OPTN/SRTR 2018 Annual Data Report: Deceased Organ Donation

Israni, Ajay K.; Zaun, David; Hadley, N.; Rosendale, John D.; Schaffhausen, Cory R.; McKinney, Warren T; Snyder, Jon J.; Kasiske, B. L.

doi:10.1111/ajt.15678

Cited by 70 publications

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“…The annual report published by OPTN and the Scientific Registry of Transplant Recipients (SRTR) reports the donation rate of lungs as 20.2%, the second lowest behind pancreas donation, which represents a significant quandary as the demand for donor lungs continues to outpace availability 1,18 . Thus, as drowning represents the third leading cause of death worldwide from unintentional injury, it is valuable to consider this population, whether drowned in seawater or swimming pools 9 .…”

Section: Discussionmentioning

confidence: 99%

Lung transplantation from swimming pool drowning victims: A case series

Tsou

Chen

Brzeziński

et al. 2021

American Journal of Transplantation

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The use of donor lungs from victims of drowning remains a rare occurrence, given concerns over lung parenchymal injury and microbial contamination secondary to aspiration. Given this infrequency, there is a relative paucity of literature surrounding the use of organs from drowned donors, with the few that exist on this subject focusing primarily on cases of drowning in naturally occurring bodies of water (i.e., drowning at sea). Little is known regarding the outcomes of utilizing donor lungs from victims of drowning in artificial bodies of water (i.e., swimming pools). Here, we describe three cases of bilateral lung transplantation from donors who drowned in swimming pools, with good short‐ and long‐term outcomes. These cases lend further evidence to the feasibility of using such organs that have traditionally been viewed with much trepidation. With continually growing demand for donor organs, the use of drowned donor lungs may serve as a means to expand the donor pool and lessen the burden of waitlist mortality.

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Section: Discussionmentioning

confidence: 99%

Lung transplantation from swimming pool drowning victims: A case series

Tsou

Chen

Brzeziński

et al. 2021

American Journal of Transplantation

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“…The exact reasons for this reduced activity for these centers need to be determined, but American Centers have observed a reduction in pancreas donors since the mid-2000s (https://optn.transplant.hrsa.gov/data/view-datareports/national-data/#). Unfortunately, among all organs isolated for transplantation the pancreas has become the organ with the lowest donation rate [approximately 11 donors per 100 eligible deaths were recorded in 2018 (26)].…”

Section: Why the Need For Stem-cell Based Therapy In Diabetes?mentioning

confidence: 99%

Stem Cell-Based Clinical Trials for Diabetes Mellitus

Klerk

Hebrok

2021

Front. Endocrinol.

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Since its introduction more than twenty years ago, intraportal allogeneic cadaveric islet transplantation has been shown to be a promising therapy for patients with Type I Diabetes (T1D). Despite its positive outcome, the impact of islet transplantation has been limited due to a number of confounding issues, including the limited availability of cadaveric islets, the typically lifelong dependence of immunosuppressive drugs, and the lack of coverage of transplant costs by health insurance companies in some countries. Despite improvements in the immunosuppressive regimen, the number of required islets remains high, with two or more donors per patient often needed. Insulin independence is typically achieved upon islet transplantation, but on average just 25% of patients do not require exogenous insulin injections five years after. For these reasons, implementation of islet transplantation has been restricted almost exclusively to patients with brittle T1D who cannot avoid hypoglycemic events despite optimized insulin therapy. To improve C-peptide levels in patients with both T1 and T2 Diabetes, numerous clinical trials have explored the efficacy of mesenchymal stem cells (MSCs), both as supporting cells to protect existing β cells, and as source for newly generated β cells. Transplantation of MSCs is found to be effective for T2D patients, but its efficacy in T1D is controversial, as the ability of MSCs to differentiate into functional β cells in vitro is poor, and transdifferentiation in vivo does not seem to occur. Instead, to address limitations related to supply, human embryonic stem cell (hESC)-derived β cells are being explored as surrogates for cadaveric islets. Transplantation of allogeneic hESC-derived insulin-producing organoids has recently entered Phase I and Phase II clinical trials. Stem cell replacement therapies overcome the barrier of finite availability, but they still face immune rejection. Immune protective strategies, including coupling hESC-derived insulin-producing organoids with macroencapsulation devices and microencapsulation technologies, are being tested to balance the necessity of immune protection with the need for vascularization. Here, we compare the diverse human stem cell approaches and outcomes of recently completed and ongoing clinical trials, and discuss innovative strategies developed to overcome the most significant challenges remaining for transplanting stem cell-derived β cells.

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“…The pancreas is the organ with the lowest donation rate per 100 eligible deaths, with approximately 12 donors per 100 eligible deaths being recorded in 2016. With 10,717 eligible deaths that year, this means that only 1,283 new pancreases were made available for transplantation [21]. Following the Edmonton protocol, over 5,000 islet equivalents (IEQ) need to be infused per kg of patient body weight for each transplantation [22,23].…”

Section: Beta-cell Replacement With Cadaveric Isletsmentioning

confidence: 99%

Economics of Beta-Cell Replacement Therapy

et al. 2019

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Purpose of Review: Type 1 diabetes impacts 1.3 million people in the United States with a total direct lifetime medical cost of $133.7 billion. Management requires a mix of daily exogenous insulin administration and frequent glucose monitoring. Decision making by the individual can be burdensome. Recent Findings: Beta-cell replacement, which involves devices protecting cells from autoimmunity and allorejection, aims at restoring physiological glucose regulation and improve clinical outcomes in patients. Given the significant burden of T1D in the healthcare systems, cost-effectiveness analyses can drive innovation and policymaking in the area. Summary: This review presents the health economics analyses performed for donor-derived islet transplantation and the possible outcomes of stem cell-derived beta cells. Long-term cost-effectiveness of islet transplantation depends on the engraftment of these transplants, and the expenses and thresholds assumed by healthcare systems in different countries. Early health technology assessment analyses for stem cell-derived beta-cell replacement suggest manufacturing optimization is necessary to reduce upfront costs.

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OPTN/SRTR 2018 Annual Data Report: Deceased Organ Donation

Cited by 70 publications

References 0 publications

Lung transplantation from swimming pool drowning victims: A case series

Lung transplantation from swimming pool drowning victims: A case series

Stem Cell-Based Clinical Trials for Diabetes Mellitus

Economics of Beta-Cell Replacement Therapy

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