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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
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Tissue Transplantation01:24

Tissue Transplantation

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Blood Transfusion and Agglutination02:45

Blood Transfusion and Agglutination

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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
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Blood Transfusion01:15

Blood Transfusion

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Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
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Related Experiment Video

Updated: Jul 11, 2025

In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
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Reducing donor acceptance practice variation - Learnings from a discussion forum.

Neha Bansal1, Aamir Jeewa2, Kae Watanabe3

  • 1Icahn School of Medicine at Mount Sinai, Mount Sinai Kravis Children's Hospital, New York, New York, USA.

Pediatric Transplantation
|November 13, 2023
PubMed
Summary

Pediatric heart transplant centers often reject donor hearts. A donor decision discussion forum (DDDF) revealed significant practice variation, suggesting this format can improve donor utilization.

Keywords:
donor heartheart transplantationpediatric heart transplant

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Area of Science:

  • Pediatric Cardiology
  • Transplant Surgery
  • Organ Donation

Background:

  • Waitlist mortality in pediatric heart transplantation remains high.
  • Nearly half of donor heart offers are rejected by pediatric heart transplant centers, contributing to mortality.
  • Significant practice variation exists in donor heart acceptance decisions among centers.

Approach:

  • A multi-institutional donor decision discussion forum (DDDF) was convened by the Advanced Cardiac Therapy Improving Outcome Network (ACTION) and Pediatric Heart Transplant Society (PHTS).
  • Monthly virtual sessions involved case presentations, pre-decision polling, group discussions, and literature reviews over two years.
  • Participation metrics, decision agreement, and impact on future practices were collected and analyzed.

Key Points:

  • Over two years, 41 cases were discussed with approximately 50 clinicians per session.
  • Donor quality, size discrepancy, and COVID-19 were key risk factors influencing decisions.
  • Participants agreed with presenting center decisions only 49% of the time, with 25% changing their decision post-discussion.

Conclusions:

  • The donor decision discussion forum identified substantial variation in pediatric donor decision-making.
  • DDDF may be an effective strategy to reduce practice variation and enhance donor utilization.
  • This educational format has the potential to improve decision-making and increase the number of successful pediatric heart transplants.