRFs in the nucleus, cytoplasm, whole mitochondrion (MT), mitoplast (MP), and whole cell. Using a rigorous mathematical model we developed, we accounted for cross-fraction contamination and technical errors and adjusted the measured abundances accordingly. Analyses of the adjusted abundances show that isomiRs, tRFs, and rRFs exhibit complex patterns of subcellular distributions. These patterns depend on each sncRNA’s exact sequence and the cell type. Even in the same cell line, isoforms of the same sncRNA whose sequences differ by a few nucleotides (nts) can have different subcellular distributions.ConclusionsSncRNAs with similar sequences have different subcellular distributions within and across cell lines, suggesting that each isoform could have a different function. Future computational and experimental studies of isomiRs, tRFs, and rRFs will need to distinguish among each molecule’s various isoforms and account for differences in each isoform’s subcellular distribution in the cell line at hand. While the findings add to a growing body of evidence that isomiRs, tRFs, rRFs, tRNAs, and rRNAs follow complex intracellular trafficking rules, further investigation is needed to exclude alternative explanations for the observed subcellular distribution of sncRNAs.

Protocol for a clinically annotated biorepository of samples from Australian immune-compromised patients to investigate the host–microbiome interaction

IntroductionThe human gut microbiota has the potential to modulate the outcomes of several human diseases. This effect is likely to be mediated through interaction with the host immune system. This...

Hydrogen sulfide ameliorates non-alcoholic fatty liver disease in mice

Non-alcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome characterized by excessive accumulation of intrahepatic fat and elevated hepatic metabolic enzyme levels, leading to hepatocellular vesicular steatosis. The global prevalence of this liver disease has been steadily increasing, closely associated with lifestyle factors such as obesity, hypertension, and hyperlipidemia. Notably, there is currently no approved pharmaceutical treatment for NAFLD. Hydrogen sulfide (H2S) is considered a vital gaseous signaling molecule in mammalian cells, playing a crucial role in various physiological and pathological processes. Numerous recent studies have demonstrated that H2S is involved in modulating a diverse array of biological functions. In vitro and in vivo research often utilizes various readily soluble organic or inorganic compounds H2S donors, such as sodium hydrosulfide, sodium sulfide, and GYY4137, which allow for controlled release and concentration adjustment of H2S, thereby facilitating the exploration of its biological effects and underlying mechanisms. Our findings indicate that H2S holds significant potential in reducing the accumulation of cellular lipid droplets and multiple lipid deposits, as evidenced by cellular and tissue staining, as well as triglyceride and total cholesterol assays. Subsequent transcriptomic analysis revealed a potential association between the degradation of lipid droplets by H2S and the activation of cellular autophagy. Validation through Western blotting in both cellular and animal models demonstrated that H2S effectively triggers autophagy through the AMP-activated protein kinase and mechanistic target of rapamycin pathway. This activation results in enhanced degradation of intracellular lipid content and decreased lipid accumulation in hepatocytes, ultimately ameliorating NAFLD in mice.

Pasienter innlagt ved en medisinsk intensivavdeling etter henging 2010–21

Hanging is one of the most common causes of death among young adults in Norway. Our aim was to study the hospital course and cerebral function on discharge in patients admitted to our Medical Intensive Care Unit after hanging without skeletal injury. Retrospective study based on the medical records of patients admitted to the Medical Intensive Care Unit at Oslo University Hospital (OUS), Ullevål after hanging, from January 2010 to December 2021. Cerebral function on discharge was classified according to Cerebral Performance Category (CPC) from grade 1 (normal cerebral function) to 5 (brain death). 135 patients were admitted to OUS after hanging during the period; 60 of these were admitted to the Medical Intensive Care Unit and were included in this study. There were 35 men and 25 women. Mental illness was documented in the medical records of 43 patients, somatic illness in 24, previous substance abuse in 19, and previous suicide attempts in 19. Upon admission, 34 patients had suffered cardiac arrest, and 39 had a Glasgow Coma Scale (GCS) score of 3. The most common complication was pneumonia (n=42). Twenty-seven patients (45%) died, all with a GCS score of 3 on admission, of which 25 had pre-hospital cardiac arrest. Ten became organ donors. Among the 33 survivors, 28 had a CPC score of 1 and five had a CPC score of 2 on discharge. The median lactate concentration at admission was 8.1 mmol/L among those who died versus 3.8 mmol/L among survivors. Hanging has a high mortality rate. Cardiac arrest, a GCS score of 3, and lactic acidosis were more common among those who died than among the survivors. The organ donation rate was high, and most survivors had a good cerebral function, assessed by CPC score.

SP6.5 - The NHS's value-based funding model for organ transplantation achieves superior equity and outcomes vs global peers

Abstract Introduction Value-based practice is gaining traction as a way to control costs, improve patient satisfaction, and increase provider accountability. The rising prevalence of end-stage organ disease contrasts with limited donor organs, necessitating maximising equitable access, clinical outcomes, and appropriate cost control. We compare key kidney transplant metrics across the UK, US, and Canada. Methods Parameters analysed from the 2010–2022 national registries include: (1) Policy-components, (2) Transplant rates per million population; (3) 1-5 year survival, (4) Median waiting times, (5) Average cost per patient. Inequality was assessed using the Gini-index and concentration-curves. Results The UK NHS funded >1000 kidney-transplants in 2021 under standardised pricing and coordinated care. This enabled 98% one-year patient survival, 7 percentage points higher than in the US and Canada. The median kidney waiting time is 54% lower than in Canada. The UK transplantation rate per million increased by 25% over the decade, versus a 3% rise in the US and Canada. The Gini index is 0.03 in the UK, indicating highly equitable access, versus 0.11 in the US. Average transplant costs per patient are nearly 85% lower in the UK ($130,000) than in the US ($830,000). Conclusions The integrated funding and oversight model has facilitated access, survival, and sustainability gains on kidney transplantation for the UK NHS system versus lagging peer countries. Continued value optimisation remains necessary to tackle trade-offs. High-Level Structural Comparison ParameterUnited-KingdomUnited-StatesCanadaKey Payer(s)Single: NHSMedicare, Medicaid, PrivateSingle: Provincial-plansUse of Quality-MetricsYesPartialIn ProgressPricing ModelNational-TariffFragmentedProvincialRegulatory-OversightCentralizedVariableProvincial

Impact of single centre kidney-exchange transplantation to increase living donor pool in India: A cohort study involving non-anonymous allocation.

In India, 85% of organ donations are from living donors and 15% are from deceased donors. One-third of living donors were rejected because of ABO or HLA incompatibility. Kidney exchange transplantation (KET) is a cost-effective and legal strategy to increase living donor kidney transplantation (LDKT) by 25%-35%. We report our experience with 539 KET cases and the evolution of a single-centre program to increase the use of LDKT. Between January 2000 and 13 March, 2024, 1382 deceased donor kidney transplantations and 5346 LDKT were performed at our centre, including 10% (n = 539) from KET. Of the 539 KET, 80.9% (n = 436) were ABO incompatible pairs, 11.1% (n = 60) were compatible pairs, and 8% (n = 43) were sensitized pairs. There were 75% 2-way (n = 2 × 202 = 404), 16.2% 3-way (n = 3 × 29 = 87), 3% 4-way (n = 4 × 4 = 16), 1.8% 5-way (n = 5 × 2 = 10), 2.2% 6-way (n = 6 × 2 = 12), and 1.8% 10-way KET (n = 10 × 1 = 10). Of the recipients 81.2% (n = 438) were male and 18.8% (n = 101) were female, while of the donors, 78.5% (n = 423) were female and 21.5% (n = 116) were male. All donors were near relatives; wives (54%, n = 291) and mothers (20%, n = 108) were the most common donors. At a median follow-up of 8.2 years, patient survival, death censored graft survival, acute rejection, and median serum creatinine levels of functioning grafts were 81.63% (n = 440), 91% (n = 494), 9.8% (n = 53) and 1.3 mg/dL respectively. We credited the success to maintaining a registry of incompatible pairs, high-volume LDKT programs, non-anonymous allocation and teamwork. This is the largest single-centre KET program in Asia. We report the challenges and solutions to replicate our success in other KET programs.

A Study to Assess the effectiveness of Awareness Programme on Organ Donation Among the B.Sc. Nursing students of Arya Nursing College, Changsari, Kamrup (R), Assam

An experimental study was conducted with the objective to assess the pre-test and post-test knowledge on organ donation, to evaluate the effectiveness of awareness programme on organ donation among the B. Sc Nursing students of Arya nursing college, to find out the association between pre-test knowledge on organ donation and selected demographic variables. The students were selected from B. Sc Nursing 2nd year by using purposive sampling technique. Total 50 sample were selected and self-structured questionnaires were used to collect the data and analyzed according to the study objective. Descriptive and inferential statistics were used for data analysis. The study findings showed that 8% respondents belong to age group of 17-19 years, 86% belongs to the age group of 20-22 years and 6% belongs to the age group who were more than 22 years. 52% belongs to Hindu religion, 36% belongs to Islam religion, 12% belongs to Christian religion. 84% resides in rural area and 16% resides in Urban area. 14% had attended training programme on organ donation while 86% did not. In pre-test 14% have inadequate knowledge, 74% have moderate knowledge and 12% have adequate knowledge regarding organ donation and in post-test 8% have inadequate knowledge, 72% have moderate knowledge and 20% have adequate knowledge. The mean knowledge score of pre-tests is 14.32 and standard deviation is 3.30. The mean knowledge score of post-tests is 21.66 and standard deviation is 3.14. Hence, it shows that there is increase in mean post-test knowledge score when compared to mean pre-test knowledge score.

Temporal trends in organ donation among cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation

AimsThis study explores the evolution of organ donation from patients treated with extracorporeal-cardiopulmonary-resuscitation (ECPR) for refractory out-of-hospital-cardiac-arrest (OHCA) and evaluates the public health benefits of a mature ECPR program. MethodsThis retrospective, single-center study included OHCA patients (2016–2023) who had mostly initial shockable rhythms and were treated with ECPR. Organ donation rates from non-survivors through these years were analyzed. The public health benefit of ECPR was determined by the ratio of the sum of survivors with Cerebral Performance Category 1–2 and non-survivors who donated at least 1 solid organ, to the total ECPR patients. Temporal trends were analyzed yearly using linear regression. ResultsOut of 419 ECPR patients presenting with refractory OHCA over the study period, 116 survived neurologically intact (27.7%). Among non-survivors (n = 303), families of 41 (13.5%) consented to organ donation (median age 51 years, 75.6% male) and organs from 38 patients were harvested, leading to 74 organ transplants to 73 recipients. The transplanted organs included 43 kidneys (58.1%), 27 livers (36.5%), 3 lungs (4%), and 1 heart (1.4%), averaging 2.4 ± 0.9 accepted organs/donor. The number of organ donors and successful transplants correlated positively with the years since the ECPR program’s initiation (ptrend = 0.009, ptrend = 0.01). Overall, 189 patients (116 survivors, 73 organ recipients) benefited from ECPR, achieving organ-failure-free survival. The cumulative public health benefit of ECPR, considering the 116 survivors and 38 donors was 36.8%. ConclusionThe public health benefits of an established ECPR program extend beyond individual ECPR patient survival, forming a new, previously under-recognized source of transplant donors.

Engagement With Sports After Solid Organ Transplant.

Introduction Transplant Games lend a unique opportunity not only by providing a platform for donors and recipients to engage in sports but also to counter the negativity surrounding organ donation and showcase to the world that transplant recipients can lead active lives. When the Transplant Games were held in Kochi, Kerala, India, for the first time, it provided a venue to engage with transplant recipients, donors, and the families of deceased donors. We aimed to understand the impact that engagement in sports brings on the lives of donors and recipients. Methods After obtaining permission from the organizers, we explained the objectives of the survey to the participants and encouraged them to participate. A survey, covering basic demographic information, transplantation details, and questions related to sports engagement was formulated. Participants could complete the survey electronically via a quick response code or in hard copy. They were fully informed about the objectives of the survey and had the right to withdraw at any stage without consequences. The survey was available for five hours during the games. The study received institutional ethics committee approval (ECASM-AIMS-2024-059). Results Among the approximate 150 participants, we received 78 respondents (52%). After the nine who withdrew consent were removed, we had a full response from 69 participants. Of these, 59 were males (85.5%), and 10 (14.5%) were females. The average age of the participants was 45 ± 13 years. Self-motivation was the most common factor in taking up sports for 30.4% of the responders, followed by family and friends in 23.2% and transplant doctors in 5.8%. Liver Foundation of Kerala (LIFOK), a self-help group of transplant recipients, played a major role in 4.3% of the responders. Bowling was the most popular sport with 23 mentions, followed by carroms and badminton with 27 and 20 mentions, respectively. Donors started to take an active role in sports earlier than recipients, 3.1 ± 1.89 vs. 5.7 ± 5.5 months. The most common reason cited for taking up sports was to become part of the transplant community, followed by a desire to embrace a healthier lifestyle and improve fitness levels. Although none had a personalized coach, most intensified their training and improved nutrition as part of their preparation for the games. Conclusion Our survey is limited by its small and self-selected sample size. Our study highlights the significant role of self-motivation, family support, and self-help groups in encouraging solid organ transplant recipients and donors to engage in sports after surgery. It also highlights the need for more proactive encouragement from doctors and better availability of sports facilities and support staff to help transplant recipients and donors engage in physical activities, which are crucial for their physical and emotional well-being.

Solid Organ Donation Process: Correlation between Pro!le, Learning and Course Indication

Objectives: To understand the pro!le of professionals trained in the solid organ donation process, to analyze the result of their learning before and after the course, and to correlate the pro!le and the performance of the professional with the learning and indication of the course. Methods: Retrospective, quantitative, analytical-descriptive study with participants of the course Processo de Doação de Órgãos Sólidos para Pro!ssionais de Saúde. Online questionnaires were used on professional pro!le, performance in the area of organ donation, knowledge assessment, and course indication. "e analyses and correlations were veri!ed with the McNemar test, Spearman's rank, and the bisserial point. Results: Of the 130 professionals, 62% were nurses, 38% physicians, 35% emergency physicians, 26% intensivists, and 42% had more than 10 years of training. For the pro!le of work in the area of organ donation, the professionals report having participated in up to !ve cases in each of the following stages: 44% were involved in the brain death protocol, 56% in the family interview, and 60% in the organ donation process. "e class knowledge retention rate was 26.7%, with 29.5% for physicians and 24.8% for nurses. "e indication of the course was evaluated following the Net Promoter Score (NPS), being in the promoters zone. "e correlation between the groups was positive and statistically signi!cant for those working in the emergency room, with more than 5 years since graduation and with more than !ve cases reported on the questioned stages of organ donation. No signi!cant correlation was identi!ed between these variables and the indication of the course. Conclusion: "e course contributed to the learning of professionals with more training time, greater previous experience in the stages of the organ donation process, and working in the emergency sector.

Pediatric Organ Donation: 16-Year Experience of PICU/ICU of a Third Level Hospital in Portugal, 2006-2021.

Although pediatric organ donation represents a small proportion of overall organ donation, children and adolescents make a significant contribution to the pool of donated organs. In this study 252 solid organs were collected from children and adolescent. Two hundred and two recipients benefited from 62 pediatric organ donors, with a recipient/donor ratio of 3.3.

Concomitant circumaortic and retro-aortic left renal veins associated with fenestrated renal artery.

Variations of the left renal vein can be in the form of circumaortic vein or renal collar, retro-aortic vein, additional renal vein, or multiple primary tributaries. We report a unique complex venous pattern of concomitant circumaortic and retro-aortic left renal veins associated with a fenestrated left renal artery. Two renal veins, anterior and posterior to the renal artery, originated from the renal hilum. The anterior vein was further divided into two branches. One branch passed through the fenestrated renal artery to continue as the anterior limb of the circumaortic vein. It received the suprarenal and gonadal veins and drained into the inferior vena cava. The other branch coursed posterior to the fenestrated renal artery and joined the posterior renal vein. The posterior renal vein was divided into two branches: one forming the posterior limb of the circumaortic vein, and the other continued obliquely downwards as the retro-aortic vein. Variations in the left renal vein have been implicated in several clinical conditions, such as varicocele and pelvic varices. It also plays a crucial role in renal transplantation, as the left kidney is often used as the donor organ. Even though many reports have been published on circumaortic and retro-aortic veins, the complex venous pattern associated with a fenestrated renal artery has not been reported previously.

Advancements in Donation after Circulatory Death Heart Procurement and Preservation: A Comprehensive Review of Recent Innovations.

The persistent shortage of donor hearts for transplantation has prompted exploration into Donation after Circulatory Death (DCD) as a promising avenue for organ procurement. This comprehensive review aims to examine recent advancements in DCD heart procurement and preservation techniques to address the critical need for donor organs and improve transplant outcomes. A systematic review was conducted to identify relevant studies and innovations related to DCD heart procurement and preservation. Electronic databases including PubMed, MEDLINE, and Google Scholar were searched using keywords such as "DCD heart donation," "organ preservation," and "transplantation." Studies with statistical analyses on transplant outcomes were included for further evaluation. A meta-analysis of DCD heart transplantation outcomes revealed a statistically significant increase in successful transplants utilizing hearts procured after circulatory death (p<0.05). Normothermic machine perfusion demonstrated a 20% reduction in ischemic time compared to traditional cold storage methods, leading to improved post-transplant cardiac function and reduced rates of primary graft dysfunction. These findings highlight the potential of DCD heart procurement and preservation techniques to address the critical shortage of donor hearts while enhancing transplant outcomes. Recent innovations in DCD heart procurement and preservation techniques show promise in overcoming the challenges of donor organ scarcity and improving transplant success rates. Continued research and development in this field are essential to further optimize these techniques and meet the growing demand for donor hearts worldwide.

Activation of Piezo1 channels enhances spontaneous contractions of isolated human bladder strips via acetylcholine release from the mucosa

Enhanced spontaneous bladder contractions (SBCs) have been thought one of the important underlying mechanisms for detrusor overactivity (DO). Piezo1 channel has been demonstrated involved in bladder function and dysfunction in rodents. We aimed to investigate the modulating role of Piezo1 in SBCs activity of human bladder. Human bladder tissues were obtained from 24 organ donors. SBCs of isolated bladder strips were recorded in organ bath. Piezo1 expression was examined with reverse transcription-quantitative polymerase chain reaction and immunofluorescence staining. ATP and acetylcholine release in cultured human urothelial cells was measured. Piezo1 is abundantly expressed in the bladder mucosa. Activation of Piezo1 with its specific agonist Yoda1 (100 nM–100 μM) enhanced the SBCs activity in isolated human bladder strips in a concentration-dependent manner. The effect of Yoda1 mimicked the effect of a low concentration (30 nM) of carbachol, which can be attenuated by removing the mucosa, blocking muscarinic receptors with atropine (1 μM), and blocking purinergic receptors with pyridoxal-phosphate-6-azophenyl-2′,4′-disulfonate (PPADS, 30 μM), but not by tetrodotoxin (1 μM). Activation of urothelial Piezo1 with Yoda1 (30 μM) or hypotonic solution induced the release of ATP and acetylcholine in cultured human urothelial cells. In patients with benign prostatic hyperplasia, greater Piezo1 expression was observed in bladder mucosa from patients with DO than patients without DO. We conclude that upregulation and activation of Piezo1 may contribute to DO generation in patients with bladder outlet obstruction by promoting the urothelial release of ATP and acetylcholine. Inhibition of Piezo1 may be a novel therapeutic approach in the treatment of overactive bladder.

Organ Donation through the Eyes of Jordanian Medical Students

Background: Organ donation is a critical component in the field of transplantation medicine, offering lifesaving opportunities for patients with end-stage organ failure. This study investigated the knowledge, attitude, and practice (KAP) survey regarding organ donation among medical students in Jordan. Methods: A cross-sectional survey was conducted among medical students across six Jordanian universities. Using a convenience sampling method, participants were invited via email, social media, and professional networks to complete a structured online questionnaire. The survey captured data on demographics, knowledge about organ donation processes, attitudes toward organ donation, and self-reported practices. Statistical analyses explored associations between students’ KAP and their demographic characteristics. Results: A total of 539 medical students participated in the study. Findings revealed moderate knowledge and generally positive attitudes toward organ donation, with significant variability influenced by demographic factors. Students from various universities demonstrated different levels of knowledge and attitudes. Notably, religious and cultural beliefs significantly affected students’ attitudes toward organ donation. Conclusions: The study highlighted a gap between the positive attitudes and the actual commitment to organ donation among the participants, revealing a need for targeted educational interventions to address misconceptions and enhance the willingness to donate organs. Promoting organ donation education within medical schools could foster a more supportive environment for organ donation, ultimately contributing to increased donor rates and improved transplantation outcomes in Jordan.

Impact of the life-sustaining treatment decision act on organ donation in out-of-hospital cardiac arrests in South Korea: a multi-centre retrospective study

BackgroundThe demand for organ transplants, both globally and in South Korea, substantially exceeds the supply, a situation that might have been aggravated by the enactment of the Life-Sustaining Treatment Decision Act (LSTDA) in February 2018. This legislation may influence emergency medical procedures and the availability of organs from brain-dead donors. This study aimed to assess LSTDA’s impact, introduced in February 2018, on organ donation status in out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city and identified related factors.MethodsWe conducted a retrospective analysis of a regional cardiac arrest registry. This study included patients aged 16 or older with cardiac arrest and a cerebral performance category (CPC) score of 5 from January 2015 to December 2022. The exclusion criteria were CPC scores of 1–4, patients under 16 years, and patients declared dead or transferred from emergency departments. Logistic regression analysis was used to analyse factors affecting organ donation.ResultsOf the 751 patients included in this study, 47 were organ donors, with a median age of 47 years. Before the LSTDA, there were 30 organ donations, which declined to 17 after its implementation. In the organ donation group, the causes of cardiac arrest included medical (34%), hanging (46.8%), and trauma (19.2%). The adjusted odds ratio for organ donation before the LSTDA implementation was 6.12 (95% CI 3.09–12.12), with non-medical aetiology as associated factors.ConclusionThe enactment of the LSTDA in 2018 in South Korea may be linked to reduced organ donations among patients with OHCA, underscoring the need to re-evaluate the medical and legal aspects of organ donation, especially considering end-of-life care decisions.

Organic Bases as the Organic Electron Donors (OED) Promoted Reductive Coupling of Diarylhalomethanes: Halogens Controlled Construction of Tetraarylethylenes and Tetraarylethanes.

Using the organic base as the organic electron donors, the reductive coupling of diaryhalomethanes was smoothly achieved under transition-metal-free reaction conditions, giving a series of synthetically important tetraarylethylenes and tetraarylethanes in high yields. The mechanistic study revealed that the organic bases acting as the electron donor initiated the generation of a radical intermediate, realizing the construction of tetraarylethylene and tetraarylethane skeletons.