INTRODUCTION: There are limited reports on the epidemiology of paediatric intensive care unit (PICU) admissions, deaths and organ donation candidacy. We aimed to describe PICU admission characteristics and outcomes, determine risk factors for mortality, and perform an independent assessment of missed organ donation opportunities. METHOD: We adopted a clinical audit design recruiting consecutive patients admitted to a single-centre multidisciplinary PICU from June 2020 to December 2023. Clinical characteristics and outcomes of survivors and non-survivors were described. Multivariable regression was performed to identify independent risk factors for mortality. Organ donation candidacy was evaluated by an independent team based on the criteria by Singapore's National Organ Transplant Unit. RESULTS: There were 1766 PICU admissions with mean age ± standard deviation of 5.9 ± 6.0 years. Surgical admissions accounted for 707/1766 (40%), while the most common medical admission category was respiratory (416/1766; 23.6%). The majority of 983/1766 (55.7%) had a chronic comorbidity and 312/1766 (17.6%) were dependent on at least 1 medical technology device. Mortality occurred in 99/1766 (5.6%). After adjusting for elective admissions and admission category; comorbidity with adjusted odds ratio (aOR) 95% confidence interval (CI) 3.03 (1.54-5.96); higher Pediatric Index of Mortality 3 (PIM 3) score with aOR 1.06 (95% CI 1.04-1.08); and functional status scale with aOR 1.07 (95% CI 1.00-1.13) were associated with mortality. Among non-survivors, organ donor candidacy was 21/99 (21.2%) but successful organ donation occurred in only 2/99 (2.0%). CONCLUSION In this single-centre audit, comorbidities, PIM 3 score and functional impairment were associated with mortality. Efforts are needed to improve paediatric organ donation rates.
Humans ; Male ; Female ; Tissue and Organ Procurement/statistics & numerical data* ; Intensive Care Units, Pediatric/statistics & numerical data* ; Child, Preschool ; Child ; Infant ; Singapore/epidemiology* ; Risk Factors ; Patient Admission/statistics & numerical data* ; Hospital Mortality ; Adolescent ; Medical Audit ; Comorbidity ; Clinical Audit

Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Intensive Care Units ; statistics & numerical data ; Male ; Middle Aged ; Organ Transplantation ; psychology ; statistics & numerical data ; Surveys and Questionnaires ; Tissue and Organ Procurement ; statistics & numerical data ; Young Adult

BACKGROUND: This retrospective study analyzed the causes of failure in the management process from the identification of brain-dead potential organ donors to actual donation in Korea over the past 5 years. METHODS: Data of 8,120 potential brain deaths reported to the Korea Organ Donation Agency were used, including information received at the time of reporting, donation suitability evaluation performed by the coordinator after the report, and data obtained from interviews of hospital medical staff and the donor's family. RESULTS: From January 2012 to December 2016, the total number of brain-dead potential organ donors in Korea was 8,120, of which 2,348 (28.9%) underwent organ procurement surgery with designated recipients. While the number of transplant donors has increased over time, the ratio of transplant donors to medically suitable brain-dead donors has decreased. The common causes of donation failure included donation refusal (27.6%), non-brain death (15.5%), and incompatible donation (11.6%); 104 potential donors (7.8%) were unable to donate their organs because they were not pronounced brain dead. CONCLUSION: The rate of successful organ donation may be increased by analyzing the major causes of failure in the brain-dead organ donation management process and engaging in various efforts to prevent such failures.
Brain Death ; Humans ; Korea* ; Medical Staff, Hospital ; Retrospective Studies ; Statistics as Topic* ; Tissue and Organ Procurement ; Tissue Donors* ; Transplantation

ObjectiveTo investigate the relationship of the characteristics of sperm donors with the results of screening and provide some reference for the screening of sperm donors.

METHODSWe statistically analyzed the screening data about 12 362 sperm donors at the Guangdong Human Sperm Bank from January 2003 to June 2017 and the relationship of the eligibility rate of screening with the donors' age, education, occupation, marriage, and fatherhood.

RESULTSOf the 12 362 sperm donors, 3 968 (32.1%) met the standards of semen quality and 3 127 (25.3%) filled all the requirements of sperm donation. The eligibility rate of screening was 27.7% in the donors aged 20－24 years, 24.3% in those aged 25－29 years, 23.8% in those aged 30－34 years, and 17.5% in those aged =≥35 years (P < 0.01); 23.5% in the senior high school students, 24% in the junior college students, 25.9% in the undergraduates, and 30.3% in the postgraduates (P < 0.01); 29.3% in the students versus 22.9% in the others (P < 0.01), 41.5% in the married versus 20.7% in the unmarried (P < 0.01), and 45.6% in the fathers versus 20.9% in the childless husbands (P < 0.01).

CONCLUSIONSA higher eligibility rate of screening was found among the sperm donors aged <35 years or with a bachelor's or higher degree, particularly among students.

Adult ; Humans ; Male ; Semen Analysis ; standards ; Spermatozoa ; Students ; statistics & numerical data ; Tissue Donors ; statistics & numerical data ; Tissue and Organ Procurement ; Young Adult

PURPOSE: This study was conducted to examine awareness of biomedical ethics, and to identify affecting factors of the awareness of biomedical ethics in nursing students. METHODS: The subjects consisted of 266 nursing students their third and fourth years of study. The data were collected from October to December, 2015 by self-report using questionnaires. Data analysis was performed using SPSS/WIN 18.0, descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis. RESULTS: The mean score of the awareness of biomedical ethics was 2.81±0.22, perception of death was 3.15±0.36, and knowledge of brain death, organ donation, and organ transplant was 12.12±3.02. The prediction factors of awareness of biomedical ethics were gender (β=.29, p<.001), participation in religious activity (β=.23, p=.015), and perception of death (β=.20, p=.016). The explanation power was 17.1%. CONCLUSION: These results showed that education about biomedical ethics is necessary for nursing students, and the development of biomedical ethics educational programs should reflect affecting factors.
Bioethics* ; Brain Death ; Education ; Humans ; Nursing* ; Organ Transplantation ; Statistics as Topic ; Students, Nursing* ; Tissue and Organ Procurement ; Transplants

OBJECTIVETo explore the effect of donations after cardiac death (DCD) kidney transplant performed in northwest China and the measures for management of delayed graft function (DGF).

METHODSIn the period of 2011-2013, a total of 51 families of DCD donor gave their consent to organ donation by signing the informed consent with the help by a Red Cross Organization (ROC) coordinator, and 102 kidneys were retrieved by organ procurement organization (OPO) teams. Ninety-four operations of renal transplantation were carried out in our hospital. All the patients were followed-up and based on the occurrence of DGF after transplantation, they were divided into DGF group and non-DGF group for comparative studies.

RESULTSThe success rate of donation after cardiac death was 29.3%, and the incidence of post-transplantation DGF was 27.7%. The 1-year human/kidney survival rate was 98.9%/95.7%. Within six months after the transplant, the values of eGFR in DGF group were significantly lower and serum creatinine significantly higher than those in non-DGF group (P<0.05), but no significant differences were found between the two groups thereafter (P>0.05). The occurrence of DGF in LifePort mechanical perfusion cohorts was significantly lower than that in the simple cold preservation group (21.5% vs. 41.4%, P<0.05).

CONCLUSIONThe overall effect of DCD kidney transplant is good despite a high incidence of early DGF, and we recommend the use of low-temperature mechanical perfusion for storage and transportation of DCD donor kidney.

Adult ; China ; Death ; Delayed Graft Function ; etiology ; Female ; Humans ; Kidney Transplantation ; Male ; Tissue and Organ Procurement ; statistics & numerical data ; Young Adult

BACKGROUNDPeople's attitude toward organ donation after cardiac death (DCD) has not come to an agreement in different countries and regions. Influenced by the local culture in China for thousands of years, the general public has different ideas about this issue. The purpose of this study was to investigate the current attitudes trend and characteristics of transplantation with organs donated after cardiac death in northwest China.

METHODSThis largest single-center cohort study was performed by an interview or by telephone using a questionnaire. The family members of potential DCD donors were recruited from the First Affiliated Hospital, medical college of Xi'an Jiaotong University located in a metropolitan area of northwest China. The 12-item attitude questionnaire was specifically developed from the literature review with coordinator, physician, and donor's family feedback. The participants were asked to rate the queries on a 5-point Likert intensity scale.

RESULTSThe 174 participants included 56 (32.2%) women and 118 (67.8%) men. Most people were aged between 41 and 50 years (n = 63, 36.2%), 31 and 40 years (n = 59, 33.9%), and less than 30 years (n = 36, 20.7%). The top five attitudes of participants were the best person to suggest organ donation to a family was ranked as the DCD coordinator of Red Cross Organization (RCO, n = 160, 92%), donor is a hero (n = 143, 82.2%), honor to be a donor's family member (n = 136, 78.2%), improved relationship with colleagues (n = 124, 71.3%), and with recipient after donation (n = 123, 70.7%). The best person to suggest organ donation to a family was ranked as the coordinator of RCO (n = 160, 92%), doctor unrelated to transplantation (n = 104, 59.8%), social worker (n = 36, 20.7%), and doctor related to transplantation (n = 25, 14.4%). The top two reasons for non-consent to donation were that the family insisted on intact body after patient death and did not want to have surgery again (n = 51, 41.5%), and feared that they would be misunderstood by neighbors, relatives, and friends about donation (n = 28, 22.8%).

CONCLUSIONSThis study revealed initial attitudes toward DCD in China. Some data afford insight into the decision-making procedure. The concerns of potential DCD donors and their families may help professionals provide better interventions in the future.

Adult ; Attitude ; China ; Death ; Decision Making ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires ; Tissue and Organ Procurement ; statistics & numerical data

OBJECTIVETo retrospectively investigate the distribution in kidney transplantation for fifteen years in Peking Union Medical College Hospital.

METHODSWe conducted a descriptive research counting up the number of patients who received kidney transplantation each year in our hospital during 1995 and 2010.

RESULTSThe first kidney transplantation in our hospital occurred in the 1960s. The number of kidney transplantation increased until reaching a maximum of 47 grafts in 2001; since then the number fell.

CONCLUSIONSWith the decreased number of kidney transplantation, we have realized the shortage of transplantable organs is very serious. The continuing transplant shortage requires major efforts to expand the donor pool. Donation after cardiac death offers the potential to enlarge the donor pool, but we need to strictly control the criteria for potential donors.

China ; Humans ; Kidney Transplantation ; methods ; statistics & numerical data ; trends ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Time Factors ; Tissue Donors ; statistics & numerical data ; Tissue and Organ Procurement ; statistics & numerical data ; trends ; Treatment Outcome

BACKGROUND/AIMS: Kidney transplantations at our center rely mainly on living donors. The purpose of this study was to suggest future donor supply directions by reviewing changing trends in donor type. METHODS: During the past 40 years, 1,690 kidney transplantations were performed at our center. We divided the follow-up period into four decades and the donor population into three groups: living related, living unrelated, and deceased. We analyzed changing trends in donors from each group for each decade. Patients receiving overseas transplantation were also included. RESULTS: The proportion of living related donors decreased from 84% (54/64) in the 1970s to 61% (281/458) in the 2000s. Living unrelated donors showed a sustained proportion of around 20% after 1990. However, among living unrelated donors, the proportion of spouse donors increased from 4.6% (17/369) in the 1980s to 8.5% (39/458) in the 2000s. Transplants from deceased donors were only 3.3% (12/369) in the 1980s. However the proportion of deceased donors increased gradually, reaching 13.2% (105/799) in the 1990s and 19.9% (91/458) after 2000. Overseas transplantations increased after 2000 and reached 20% of all cases treated in our center during the 2000s. Such transplantations peaked in 2006 and decreased markedly thereafter. CONCLUSIONS: The proportion of each donor type has continuously changed, and the changes were associated with changes in the social structure and system. We expect that this study could be an important reference for other countries to estimate future changes of donor type.
Adult ; Female ; History, 20th Century ; History, 21st Century ; Humans ; Kidney Transplantation/*history/statistics & numerical data/trends ; Korea ; Living Donors/history/statistics & numerical data ; Male ; Middle Aged ; Tissue Donors/*history/statistics & numerical data ; Tissue and Organ Procurement/history/statistics & numerical data/trends

PURPOSE: This study analyzes the trends of nursing researches about organ donation and transplantation, and recommends the direction of future nursing studies in Korea. METHODS: Ninety-nine researches based upon organ donation and transplantation in Korea were analyzed by descriptive statistics. RESULTS: Among them 58 papers were master's theses and 9 were doctoral dissertations. Articles about organ beneficiaries were seventy. The 47 articles among them were for kidney transplantation. By the types of research design, there were 73 quantitative studies, 19 qualitative studies, and 9 methodological studies. In correlation studies, the quality of life of subjects were evaluated the association with stress, social support, self-efficacy, and compliance. In experimental studies, the independent variables were self efficacy promotion exercise, steroid medication, educational programs regarding an organ transplantation and a brain death, Danjeon breathing exercise, and telephone counseling. The methods of qualitative studies were based on the grounded theory, phenomenology, interpretive phenomenology, and ethnography. The dominant concepts of qualitative researches were experiences of a decision-making of donors and of recipients for organ transplantation. CONCLUSION: Descriptive surveys or correlation studies were predominant on the nursing research about organ transplantation. Qualitative studies were conducted to some extent. It is recommended to conduct clinically applicable interventional researches with the experimental design.
Anthropology, Cultural ; Brain Death ; Compliance ; Counseling ; Humans ; Kidney Transplantation ; Korea ; Nursing Research ; Organ Transplantation ; Qualitative Research ; Quality of Life ; Research Design ; Respiration ; Self Efficacy ; Statistics as Topic ; Telephone ; Tissue and Organ Procurement ; Tissue Donors ; Transplants