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A Novel Approach to High-Quality Postmortem Tissue Procurement: The GTEx Project.
Carithers LJ, Ardlie K, Barcus M, Branton PA, Britton A, Buia SA, Compton CC, DeLuca DS, Peter-Demchok J, Gelfand ET, Guan P, Korzeniewski GE, Lockhart NC, Rabiner CA, Rao AK, Robinson KL, Roche NV, Sawyer SJ, Segrè AV, Shive CE, Smith AM, Sobin LH, Undale AH, Valentino KM, Vaught J, Young TR, Moore HM, GTEx Consortium
(2015) Biopreserv Biobank 13: 311-9
MeSH Terms: Biomedical Research, Humans, Tissue Banks, Tissue and Organ Procurement
Show Abstract · Added April 13, 2017
The Genotype-Tissue Expression (GTEx) project, sponsored by the NIH Common Fund, was established to study the correlation between human genetic variation and tissue-specific gene expression in non-diseased individuals. A significant challenge was the collection of high-quality biospecimens for extensive genomic analyses. Here we describe how a successful infrastructure for biospecimen procurement was developed and implemented by multiple research partners to support the prospective collection, annotation, and distribution of blood, tissues, and cell lines for the GTEx project. Other research projects can follow this model and form beneficial partnerships with rapid autopsy and organ procurement organizations to collect high quality biospecimens and associated clinical data for genomic studies. Biospecimens, clinical and genomic data, and Standard Operating Procedures guiding biospecimen collection for the GTEx project are available to the research community.
0 Communities
1 Members
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4 MeSH Terms
Human islet preparations distributed for research exhibit a variety of insulin-secretory profiles.
Kayton NS, Poffenberger G, Henske J, Dai C, Thompson C, Aramandla R, Shostak A, Nicholson W, Brissova M, Bush WS, Powers AC
(2015) Am J Physiol Endocrinol Metab 308: E592-602
MeSH Terms: Adolescent, Adult, Aged, Child, Female, Humans, Insulin, Insulin Secretion, Islets of Langerhans, Male, Middle Aged, Research, Specimen Handling, Tissue Donors, Tissue and Organ Procurement, Young Adult
Show Abstract · Added July 28, 2015
Human islet research is providing new insights into human islet biology and diabetes, using islets isolated at multiple US centers from donors with varying characteristics. This creates challenges for understanding, interpreting, and integrating research findings from the many laboratories that use these islets. In what is, to our knowledge, the first standardized assessment of human islet preparations from multiple isolation centers, we measured insulin secretion from 202 preparations isolated at 15 centers over 11 years and noted five distinct patterns of insulin secretion. Approximately three quarters were appropriately responsive to stimuli, but one quarter were dysfunctional, with unstable basal insulin secretion and/or an impairment in stimulated insulin secretion. Importantly, the patterns of insulin secretion by responsive human islet preparations (stable Baseline and Fold stimulation of insulin secretion) isolated at different centers were similar and improved slightly over the years studied. When all preparations studied were considered, basal and stimulated insulin secretion did not correlate with isolation center, biological differences of the islet donor, or differences in isolation, such as Cold Ischemia Time. Dysfunctional islet preparations could not be predicted from the information provided by the isolation center and had altered expression of genes encoding components of the glucose-sensing pathway, but not of insulin production or cell death. These results indicate that insulin secretion by most preparations from multiple centers is similar but that in vitro responsiveness of human islets cannot be predicted, necessitating preexperimental human islet assessment. These results should be considered when one is designing, interpreting, and integrating experiments using human islets.
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2 Resources
16 MeSH Terms
Fatal Scopulariopsis infection in a lung transplant recipient: lessons of organ procurement.
Shaver CM, Castilho JL, Cohen DN, Grogan EL, Miller GG, Dummer JS, Gray JN, Lambright ES, Loyd JE, Robbins IM
(2014) Am J Transplant 14: 2893-7
MeSH Terms: Fatal Outcome, Graft Rejection, Humans, Idiopathic Pulmonary Fibrosis, Lung Transplantation, Male, Middle Aged, Mycoses, Postoperative Complications, Scopulariopsis, Tissue Donors, Tissue and Organ Procurement, Transplant Recipients
Show Abstract · Added February 12, 2015
Seventeen days after double lung transplantation, a 56-year-old patient with idiopathic pulmonary fibrosis developed respiratory distress. Imaging revealed bilateral pulmonary infiltrates with pleural effusions and physical examination demonstrated sternal instability. Broad-spectrum antibacterial and antifungal therapy was initiated and bilateral thoracotomy tubes were placed. Both right and left pleural cultures grew a mold subsequently identified as Scopulariopsis brumptii. The patient underwent pleural irrigation and sternal debridement three times but pleural and wound cultures continued to grow S. brumptii. Despite treatment with five antifungal agents, the patient succumbed to his illness 67 days after transplantation. Autopsy confirmed the presence of markedly invasive fungal disease and pleural rind formation. The patient's organ donor had received bilateral thoracostomy tubes during resuscitation in a wilderness location. There were no visible pleural abnormalities at the time of transplantation. However, the patient's clinical course and the location of the infection, in addition to the lack of similar infection in other organ recipients, strongly suggest that Scopulariopsis was introduced into the pleural space during prehospital placement of thoracostomy tubes. This case of lethal infection transmitted through transplantation highlights the unique risk of using organs from donors who are resuscitated in an outdoor location.
© Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.
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13 MeSH Terms
Getting more people TALKing about kidney transplantation.
Cavanaugh KL
(2013) Am J Kidney Dis 61: 368-70
MeSH Terms: Attitude to Health, Female, Humans, Kidney Transplantation, Living Donors, Male, Patient Education as Topic, Renal Insufficiency, Chronic, Social Work, Tissue and Organ Procurement
Added March 7, 2014
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1 Members
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10 MeSH Terms
A web-based application for initial screening of living kidney donors: development, implementation and evaluation.
Moore DR, Feurer ID, Zavala EY, Shaffer D, Karp S, Hoy H, Moore DE
(2013) Am J Transplant 13: 450-7
MeSH Terms: Adult, Body Mass Index, Cohort Studies, Female, Humans, Internet, Kidney Transplantation, Living Donors, Male, Middle Aged, Models, Statistical, Patient Education as Topic, Program Development, Referral and Consultation, Renal Insufficiency, Retrospective Studies, Software, Tissue and Organ Procurement
Show Abstract · Added May 22, 2014
Most centers utilize phone or written surveys to screen candidates who self-refer to be living kidney donors. To increase efficiency and reduce resource utilization, we developed a web-based application to screen kidney donor candidates. The aim of this study was to evaluate the use of this web-based application. Method and time of referral were tabulated and descriptive statistics summarized demographic characteristics. Time series analyses evaluated use over time. Between January 1, 2011 and March 31, 2012, 1200 candidates self-referred to be living kidney donors at our center. Eight hundred one candidates (67%) completed the web-based survey and 399 (33%) completed a phone survey. Thirty-nine percent of donors accessed the application on nights and weekends. Postimplementation of the web-based application, there was a statistically significant increase (p < 0.001) in the number of self-referrals via the web-based application as opposed to telephone contact. Also, there was a significant increase (p = 0.025) in the total number of self-referrals post-implementation from 61 to 116 per month. An interactive web-based application is an effective strategy for the initial screening of donor candidates. The web-based application increased the ability to interface with donors, process them efficiently and ultimately increased donor self-referral at our center.
© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.
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1 Members
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18 MeSH Terms
Liver transplant center risk tolerance.
Johnson SR, Karp SJ, Curry MP, Barugel M, Rodrigue JR, Mandelbrot DA, Rogers CP, Hanto DW
(2012) Clin Transplant 26: E269-76
MeSH Terms: Adolescent, Adult, Centers for Medicare and Medicaid Services (U.S.), Computer Simulation, End Stage Liver Disease, Female, Follow-Up Studies, Graft Survival, Humans, Liver Transplantation, Male, Middle Aged, Monte Carlo Method, Outcome Assessment (Health Care), Risk Assessment, Survival Rate, Tissue and Organ Procurement, United States, Young Adult
Show Abstract · Added May 22, 2014
Recent changes in Center for Medicare & Medicaid Services (CMS) condition for participation, using benchmark volume/outcomes requirements for certification, have been implemented. Consequently, the ability of a transplant center to assess its risk tolerance is important in successful management. An analysis of SRTR data was performed to determine donor/recipient risk factors for graft loss or patient death in the first year. Each transplant performed was then assigned a prospective relative risk (RR) of failure. Using a Monte-Carlo simulation, transplants were selected at random that met the centers' acceptable risk tolerance. Transplant center volume was fixed and its risk tolerance was adjusted to determine the impact on outcomes. The model was run 1000 times on centers with varying volume. The modeling demonstrates that centers with smaller annual volumes must use a more risk taking strategy than larger volume centers to avoid being flagged for CMS volume requirements. The modeling also demonstrates optimal risk taking strategies for centers based upon volume to minimize the probability of being flagged for not meeting volume or outcomes benchmarks. Small volume centers must perform higher risk transplants to meet current CMS requirements and are at risk for adverse action secondary to chance alone.
© 2012 John Wiley & Sons A/S.
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19 MeSH Terms
Factors associated with African American and White elders' participation in a brain donation program.
Jefferson AL, Lambe S, Cook E, Pimontel M, Palmisano J, Chaisson C
(2011) Alzheimer Dis Assoc Disord 25: 11-6
MeSH Terms: African Americans, Aged, Brain, Cultural Characteristics, Educational Status, European Continental Ancestry Group, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Religion, Surveys and Questionnaires, Tissue Donors, Tissue and Organ Procurement
Show Abstract · Added March 26, 2019
This study examined factors associated with brain donation program participation among African American and White elders. By postal mail, participants were recruited from an Alzheimer's research registry (all of whom had been invited to participate in the Center's brain donation program) and asked to complete surveys assessing brain donation knowledge, trust in healthcare systems, and religiousness. African American respondents completed a cultural mistrust inventory. Demographic, brain donation status, and literacy data (as assessed by the Wide Range Achievement Test-3 Reading subtest) were compiled from the respondents' most recent registry visit. The survey response rate was 60% (n=184 White and n=49 Black respondents). Logistic regression, comparing religiousness, trust in healthcare institutions, and educational attainment, identified a single predictor (ie, religiousness) in the prediction of donation status among White respondents (P=0.008), whereas no predictors were observed for donation status among the Black respondents. Using all African American donors and nondonors from the registry (n=68), comparisons revealed Wide Range Achievement Test-3 Reading score differences for African American donors (46.8±5.9) and nondonors (42.8±8.4, P=0.02). Results suggest that increased religiousness is related to White elders' decisions not to donate, whereas lower reading ability might be related to African American participants' decisions not to donate.
Copyright © 2011 by Lippincott Williams & Wilkins
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MeSH Terms
Renal donation after cardiac death.
Shah N, Langone A
(2010) J Am Soc Nephrol 21: 888-90
MeSH Terms: Death, Female, Graft Survival, Humans, Kidney Transplantation, Male, Netherlands, Survival Rate, Time Factors, Tissue and Organ Procurement, Waiting Lists
Added March 19, 2014
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11 MeSH Terms
Practices and barriers in long-term living kidney donor follow-up: a survey of U.S. transplant centers.
Mandelbrot DA, Pavlakis M, Karp SJ, Johnson SR, Hanto DW, Rodrigue JR
(2009) Transplantation 88: 855-60
MeSH Terms: Albuminuria, Blood Glucose, Follow-Up Studies, Hospitals, University, Humans, Kidney Transplantation, Living Donors, Physicians, Proteinuria, Time Factors, Tissue and Organ Procurement, United States
Show Abstract · Added May 22, 2014
BACKGROUND - Many have called for more comprehensive follow-up of living kidney donors, both for the donor's benefit and to establish a high-quality database of donor outcomes. United Network for Organ Sharing currently requires transplant centers to report donor follow-up information at several time points after donation, but little is known about how frequently this information is obtained, or which barriers exist to compliance with United Network for Organ Sharing requirements.
METHODS - To assess practices and barriers in providing follow-up care to living donors, we sent a questionnaire to all program directors at U.S. transplant centers.
RESULTS - Few transplant centers are currently seeing donors for long-term follow-up. Many centers recommend that donor follow-up care be provided by primary care physicians, but follow-up information is rarely received from primary care physicians. The main barriers to collecting more complete information are donor inconvenience, costs, and lack of reimbursement to the transplant center for providing follow-up care.
CONCLUSIONS - Significant changes are required to improve long-term donor follow-up by U.S. transplant centers.
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12 MeSH Terms
Donor postextubation hypotension and age correlate with outcome after donation after cardiac death transplantation.
Ho KJ, Owens CD, Johnson SR, Khwaja K, Curry MP, Pavlakis M, Mandelbrot D, Pomposelli JJ, Shah SA, Saidi RF, Ko DS, Malek S, Belcher J, Hull D, Tullius SG, Freeman RB, Pomfret EA, Whiting JF, Hanto DW, Karp SJ
(2008) Transplantation 85: 1588-94
MeSH Terms: Adult, Age Factors, Blood Pressure, Death, Female, Follow-Up Studies, Humans, Hypotension, Incidence, Intubation, Intratracheal, Kidney Transplantation, Liver Transplantation, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Survival Rate, Tissue Donors, Tissue and Organ Procurement, United States, Ventilator Weaning
Show Abstract · Added May 22, 2014
BACKGROUND - Compared with standard donors, kidneys recovered from donors after cardiac death (DCD) exhibit higher rates of delayed graft function (DGF), and DCD livers demonstrate higher rates of biliary ischemia, graft loss, and worse patient survival. Current practice limits the use of these organs based on time from donor extubation to asystole, but data to support this is incomplete. We hypothesized that donor postextubation parameters, including duration and severity of hemodynamic instability or hypoxia might be a better predictor of subsequent graft function.
METHODS - We performed a retrospective examination of the New England Organ Bank DCD database, concentrating on donor factors including vital signs after withdrawal of support.
RESULTS - Prolonged, severe hypotension in the postextubation period was a better predictor of subsequent organ function that time from extubation to asystole. For DCD kidneys, this manifested as a trend toward increased DGF. For DCD livers, this manifested as increased rates of poor outcomes. Maximizing the predictive value of this test in the liver cohort suggested that greater than 15 min between the time when the donor systolic blood pressure drops below 50 mm Hg and flush correlates with increased rates of diffuse biliary ischemia, graft loss, or death. Donor age also correlated with worse outcome.
CONCLUSIONS - Time between profound instability and cold perfusion is a better predictor of outcome than time from extubation to asystole. If validated, this information could be used to predict DGF after DCD renal transplant and improve outcomes after DCD liver transplant.
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22 MeSH Terms