Search

The growing number of organ donors in the United States, from 14,011 in 2012 to 21,374 in 2022, highlights progress in addressing the critical issue of organ shortages. However, the demand remains high, with 17 patients dying daily while on the waiting list. As of August 2023, over 103,544 individuals are awaiting transplants, predominantly for kidneys (85.7%). To expand the donor pool, the inclusion of elderly donors, including those with a history of malignancies, is increasingly considered. In 2022, 7% of all donors were aged 65 and above, despite the complexities their medical histories may introduce, particularly the risk of donor-transmitted cancer (DTC). This review examines the challenges and potential benefits of using donors with known malignancy histories, balancing the risks of DTC against the urgency for transplants. A critical analysis is presented on current knowledge and the decision-making processes that consider cancer types, stages, and patient survival outcomes. The goal is to identify missed opportunities and improve strategies for safe and effective organ transplantation from this donor demographic. [ABSTRACT FROM AUTHOR]

Background: Effective blood transfusion services rely heavily on comprehending the distribution of blood antigens among populations. Saudi Arabia's unique genetic and evolutionary influences require thorough comprehension of these antigen frequencies as they are crucial for patient care. This systematic analysis aimed to explore the frequencies of Rh and Kell blood group antigens across various regions of Saudi Arabia. Methods: An exhaustive literature search was conducted using PubMed, Embase, and the Cochrane Library, focusing on studies from 2019 through 2024 that report Rh and Kell blood antigen frequencies within the Saudi population. Results: Analysis of seven selected studies provided data from locales including Samtah, Jazan, Hail, Riyadh, the Eastern region, Taif City, and Najran. The DCcee (R1r) Rh phenotype was the most prevalent throughout these regions. However, the frequencies of individual Rh (D, C, E, c, e) and Kell (K) antigens demonstrated regional variability. Notably, the K antigen was found to be less common in Jazan compared to other regions. The observed variations in antigen frequencies suggest that factors beyond geography may influence the distribution of Rh and Kell blood groups. Comprehending these findings is critical for enhancing blood transfusion services, including refining donor recruitment strategies, managing blood inventory, and developing personalized transfusion protocols. Additionally, understanding similarities and variations is essential for managing pregnancies affected by Rh incompatibility and improving care for patients with conditions like sickle cell disease that require frequent transfusions. Further investigation is needed to explore the underlying causes of regional similarities or variations. Conclusions: Further studies are necessary to investigate the genetic and environmental factors influencing the regional similarity and differences in blood group antigen frequencies. Expanding the scope of data collection throughout Saudi Arabia is also imperative to provide a comprehensive understanding that supports optimal transfusion practices and enhanced healthcare outcomes. [ABSTRACT FROM AUTHOR]

Background: Effective interventions during the coronavirus disease 2019 (COVID-19) pandemic require an understanding of patients' knowledge and perceptions that influence their behaviour. Our study assessed knowledge of COVID-19 among kidney transplant recipients and donors, hitherto unevaluated. Methods: We conducted a cross-sectional survey among 325 kidney transplant recipients and 172 donors between 1 May 2020 and 30 June 2020. The survey questionnaire assessed knowledge levels of COVID-19, sociodemographic data, health status, psychosocial impact of COVID-19 and precautionary behaviours during the pandemic. Results: The mean COVID-19 knowledge score of the study population was 7.5 (standard deviation: 2.2) out of 10. The mean score was significantly higher among kidney recipients compared to kidney donors (7.9 [1.9] vs. 6.7 [2.6]; P <0.001). Younger age (21-49 vs. =50 years) and higher education (diploma and higher vs. secondary and lower) were associated with significantly higher knowledge scores in donors, but not among recipients (P-interactions =0.01). In both kidney recipients and donors, financial concerns and/or social isolation were associated with lower knowledge levels. Conclusions: Concerted efforts are needed to improve COVID-19 knowledge in kidney transplant recipients and donors, particularly older donors, donors with lower education and patients with financial concerns or feelings of social isolation. Intensive patient education may mitigate the impact of education levels on COVID-19 knowledge levels. [ABSTRACT FROM AUTHOR]

AbstractThis review article highlights the importance of novel charge transfer (CT) sensing approach for the detection of ions which are crucial from environmental and biological point of view. The importance, principles of charge transfer, ion sensing, its different types, and its basic process will all be covered here. The strategy has been reported with enormous sensitivity and fast signaling response owing to the fact that strong electronic connection communication exists between donor (D) and acceptor (A) part. Important discoveries made since 2010 will be examined. Herein, we will showcase the binding constants, conditions employed for sensing, and limit of detection of crucial ions via CT based sensors that researchers have bough forth for real-time applications. Additionally, the focus will be on the mechanistic aspects and signaling response as a result of the interaction between ion and sensor molecule. [ABSTRACT FROM AUTHOR]

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fecal microbiota transplantation is a procedure when fecal matter from a healthy donor is administered into the intestinal tract of a recipient in order to restore microbial balance and strengthen immune responses. Mainly, fecal microbiota transplantation increases bacterial diversity and facilitates a growth in beneficial microorganisms. Thus, the procedure makes it possible to stabilize and maintain a healthy gut microbiome that inhibits the pathogen growth. In veterinary medicine, fecal microbiota transplantation is considered as a potential alternative to traditional antibiotics amid rising antibiotic resistance. Despite the lack of commonly accepted procedures, studies show that the fecal microbiota transplantation for the purposes of veterinary medicine can be used for a wide range of tasks: starting from disease prevention to immunomodulation. This review is devoted to the use of fecal microbiota transplantation for different animal species. An analysis of scientific literature suggests that most researches into the topic describe the use of fecal microbiota transplantation as a method to treat diarrhea, which is a common disorder in animals. Interestingly, the technique has been successfully used to treat canine atopic dermatitis and monitor age-related changes in fish, thus, confirming the universal nature of this procedure. There are research projects when fecal microbiota transplantation demonstrated only partial effectiveness or no effectiveness at all. Scientific evidence suggests that the effectiveness of fecal microbiota transplantation depends on the delivery route and the donor, and the first factor may have a different impact on the therapy effectiveness depending on the animal species under study. The impact of the second factor on the success of transplantation has been most widely studied for calves. Further research is needed into effects of fecal microbiota transplantation on different animals and standards need to be developed to support large-scale and safe use of the technique for animals.

SARS-CoV-2 infection represents a new challenge for solid organ transplantation (SOT) with evolving recommendations. A cross-sectional survey was performed (February–June 2024) to describe practices among Member States of the Council of Europe (COE) on the use of organs from deceased donors with resolved or active SARS-CoV-2 infection. Overall, 32 out of 47 Member States with a transplant program participated in the study. Four (12.5%) countries did not use organs from deceased donors either with resolved or with active SARS-CoV-2 infection and 8 (25%) countries accepted organs only from deceased donors with resolved SARS-CoV-2 infection. Donor evaluation for SARS-CoV-2 included universal screening with standard PCR testing on respiratory specimens generally (61.4%) performed within 24 h prior to organ recovery. Further microbiological, immunological and radiological investigations varied. Most waitlisted patients receiving organs from a deceased donor with active (94.5%) or resolved (61.5%) SARS-CoV-2 infection were preferred to have natural, vaccine-induced or hybrid SARS-CoV-2 immunity. Most countries did not require recipients to undergo specific anti-SARS-CoV-2 treatment as pre-exposure (0%), post-exposure prophylaxis (15.4%) or modification of immunosuppression regimen (24%). This study highlights similarities and heterogeneities in the management of SARS-CoV-2 positive donors between COE countries, and a potential to safely expand donors' pool. [ABSTRACT FROM AUTHOR]

Introduction: There is a lack of evidence regarding the impact of donor blood transfusion on heart transplant (HT) outcomes. We sought to elucidate the influence of donor transfusion on HT outcomes using the national database. Methods: From January 2004 to March 2023, donor transfusion information was available for 40 538 recipients for HT in the United Network for Organ Sharing (UNOS) database. We used the UNOS 4‐level designation of transfusion (no blood [N = 18 575], 1–5 units [N = 14 098], 6–10 units [N = 4766], and massive transfusion of > 10 units [N = 3099]). Results: Among this cohort, 53.2% of donors (N = 20 220) received a blood transfusion during the same admission. Donors who required blood transfusion commonly had head trauma as a cause of death (no‐blood, 22% vs. 1–5 units, 61%, 6–10 units, 88%, massive, 89%, p < 0.001). An increased amount of donor blood transfusion did not affect rates of acute rejection (no‐blood, 18% vs. 1–5 units, 19%, 6–10 units, 17%, massive, 19%, p = 0.13). The number of units transfused also did not affect 1‐year survival rates. The Cox hazard model showed no effect of massive transfusion on mortality following transplant (no‐blood, reference vs. 1–5 units; HR, 1.02 [p = 0.35], 6–10 units; HR, 1.10 [p = 0.01], massive transfusion; HR 1.04 [p = 0.3]). Conclusions: Massive transfusion in donors was not associated with increased recipient mortality. Additionally, the amount of donor blood transfusion did not affect rejection rates following HT. The present study suggests that a history of donor blood transfusion, as well as the amount of transfusion, should not preclude donor heart utilization. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What are the experiences and outcomes of donor conceived adults who are actively searching for, open to contact with, or not searching for donor connections? SUMMARY ANSWER Most participants were actively searching or open to contact, and 67% had found or been found by a connection; finding or not finding experiences were complex. WHAT IS KNOWN ALREADY There is variation among donor conceived individuals in their interest in donor connections. Individual reasons for searching for connections, and which donor connections are searched for, also vary. Most research studies have focussed on individuals who are actively searching for their donor or donor siblings. Global increases in direct-to-consumer DNA testing and social media participation mean that connections may be made to individuals unaware of their (or their relatives') involvement with donor conception. These social and technological changes have also increased the chances of donor conceived individuals being contacted without expecting or desiring contact. STUDY DESIGN, SIZE, DURATION This study included 88 donor conceived adults, in the UK, who participated in an online multi-method survey between January and August 2022. The survey was designed in consultation with staff and volunteers from the UK's largest community networks for donor conception families (Donor Conception Network, DCN) and donor conceived people (Donor Conceived Register Registrants' Panel, DCRRP). It was piloted by five donor conceived people before its launch. Participants were recruited with assistance from DCN and DCRRP, via social media, university mailing lists, and snowballing. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were mostly female (n = 65, 74%) and sperm donor conceived (n = 79, 90%). Of the 88 participants, 39 (44%) were actively searching for their donor connections, 44 (50%) were open to contact but not actively searching, and 5 (6%) were not searching. Questions were closed (yes/no, rating scale, or multiple choice) or open-ended, addressing experiences of donor conception, searching for connections, and finding or not finding connections. Data were analysed both quantitatively and qualitatively. MAIN RESULTS AND THE ROLE OF CHANCE Quantitative results showed no differences between the groups on any demographic variables or in when or how they found out about being donor conceived, and no differences between active searchers and those open to contact in whether they had found their donor connections. Significant differences were found between groups in their interest in their genetic history and the perceived importance of genetics to their sense of identity, with active searchers being more interested and rating this as more important than those open to contact. Methods of searching significantly differed across groups, with active searchers using genetic testing and social media more than those open to contact. 59 participants across all groups (active searchers (n = 29, 74%), open to contact (n = 27, 61%), not open to contact (n = 3, 60%)) had found or been found by a donor connection. Experiences of finding or not finding donor connections among participants actively searching or open to contact were captured by the theme complexities, with six subthemes: uncertainties in searching and relating; searching as open-ended; different donor connections, different experiences; expectations and realities; searching and finding or not finding as catalysing change; and experiences of other donor conceived people. LIMITATIONS, REASONS FOR CAUTION Most participants were members of relevant community organizations. As is common in research in this area, the sample was mostly female and conceived using donor sperm. Donor conceived people who are disinterested in donor connections may be unlikely to participate in research on this topic. WIDER IMPLICATIONS OF THE FINDINGS The nature and impact of the search process itself should be considered when developing appropriate mechanisms of support for all donor conceived people, regardless of whether they are actively searching for connections or not. Further research should seek to better understand how donor conceived people with varying levels of interest in searching for donor connections differ from one another. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the UK Economic and Social Research Council [New Investigator Award ES/S015426/1]. The authors have no competing interests to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

By causing inflammation and tissue damage, neutrophil extracellular traps (NETs) constitute an underlying mechanism of aspiration-induced lung injury, a major factor of the low utilization of donor lungs in lung transplantation (LTx). To determine whether NET removal during ex vivo lung perfusion (EVLP) can restore lung function and morphology in aspiration-damaged lungs, gastric aspiration lung injury was induced in 12 pigs. After confirmation of acute respiratory distress syndrome, the lungs were explanted and assigned to NET removal connected to EVLP (treated) (n = 6) or EVLP only (nontreated) (n = 6). Hemodynamic measurements were taken, and blood and tissue samples were collected to assess lung function, morphology, levels of cell-free DNA, extracellular histones, and nucleosomes as markers of NETs, as well as cytokine levels. After EVLP and NET removal in porcine lungs, PaO 2 /FiO 2 ratios increased significantly compared to those undergoing EVLP alone (p = 0.0411). Treated lungs had lower cell-free DNA (p = 0.0260) and lower levels of extracellular histones in EVLP perfusate (p = 0.0260) than nontreated lungs. According to histopathology, treated lungs showed less immune cell infiltration and less edema compared with nontreated lungs, which was reflected in decreased levels of proinflammatory cytokines in EVLP perfusate and bronchoalveolar lavage fluid. To conclude, removing NETs during EVLP improved lung function and morphology in aspiration-damaged donor lungs. The ability to remove NETs during EVLP could represent a new therapeutic approach for LTx and potentially expand the donor pool for transplantation. [ABSTRACT FROM AUTHOR]

Background: The ABO, Rh, and Kell blood groups are the most immunogenic and clinically important blood antigens. These antigens can trigger strong immune responses after blood transfusions, leading to alloimmunization and post-hemolytic transfusion reactions. The aim of this study was to determine prevalence of ABO, Rh, and Kell blood group antigens at the Al-Qurayyat Regional Laboratory and Blood Bank Center, Al-Qurayyat region, Saudi Arabia. Methods: This study was a prospective observational cross-sectional study conducted at the Al-Qurayyat Regional Laboratory and Blood Bank Center from November 2022 to September 2023. The selection of voluntary and replacement donors was based on recommendations by the Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI). A total of 779 Saudi donors aged between 18 and 60 years participated in the study. Results: In this study, O blood group was the most prevalent (50.1%), followed by B (32.0%), A (14.4%), and AB (3.6%). RhD positivity was relatively high (93.3%); a characteristic of global trends. Among RhD-positive individuals, R1r and R1R1 were the most prevalent Rh phenotypes, consistent with trends observed in Caucasian and Asian populations; however, the most frequent Rh phenotype in RhD-negative individuals was rr. Presence of the Kell antigen was observed in 9.5% of the participants, and interestingly all individuals who tested positive for the Kell antigen were also RhD positive. Conversely, no RhD-negative individuals exhibited the Kell antigen. Conclusions: Findings from this study highlight the importance of implementing proper inventory management to ensure safe transfusion of blood products. Additionally, this study established a crucial baseline for clinically important blood antigens that also enhances understanding of blood groups and regional variations that could better inform healthcare management systems and public health policies in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Purpose of Review: Allogeneic hematopoietic cell transplantation is the only potentially curative treatment for myelofibrosis. This review discusses issues not well-covered by existing guidelines: timing of transplant, pre-transplant spleen management and alternative donors; providing our approach to these situations. Recent Findings: Research continues to allow better identification, by better risk stratification and advances in understanding likelihood of durable JAKi response, which patients are likely to derive benefit from upfront transplant versus those for whom delayed transplant may be more appropriate. Several options of JAKi therapy provide a non-surgical option for pre-HCT splenomegaly management, allowing some patients to avoid risks associated with splenectomy. Recent years have also seen a sharp spike in haploidentical donor transplants, along with narrowing of the gap in outcomes between donor types. Summary: Continuous enrollment in prospective studies or well-designed registries is required to generate the high-quality data needed to develop better decision tools for these scenarios. [ABSTRACT FROM AUTHOR]

Background: The selection of the best donor for each specific patient is crucial for the success of allogeneic hematopoietic stem cell transplantation (HSCT). However, there is debate on the choice of the best donor when multiple suitable donors exist. Methods: By using own data from two transplant centers, we have developed a calculator able to provide the patients' 2-year overall survival (OS) associated with each of the potential donor options during the selection process, in order to support the transplant physician during the choice. Data on 737 HSCTs with HLA-identical siblings, and unrelated or related haploidentical donors from January 2010 to July 2022 have been retrospectively obtained. Results: Patients' age, disease, comorbidity index, and donor type were found to be significant variables able to predict the outcome with robustness (concordance index: 0.677). Estimates are provided within an example in the text showing outcomes with four donor options for a specific patient. Conclusions: We present the prototype of a tool supporting the selection of the best donor, guiding transplant physicians during the delicate process of donor selection before HSCT. This approach relies on real data from the centers, reflecting their local clinical experience. Improvements are underway with a larger, ongoing multicenter study. [ABSTRACT FROM AUTHOR]

Background: Allogeneic hematopoietic cell transplantation remains limited when stem cell registrants cannot be contacted, are not medically fit, are unavailable, or unwilling to proceed. In a recent report, registrants who were prior blood donors were more likely to be available for donation. In this study, we analyzed extent to which recruiting blood donors to the Canadian Blood Services Stem Cell Registry (CBS SCR) can meet targets for ethnic diversity, age, and proximity to collection facilities. Methods and Results: We analyzed 124,496 active blood donors on July 1, 2023 regarding the criteria for recruitment to the CBS SCR. A total of 40,518 (32%) were younger than 36 years of age and 49% were first‐time donors (potential new recruits year over year). The ethnicity of blood donors younger than 36 years aligns more closely with the 2021 Canadian census compared to stem cell donors who were also previous blood donors, and to the current total inventory of all registrants on the CBS SCR. Of the blood donors, certain ethnic groups, including Black, Chinese, and First Nations/Indigenous, remain underrepresented. A greater proportion of active whole blood donors live within 400 km of a stem cell collection center (91%) compared to stem cell donors who donated during the past 10 years (80%). Conclusions: Recruitment of blood donors offers an opportunity to improve the ethnic diversity of the CBS SCR and increase proximity of registrants to stem cell collection centers. The potential improved availability of registrants when matched to patients requires confirmation. [ABSTRACT FROM AUTHOR]

Background: Better access to direct‐acting antiviral (DAA) therapy has broadened the utilization of hepatitis C virus (HCV) nucleic acid testing (NAT) positive organs with excellent outcomes. However, DAA therapy has been associated with hepatitis B virus (HBV) reactivation. Aim: To determine the risk of HBV transmission or reactivation with utilization of HBV core antibody positive (HBcAb+) and HCV NAT positive (HCV+) organs, which presumably required DAA therapy. Methods: The number of HBcAb+ donors with delineated HCV NAT status was obtained from the Organ Procurement and Transplantation Network (OPTN) database. The number of unexpected HBV infections from transplanted organs adjudicated as "proven" or "probable" transmission was obtained from the OPTN Ad Hoc Disease Transmission Advisory Committee database. A chart review of the donors of "proven" or "probable" cases was conducted. Results: From January 1, 2016, to December 31, 2021, 7735 organs were procured from 3767 HBcAb+ donors and transplanted into 7469 recipients; 545 (14.5%) donors were also HCV+. HBV transmission or reactivation occurred in seven recipients. The rate is not significantly different between recipients of HCV+ (0.18%, 2/1115) and the HCV NAT negative (HCV‐) organs (0.08%, 5/6354) (p = 0.28) or between recipients of HCV+ and HCV‐ livers as well as non‐liver organs. HBV transmission or reactivation occurred within a median of 319 (range, 41–1117) days post‐transplant in the setting of missing, inadequate, or truncated prophylaxis. Conclusion: HBV reactivation associated with DAA therapy for HBcAb+ HCV+ organs is less frequent than reported in the non‐transplant population, possibly due to the common use of HBV prophylaxis in the at‐risk transplant population. [ABSTRACT FROM AUTHOR]

To evaluate donor gamete utilization, patient satisfaction, and fertility treatment outcomes of patients pursuing treatment with donor gametes stratified by the desired race as well as ethnicity of the gamete donor. Survey study. Clinic. Patients planning to undergo treatment using donor sperm and/or donor oocytes at a single academic fertility clinic in the Southeastern United States between 2015 and 2020. None. Utilization rates of donor gametes, satisfaction with donor gamete selection, and fertility treatment outcomes stratified by race and ethnicity of patient, as well as that of their gamete donor. Four hundred fifty patients were eligible for inclusion and 170 (38%) responded to the survey. Among the respondents, 59% desired a non-Hispanic White gamete donor and 20% desired a non-Hispanic Black gamete donor. Patients seeking a non-Hispanic Black gamete donor had lower odds of using donor gametes (Odds ratio [OR], 0.13; 95% confidence interval [CI], 0.04–0.40) compared with individuals seeking a non-Hispanic White gamete donor. When evaluating satisfaction with donor gamete selection, patients seeking a non-Hispanic Black gamete donor reported lower satisfaction compared with individuals seeking a non-Hispanic White gamete donor (OR, 0.19; 95% CI, 0.09–0.43). When evaluating fertility outcomes, Non-Hispanic Black patients and those using non-Hispaninc Black gamete donors were found to have lower odds of successful conception compared with non-Hispanic White patients (OR, 0.18; 95% CI, 0.07–0.46) and individuals seeking non-Hispanic White gamete donors (OR, 0.26; 95% CI, 0.09–0.75), respectively. Patients seeking non-Hispanic Black donor gametes have lower utilization rates, less satisfaction with gamete donor selection, and lower odds of conception when compared with those seeking non-Hispanic White gamete donors. These findings highlight the need for more racial diversity within donor gamete banks, as well as within the donor pools available through agencies and fertility clinics. [ABSTRACT FROM AUTHOR]

The study explores carbazole‐based organic molecules as transport layers in durable perovskite solar cells, focusing on their optoelectronic and charge transfer properties. Thirteen carbazole derivatives are systematically analyzed via density functional theory (DFT) calculations to understand their structure and optoelectronic characteristics. Substituents like bromo, phenyl, thiophenyl, and pyridyl at positions 3,6‐ and 2,7‐ of carbazole were studied. Phenyl and thiophenyl substitutions lowered highest occupied molecular orbital (HOMO) energy levels, while bromo and pyridyl increased them, tuning HOMO energies from −5.45 to −6.03 eV. These energies align well with perovskite materials valence bands, with absorbance primarily below 400 nm, complementing perovskite absorption. The compounds showed high light‐harvesting efficiencies (LHEs) (0.22 to 0.94) and improved radiative lifetimes. Theoretical investigations identified most compounds as effective p‐type hole‐transport materials (HTM), except 3,6‐ and 2,7‐dithiophenyl carbazoles, which exhibited n‐type behavior due to low hole reorganization energies. Overall, the study highlights computational design's role in developing carbazole derivatives as promising charge carrier precursors for perovskite solar cells. [ABSTRACT FROM AUTHOR]

The article highlights the standards of the Council of Europe regarding the right to transfer embryos obtained through in vitro fertilization for scientific research. Attention is focused on the fact that, in accordance with the resolutions of the Parliamentary Assembly of the Council of Europe, states are required to treat the human embryo or fetus with respect. This respect is commensurate with human dignity. The following standards of the Council of Europe regarding the right to transfer embryos obtained through in vitro fertilization for scientific research are highlighted: 1) the principle of respect for the human embryo and/or fetus must be enshrined in the legislation of a member state of the Council of Europe; 2) the use of materials and tissues of a human embryo and fetus must be strictly limited and regulated by state legislation; 3) the legitimate purpose that allows the use of a human embryo or fetus should be only to achieve a therapeutic, diagnostic, prophylactic effect if no other means/means exist; 4) in the industrial context, the use of human embryos and fetuses must be limited by state legislation; 5) state legislation must determine the conditions under which the extraction and use for the purpose of diagnosis or therapy of human embryos and fetuses is allowed; 6) any creation of human embryos by artificial insemination for the purpose of conducting research during their life or after death is prohibited; 7) research on viable human embryos, experiments on live human embryos, regardless of whether they are viable; 8) the grounds of objective biological criteria for the nonviability of human embryos and fetuses must be determined in each state. The transfer and use of human embryological material is possible under the following conditions: 1) free written consent of the donor parents; 2) lack of a commercial aspect. Prohibitions regarding the transfer and use of human embryological material are as follows: 1) prohibition of the purchase and sale of embryos or fetuses, their parts by donor parents or other persons; 2) prohibition of import or export of human embryological material; 3) prohibition of the transfer and use of human embryological material for the production of dangerous and destructive biological weapons; 4) prohibition of the collection to destroy human embryos to obtain stem cells if it is possible to obtain them from tissues and fluids of people of any age. [ABSTRACT FROM AUTHOR]

In 2016, we initiated a quality improvement endeavor to increase pediatric heart offer acceptance. This study assessed the effect of these interventions at our center. We evaluted pre- and postimplementation cohorts (January 1, 2008-December 31, 2016 vs January 1, 2017-July 1, 2023) comparing donor heart utilization. Six interventions were iterated over time to increase offer acceptance ("extended criteria"): ABO-incompatible transplant, ex vivo perfusion for distanced donors, 3-dimensional total cardiac volume (TCV) assessment, acceptance of hepatitis-C or Severe Acute Respiratory Syndrome Coronavirus 2 infected donors, and institutional culture change favoring consideration of donors previously considered unacceptable. Outcomes studied included annual HT volume, median waitlist duration, sequence number at acceptance, and post-transplant clinical outcomes. During the study period, annual transplant volume increased from 16/year to 25/year pre- and postimplementation. Three hundred thirteen of 389 (80%) listed patients were transplanted. Waitlist duration shortened postimplementation (p = 0.01), as did the percentage of accepted heart offers utilizing at least 1 extended criterion (p < 0.001). Institutional culture change and TCV assessment had the largest impact on donor heart utilization (p = 0.04 and p < 0.001). There was no difference in post-HT intubation or intensive care unit days (p = 0.05-0.9), though post-transplant hospitalization duration (p < 0.001) increased. Post-transplant survival was unaffected by the use of extended criteria hearts (p = 0.3). We report a successful longitudinal, multifaceted effort to increase organ offer utilization, with institutional culture change and TCV assessments most impactful. The use of extended criteria hearts was not associated with inferior survival. [ABSTRACT FROM AUTHOR]

Fused polycyclic aromatic compounds containing carbazole and diazapyrene skeletons as electron donors and acceptors, respectively, were synthesized in a few steps from readily accessible starting materials. The incorporation of diazapyrene units into the polycyclic compounds resulted in significant bathochromic shifts in their absorption and emission bands compared to those of the corresponding carbazole derivatives. Electrochemical measurements and density functional theory calculations were performed to gain further insight into their electronic properties. Our findings demonstrate that the incorporation of nitrogen atoms and substituents, as well as the different topologies of the fused‐ring system, exert a profound effect on the electronic properties of the polycyclic compounds. [ABSTRACT FROM AUTHOR]

Objective To explore the causes and nursing strategies of red blood cell spillage in apheresis platelet donors, so as to avoid adverse reactions to blood donation and platelet discarding and improve blood donation services. Methods A nursing flowchart for red blood cell spillage was developed based on literature. One case of red blood cell spillage in a apheresis platelet donor as attached, and corresponding literature review was conducted. Results After the nursing intervention through the nursing flowchart of red cell spillage, platelet apheresis was successfully conducted. The donor felt good and did not experience any adverse reaction to blood donation, and with no more red blood cell spillage. By reviewing relevant literature, the incidence, principles, causes, treatments, prevention of adverse reactions to blood donation and psychological care methods of red blood cell spillage were systematically summarized. Conclusion Red blood cell spillage in apheresis platelet donors occurs occasionally, and a flowchart of care for red blood cell spillage can help blood station staff quickly identify the cause and handle it correctly to avoid mishandling whicn can result in adverse reactions or discarding of platelets.

Aim. To test in experiment a pathogenetically adequate model of brain death due to increased intracranial pressure with gradual induction, allowing the evaluation of the changes occurring in the organs of a potential donor.Materials and methods. 6–8 months old outbred male rats of the experimental group (n = 18) and the control group (n = 8) were anesthetized, the left common carotid artery was catheterized to record systolic, diastolic blood pressure (BP) and heart rate (HR), the mean BP (MBP) was calculated. After transfer to artifi cial ventilation, brain death was simulated in the experimental group using the developed method.Results. All animals in the experimental group suffered brain death 30 minutes from the start of the experiment;10 rats (56%) died within 3 hours due to progression of circulatory failure. Initially, in anesthetized animals, MBP was 101 (90; 105) mm Hg, HR 310 (297; 315) beats/min. After 5 minutes from the start of brain death induction, MBP increased to 147 (140; 150) mm Hg (p = 0.01), HR to 396 (384; 406) beats/min (p = 0.03). Further, within 20 minutes there was a decrease in MBP to 94 (90; 100) mm Hg and HR to 290 beats/min. During the observation period from 26 to 90 minutes, there was a stabilization of MBP at the level of 87–92 mm Hg, there was a tendency to bradycardia with HR from 263 to 274 beats/min (p = 0.01). Then after 120–150 minutes from the beginning of brain death induction, MBP continued to decrease to 75–80 mmHg (p = 0,03), HR to 256–264 beats/min (p = 0,01). At the end of the experiment, despite volemic support, MBP decreased to 64 (61; 67) mm Hg (p = 0.02), bradycardia worsened with HR to 250 (248; 260) beats/min (p = 0.01), indicating the hemodynamic decompensation.Conclusion. The results of experimental testing of an animal brain death model on outbred rats showed that this model is pathogenetically adequate and useful to assess the condition of potential donor organs within 3 hours after the induction of brain death.

Organ trafficking, a very profitable worldwide illegal activity today, is frequently overlooked by those involved in combating human trafficking due to its complex and covert nature. Numerous international documents underscore the importance of countering trafficking in human organs and transplant tourism. This article analyzes the legal frameworks of Spain and Brazil, with a particular focus on their compliance with international and supranational standards aimed at combating, inter alia, the illegal circulation of organs and other phenomena associated with it. Firstly, the article distinguishes such phenomena as transplant commercialism, transplant tourism and illegal trafficking in organs and draws attention to the fact that currently there is no uniform understanding of the clear boundaries of the concept of illegal trafficking in organs. Elaborating on the various aspects of the above-mentioned types of criminal activity may allow one to properly determine the legal interests and rights protected by criminal law and the types of behavior subject to imputation in an exhaustive way. Secondly, the authors outline a number of controversial issues that arise due to the complex nature of organ trafficking and suggest several ways to meet these challenges.

The article describes the case of a 13-year-old boy who underwent autotransplantation (AT) to replace a congenitally missing tooth using the 3D replica as a socket preparation tool. Topics discussed include alternatives that have been suggested for the replacement of a missing tooth, main reason for tooth loss in male patients, and information on the surgery performed on the patient.

This study proposes a novel therapeutic strategy for cancer management by combining the antitumor effects of hydrogen sulfide (H2S) and inhibition of carbonic anhydrases (CAs; EC 4.2.1.1), specifically isoforms IV, IX, and XII. H2S has demonstrated cytotoxicity against various cancers at high concentrations. The inhibition of tumor-associated CAs leads to lethal intracellular alkalinization and acidification of the extracellular tumor microenvironment and restores tumor responsiveness to the immune system, chemotherapy, and radiotherapy. The study proposes H2S donor–CA inhibitor (CAI) hybrids for tumor management. These compounds effectively inhibit the target CAs, release H2S consistently, and exhibit potent antitumor effects against MDA-MB-231, HCT-116, and A549 cancer cell lines. Notably, some compounds display high cytotoxicity across all investigated cell lines. Derivative 30 shows a 2-fold increase in cytotoxicity (0.93 ± 0.02 µM) under chemically induced hypoxia in HCT-116 cells. These compounds also disturb the cell cycle, leading to a reduction in cell populations in G0/G1 and S phases, with a notable increase in G2/M and Sub-G1. This disruption is correlated with induced apoptosis, with fold increases of 37.2, 24.5, and 32.9 against HCT-116 cells and 14.2, 13.1, and 19.9 against A549 cells compared to untreated cells. These findings suggest the potential of H2S releaser–CAI hybrids as effective and versatile tools in cancer treatment. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Are donor-conceived adults in Belgium interested in obtaining donor information, and do these interests vary based on their family backgrounds? SUMMARY ANSWER Donor-conceived adults express a significant interest in obtaining donor-related information, with the highest interest reported by offspring from heterosexual couples compared to those from lesbian couple-parented or single-parent families. WHAT IS KNOWN ALREADY In Belgium, sperm donation is mainly anonymous, but the rise of direct-to-consumer genetic testing challenges this anonymity. STUDY DESIGN, SIZE, DURATION This was a cross-sectional study involving an online nationwide survey conducted from July 2022 to October 2023. Participants, aged 18 years and older and being aware of their anonymous sperm donor-conceived status, were recruited through various channels. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 203 participants were included: 62.6% grew up in heterosexual families with infertile fathers, 26.1% with lesbian couples, 8.4% with single parents, and 3.0% in various or diverse family structures. The survey was available in both French and Dutch and consisted of 43 questions, including a mix of yes/no questions and multiple-choice items. MAIN RESULTS AND THE ROLE OF CHANCE The average age of disclosure was 16.5 years, with notably later disclosure in heterosexual couple-parented households. A substantial 82.8% of donor-conceived individuals expressed a keen interest in obtaining non-personally identifiable donor information, while 69% were curious about personally identifiable donor data. Furthermore, 61.6% conveyed a desire for personal contact with their donors, and 26.6% advocated for the inclusion of the donor's name on their birth certificates. Participants raised in lesbian two-parent families exhibited the lowest level of interest in donor-related information compared with those raised in other family structures. An overwhelming 90.1% wondered about the possibility of having half-siblings from the same sperm donor. Analysis of survey responses on DNA database registration revealed that 55.2% of donor-conceived offspring were already registered, with 68.8% discovering the same donor offspring and 30.4% successfully locating their donors. Compared to individuals from other family structures, those raised in heterosexual couple-parented households exhibit a less positive attitude toward their conception through anonymous sperm donation. About 61.6% of donor-conceived individuals reported experiencing distinct emotions compared to their peers, while 44.1% encountered psychological difficulties related to anonymous sperm donation, primarily attributed to late disclosure. The majority supported the idea of informing the donor about the number of children he facilitated to conceive. Lastly, the study highlighted that 21.2% of donor-conceived adults considered becoming donors themselves, and 31.3% expressed willingness to use an anonymous donor whenever faced with fertility challenges. LIMITATIONS, REASONS FOR CAUTION Our sample size may not fully represent all adults conceived through anonymous sperm donation in Belgium. Participation bias may have influenced the results, especially due to the overrepresentation of participants from heterosexual couples. Additionally, an association exists between individuals raised by heterosexual couples and late disclosure, complicating the analysis by introducing a confounding factor. WIDER IMPLICATIONS OF THE FINDINGS The findings of this study contribute to a better understanding of the needs and preferences of donor-conceived adults, with significant potential impact on patient education and healthcare policy. STUDY FUNDING/COMPETING INTEREST(S) Study funding was not obtained for this research. There are no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Objective: To evaluate twin survival stratified by Quintero stage in patients with twin‐to‐twin transfusion syndrome (TTTS) after Solomon laser treatment. Methods: This was a single‐center study at Johns Hopkins Center for Fetal Therapy, investigating a cohort of consecutive twin pregnancies treated with the Solomon laser technique for TTTS. Preoperative Quintero stage, perioperative characteristics and obstetric factors were investigated in relation to neonatal survival of the recipient and donor twins at discharge. Determinants of twin survival were evaluated using univariate logistic regression and cumulative survival probability analyses. Results: Of 402 pregnancies with TTTS that underwent Solomon laser treatment, 80 (19.9%) were diagnosed with Quintero Stage‐I TTTS, 126 (31.3%) with Stage II, 169 (42.0%) with Stage III and 27 (6.7%) with Stage IV. Post‐laser twin anemia polycythemia sequence or recurrent TTTS occurred in 19 (4.7%) patients and 11 (2.7%) required repeat laser surgery. Preterm prelabor rupture of membranes occurred in 150 (37.3%) patients and median gestational age at delivery was 32 + 1 weeks. In 303 (75.4%) patients, both twins were alive at discharge; 67/80 (83.8%) were Stage I, 101/126 (80.2%) were Stage II, 113/169 (66.9%) were Stage III and 22/27 (81.5%) were Stage IV (P = 0.062). Donor twin survival was lower than that of recipients in cases with Stage‐III TTTS (118/169 (69.8%) vs 145/169 (85.8%) (χ2 = 26.076, P < 0.0001)). Higher intertwin size discordance and absent or reversed umbilical artery (UA) end‐diastolic velocity (EDV) were associated with donor demise (Nagelkerke R2, 0.38; P < 0.001). Overall, spontaneous post‐laser donor demise occurred in 53 (39.6%) patients, accounting for the majority of all losses. Cumulative donor survival decreased from 92% to 65% when intertwin size discordance was >30% and to 48% when UA‐EDV was absent or reversed (P < 0.001). Conclusions: The Solomon laser technique achieves TTTS resolution and double twin survival in a high proportion of cases. Recipient and donor survival is comparable unless there is significant intertwin size discordance and placental dysfunction. This degree of unequal placental sharing, typically found in Stage‐III TTTS, is the primary factor preventing double survival due to a higher rate of donor demise. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Research regulations around the world do not impose any limits on the risks to which consenting adults may be exposed. Nonetheless, most review committees regard some risks as too high, even for consenting adults. To justify this practice, commentators have appealed to a range of considerations which are external to informed consent and the risks themselves. Most prominently, some argue that exposing consenting adults to very high risks has the potential to undermine public trust in research. This justification assumes that it is not the magnitude of the risks themselves which raises concern, but the way in which the public might respond to them. This justification thus depends on the possibility that the public will find out about the risks and respond to them in the specified way. Like the other proposed external justifications, it thereby fails to offer a reason to think that exposing consenting adults to very high risks is problematic in itself. In the present paper, we describe and endorse a different justification. Rather than appealing to external factors, we argue that limits on risks for consenting adults trace to internal limits on informed consent, to limits on the things consent can and cannot make ethically permissible. In doing so, we aim to provide a firmer conceptual basis for the view that some research risks are unacceptably high, no matter how the research is conducted. [ABSTRACT FROM AUTHOR]

Background: When a potential stem cell donor to a seriously ill child is a healthy sibling below 18 years, Swedish parents have the legal right and obligation to decide on behalf of the donor child. However, there are potentially conflicting loyalties when parents have one severely ill child in need for a cure and one healthy child who will be subjected to medical procedures. This study explored parents' experiences related to their decision on stem cell donation, as well as ethical considerations in the donation process where outcomes are uncertain. Method: Individual interviews were performed with 18 parents of 13 minor donors after successful hematopoietic stem cell transplantations. Interviews were analyzed using inductive Reflexive Thematic Analysis. Results: The parents were living with the threat of losing a child, and in this context, the main theme No conflicting loyalties was found and included four subthemes; Focus on the ill child, Sibling as the preferred donor, Obvious that the healthy child should donate, and Keep on keeping on. Conclusion: When a healthy child is a potential donor to an ill sibling, their parents' main focus is on the cure for the ill child. The lack of obvious conflicting loyalties among parents highlights the need to secure an ethical process for healthy minor donors and the importance of a separate donor advocate for these minor donors. [ABSTRACT FROM AUTHOR]

RESEARCH OBJECTIVE: The main objective of the article is to analyze the issues that constitute the potential of Polish humanitarian diplomacy, including the specific political circumstances that have arisen in 2022 related to the humanitarian crisis in Ukraine. THE RESEARCH PROBLEM AND METHODS: The main research problem in this study revolves around outlining the elements of the process of conducting humanitarian diplomacy by the Polish authorities. The objective is to demonstrate that thoughtful approaches have been taken in this regard. The study employs various research methods, including document analysis, literature review, press review, and expert interviews. THE PROCESS OF ARGUMENTATION: The first part of the article presents humanitarian diplomacy as a theoretical concept, the second part describes strategic domestic documents, administrative and financial resources of Poland's humanitarian policy, while the third part analyzes the evolution of Poland's status as a donor conducting humanitarian diplomacy. RESEARCH RESULTS: The analysis of the subject reveals that there have been symptoms indicating that the Polish authorities are striving to conduct conscious activities within the framework of humanitarian diplomacy, especially by creating international events and advocacy for Ukraine humanitarian needs on the international forum. It also exposes shortcomings and opportunities of "Polish Aid" in the context of current geopolitical conditions. CONCLUSIONS, INNOVATIONS, AND RECOMMENDATIONS: It should be noted that the issue of humanitarian diplomacy of Poland has not been extensively discussed by researchers. The article serves as a pioneering introduction to a comparative study on humanitarian diplomacies conducted by other medium-sized and middle-income countries, primarily from Central and Eastern Europe. [ABSTRACT FROM AUTHOR]

The current economic and political crisis has brought about a change in the environment in which non-governmental development organisations (NGDOs) have traditionally operated. This change can be summed up as a reduction in the funds they receive and an increase in the population they must serve. The need then arises to have mechanisms that allow an analysis of the good work performed by the NGDOs. Knowing the efficiency of the NGDOs in the management of their previous projects can contribute towards improving their future achievements. The aim of this research is to establish some objective indicators that allow an evaluation of the efficiency of these organisations. Firstly, a detailed analysis of the regulation of the three agencies is conducted (Spanish-AECID, European-EuropeAid, and American-USAID). This allows us to synthesise the indicators of good performance of the NGDO based on the study of the eligibility criteria of public donors. The research concludes with the study of the efficiency following the Promethee Approach. Our results reveal that 44.6% of the NGDOs (33 out of the 74 studied) operate inefficiently, compared to 29.7%, which are efficient. [ABSTRACT FROM AUTHOR]

Jean Emily Fairfax’s life (1920–2019) essentially comprised two careers – the first, as a Legal Defense Fund staffer during the civil rights movement of the 1960s and subsequent efforts to implement and preserve equity measures, and another in “retirement” as an elder stateswoman, donor, and shaper of ideas about Black philanthropy. Both careers reflected her unwavering commitment to championing a more equitable society, anchored in her belief in the transformative power of philanthropy. Drawing on oral history interviews and engagement with the histories of education and philanthropy, at the intersection of gender, race, and ageing, Fairfax’s story offers insights into the resilience and agency of older Black women who, having been engaged in earlier civil rights movements, continued to shape social change in their later years. Her activism and philanthropy were deeply intertwined, reflecting her unwavering belief in the possibility of justice. [ABSTRACT FROM AUTHOR]

Summary: The global pandemic has resulted in the common occurrence of SARS‐CoV‐2 infection in the population. In the post‐pandemic era, it is imperative to understand the influence of donor SARS‐CoV‐2 infection on outcomes after allogeneic haematopoietic stem cell transplantation (allo‐HSCT). We retrospectively analysed allo‐HSCTs from donors with mild SARS‐CoV‐2 infection or early recovery stage (ERS) (group 1, n = 65) and late recovery stage (group 2, n = 120). Additionally, we included allo‐HSCT from donors without prior SARS‐CoV‐2 infection as group 0 (n = 194). Transplants from donors with different SARS‐CoV‐2 infection status had comparable primary engraftment and survival rates. However, group 1 had higher incidences of acute graft‐versus‐host disease (aGvHD), grade II–IV (41.5% vs. 28.1% in group 0 [p = 0.014] and 30.6% in group 2 [p = 0.067]) and grade III–IV (22.2% vs. 9.6% [p = 0.004] in group 0 and 12.2% in group 2 [p = 0.049]). Conversely, the risk of aGvHD in group 2 was similar to that in group 0 (p > 0.5). Multivariable analysis identified group 1 associated with grade II–IV (hazard ratio [HR] 2.307, p = 0.010) and grade III–IV (HR 2.962, p = 0.001) aGvHD, which yielded no significant risk factors for survival. In conclusion, we preliminarily demonstrated donors in the active infection state or ERS of mild SARS‐CoV‐2 infection were associated with higher incidences of aGvHD in transplants from related donors. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is usually regarded as a relative contraindication for deceased kidney donation. The pathological variations because of the changes in the immune environment after kidney transplantation (KT) are unclear, and the recovery of renal function is poorly understood. We present a case of KT from a deceased donor with SLE who was followed-up for one year. Although SLE-related hemangioma developed during the perioperative period, it was cured after interventional treatment. A pre-planned biopsy was performed one year after KT, and it was found that most of the pathological changes and immunofluorescent markers of lupus had resolved. Renal function was stable, and urinary protein and occult blood levels reduced one year after KT. [ABSTRACT FROM AUTHOR]

Haploidentical stem cell transplantation (haplo-SCT) using post-transplantation cyclophosphamide (post-Cy) is considered a reasonable therapeutic option for patients who lack matched donor or who urgently need transplant procedure due to high risk disease. We analyzed the results of haplo-SCT performed in years 2018–2023. Eighty one patients (46 males) at median age of 52 years underwent haplo-SCT using peripheral blood as a stem cell source in most cases. Indications included hematological malignancies (acute leukemias in 88% of cases). In 25 cases (31%) transplantation was performed in relapsed/refractory disease. Majority of patients (61%) presented with very high and high disease risk index (DRI). Conditioning regimens were as follows: nonmyeloablative − 46 cases (57%), myeloablative – in 18 (22%) and reduced intensity – 17(20%). 90% of patients engrafted. All patients received unified immunosuppressive treatment (post-Cy/TAC/MMF). Median follow-up time was 12 months The cumulative incidence of acute and chronic GVHD was 37.5% and 37.6%, respectively. Estimated 2-year overall survival (OS) was 43.1% and donor's age was the only factor influencing survival. The 2-year progression-free survival (PFS) was 42.5%, whereas relapse incidence (RI) − 35%. The cumulative incidence of non-relapse mortality (NRM) was 44% and was mostly due to infections. Haplo-SCT is a feasible treatment option for hematological patients. Younger donor improves post-transplant survival. Strategies to reduce infection-related mortality and relapse rate remain a challenge. [ABSTRACT FROM AUTHOR]

The psychological side effects of granulocyte colony-stimulating factor mobilization in related donors of allogeneic hematopoietic cell transplantation (allo-HCT) and impacts of psychological/physical side effects on harvest outcomes remain largely unknown. We prospectively analyzed 349 consecutive related peripheral blood stem cell (PBSC) donors for allo-HCT at the First Affiliated Hospital, Zhejiang University, School of Medicine from March 2021 to August 2023. Higher baseline peripheral blood white blood cell counts (p = 0.046), monocyte counts (p < 0.001), platelet counts (p = 0.001), and hemoglobin (p < 0.001) had a positive correlation to CD34+ cell counts in the first leukapheresis, while female donors (male vs. female, p < 0.001) and older age (> 40 vs. < = 40, p = 0.003) were negatively related to CD34+ cell counts. Bone pain was the most observed physical side effect and was more frequent in female donors (p = 0.032). The incidence of fatigue was higher in female donors and older donors (female vs. male, p = 0.016; > 40 vs. < = 40, p = 0.015). Donor depression (pre vs. during mobilization, p < 0.001), anxiety (pre vs. during mobilization, p = 0.043) and insomnia (pre vs. during mobilization, p = 0.011) scores increased during the mobilization period. Donors with higher depression, anxiety and stress scores at admission were more likely to experience nausea. At 1 month after the last leukapheresis, the counts of white blood cell, neutrophil, monocyte and hemoglobin were significant lower than baseline counts, while the platelet counts recovered to baseline. The mobilization and harvest process can increase the depression, anxiety and insomnia scores. Poor psychological status of the donor can aggravate the occurrence of physical side effects. [ABSTRACT FROM AUTHOR]