Awareness of Cornea Donation of Registered Tissue Donors in Nanjing

Objective To evaluate the current cornea donation awareness of tissue donors in the city of Nanjing, China Methods Altogether 2000 registered tissue donors in the Red Cross Eye Bank of Nanjing by the end of 2010 and 2000 control residents of Nanjing in February to June 2011 were randomly selected to par- ticipate in our field questionnaire survey. The questionnaire consisted of questions regarding the understand- ing of cornea donation, the attitude toward cornea donation, and attitude toward legislation and free dona- tion. The awareness of cornea donation between the registered tissue donors and residents was compared. Related factors of the willingness to donate corneas and to become a tissue donor were evaluated with uni- variate and multiple logistic regression analysis. Results A total of 1867 （response rate： 93.4%） tissue donors and 1796 （response rate： 89.8%; ef- fective questionnaires： 1697） residents participated in this survey. For the questions about the knowledge of cornea donation, 90.3% tissue donors （residents： 78.9%） knew that donated corneas could be used for transplantations; 71.2% tissue donors （residents： 47.6%） knew that the appearance would not be destroyed after cornea donation; 70.7% tissue donors （residents： 20.0%） knew the formalities to become a cornea do- nor. For attitude toward cornea donation, 82.2% tissue donors （residents： 45.1%） were willing to donate corneas or eyeballs after death; 84.0% tissue donors （residents： 30.2%） had discussed with their families about donation; 85.1% tissue donors （residents： 24.8%） supported their families＇ or friends＇ cornea donation For attitude toward legislation and free donation, 88.3% tissue donors （residents： 61.3%） approved of legis- lation to regular cornea donation; 72.2% tissue donors （residents： 38.8%） thought that cornea or organ do- nation should be gratis. The difference between two groups was significant （P〈0.001）. However, some tissue donors did not know cornea donation well, some even opposed the legislation of cornea donation and free donation protocol. For the factors influencing the willingness to donate corneas, population was the mostrelevant factor （P〈0.O01）, since tissue donors were more willing to donate corneas than residents. Other significantly related factor were age, gender, occupation, and education level （P〈0.001 ）, while political status or religion were not significant. For the factors related to becoming a tissue donor, older age, male, white-collars （including white-collar, civil servant, teacher, soldier, lawyer, salesman, healthcare provider）, higher education level, party members （including the Chinese Communist Party members, democratic party members, and the CommunistYouth League members） （P〈0.05）. Conclusions The registered tissue donors have better understanding and more positive attitude to- wards cornea donation than control residents do. They approve of the legislation of cornea donation and free donation protocol. It may be more effective to target the population of over 58 years old, male, white-collars, well-educated people, and party members in the promotion of cornea donation.

Liver transplantation using organs from deceased organ donors: a single organ transplant center experience

BACKGROUND： In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot program.METHODS： From July 2011 to August 2012, our center performed 26 liver transplants from a pool of 29 deceased donors. All organ donation and allograft procurement were conducted according to the national protocol. The clinical data of donors and recipients were collected and summarized retrospectively.RESULTS： Among the 29 donors, 24 were China Category II donors（organ donation after cardiac death）, and five were China Category III donors（organ donation after brain death followed by cardiac death）. The recipients were mainly the patients with hepatocellular carcinoma. The one-year patient survival rate was 80.8% with a median follow-up of 422（2-696） days. Among the five mortalities during the follow-up,three died of tumor recurrence. In terms of post-transplant complications, 9 recipients（34.6%） experienced early allograft dysfunction, 1（3.8%） had non-anastomotic biliary stricture,and 1（3.8%） was complicated with hepatic arterial thrombosis.None of these complications resulted in patient death. Notably,primary non-function was not observed in any of the grafts.CONCLUSION： With careful donor selection, liver transplant from deceased donors can be performed safely and plays acritical role in overcoming the extreme organ shortage in China.

Rapid donor liver procurement with only aortic perfusion

AIM: To describe a rapid technique for procurement of donor liver with aortic perfusion only (APO). METHODS: Only the aorta is cannulated and perfused with chilled preservation solution. RESULTS: The quality of donor liver can ensure the grafted liver functions. CONCLUSION: The method of APO can simplify the operative procedure, compared with the dual cannulation. It also can minimize the danger of injuring vascular structures and involve less dissection.

Immediate post-operative complications(I):Post-operative bleeding;vascular origin:Thrombosis pancreatitis

Simultaneous pancreas-kidney transplantation is the treatment of choice forinsulin-dependent diabetes that associates end-stage diabetic nephropathy, sinceit achieves not only a clear improvement in the quality of life, but also provides along-term survival advantage over isolated kidney transplant. However, pancreastransplantation still has the highest rate of surgical complications among organtransplants. More than 70% of early graft losses are attributed to technical failures,that is, to a non-immunological cause. The so-called technical failures includegraft thrombosis, bleeding, infection, pancreatitis, anastomotic leak and pancreaticfistula. Pancreatic graft thrombosis leads these technical complications as the mostfrequent cause of early graft loss. Currently most recipients receive postoperativeanticoagulation with the aim of reducing the rate of thrombosis. Hemoperitoneumin the early postoperative period is a frequent cause of relaparotomy, but it is notusually associated with graft loss. The incidence of hemoperitoneum is clearlyrelated to the use of anticoagulation in the postoperative period. Post-transplantpancreatitis is another cause of early postoperative complications, less frequentthan the previous. In this review, we analyze the most common surgicalcomplications that determine pancreatic graft losses.

Classical orthotopic liver transplantation from a donor with situs inversus totalis using slight rotation of the liver graft

Situs inversus totalis （SIT） is a rare congenital abnormality that affects approximately 0.005% of all live births. 1 Liver grafts with SIT have traditionally been considered as an absolute contraindication for transplant because of anatomical concerns.2 A review of the literature indicated that there were only four cases of liver transplantation using an SIT donor and normal recipient.3-6 Various modified ＂piggyback＂ techniques were used in all of these cases. In the present case, we obtained a liver from a deceased donor with SIT,