Background: Organ donation from a brain-dead person is done through a three-step process that begins with the identification of a suspected brain-dead case, continues with the mission of coordinator, and ends with the allocation of an organ. Postponed identification processes and poor management led to organ and donor loss. In which, during the last 14 months in a single center procurement unit, out of 428 potential donors, 174 cases were missed. In case of developing a smart process, all cofounding factors, would be considered beyond the human faults. We introduce a platform to overcome all concerns of donation process. Methods: We created an application which nurses can use for input GCS of patients instead of writing on sheets. It alerts if their GCS is three and recommends further considerations. Coordinator will be notified if a clinical examination indicated brain death. Application guides coordinator step by step. Allocation system works as a block chain system which each receiver considered as a new block and more stakes get the organ. Also, it includes a social media to share experiences. We employed this method in Imam Hossein Hospital for 3 months in 2022 and compared donation rates with the same period in 2021. Results: There was an increase of 5.41 folds in potential donors, 1.5 folds in actual donors, and 1.5 folds in procured organs (four kidneys, three livers and one heart). Conclusions: Donors detection will improve by using this application and saves time and human sources. Also, reduces hospital staffs' mismanagement which lead to improvement in the process. Guidance of this application helps coordinators with better choices in the face of challenges and it can be used as a learning courses platform. Blockchain system ensures transparency and security in allocating resources, and social media improves colleagues' communication.

Background Liver transplantation (LT) is widely recognized as a life-saving therapy for patients with end-stage liver disease. However, due to certain posttransplant complications, reoperations or endovascular interventions may be necessary to improve patient outcomes. This study was conducted to examine reasons for reoperation during the initial hospital stay following LT and to identify its predictive factors. Methods We evaluated the incidence and etiology of reoperation in 133 patients who underwent LT from brain-dead donors over a 9-year period based on our experiences. Results A total of 52 reoperations were performed for 29 patients, with 17 patients requiring one reoperation, seven requiring two, three requiring three, one requiring four, and one requiring eight. Four patients underwent liver retransplantation. The most common cause of reoperation was intra-abdominal bleeding. Hypofibrinogenemia was identified as the sole predisposing factor for bleeding. Frequencies of comorbidities such as diabetes mellitus and hypertension did not differ significantly between groups. Among patients who underwent reoperation due to bleeding, the mean plasma fibrinogen level was 180.33±68.21 mg/dL, while among reoperated patients without bleeding, it was 240.62±105.14 mg/dL (P=0.045; standard mean difference, 0.61; 95% confidence interval, 0.19–1.03). The initial hospital stay was significantly longer for the reoperated group (47.5±15.5 days) than for the non-reoperated group (22.5±5.5 days). Conclusions Meticulous pretransplant assessment and postoperative care are essential for the early identification of predisposing factors and posttransplant complications. In order to enhance graft and patient outcomes, any complications should be addressed without hesitation, and appropriate intervention or surgery should not be delayed.

Background: Recombinant tissue plasminogen activator (rTPA) is the gold standard therapy for ischemic stroke patients within the appropriate time interval. In addition to its undoubtedly benefits, recognizing its possible adverse effects is of utmost importance. This study aims to investigate the possible correlation between rTPA administration and the risk of post-stroke epilepsy. Methods: In a retrospective cohort study, we enrolled subjects identified to have an ischemic stroke event without prior history of epilepsy based on their medical records. Then, followed them retrospectively regarding any subsequent seizure or epilepsy syndromes. Results: rTPA therapy showed no correlations with seizures during the first week after stroke or with the epilepsy syndromes. Positive history of prior ischemic stroke, cortical localization of stroke, cardio embolic source of the stroke, and positive hemorrhagic complication were predictors of post-stroke seizure during the first week following the stroke event. Higher final Modified Rankin Scale (MRS) and cortical localization of stroke were predictors of post-stroke epilepsy (PSE). Conclusion rTPA is a safe therapeutic measure for patients with ischemic stroke with no concerns of subsequent development of post-stroke seizure or epilepsy.