Procurement Rates Research Articles

Patients with cardinal symptoms of eosinophilic esophagitis. Prejudice affects clinical practice….

Dysphagia and bolus impaction are the cardinal manifestations of eosinophilic esophagitis (EoE). Esophageal biopsy sampling is mandatory for EoE diagnosis, data though suggest that clinician do not always obtain biopsies from patients with cardinal EoE symptoms during upper gastrointestinal endoscopy even if no other entity than EoE can explain patients symptoms. We aimed to search for the esophageal biopsy procurement rate as also for factors that drive clinicians to obtain esophageal biopsies among patients with cardinal EoE symptoms. We retrospectively searched for patients with cardinal EoE symptoms submitted to upper gastrointestinal endoscopy between 1/2018 and 12/2023 in our department. Epidemiologic, clinical, endoscopic, and histological data were analyzed. In total 163 patients with cardinal EoE symptoms (dysphagia: 63 and bolus impaction: 100) were included in the study (M/F: 100/63, mean age: 54 ± 22 years). Biopsy sampling was obtained in 77/163 (47.2%) patients and sampling rates did not differ between patients with bolus impaction or dysphagia (47/100, 47% vs 30/63, 47.6%, P = 0.553). Higher rates of sampling were observed in males ( P = 0.045), those younger than 65 years old ( P < 0.001) and patients with endoscopic EoE signs ( P = 0.004). Age and endoscopic findings compatible to EoE were independently correlated to biopsy sampling. EoE was diagnosed in 35/74 patients (47.3%); the majority of patients were male, with a bolus impaction episode, compatible endoscopic findings and all were younger than 65 years old. Clinicians take esophageal biopsies in half of patients with cardinal EoE. Age and supportive endoscopic evidence drive clinicians' decision to obtain esophageal biopsies.

Coronary Angiography During Ex-Situ Heart Perfusion in a Porcine Model.

Heart transplantation is the gold standard treatment for advanced heart failure. The procurement of extended criteria donors (ECD) increases due to the current organ shortage. Coronary angiography is recommended in ECD at risk for coronary artery disease but is not systematically performed. These hearts are, therefore, either declined for transplant or procured without screening for coronary artery disease. Coronary angiography during normothermic ex-situ heart perfusion (NESP) could be an interesting approach to enhance the rate of ECD procurement and to reduce the risk of primary graft failure in the absence of coronary angiography in ECD. The present protocol aims to provide material details along with optimal imaging views for coronary angiography during NESP. Reproducible angiographic views were observed, including one dedicated to the right coronary artery, two for the left anterior descending artery, two for the circumflex artery, and a spider view. Continuous lactate extraction was observed in all procedures with a final median concentration of 1.10 mmol/L (0.61-1.75 mmol/L) two hours after coronary angiography, consistent with myocardial viability. The median contrast agent volume used for ex-situ imaging of the isolated perfused heart was 48 mL (38-108 mL). This protocol was reproducible for coronary artery imaging and did not impair myocardial viability during NESP.

1508-P: The Therapy of Type 1 Diabetes Mellitus with Neo-islets, 3-D Organoids of Mesenchymal Stromal and Islet Cells, Has the Capacity to Compensate for the Very Low Procurement Rate of Pancreata and Islets and This without the Need for Antirejection Drugs

1508-P: The Therapy of Type 1 Diabetes Mellitus with Neo-islets, 3-D Organoids of Mesenchymal Stromal and Islet Cells, Has the Capacity to Compensate for the Very Low Procurement Rate of Pancreata and Islets and This without the Need for Antirejection Drugs

Deceased Donors With HIV in the Era of the HOPE Act: Referrals and Procurement.

The HIV Organ Policy Equity Act legalizes organ procurement from donors with HIV (HIV D+). A prior survey of Organ Procurement Organizations (OPOs) estimated >2000 HIV D+ referrals/year; however, only 30-35 HIV D+/year have had organs procured. Given this gap, we sought to understand HIV D+ referrals and procurements in practice. We prospectively collected data on all OPO-reported HIV D+ referrals, including reasons for nonprocurement. We evaluated trends and compared HIV D+ characteristics by procurement status using regression, chi-squared tests, and Wilcoxon rank-sum tests. From December 23, 2015 to May 31, 2021, there were 710 HIV D+ referrals from 49 OPOs, of which 171 (24%) had organs procured. HIV D+ referrals increased from 7 to 15 per month (P < 0.001), and the procurement rate increased from 10% to 39% (P < 0.001). Compared with HIV D+ without procurement, HIV D+ with procurement were younger (median age 36 versus 50 y), more commonly White (46% versus 36%), and more often had trauma-related deaths (29% versus 8%) (all P < 0.001). Nonprocurement was attributed to medical reasons in 63% of cases, of which 36% were AIDS-defining infections and 64% were HIV-unrelated, commonly due to organ failure (36%), high neurologic function (31%), and cancer (14%). Nonprocurement was attributed to nonmedical reasons in 26% of cases, commonly due to no authorization (42%), no waitlist candidates (21%), or no transplant center interest (20%). In the early years of the HIV Organ Policy Equity Act, actual HIV D+ referrals were much lower than prior estimates; however, the numbers and procurement rates increased over time. Nonprocurement was attributed to both medical and nonmedical issues, and addressing these issues could increase organ availability.

Patient management for thoracic organ donor candidates: the lung transplantation team's view.

Despite the increasing demand for lung transplants, donor lungs remain in short supply. Although organ donations have been steadily increasing in Korea, with the utilization rate for donor lungs increasing to 40% in recent years, many potential donor organs remain unused. To match the increasing number of patients on the lung transplant waitlist, it is essential to increase the donor procurement rate through optimal management. Improvements in donor lung management programs can lead to expansion of the donor pool and optimal posttransplant outcomes. This review focuses on basic protocols for the optimal management of donor lungs and summarizes coronavirus disease 2019-related considerations for donor lung evaluation.

The kidney distribution system for transplantation in Chile explained according to Game Theory: How theoretical generosity is transformed into real selfishness

Context: There is a huge mismatch between demand and supply of organs for transplantation, particularly kidneys. Their allocation system in Chile delivers one kidney to the procuring institution and the second to another national institution; policy designed seeking to stimulate procurement in transplant institutions. Objectives: Evaluate whether this policy has been effective for increasing nationwide organ donation and procurement rates in procuring centers, whether their behavior is aligned with the local / pool kidney allocation system, and whether the policy has contributed to increasing equity in access to kidney transplantation. Methods: We obtained the origin of all organ donors between 2010-2020 from public records, separating them by private or public institutions, and matched those organs with the corresponding information from the centers that implanted them, and used descriptive statistics, t-student tests, and linear regressions over time for analysis. We performed an economic analysis of the costs of procuring a kidney for transplantation, for which we gathered the public static prices, and a sample of the 5 largest private transplantation facilities’ prices. Results: We found no significant increase in the total number of organ donors in the country during the studied period, and the mild increase observed was due to the addition of new public centers to the system. We observed that private institutions are increasing their participation in the transplant market and they do so at the expense of public institutions and without increasing their contribution of organs to the system, because of the high cost of procuring compared to the cost of transferring a kidney. Conclusions: This behavior can be framed within the Game Theory, specifically the Tragedy of the Commons, describing that the players maximize their benefit at the expense of the rest without considering the subsequent consequences, which leads to an imbalance between demand and supply of organs for transplantation that worsens over time and lengthens waiting lists.

Improvement Gaps to Deal with the Shortage of Lungs for Transplant From a Middle Income Country's Perspective.

Our study aimed to identify the potential causes for the low lung procurement rate in Argentina and to develop strategies to the actual problems in donor management focused on lung retrieval. We performed a crosssectional study in which we analyzed data obtained from digital self-reported surveys conducted on professionals participating in the organ procurement process in Argentina. The surveys included questions on donor management, selection criteria, and resource availability involving increasing lung procurement. Among professionals surveyed, 23.7% did not use advanced hemodynamic monitoring in their donor maintenance and limited their use to central venous pressure. Only 35.8% of participants considered maintaining central venous pressure <10 mm Hg during donor maintenance. With regard to donors with severe deterioration of the ejection fraction, 47.4% of participants would not use restrictive fluid, and only 23.2% would use an advanced monitoring of the hemodynamic status to guide fluid management. Only 27.8% of participants routinely would use steroids to improve lung function in donors. With regard to mechanical ventilation, 80.4% of participants used protective ventilation, but only 4.10% used it adequately. Recruitment maneuvers were routinely used by only 3.1% of those surveyed. With regard to expanded selection criteria (age >55 years, smoking habit of >20 packs/year, positive upper airway cultures, unspecific infiltrates in radiography, and >72 hours of mechanical ventilation), 92.8% of surveyed participants would discount patients with some of these expanded selection criteria without considering offering the lungs for donation. Opportunities for improvement may involve training physicians involved in the donor maintenance process and reviewing the donor selection criteria used to increase adherence to expanded selection criteria.

What is visible is fixable: Visual dashboards for multi-domain assessment of organ procurement organization performance

With stakeholder focus on the United States organ procurement system, there is a need for tools that permit comparative assessment of organ procurement providers. We developed a public-facing dashboard for organ procurement organizations (OPOs), using data from multiple sources, to create an online, readily accessible visualization of OPO practice conditions and performance for the period 2010-2020. With this tool, OPOs can be compared on the CMS metric of donors procured per 100 donation-consistent deaths, as well as donation after circulatory death procurement, procurement of older and minority patient populations, procurement in smaller hospitals, and procurement of patients without a significant drug history. Patterns of higher performance were identified, and 74% of differences in overall donor procurement rates could be explained using model variables. Procurement differences were affected to a greater and more reproducible degree by OPO performance among Black and non-White patient populations, as well as in smaller hospitals, than by donation service area characteristics. Dashboards such as ours support OPOs and stakeholders in quality improvement actions, through leveraging benchmarked performance data among organ procurement clinical providers.

Interplay between humanitarian procurement operations and fundraising

Procuring requested relief items, while ensuring an available budget, is an essential task in humanitarian logistics. Humanitarian organizations (HOs) are facing difficult decisions about procurement portfolios (i.e., prepositioning-versus-emergency procurement) and fundraising strategies. We develop a two-stage newsvendor model in the context of a leader–follower game between a representative HO (the leader and donors (the follower)to characterize their interactions. In our model, the HO decides on the prepositioning level for disaster preparedness under uncertainty, while the fundraising expense is determined on the disaster response phase. Our research compares a budget-constrained case with a budget-unconstrained benchmark case. Furthermore, we discuss the trade-off between the efficiency (i.e., maximizing HO’s expected budget) and effectiveness (i.e., maximizing expected demand fill rate) of procurement and fundraising operations. Our numerical analysis reveals that the budget-unconstrained environment would provide the HO with misleading managerial insights into procurement portfolios—overemphasis on prepositioning. Further, an effective fund-raise mechanism that could raise donors’ motivation for donations would reduce prepositioning. We also observe that prepositioning cannot guarantee to achieve the highest operational effectiveness (demand fill rate) due to the loss of fundraising opportunities. Research implications and managerial guidelines are proposed.

Organ donation and transplantation in the Russian Federation in 2022. 15&lt;sup&gt;th&lt;/sup&gt; Report from the Registry of the Russian Transplant Society

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on data from the year 2022.Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. We performed a comparative analysis of data obtained over years from various federal subjects of the Russian Federation and transplant centers.Results. Based on data retrieved from the National Registry in 2022, 46 kidney, 31 liver and 16 heart transplant programs were existing in the Russian Federation as of the year 2022. Organ donation activity in 2022 was 5.2 per million population (p.m.p.), with a 73.7% multi-organ procurement rate and an average of 2.8 organs procured from one effective donor. In 2022, 2,555 organ transplants were performed in the Russian Federation, which included 1,562 kidney, 659 liver and 310 heart transplants. Same year, the number of transplant surgeries performed in the Russian Federation increased by 10.0% compared to 2021. In Moscow, organ donation activity was 26.3 p.m.p. The city of Moscow and the Moscow Oblast alone had a total of 12 transplant centers, accounting for 52.6% of all kidney transplants and 64.8% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation exceeds 150 p.m.p.Conclusion. The geographic distribution of transplant centers in the Russian Federation continues to expand. Five new centers were opened in 2022. Over the past year, the number of effective donors and organ transplants increased in the country. The resource potential of medical institutions has not been exhausted and this is set to further increase the number of organ transplants performed. Moscow is the powerhouse of Russian transplantology. However, other regional leaders have since appeared in the Russian Federation, such as in Kemerovo, Kazan, Rostov-on-Don, Tyumen, Irkutsk, and Volzhsky. In the Russian Federation, priority is being given to pediatric transplant care. It is expedient to implement a complex of measures aimed at identifying potential recipients.

Barriers to Deceased Donor Procurements: The Saudi Experience.

Barriers to Deceased Donor Procurements: The Saudi Experience.

Trends and correlated outcomes in population-level prescription opioid and transdermal fentanyl use in Israel

BackgroundIn the last twenty years, there was a documented increase in prescription opioid procurement in Israel. However, there is still little evidence of the association between opioid procurement rates, health service utilisation in secondary care, and enrollment rates to substance use disorder treatment programmes. In this study, we show trends in the reports of opioid-related hospitalisations, emergency department visits, enrollment to community-based outpatient treatment for Prescription Opioid Use Disorder and opioid-related mortality rates. Additionally, we examine potential correlations between these health service utilisation rates and prescription opioid procurement rates at the population level, with a focus on transdermal fentanyl.MethodsA longitudinal study at the population level. We used seven-year data on indicators of opioid-related morbidity, prescription opioid procurement data for 2015–2021, and six-year opioid-related mortality data for 2015–2020. We measure the correlation between procurement rates of prescription opioids in Oral Morphine Equivalent per capita, and aggregated rates obtained from hospital administrative data for hospitalisations, emergency department visits, and patient enrolment in specialised prescription opioid use disorder outpatient treatment in the community setting.ResultsBetween 2015 and 2021, procurement rates in primary care per capita for all prescription opioids increased by 85%, while rates of transdermal fentanyl procurement increased by 162%. We found a significant positive correlation at the population level, between annual opioid procurement rates, and rates per population of opioid-related visits to emergency departments (r = 0.96, p value < 0.01, [CI 0.74–0.99]), as well as a positive correlation with the rates per population of patient enrolment in specialised prescription opioid use disorder outpatient treatment (r = 0.93, p value = 0.02, [CI 0.58–0.99]). Opioid-related mortality peaked in 2019 at 0.31 deaths per 100,000 but decreased to 0.20 deaths per 100,000 in 2020.ConclusionData shows that all-opioid and transdermal fentanyl procurement has increased yearly between 2015 and 2021. This increase is positively correlated with a growing demand for community-based Prescription Opioid Use Disorder outpatient treatment. Efforts to reduce opioid-related morbidity may require effective approaches toward appropriate prescribing, monitoring, and further increasing access to prescription opioid outpatient treatment.

A Status and Performance of Dairy Cooperative Societies in Karnataka

The present study was carried out in Karnataka state to assess the status and performance of Dairy Cooperative Societies (DCS). A total number of 18 DCS were selected from the three regions of the state, such as the southern, central coastal and , northern regions, in equal numbers. The annual growth rate of the establishment of dairy cooperatives in the state was reported to be 4.01 per cent, and the growth rate of the milk procurement of the society per annum was increased to 9.18 per cent. The milk procurement of the society directly influenced the performance of the DCS. Among the selected societies, the highest milk procurement was observed for those under BAMUL, followed by SHIMUL and RBKMUL. The Principal Component Analysis (PCA) was applied to assess the performance of selected DCS. The results of PCA showed that about 39 per cent of the DCS were categorized under the lowperformance group, followed by 33 and 28 per cent of the societies classified as medium and high-performance, respectively. Overall, the performance of DCS was low to medium, which may be attributed to less per cent of active members per DCS, low milk procurement per society per day and unequal distribution of inputs. Therefore, dairy farmers need to be aware of the benefits provided by dairy cooperatives so that many farmers may participate actively and get benefitted.

Comparison between three types of needles for endoscopic ultrasound-guided tissue acquisition of pancreatic solid masses: a multicenter observational study

It is debatable which needle has clear superiority of diagnostic performance in endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) of solid pancreatic masses. This study aimed to compare the performance of three needles and determine the variables that affect diagnostic accuracy. From March 2014 to May 2020, 746 patients with solid pancreatic masses who underwent EUS-FNB using three types of needles (Franseen needle, Menghini-tip needle, and Reverse-bevel needle) were retrospectively reviewed. Multivariate analysis using a logistic regression model was used to identify factors related to diagnostic accuracy. There were significant differences between the groups regarding the procurement rate of the histologic and optimal quality cores (Franseen vs. Menghini-tip vs. Reverse-bevel: 98.0% [192/196] vs. 85.8% [97/113] vs. 91.9% [331/360], P < 0.001 and 95.4% [187/196] vs. 65.5% [74/113] vs. 88.3% [318/360], P < 0.001, respectively). The sensitivity and accuracy using histologic samples were 95.03% and 95.92% for Franseen, 82.67% and 88.50% for Menghini-tip, and 82.61% and 85.56% for Reverse-bevel needles, respectively. In direct comparison between the needles using histologic samples, the Franseen needle showed significantly superior accuracy than the Menghini-tip (P = 0.018) and Reverse-bevel needles (P < 0.001). Multivariate analysis indicated that tumor size ≥ 2 cm (odds ratio [OR] 5.36, 95% confidence interval [CI] 3.40–8.47, P < 0.001) and fanning technique (OR 1.70, 95% CI 1.00–2.86, P = 0.047) were significantly associated with an accurate diagnosis. EUS-FNB using the Franseen needle enables the acquisition of a larger and more adequate histologic core tissue and achieves an accurate histological diagnosis when using the fanning technique.

Effect of three-dimensional intraoperative imaging on surgical outcomes with breast conservation therapy

BackgroundBreast conservation therapy (BCT) is frequently performed for breast cancer and associated with a significant risk for positive margins. Intraoperative three-dimensional (3-D) tomosynthesis potentially could limit the risk of positive margins. MethodsRetrospective review of an institutional breast cancer registry. Evaluated BCT cases for a two year time period prior to and after the introduction of intraoperative 3-D tomosynthesis. Primary outcome was the effect of 3-D tomosynthesis on margin positivity rates. Secondary measures were the impact of 3-D tomosynthesis on additional margin procurements at the index surgery and operative time. ResultsA total of 228 cases were evaluated with 106 cases utilizing 3-D tomosynthesis and 122 cases with standard imaging. No significant difference in margin positivity rates between the cohorts at 23.9% versus 15.8% for 3-D tomosynthesis and standard imaging respectively (OR 1.53, CI 0.772–3.032, P = 0.221). 3-D tomosynthesis was associated with increased margin procurement rates (OR 2.34, 95%CI 1.303–4.190, P = 0.004) and longer operative times (P < 0.001). ConclusionIntraoperative 3-D tomosynthesis was not found to limit margin positivity rates or improve the performance of the procedure.

Evaluation of red blood cell transfusion threshold in the management of brain-dead organ donors

The disparity between the demand and supply of organs has necessitated an expansion of the criteria for organ donation. Consequently, numerous guidelines have been proposed for managing brain-dead organ donors (BDODs) to improve their organ function and the organ procurement rate. Therefore, we aimed to evaluate the previously recommended threshold for red blood cell transfusion in BDODs. Medical records of BDODs were retrospectively reviewed from January 2012 to December 2021. We enrolled BDODs who stayed for more than 24 hours at an hospital organ procurement organization. We analyzed their organ function and the rate of organ procurement according to the hemoglobin concentration. A total of 111 BDODs were enrolled and divided into the following 2 groups: hemoglobin (Hb) ≥ 10 g/dL (45.0 %) and Hb < 10 g/dL (55.0 %). There were no significant differences between the groups in the total bilirubin, creatinine, arterial blood lactate, and the rate of organ procurement. A correlation analysis did not reveal any association between the hemoglobin concentration and organ function of the BDODs. Hemoglobin concentration of 10 g/dL cannot be considered a threshold for red blood cell transfusion. Furthermore, organ function is not correlated with a hemoglobin concentration > 7 g/dL. Restrictive transfusion strategy is appropriate for BDOD management.

Knowledge, Awareness, and Perception of Common Eye Diseases and Eye Donation Among People Seeking Healthcare in a Tertiary Hospital in Telangana, South India.

Background Globally billions of people have vision impairment (VI) or blindness, and at least half of the VI could have been prevented or has yet to be addressed. With the policies focused exclusively on treating ailments, we need to recognize the need to educate the country's population regarding diseases and their outcomes. This is evident in the poor eye donation rates, as documented by the Eye Bank Association of India (EBAI). The National Programme for Prevention of Blindness (NPCB) also advocates the need for active campaigning to promote eye donations and improve the corneal procurement rate by increasing health awareness. This study aimed to assess the knowledge, awareness, and perception regarding eye diseases and eye donation among the rural population of Telangana, South India. Methods A cross-sectional study involving 150 participants who were randomly selected from non-triaged attendants in the outpatient queue at Mahavir institute of medical sciences (MIMS) was included. Trained enumerators used verbally administered, semi-structured questionnaires on their awareness and knowledge of cataracts, glaucoma, diabetic retinopathy, and night blindness. The Chi-square test was applied to determine the statistical significance of the results obtained from the pre-test and post-test. The significance threshold of the p-value was set at <0.05. Results The population studied belonged to a mean age of 34.98 years. The study included 72 (48%) male and 78 (52%) female subjects, and the majority (48.6%) of them belonged to the age range of 21-30 years. More than 85% of subjects belonged to the middle and lower middle class, and the majority (74.7%) were Hindus by religion. Regarding cataracts, 64 (42.7%) did not know, and 86 (57.3%) had varied perceptions. The awareness regarding glaucoma was the least (88.7%) of all common ocular diseases. The study showed a significant association between knowledge of eye diseases and literacy status plus the population's socioeconomic status (p<0.05 ). A significant association was found to exist between willingness to eye donation and the religion of the study population (p<0.05). Conclusion This study identifies that the awareness regarding various ocular diseases was poor. Moreover, the participants had an alarmingly high misconception regarding different aspects of eye donation. Increasing public awareness is essential to minimize eye diseases, improve eye care, and encourage eye donations.

Organ donation and transplantation in the Russian Federation in 2021. 14th Report from the Registry of the Russian Transplant Society

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on data from the year 2021. Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. We performed a comparative analysis of data obtained over years from various federal subjects of the Russian Federation and transplantation centers. Results. Based on data retrieved from the 2021 Registry, 45 kidney, 29 liver and 17 heart transplantation programs were existing in the Russian Federation as of the year 2021. The kidney transplant waiting list in 2021 included about 10.5% of the 60,000 patients receiving dialysis. Organ donation activity in 2021 was 4.5 per million population, with a 78.4% multi-organ procurement rate and an average of 3.0 organs procured from one effective donor. In 2021, there were 9.5 kidney transplants per million population, 4.2 liver transplants per million population and 2.0 heart transplants per million population. Same year, the number of transplant surgeries performed in the Russian Federation increased by 18.3% compared to the year 2020, reaching the level of 2019. In Moscow, organ donation activity was 23.7 per million population, that of 2019. In 2021, the city of Moscow and the Moscow region accounted for 12 functioning organ transplant centers, performing 57.7% of all kidney transplants and 70.5% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation has exceeded 140 per million population. Conclusion. In 2021, donor activity and volume of transplant care in Russian regions recovered. This was after the decline in 2020 that resulted from the new coronavirus disease (COVID-19) pandemic. In addition, 7 new transplant programs were established. Further development of regional organ donation and transplantation programs, improvement in their efficiency, increase in the activity of transplant centers and development of inter-regional collaboration are expected in the Russian Federation in 2022.

Determinants of the Rate of Procurement Practices on Disposal of Assets in Kenya's Public Sector: A Case of the Judiciary

Disposal of unwanted assets to the Public is an important aspect of procurement and store management in many organizations. When equipment is in surplus or obsolete, keeping it through maintenance, parking, insurance or storage may lead to exceedingthe recoverable amount which can be the result of continued use of the equipment. In Kenya, the public sector has certain disposal guidelines and procedures as stated in the Public Procurement and Disposal Act, 2005, and the Public Procurement and DisposalRegulations, 2006. The PPDA applies to all procurement of works, goods, and services, and also, the disposal of assets by all public entities. Disposal of assets in the Public sector is complex due to the multiple interests from various stakeholders against a backdrop of the objectivesit tries to achieve amidst various regulatory bodies or policies which are supposed to be observed. The main goal of this research was to make an assessment on the determinants of the rate of procurement and disposal of the assets in Kenya‟s public institutions, a case of the Judiciary. However, the objectives were used in determining the influence of procurement planning on the disposal of assets; determine how accounting and financial risks affect the disposal of the assets, and identifying the effects of the management methods chosen on the rate of disposal of assets. The study adopted a descriptive study design with a case-study approach to the Judiciary. For purposes of this study, the population of interest was 101 respondents from the Judiciary, which included the department heads, deputies, the disposal committees, and procurement and disposal staff. The study adopted a census sampling technique. The collection of primary data was done using a questionnaire research method The findings show that procurement planning, financial and accounting risks, and choice of management methods affected the rate of assets disposal in the Judiciary to a large extent, It also revealed issues such as corruption, political interference, non-adherence to the PPDA provisions, and PPOA inefficiency as impediments to assets disposal effectiveness and further the study also revealed that the legal framework and regulations had an impact on the relationship between determinants of the rate of procurement and disposal of the assets. The study recommended that The Judiciary‟s procurement department should consider scaling up efforts and work with diligence in stemming out corrupt officers, and ensure total adherence to set PPDA procedures; include strict disposal procurement planning and adopt the well-researched choice of management methods; allocate resources for update training to the procurement and finance staff, and properly explain stakeholders‟ limits and roles when dealing with assets disposal and adopt a proactive and stringent approach

Organ donation and transplantation in the Russian Federation in 2020 13th Report from the Registry of the Russian Transplant Society

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on the 2020 data.Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. Between separate federal subjects of the Russian Federation and between transplantation centers, comparative analysis of data obtained over years was performed.Results. Based on data retrieved from the 2020 Registry, 44 kidney, 29 liver and 16 heart transplantation programs were functioning in the Russian Federation in 2020. The kidney transplant waitlist in 2020 included about 11.5% of the total 60,000 patients receiving dialysis. Organ donation activity in 2020 was 3.9 per million population, with a 74.6% multi-organ procurement rate and an average of 2.9 organs being procured from one effective donor. In 2020, there were 7.7 kidney transplants per million population, 3.8 liver transplants per million population and 1.7 heart transplants per million population. Same year, the number of transplant surgeries performed in the Russian Federation fell by 19.2% to 13.4 per million population against the background of the outbreak caused by the new coronavirus disease COVID-19. The city of Moscow and the Moscow region in 2020 accounted for 13 out of the 14 functioning organ transplantation centers, performing 66.3% of all kidney transplants and 72.4% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation have exceeded 130 per million population.Conclusion. In 2020, despite the new coronavirus disease COVID-19 pandemic and accompanying restrictive measures, transplant centers continued to perform organ transplants, run a waiting list and monitor organ recipients. However, the number of effective donors (–22.9%) and organ transplants (–19.2%) decreased, tentatively to the 2017 levels. In 2021, transplant centers with support from health authorities will have to restore the volume of transplant care with consideration to the real needs of the population and the donor resource. The COVID-19 factor, including vaccination of the population, as well as financial support to transplantation programs, will be decisive in shaping the trend of transplantation care and organ donation in the federal subjects of the Russian Federation in the coming 1–2 years.