Scarcity Of Donors Research Articles

Examining the Role of the Health Belief Model Framework in Achieving Diversity and Equity in Organ Donation Among South Asians in the United Kingdom.

Organ donation continues to be low among ethnic minorities in the United Kingdom (UK), especially within the South Asian community, with a disproportionate number of patients of South Asian ethnicity awaiting organ transplants. In 2020/21, Minority Ethnic (ME) patients comprised almost a third of the national transplant waiting list, highlighting the continued imbalance between the need for transplants in South Asian communities and the availability of suitable organs. Median waiting times for transplants show that, generally, white patients wait less time than ME patients; Only 39.5% of ME families consented to proceed with deceased organ donation when approached compared to 69% of white families. How to increase awareness among the South Asian community on the scarcity of organ donors continues to be a growing challenge facing the healthcare system in the UK and globally. This article reflects on the education strategy implemented using the Health Belief Model. It provides a detailed framework with which to consider the rationale that led to a specific behaviour, in this case organ donation among the three major ethnicities (i.e., Indian, Pakistani, Bangladeshi) within the South Asian community as part of a single study.

A HANDS-ON MANUAL FOR IDENTIFYING AND TREATING HEART FAILURE IN CHILDREN

The incidence of heart failure among children constitutes a major cause of sickness and mortality during their initial years of existence. Whereas well-established guidelines are present for managing heart failure in adults, a corresponding consensus for the pediatric group is lacking. Within a healthcare setting, it's of paramount importance to establish a correct diagnosis and identify the root cause for the most effective intervention. Primary interventions include diuretics and angiotensin-converting enzyme inhibitors, however, the utilization of beta-blockers and cardiac therapy devices is less common in pediatric cases as compared to adults. For severe conditions, heart transplant remains the go-to therapeutic choice. Additionally, left ventricular assist devices can be employed as a temporary solution awaiting transplantation (due to scarcity of organ donors), recovery (in instances of myocarditis), or a definitive solution (for patients with systemic disease).

Current Progress of 3D Bioprinting of Cardiac Tissues

Heart disease is the leading cause of death worldwide. Heart transplants are used when treating end-stage heart disease. The main problem faced by heart transplantation is the scarcity of donors. Therefore, finding a way to replace the donor heart remains a major medical challenge. In recent years, 3D bioprinting has often been used in tissue engineering, and it has achieved results in the preparation of many types of human tissues. Therefore, it is regarded as a promising method for alleviating donor heart scarcity. In this article, we summarize the current research progress of 3D bioprinting of cardiac tissue, and after introducing several 3D bioprinting methods, bioinks, and 3D bioprinting steps for heart tissue, we proposed our perspectives on 3D bioprinting, discussed several current challenges, and analysed the future of development.

A Detailed Review on 3D Bioprinting and it's Application in Pharmaceutical Science

Cellular tissues have intricate, highly complex tissue microenvironments. cytoarchitecture, structure tissue-specific compositional and mechanical heterogeneity, as well as a hierarchy of functions. Given the high demand for organ transplants and the scarcity of organ donors, bioprinting is an emerging technology that Having the capacity to address the issue of an organ shortage by creating entire, fully-functional organs. Even if the idea of printing organs is still far away off, there has been significant and laudable advancement when it comes to bioprinting that could be used to create transplantable tissues for regenerative medicine. The eleven organ systems used by humans body, including the skeletal, muscular, nervous, lymphatic, endocrine, reproductive, integumentary, respiratory, digestive, urinary, and circulatory systems, were critically reviewed. A first-ever an analysis of 3D bioprinting in regenerative medicineis presented in this study. 3D bioprinting's effects In terms of in vitro drug testing models and drug delivery systems, there is also a brief discussion of drug discovery, development, and personalized medicine. While there is a substantial progress pertaining totechnology.

End-ischemic hypothermic oxygenated perfusion for extended criteria donors in liver transplantation: a multicenter, randomized controlled trial—HOPExt

BackgroundGiven the scarce donor supply, an increasing number of so-called marginal or extended criteria donor (ECD) organs are used for liver transplantation. These ECD liver grafts are however known to be associated with a higher rate of early allograft dysfunction and primary non-function because of a greater vulnerability to ischemia–reperfusion injury. The end-ischemic hypothermic oxygenated machine perfusion (HOPE) technique may improve outcomes of liver transplantation with ECD grafts by decreasing reperfusion injury.MethodsHOPExt trial is a comparative open-label, multicenter, national, prospective, randomized, controlled study, in two parallel groups, using static cold storage, the gold standard procedure, as control. The trial will enroll adult patients on the transplant waiting list for liver failure or liver cirrhosis and/or liver malignancy requiring liver transplantation and receiving an ECD liver graft from a brain-dead donor. In the experimental group, ECD liver grafts will first undergo a classical static cold (4 °C) storage followed by a hypothermic oxygenated perfusion (HOPE) for a period of 1 to 4 h. The control group will consist of the classic static cold storage which is the gold standard procedure in liver transplantation. The primary objective of this trial is to study the efficacy of HOPE used before transplantation of ECD liver grafts from brain-dead donors in reducing postoperative early allograft dysfunction within the first 7 postoperative days compared to simple cold static storage.DiscussionWe present in this protocol all study procedures in regard to the achievement of the HOPExt trial, to prevent biased analysis of trial outcomes and improve the transparency of the trial results. Enrollment of patients in the HOPExt trial has started on September 10, 2019, and is ongoing.Trial registrationClinicalTrials.gov NCT03929523. Registered on April 29, 2019, before the start of inclusion.

Recent advances in the immunomodulation mechanism of mesenchymal stem cell therapy in liver diseases.

Liver fibrosis, acute liver injury or liver failure, liver tumors, and immune rejection after liver transplantation are common clinical liver diseases. Immune responses are the key to determining the prognosis of liver diseases. Liver transplantation could be the last resort for patients with liver failure. However, the use of liver transplantation is limited because of the scarcity of organ donors, immunological rejection in recipients, and high cost. Mesenchymal stem cells (MSCs) are pluripotent adult stem cells with extensive anti-inflammatory and immunomodulation effects. MSCs can be effectively used for treating liver diseases but without the limitations that are associated with liver transplantation. Therefore, several clinical trials have utilized MSCs for the treatment of refractory liver diseases and the related mechanism is increasingly being elucidated. We have mainly summarized the recent studies that focus on the immunomodulation mechanism of MSC therapy in liver diseases. Further, we have presented our insights on the prospects of using MSCs in the treatment of liver diseases.

PULM9: Development of a Novel Cannula for Durable Venovenous Extracorporeal Membrane Oxygenation

Background: Fifteen million Americans suffer from chronic obstructive pulmonary disease (COPD). After failed optimal medical therapy, the only definitive treatment is lung transplantation, which is limited due to donor scarcity. Extracorporeal membrane oxygenation (ECMO) can be used in acute exacerbations of COPD or as a bridge to transplant for waitlisted COPD patients, but it is not currently suited for long-term respiratory support. Existing venovenous (VV) ECMO configurations often utilize a dual lumen cannula that is inserted into the jugular vein and is designed for short term use. While effective, dual lumen cannulas are associated with high resistance and malposition which limits blood flow, promotes cavitation, and increases blood trauma. Furthermore, patient ambulation is cumbersome because of the difficulty of securing the dual lumen cannula safely to the patient. A novel ECMO system that provides durable respiratory support could reduce morbidity and mortality in patients and facilitate ambulatory use. To this end, a dual lumen cannula that is attached to the heart and tunneled to a more ergonomic position could provide more durable, long term ECMO support. Here, we describe our initial efforts to develop a durable VV ECMO cannula with reduced resistance. Methods: A novel cannula for long-term VV ECMO support was developed using computer aided design. The cannula is designed for surgical attachment to the right atrium with the cannula’s drainage tip at the cavoatrial junction and the reinfusion port directed towards the tricuspid valve to minimize recirculation. Pressure drop was evaluated for the novel cannula, 28Fr, and 32Fr Crescent cannulas (MC3, Dexter, MI) for comparison (N≥5) in circuits primed with deionized water at ambient temperature. A Rotaflow (Maquet, Wayne, NJ) blood pump was operated at 2700-3625 RPM, and pressure drop was assessed for flow rates between 0.1 – 5 LPM. Porcine hearts were harvested from healthy pigs and utilized for ex vivo cannula fit studies. Water flow through the cannula into the right atrium was evaluated using videography. Results: The novel cannula drainage pressure drop (-12±1.1mmHg) was similar to the 28Fr Crescent (-13± 0.3mmHg) and 32Fr Crescent (-9±0.3mmHg) at 2LPM (Figure 1). Reinfusion pressure drop was similar between the novel cannula (22±1.2mmHg) and the 32Fr Crescent (21±0.4mmHg), and higher for the 28Fr Crescent (43±0.9mmHg) at 2LPM. Total pressure drop was similar between the novel cannula (33.4±1.2mmHg) and 32Fr Crescent (29.4±0.5mmHg) and higher for the 28Fr Crescent (57±1.0mmHg) at 2LPM. In ex-vivo heart studies flow through the novel cannula was directed towards the tricuspid valve and entered the right ventricle. Conclusions: Our novel cannula possesses an excellent pressure-flow profile, comparable to the largest-bore commercially available dual lumen cannulas. This novel cannula will enhance durability and ease of use for patients requiring durable mechanical respiratory support.Figure 1. Pressure Flow Curve for Novel VV ECMO Cannula

Progress in Combined Liver-lung Transplantation at a Single Center.

A single-center, retrospective review of the medical records of 19 adult lung-liver transplant recipients was conducted, comparing early recipients (2009-2014) with a recent cohort (2015-2021). Patients were also compared with the center's single lung or liver transplant recipients. Recent lung-liver recipients were older (P = 0.004), had a higher body mass index (P = 0.03), and were less likely to have ascites (P = 0.02), reflecting changes in the etiologies of lung and liver disease. Liver cold ischemia time was longer in the modern cohort (P = 0.004), and patients had a longer posttransplant length of hospitalization (P = 0.048). Overall survival was not statistically different between the 2 eras studied (P = 0.61), although 1-y survival was higher in the more recent group (90.9% versus 62.5%). Overall survival after lung-liver transplant was equivalent to lung-alone recipients and was significantly lower than liver-alone recipients (5-y survival: 52%, 51%, and 75%, respectively). Lung-liver recipient mortality was primarily driven by deaths within 6 mo of transplant due to infection and sepsis. Graft failure was not significantly different (liver: P = 0.06; lung: P = 0.74). The severity of illness in lung-liver recipients combined with the infrequency of the procedure supports its continued use. However, particular attention should be paid to patient selection, immunosuppression, and prophylaxis against infection to ensure proper utilization of scarce donor organs.

A Review on the Applications of Natural Biodegradable Nano Polymers in Cardiac Tissue Engineering.

As cardiac diseases, which mostly result in heart failure, are increasing rapidly worldwide, heart transplantation seems the only solution for saving lives. However, this practice is not always possible due to several reasons, such as scarcity of donors, rejection of organs from recipient bodies, or costly medical procedures. In the framework of nanotechnology, nanomaterials greatly contribute to the development of these cardiovascular scaffolds as they provide an easy regeneration of the tissues. Currently, functional nanofibers can be used in the production of stem cells and in the regeneration of cells and tissues. The small size of nanomaterials, however, leads to changes in their chemical and physical characteristics that could alter their interaction and exposure to stem cells with cells and tissues. This article aims to review the naturally occurring biodegradable nanomaterials that are used in cardiovascular tissue engineering for the development of cardiac patches, vessels, and tissues. Moreover, this article also provides an overview of cell sources used for cardiac tissue engineering, explains the anatomy and physiology of the human heart, and explores the regeneration of cardiac cells and the nanofabrication approaches used in cardiac tissue engineering as well as scaffolds.

Future of Bioprinting in Healthcare: A Review

Tissue damage and degeneration are common pathological phenomena in higher organisms, specifically in mammalians. However, the traditional method of organ transplantation is a gold standard treatment option for life-saving, dependent upon a donor’s availability. The scarcity of organ donors and the risk of graft rejection is mainly associated with adverse immune responses. Additive manufacturing, such as bioprinting, is one of the most advanced and state-of-the-art techniques that are being utilized for generating tissue engineering construct and in-vitro disease models. Three-dimensional bioprinting associate in creation of extracellular matrix (ECM), such as microenvironments for cells and computer-aided design (CAD) modification of planned tissue morphology. Herein, formulation of suitable bio-ink composition with optimized gelation kinetics for in-situ immobilization of cells with high cell viability is the utmost priority for bio-fabrication. This review elaborates on the most current opportunities and prospects for efficiently implementing bioprinting to restructure medical and technological practices and their applications in the healthcare industry.

The unmet need of organ transplantation in Africa.

The unmet need of organ transplantation in Africa.

Stem Cell Therapy in Combination with Naturopathy: Current Progressive Management of Diabetes and Associated Complications.

Diabetes is a chronic metabolic disorder having a global prevalence of nearly doubled over the last 30 years and has become one of the major health concerns worldwide. The number of adults with diabetes increased to 537 million in 2021. The overarching goal of diabetic research and treatment has always been to restore insulin independence and an average blood glucose level. Chemotherapeutic antidiabetic agents can manage diabetes but often show toxicity and drug resistance. Natural phytomedicines may be useful along with stem cell therapy for diabetes management. Even if the whole pancreatic organ and islet transplantation, are becoming benchmark techniques for diabetes management and control, a considerable scarcity of eligible donors of pancreatic tissues and organs severely limits their use. Stem cell treatment provides a bunch of possibilities for treating people with diabetes. For this purpose, comprehensive article searching was conducted, with relevant material obtained using search engines such as Scopus, PubMed, MEDLINE, Google, and others, using appropriate keywords. Stem cell therapies, including induced pluripotent stem cells and mesenchymal stem cells, are now becoming a popular area of investigation. Recent advancements in stem cell therapy might provide a feasible treatment option. Furthermore, in recent years, some novel bioactive compounds derived from plants have demonstrated antidiabetic action with higher potency than oral hypoglycaemic medications. Recent regenerative medicine and stem cell treatment advancements might subsequently provide a feasible diabetic management option. On the other hand, medicinal herbs have been considered a better choice for the extensive treatment of diabetes. If proper attention is not given to control diabetes by antidiabetic chemotherapeutic agents, natural phytomedicine, and sophisticated treatment like stem cell therapy, then the lifespan of patients will be decreased, and some associated secondary problems will also arise. So, the present review attempts to discuss naturopathy as an alternative resource in combination with stem cell therapy for the progressive management of diabetes and associated disorders.

Three-dimensional bioprinting of functional β-islet-like constructs.

256Diabetes is an autoimmune disease that ensues when the pancreas does not deliver adequate insulin or when the body cannot react to the existing insulin. Type 1 diabetes is an autoimmune disease defined by continuous high blood sugar levels and insulin deficiency due to β-cell destruction in the islets of Langerhans (pancreatic islets). Long-term complications, such as vascular degeneration, blindness, and renal failure, result from periodic glucose-level fluctuations following exogenous insulin therapy. Nevertheless, the shortage of organ donors and the lifelong dependency on immunosuppressive drugs limit the transplantation of the entire pancreas or pancreas islet, which is the therapy for this disease. Although encapsulating pancreatic islets using multiple hydrogels creates a semi-privileged environment to prevent immune rejection, hypoxia that occurs in the core of the capsules is the main hindrance that should be solved. Bioprinting technology is an innovative process in advanced tissue engineering that allows the arranging of a wide array of cell types, biomaterials, and bioactive factors as a bioink to simulate the native tissue environment for fabricating clinically applicable bioartificial pancreatic islet tissue. Multipotent stem cells have the potential to be a possible solution for donor scarcity and can be a reliable source for generating autograft and allograft functional β-cells or even pancreatic islet-like tissue. The use of supporting cells, such as endothelial cells, regulatory T cells, and mesenchymal stem cells, in the bioprinting of pancreatic islet-like construct could enhance vasculogenesis and regulate immune activity. Moreover, scaffolds bioprinted using biomaterials that can release oxygen postprinting or enhance angiogenesis could increase the function of β-cells and the survival of pancreatic islets, which could represent a promising avenue.

Successful liver transplantation using a deceased donor liver with glycogenic hepatopathy

Background: Donor scarcity is one of the major problems in the development of a transplant program. Proper assessment of the donor liver is critical for successful liver transplantation to avoid unnecessary organ disposal as well as poor outcome.

Avances en Xeno-trasplante, Bio-impresión Aditiva 3D y Manipulación Génica para el futuro del Trasplante Cardiaco

Heart transplantation (HTx) has proved itself to be the definite therapy for patients with end- stage cardiac failure. While HTx remains the cornerstone of the surgical armamentarium, it,s long- term success has resulted in an unbalanced supply- demand equation due to severe scarcity of valid organ donors. Therefore, further developments in the field of transplant therapy remain curtailed, unless other resources are encouraged. The present report is a review on the concept evolution, present status and reasonable outlook of three different, but confluent, emerging therapies, namely, a) xenotransplantation, b) 3D additive bioprinting and c) gene therapy.

The The Scarcity of Organ Donors in Chile: How ER and ICU Professionals Can Make a Difference

Background: Despite appropriate legislation and adequate financial coverage, organ donation rates in Chile remain low. Experts blame high familial refusal rates, while dismissing the effect of procurement process inefficiencies. Our objective is to study some of those inefficiencies. Methods: Using a two-step approach, we started by obtaining two datasets, hospital discharges and organ procurements between years 2013-2017. We considered all patients that entered the system with a critical neurological condition according to ICD10, and exited dead; and all possible organ donors who entered procurement follow-up. Second, we administered a survey on healthcare professionals (physicians and registered nurses) in ER and ICU of 3 large hospitals in the capital, which aimed at describing procurement process knowledge and behavior. We used descriptive statistics for the analysis of both approaches. Results: At the first analysis we found that 87% of patients qualifying as possible donors never entered procurement follow-up and, as 50% of families refused to donate, 6% of all possible donors became effective organ donors. The survey was answered by 88 professionals. 50% physicians, 70% from ER. 51% declared they’ve actively detected a possible donor but 43% referred them to the Local Procurement Coordination. 10% of the surveyed population was not sure about the validity of brain death diagnosis, and 52% never received formal training on any organ donation topic while studying. 73% thought procurement activity was important, but 40% declared not knowing enough about it. ICU professionals were more knowledgeable than ER (81% vs 23% declared more than sufficient knowledge, p<0.001). Conclusions: The insufficient knowledge of procurement activity and concepts, especially from ER professionals may explain the lack of possible donor detection and referral found at a national level. Although the small sample may not be fully representative of the target population, the findings provide the insight that the efforts to increase Chilean organ donation rates should be put in educating healthcare professionals that participate in the procurement process, or even automating and standardizing the process to stop relying on people’s knowledge.

KAJIAN TENTANG PENURUNAN JUMLAH DONOR DARAH AKIBAT PANDEMI COVID-19: DATA SELAMA 4 TAHUN DARI UDD PMI KOTA PONTIANAK

The COVID-19 pandemic has left a noticeable mark on the health care sector. One such example is the blood services provided by the Blood Donor Unit (UDD) of Indonesian Red Cross (PMI). Every time there was an increase in COVID-19 cases, blood donation activities sharply decreased, according to the UDD PMI. During the COVID-19 pandemic, there was a scarcity of blood donors. This research aimed to see the difference in the number of blood donors before and during the pandemic. This research was descriptive analytical with a cross-sectional design by collecting data on the number of blood donors at UDD PMI Pontianak City from 2018 to 2022. The results of the study show that the number of blood donors before the pandemic was 52,607 donors, while the number of blood donors during the pandemic was 48,421 donors. which means there was a decrease in the number of blood donors by 4,186 donors (7.96%). The Independent Samples Test obtained a significant value of 0.045 (p < 0.05), which means there was a difference in the number of blood donors before and during the COVID-19 pandemic at UDD PMI Pontianak City. Concerns about the risk of infection and government policies limiting activities outside the home can explain why the COVID-19 pandemic has resulted in a decline in blood donation rates.

Tissue-engineered anterior segment eye cultures demonstrate hallmarks of conventional organ culture

BackgroundGlaucoma is a blinding disease largely caused by dysregulation of outflow through the trabecular meshwork (TM), resulting in elevated intraocular pressure (IOP). We hypothesized that transplanting TM cells into a decellularized, tissue-engineered anterior segment eye culture could restore the outflow structure and function.MethodsPorcine eyes were decellularized with freeze–thaw cycles and perfusion of surfactant. We seeded control scaffolds with CrFK cells transduced with lentiviral vectors to stably express eGFP and compared them to scaffolds seeded with primary TM cells as well as to normal, unaltered eyes. We tracked the repopulation behavior, performed IOP maintenance challenges, and analyzed the histology.ResultsTransplanted cells localized to the TM and progressively infiltrated the extracellular matrix, reaching a distribution comparable to normal, unaltered eyes. After a perfusion rate challenge to mimic a glaucomatous pressure elevation, transplanted and normal eyes reestablished a normal intraocular pressure (transplanted = 16.5 ± 0.9 mmHg, normal = 16.9 ± 0.9). However, eyes reseeded with eGFP-expressing CrFK cells could not regulate IOP, remaining high and unstable (27.0 ± 6.2 mmHg) instead.ConclusionTissue-engineered anterior segment scaffolds can serve as readily available, scalable ocular perfusion cultures. This could reduce dependency on scarce donor globes in outflow research and may allow engineering perfusion cultures with specific geno- and phenotypes.

Precise cell therapy for liver fibrosis: Endothelial cell and macrophage therapy

Liver fibrosis is typically caused by chronic viral hepatitis and, more recently, fatty liver disease associated with obesity. There are currently no approved drugs for liver cirrhosis, and liver transplantation is limited by donor scarcity, thus driving the investigation of novel therapeutic strategies. The development of liver fibrosis presents with stage- and zone-dependent characteristics that manifest as distinct dynamic changes during vascularization and extracellular matrix (ECM) deposition. However, current cellular therapies do not consider the spatiotemporal variations of liver fibrosis without identifying the precise location and stage to administer the intervention to achieve optimal therapeutic effects. Herein, we focus on endothelial cell (EC) and macrophage therapy for liver fibrosis because of their important roles in regulating the spatiotemporal changes of vascularization and ECM deposition during liver fibrosis progression. Overall, this review summarizes the stage-dependent EC and macrophage therapy for liver fibrosis, elucidates their respective mechanisms, and exemplifies potential strategies to realize precise cell therapy by targeting specific liver zones.

Polymeric Materials for Bone and Cartilage Repair Using IBM SPSS Statistics Method

Polymeric materials for bone and cartilage repair Introduction: Polymers are called macromolecules made up of very large molecules natural or artificial one of the classes of objects, the simple chemicals called monomers are multiples of units. Polymers many substances in living things make, for example, proteins, cellulose, and nucleic acids. Natural and synthetic polymeric materials in bone tissue engineering are widely used because they are extracellular similarity to matrices and have considerable biocompatibility and biodegradability. Research significance: One of the most harmful and expensive issues in human health is dysfunction, injuries, or other types of damage to human tissue and organs. Different surgical procedures have been developed to solve these concerns, including total artificial substitutes, combined artificial kidneys, etc. Inert processed tissues heart valves, autogenic or allogeneic tissues, and total artificial kidney and prosthetic kidneys (transplantation). Organ transplantation will face significant challenges due to the scarcity of organ donors, the lifetime requirement for immunity, and its devastating consequences. Also, transplanted tissue does not provide all the functionality own tissue and can covers the donor site problem. Concerning the non-biological, there could be material issues. Like, disease, and shortage limited durability and biocompatibility. These factors have made stem cells, tissue engineering (te), and organogenesis promising and significant industries. Research doesn't offer anything. Just organs and tissues transplantation, however, can provide fresh viewpoints medications for illnesses Methodology: SPSS statistics is a data management, advanced analytics, multivariate analytics, business intelligence, and criminal investigation developed by IBM for a statistical software package. A long time, spa inc. Was created by, IBM purchased it in 2009. The brand name for the most recent versions is IBM SPSS statistics. Evaluation parameters: Natural Polymer, Proteins Collagen, Silk fibroin, Polysaccharides Chitosan, Alginates, Bacterial cellulose, Synthetic Polymers. Results: the Cronbach's Alpha Reliability result. The overall Cronbach's Alpha value for the model is .590 which indicates 59% reliability. From the literature review, the above 61% Cronbach's Alpha value model can be considered for analysis. Conclusion: Cronbach's alpha reliability results. The overall Cronbach's alpha value for the model was .590, indicating a reliability of 59%. From the literature review, the above Cronbach's alpha value of 61% can be considered to analyze the model.