Journal articles: 'Critical organs'

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Sim, K. Howe, Anton Marinov, and Gary A. Levy. "Xenotransplantation: A Potential Solution to the Critical Organ Donor Shortage." Canadian Journal of Gastroenterology 13, no. 4 (1999): 311–18. http://dx.doi.org/10.1155/1999/231798.

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The success of allotransplantation as a treatment for end-stage organ failure has resulted in the need for an increasing number of organ donors. Attempts to meet this need include the use of organs from living related and unrelated donors, financial or other incentives for the donor family, and even the reuse of transplanted organs. Despite these initiatives, the supply of organs for transplantation still falls far short of the demand, as evidenced by longer waiting times for transplantation and decreasing transplantation rates. Even if Canada were able to increase its organ donor rate to that of Spain (40 to 50/million), where organ donation is governed by ‘presumed consent’ legislation, this would not alleviate the problem of donor shortage. Interest in xenotransplantation stems from the need to overcome this increasingly severe shortage of human organs. Indeed, some argue that xenotransplantation is the only potential way of addressing this shortage. As immunological barriers to xenotransplantation are better understood, those hurdles are being addressed through genetic engineering of donor animals and the development of new drug therapies. However, before xenotransplantation can be fully implemented, both the scientific/medical communities and the general public must seriously consider and attempt to resolve the many complex ethical, social and economic issues that it presents.

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Dimo, Peter Masibinyane. "Progress in Organ Donation and Transplantation: A Critical Review of Literature." Global Journal of Health Science 12, no. 10 (August 28, 2020): 133. http://dx.doi.org/10.5539/gjhs.v12n10p133.

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The majority of countries are battling with a high incidence of organ failure such as the kidneys, heart, lungs, pancreas, and liver. The only solution that can remedy the plight of patients facing the strong likelihood of death as a result of malfunctioning body organs is organ donation and transplantation. The intention of this literature study is to assess progress in organ donation and transplantation. This study has benefitted immeasurably from previous scientific investigations. Four hundred and thirty-one published papers were selected from different accredited journals. The study found that many of the countries that have implemented the opt-in system are struggling to close the gap between the high demand for and the actual availability of life-saving organs due to low rates of registered and committed organ donors. The majority of patients that are contending with end-stage diseases are added to the organ donation waiting lists, but have little hope of receiving life-prolonging organs. Among the factors that deter people from contributing to organ donation and transplantation are a lack of knowledge, the failure to obtain consent from family members or next-of-kin, social attitudes, socio-cultural aspects, and myths. This study recommends urgent measures that could be taken to increase organ transplants in public and private hospitals due to the chronic shortage of organs for transplantation and by introducing the opt-out system of organ donation.

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Hardaway, Robert M. "Traumatic Shock Alias Posttrauma Critical Illness." American Surgeon 66, no. 3 (March 2000): 284–90. http://dx.doi.org/10.1177/000313480006600312.

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Trauma is the most common cause of death under the age of 45. Many trauma patients die of multiple organ failure, especially acute respiratory distress syndrome. The basic cause of traumatic shock has only partially been elucidated. Data resources include research papers on the subject of trauma and shock from 1875 to the present. These papers numbered more than 40,000. Almost all of the papers proposed that traumatic shock was due to hypovolemia. The concept of a shock toxin as promulgated during World War I is correct. This toxin is a thrombogenic aminophospholipid that occurs only on the inner layer of all cell membranes and is liberated by cell destruction. It causes disseminated intravascular coagulation, which may obstruct the microcirculation of any and all organs producing multiple organ failure by microclots. These microclots may be lysed by plasminogen activator and circulation to the organs restored.

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Munir, Bakht, and Um e Noreen. "Balancing and Rebalancing of Judicial Autonomy: a Critical Analysis of Basic Structure Theory." Global Social Sciences Review V, no. IV (December 30, 2020): 152–59. http://dx.doi.org/10.31703/gssr.2020(v-iv).16.

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With its restoration in March 2009, the judiciary exceptionally emerged as an independent state organ and sought autonomy from parliament, which embarked on another avenue of confrontation between these two organs. Considering past experience, parliament was committed to imposing modest restraints on the judiciary and ensured its representation in the process of judicial appointments to the Superior Courts in the form of the 18th Constitutional Amendment, which the court considered as an attack on its autonomy. With the help of qualitative research methodology, this research aimed to investigate the post-2009 judicial-legislative transition, which apparently started up with their confrontation and imbalance between these organs. Both state organs are striving to identify their constitutional bounds, which will ultimately lead to equilibrium between these organs.

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Souter, Michael J., E. Eidbo, James Y. Findlay, Daniel J. Lebovitz, Marina Moguilevitch, Nikole A. Neidlinger, Gerhard Wagener, et al. "Organ Donor Management: Part 1. Toward a Consensus to Guide Anesthesia Services During Donation After Brain Death." Seminars in Cardiothoracic and Vascular Anesthesia 22, no. 2 (December 24, 2017): 211–22. http://dx.doi.org/10.1177/1089253217749053.

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Worldwide 715 482 patients have received a lifesaving organ transplant since 1988. During this time, there have been advances in donor management and in the perioperative care of the organ transplant recipient, resulting in marked improvements in long-term survival. Although the number of organs recovered has increased year after year, a greater demand has produced a critical organ shortage. The majority of organs are from deceased donors; however, some are not suitable for transplantation. Some of this loss is due to management of the donor. Improved donor care may increase the number of available organs and help close the existing gap in supply and demand. In order to address this concern, The Organ Donation and Transplantation Alliance, the Association of Organ Procurement Organizations, and the Transplant and Critical Care Committees of the American Society of Anesthesiologists have formulated evidence-based guidelines, which include a call for greater involvement and oversight by anesthesiologists and critical care specialists, as well as uniform reporting of data during organ procurement and recovery.

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Day, L. "How nurses shift from care of a brain-injured patient to maintenance of a brain-dead organ donor." American Journal of Critical Care 10, no. 5 (September 1, 2001): 306–12. http://dx.doi.org/10.4037/ajcc2001.10.5.306.

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BACKGROUND: The responsibility of obtaining organs for transplantation rests partly on critical care nurses. How nurses balance care of critically ill, brain-injured patients with the professional responsibility to procure organs is a question of ethical and clinical importance. OBJECTIVES: To describe the experiences of critical care nurses in making the shift from caring for a brain-injured patient identified as a potential organ donor to maintaining a brain-dead body. METHODS: An interpretive, phenomenological design was used. In 2 trauma centers, 9 critical care nurses were interviewed, and 2 of the 9 nurses were observed. RESULTS: Identification of potential organ donors is made under conditions of prognostic ambiguity. The transition from brain injury to brain death is a period of instability in which the critical care team must decide quickly whether to resuscitate a patient in order to procure organs. After a patient is brain dead, critical care nurses' relationship with and responsibility toward the patient change. CONCLUSIONS: The process of identifying potential organ donors and holding open the tentative possibility of organ procurement illustrates the practical difficulties of early referral of potential donors to organ procurement organizations. Early referral to an organ procurement organization implies a commitment to organ procurement that some nurses may hesitate to make because such a commitment changes their relationship with a brain-injured patient.

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Futterman, LG. "Presumed consent: the solution to the critical organ donor shortage?" American Journal of Critical Care 4, no. 5 (September 1, 1995): 383–88. http://dx.doi.org/10.4037/ajcc1995.4.5.383.

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Extraordinary advances in science and medicine such as transplantation of human tissues not only bring about previously unimaginable societal benefits but also create profound implications that involve autonomy and belonging, opposing moral considerations, and legal concerns. Today, technology is changing faster than our values. The issue of salvaging organs from the dead to meet the escalating need for human organs for lifesaving organ transplantation has evolved into an intricate web of interdisciplinary concerns and value conflicts; right and wrong are opinions and consensus does not seem to exist. This organ supply-demand mismatch, as well as suggestions for its resolution, has become a major challenge to the transplant community and to those in political and bioethical arenas. A methodical transition to presumed consent, or opting-out legislation, which removes the burden of decision from the family and the burden of request from the healthcare professional, may be the only solution to correct the imbalance between human organ need and availability.

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Zadvornov, A. A., and E. V. Grigoriev. "Extracerebral manifestations of acute cerebral insufficiency in patients in critical condition." Fundamental and Clinical Medicine 7, no. 3 (September 30, 2022): 64–73. http://dx.doi.org/10.23946/2500-0764-2022-7-3-64-73.

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Acute cerebral insufficiency is a life-threatening condition defined by a loss of basic and higher nervous activity, as well as neuronal regulation of vital organs. Along with the signs and symptoms of brain damage, acute cerebral insufficiency is often accompanied by manifestations from other vital organs (i.e., respiratory, cardiovascular, gastrointestinal, urinary and immune systems as well as haemostasis), significantly complicating the disease course. Among the critical consequences following acute cerebral insufficiency are: 1) neurogenic endocrine disorders including hypopituitarism and impaired secretion of antidiuretic hormone which are notable for electrolyte imbalance; 2) healthcare-associated infections such as congestive pneumonia, ventriculitis, and pressure ulcers. In the worst-case scenario, acute cerebral insufficiency results in a multiple organ dysfunction syndrome. Here we describe epidemiology, pathophysiology, signs, symptoms, prevention, and treatment of vital organs in patients with acute cerebral insufficiency.

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Skvortsov, A. E., S. F. Bagnenko, S. S. Komedev, V. M. Teplov, I. I. Kolachev, A. Yu Shchurov, A. L. Merkulov, V. P. Filatov, A. A. Boykov, and O. N. Reznik. "First Russian experience of liver and kidneys transplantation obtained from the donor with out-of-hospital irreversible cardiac arrest." Russian Journal of Transplantology and Artificial Organs 21, no. 1 (May 18, 2019): 88–95. http://dx.doi.org/10.15825/1995-1191-2019-1-88-95.

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Organs’ shortage remains the main limiting problem for accessibility of organ transplantation. There is the growing interest among transplant society for use organs obtained from «uncontrolled» donors after cardiac death (uDCDs), or, asystolic donors. But the warm ischemic time is critical factor for wide accepting of practice of transplantation such kind of organs. The article presents the first case of successful clinical organ transplants from the donor with out-of-hospital irreversible cardiac arrest obtained with help of life support devices.

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Scarritt, Michelle E., and Stephen F. Badylak. "Organ engineering: promise, progress and perspective." Biochemist 38, no. 4 (August 1, 2016): 20–23. http://dx.doi.org/10.1042/bio03804020.

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The only curative treatment option for patients with end-stage organ failure is transplantation. Organ engineering offers an alternative to traditional transplantation that may address the critical shortage of donor organs and eliminate the need for recipient immunosuppression. Organ engineering may be accomplished through the use of scaffold – support structures that contain the architecture of an organ. As organs are exceedingly complex, creating an organ scaffold is a difficult task; however, organ scaffolds can be derived through a process known as decellularization, which is the mechanical, chemical and/or enzymatic removal of cells from a tissue or organ. Through decellularization of xenogenic (animal) organs, biocompatible extracellular matrix (ECM) scaffolds can be produced that retain the complex macroscopic and microscopic structure and composition of the native organ ECM. These 3D ECM scaffolds are ideal for engineering human organs.

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Donkin, Marcella, Nikoleta Kolovos, and Paul A. Checchia. "Effect of a Specialized Pediatric Institutional Setting on Organ Recovery From Potential Donors." American Journal of Critical Care 15, no. 5 (September 1, 2006): 497–501. http://dx.doi.org/10.4037/ajcc2006.15.5.497.

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• Background The relationship between accessibility to the full range of subspecialty care available at freestanding pediatric hospitals and organ donor management and recovery rates has not been studied. • Objective To examine current rates of recovery of organs from children for transplantation at free-standing pediatric hospitals versus all other hospitals. • Methods Data from the hospitals served by Mid-America Transplant Services from January 2000 to July 2003 were reviewed. Organ recovery rates from freestanding children’s hospitals were compared with the rates from other types of institutions. Patients were included if their organs were considered medically suitable at the time of referral for donation. • ResultsOverall, 66% (210/318) of the potential organs were recovered. The type of institution in which the potential donor was managed did not influence the proportion of organs recovered: 67% (96/144) at freestanding children’s hospitals versus 66% (114/174) at all other hospitals. A greater proportion of livers were recovered at other donor institutions than at children’s hospitals (100% vs 85%, P≤.01). • Conclusion The organ recovery rate from potential pediatric donors is low. In general, this rate does not appear to be affected by the type of managing pediatric institution except for liver recovery, which favors institutions that are not freestanding children’s hospitals. The low rate of recovery suggests that although suitable donors are identified, appropriate referrals are made, and families provide consent for donation, major obstacles remain to the successful recovery of organs.

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Bartlett, Robert H. "Artificial organs: basic science meets critical care." Journal of the American College of Surgeons 196, no. 2 (February 2003): 171–79. http://dx.doi.org/10.1016/s1072-7515(02)01605-8.

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Crook, Juanita M., Louis Potters, Richard G. Stock, and Michael J. Zelefsky. "Critical organ dosimetry in permanent seed prostate brachytherapy: Defining the organs at risk." Brachytherapy 4, no. 3 (January 2005): 186–94. http://dx.doi.org/10.1016/j.brachy.2005.01.002.

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Hamant, O., and T. E. Saunders. "Shaping Organs: Shared Structural Principles Across Kingdoms." Annual Review of Cell and Developmental Biology 36, no. 1 (October 6, 2020): 385–410. http://dx.doi.org/10.1146/annurev-cellbio-012820-103850.

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Development encapsulates the morphogenesis of an organism from a single fertilized cell to a functional adult. A critical part of development is the specification of organ forms. Beyond the molecular control of morphogenesis, shape in essence entails structural constraints and thus mechanics. Revisiting recent results in biophysics and development, and comparing animal and plant model systems, we derive key overarching principles behind the formation of organs across kingdoms. In particular, we highlight how growing organs are active rather than passive systems and how such behavior plays a role in shaping the organ. We discuss the importance of considering different scales in understanding how organs form. Such an integrative view of organ development generates new questions while calling for more cross-fertilization between scientific fields and model system communities.

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Tang, L., R. J. Chang, B. Basso, T. Li, F. X. Zhen, L. L. Liu, W. X. Cao, and Y. Zhu. "Improving the estimation and partitioning of plant nitrogen in the RiceGrow model." Journal of Agricultural Science 156, no. 8 (October 2018): 959–70. http://dx.doi.org/10.1017/s0021859618001004.

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AbstractPlant nitrogen (N) links with many physiological progresses of crop growth and yield formation. Accurate simulation is key to predict crop growth and yield correctly. The aim of the current study was to improve the estimation of N uptake and translocation processes in the whole rice plant as well as within plant organs in the RiceGrow model by using plant and organ maximum, critical and minimum N dilution curves. The maximum and critical N (Nc) demand (obtained from the maximum and critical curves) of shoot and root and Nc demand of organs (leaf, stem and panicle) are calculated by N concentration and biomass. Nitrogen distribution among organs is computed differently pre- and post-anthesis. Pre-anthesis distribution is determined by maximum N demand with no priority among organs. In post-anthesis distribution, panicle demands are met first and then the remaining N is allocated to other organs without priority. The amount of plant N uptake depends on plant N demand and N supplied by the soil. Calibration and validation of the established model were performed on field experiments conducted in China and the Philippines with varied N rates and N split applications; results showed that this improved model can simulate the processes of N uptake and translocation well.

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Stiegler, Philipp, Augustinas Bausys, Bettina Leber, Kestutis Strupas, and Peter Schemmer. "Impact of Melatonin in Solid Organ Transplantation—Is It Time for Clinical Trials? A Comprehensive Review." International Journal of Molecular Sciences 19, no. 11 (November 8, 2018): 3509. http://dx.doi.org/10.3390/ijms19113509.

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Solid organ transplantation is the “gold standard” for patients with end-stage organ disease. However, the supply of donor organs is critical, with an increased organ shortage over the last few years resulting in a significant mortality of patients on waiting lists. New strategies to overcome the shortage of organs are urgently needed. Some experimental studies focus on melatonin to improve the donor pool and to protect the graft; however, current research has not reached the clinical level. Therefore, this review provides a comprehensive overview of the data available, indicating that clinical evaluation is warranted.

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Li, Zening, Jianan Hui, Panhui Yang, and Hongju Mao. "Microfluidic Organ-on-a-Chip System for Disease Modeling and Drug Development." Biosensors 12, no. 6 (May 27, 2022): 370. http://dx.doi.org/10.3390/bios12060370.

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An organ-on-a-chip is a device that combines micro-manufacturing and tissue engineering to replicate the critical physiological environment and functions of the human organs. Therefore, it can be used to predict drug responses and environmental effects on organs. Microfluidic technology can control micro-scale reagents with high precision. Hence, microfluidics have been widely applied in organ-on-chip systems to mimic specific organ or multiple organs in vivo. These models integrated with various sensors show great potential in simulating the human environment. In this review, we mainly introduce the typical structures and recent research achievements of several organ-on-a-chip platforms. We also discuss innovations in models applied to the fields of pharmacokinetics/pharmacodynamics, nano-medicine, continuous dynamic monitoring in disease modeling, and their further applications in other fields.

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Carsky, Katie, Christopher Carr, Cassidy Werner, Helmi Khadra, John Blair Hamner, Anil S. Paramesh, and Aaron S. Dumont. "De novo malignancy in recipients of solid organ transplant from donors with intracranial cancer." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e13507-e13507. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e13507.

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e13507 Background: In 2016, 33,610 organ transplants were performed in the US. Nevertheless, there is a critical deficiency of available organs. Currently, malignant neoplasms in the donor preclude organ donation, with some exceptions, such as certain CNS tumors without metastatic disease. The literature illustrates the risk of CNS tumor transmission with organ transplantation as 0-3% in the absence of additional risk factors, but organs from fewer than 0.5% of the 13,000 patients that die of glioma annually are procured. Given the critical need, we sought to reaffirm the safety of organs from donors with intracranial cancer by examining de novo malignancy outcomes in a large dataset. Methods: We examined the UNOS database to determine whether recipients of solid organ transplant from donors with intracranial cancer were at increased risk of de novo malignancy. Included were 119,430 subjects ages 18 to 65 who underwent heart, heart and lung, intestine, kidney, kidney and pancreas, liver, lung, or pancreas transplant from 1987 to 2012 and for whom there was complete data on donor history of intracranial cancer. 2-by-2 contingency tables were used to calculate odds ratios of exposure to donors with intracranial cancer. Outcomes included five-year survival, composite development of any malignancy, and development of specific malignancies including melanoma, esophageal, stomach, small intestine, pancreas, larynx, mouth, colorectal, primary liver tumor, and metastasis to liver. A p value of ≤ 0.05 was statistically significant. Results: 718 (0.60%) organs came from donors with intracranial cancer. 437 (79.02%) recipients of organs from donors with intracranial cancer survived 5 years, versus 71,055 (77.64%) recipients of organs from donors without intracranial cancer (p = 0.47). 113 (15.74%) recipients of organs from donors with intracranial cancer developed de novo malignancy, versus 17,963 (15.13%) recipients of organs from donors without intracranial cancer (p = 0.60). Of 17 contingency analyses of development of specific malignancies, we detected only 1 statistically significant positive association, de novo colorectal cancer in recipients of solid organ transplant from donors with intracranial cancer (p = 0.048, OR = 2.56). Given the large number of analyses and marginal significance of this in a very large dataset, it is likely type I error. Conclusions: Metastasis of primary CNS tumors beyond the CNS is a rare occurrence without additional risk factors. With the current organ shortage, donors with primary CNS malignancy are ideal candidates for organ donation.

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Zohar, Noam J. "Toward Justice in the Organ Trade." Israel Law Review 27, no. 4 (1993): 541–65. http://dx.doi.org/10.1017/s0021223700011493.

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Transplantation of organs from live persons may take place without any payment to the donors, and this involves relatively few moral problems. Gift donation appears to be widely accepted as a laudable and welcome form of benevolence. Even though an organ gift may entail some risk to the donor, his or her consent — provided that it is freely given and properly informed — renders such risk non-objectionable.Gift donation cannot, however, be expected to fill the large and growing demand for transplant organs. Thus, the issue of a market in organs has for some years now been the subject of ethical and legal scrutiny, and has been addressed by (generally prohibitive) legislation. What follows is intended as a critical survey, focusing initially on organ-buying, and then on organ-selling.

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Schlichtig, R., D. J. Kramer, and M. R. Pinsky. "Flow redistribution during progressive hemorrhage is a determinant of critical O2 delivery." Journal of Applied Physiology 70, no. 1 (January 1, 1991): 169–78. http://dx.doi.org/10.1152/jappl.1991.70.1.169.

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O2 consumption (VO2) of anesthetized whole mammals is independent of O2 delivery (DO2) until DO2 declines to a critical value (DO2c). Below this value, VO2 becomes O2 supply dependent. We assessed the influence of whole body DO2 redistribution among organs with respect to the commencement of O2 supply dependency. We measured DO2, VO2, and DO2c of whole body, liver, intestine, kidney, and remaining carcass in eight mongrel dogs during graded progressive hemorrhage. Whole body DO2 was redistributed such that the organ-to-whole body DO2 ratio declined for liver and kidney and increased for carcass. We then created a mathematical model wherein each organ-to-whole body DO2 ratio remained approximately constant at all values of whole body DO2 and assigned organ VO2 to predicted organ DO2 by interpolation and extrapolation of observed VO2-DO2 plots. The model predicted that O2 supply dependency without redistribution would have commenced at a higher value of whole body DO2 for whole body (8.11 +/- 0.89 vs. 6.98 +/- 1.16 ml.kg-1.min-1, P less than 0.05) and carcass (6.83 +/- 1.16 vs. 5.06 +/- 1.15 ml.kg-1.min-1, P less than 0.01) and at a lower value of whole body DO2 for liver (6.33 +/- 1.86 vs. 7.59 +/- 1.95, ml.kg-1.min-1, P less than 0.02) and kidney (1.25 +/- 0.64 vs. 4.54 +/- 1.29 ml.kg-1.min-1, P less than 0.01). We conclude that redistribution of whole body DO2 among organs facilitates whole body O2 regulation.

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Lewis, DD, and W. Valerius. "Organs from non-heart-beating donors: an answer to the organ shortage." Critical Care Nurse 19, no. 2 (April 1, 1999): 70–74. http://dx.doi.org/10.4037/ccn1999.19.2.70.

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McCoy, LK, and SK Bell. "Organ donation and the rural critical care nurse." American Journal of Critical Care 3, no. 6 (November 1, 1994): 473–75. http://dx.doi.org/10.4037/ajcc1994.3.6.473.

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BACKGROUND. Less than 20% of people who meet the criteria for organ donors are estimated to donate organs. OBJECTIVE. To examine the knowledge and attitudes of rural critical care nurses regarding organ donation. METHODS. Forty-six critical care nurses from a southwestern medical center provided data for this study. Self-reported knowledge and attitudes were measured using the Organ Donor Attitude Questionnaire and compared with respondents' demographic characteristics. RESULTS. Knowledge scores were found to be average (74% correct). Attitude scores reflected a strongly positive attitude toward organ donation. Increased knowledge of organ donation was not found to be related to a positive attitude. However, both attitude and knowledge were found to be positively correlated with previous experience in caring for either organ donors or recipients. Results were compared with data collected in an urban setting and found to be similar. CONCLUSIONS. Results of this study indicate that exposure to patients affected by organ procurement increased knowledge and improved attitudes of the nurses who provided care. Increased knowledge and positive attitude are important when providing support to families and caring for potential donors. These factors could increase the supply of donors for transplants, which is a goal of the organ procurement process.

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Sohn, Sogu, Maxwell Van Buskirk, Michael J. Buckenmeyer, Ricardo Londono, and Denver Faulk. "Whole Organ Engineering: Approaches, Challenges, and Future Directions." Applied Sciences 10, no. 12 (June 22, 2020): 4277. http://dx.doi.org/10.3390/app10124277.

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End-stage organ failure remains a leading cause of morbidity and mortality across the globe. The only curative treatment option currently available for patients diagnosed with end-stage organ failure is organ transplantation. However, due to a critical shortage of organs, only a fraction of these patients are able to receive a viable organ transplantation. Those patients fortunate enough to receive a transplant must then be subjected to a lifelong regimen of immunosuppressant drugs. The concept of whole organ engineering offers a promising alternative to organ transplantation that overcomes these limitations. Organ engineering is a discipline that merges developmental biology, anatomy, physiology, and cellular interactions with enabling technologies such as advanced biomaterials and biofabrication to create bioartificial organs that recapitulate native organs in vivo. There have been numerous developments in bioengineering of whole organs over the past two decades. Key technological advancements include (1) methods of whole organ decellularization and recellularization, (2) three-dimensional bioprinting, (3) advanced stem cell technologies, and (4) the ability to genetically modify tissues and cells. These advancements give hope that organ engineering will become a commercial reality in the next decade. In this review article, we describe the foundational principles of whole organ engineering, discuss key technological advances, and provide an overview of current limitations and future directions.

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IMB, David. "Age Management Medicine and Applied Healthspan Engineering: closely connected." Asploro Journal of Biomedical and Clinical Case Reports 3, no. 1 (February 6, 2020): 42–43. http://dx.doi.org/10.36502/2020/asjbccr.6184.

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All organisms have a minimal level of functional reserve required to sustain life that eventually declines to a point incompatible with survival at death. AHE seeks to maintain or restore the optimal functional reserve of critical tissues and organs. Tissue reserve correlates with well being. Diet, physical exercise, and currently available small molecule based therapeutics may attenuate the rate of decline of specific organs or organ systems, but are unlikely to restore lost reserve. Inherent evolutionary-derived limitations in tissue homeostasis and cell maintenance necessitate the development of therapies to enhance regenerative processes and possibly replace whole organs or tissues. AHE supports the study of the cell, tissue, and organ homeostatic mechanisms to derive new regenerative and tissue replacement therapies to extend the period of human health.

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Holmes, A. L., and J. S. Heilig. "Fasciclin II and Beaten path modulate intercellular adhesion in Drosophila larval visual organ development." Development 126, no. 2 (January 15, 1999): 261–72. http://dx.doi.org/10.1242/dev.126.2.261.

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Previous studies demonstrated that Fasciclin II and Beaten path are necessary for regulating cell adhesion events that are important for motoneuron development in Drosophila. We observe that the cell adhesion molecule Fasciclin II and the secreted anti-adhesion molecule Beaten path have additional critical roles in the development of at least one set of sensory organs, the larval visual organs. Taken together, phenotypic analysis, genetic interactions, expression studies and rescue experiments suggest that, in normal development, secretion of Beaten path by cells of the optic lobes allows the Fasciclin II-expressing larval visual organ cells to detach from the optic lobes as a cohesive cell cluster. Our results also demonstrate that mechanisms guiding neuronal development may be shared between motoneurons and sensory organs, and provide evidence that titration of adhesion and anti-adhesion is critical for early steps in development of the larval visual system.

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Reinhold, Ann Kristin, Markus Kredel, Christian K. Markus, and Peter Kranke. "Vaginal delivery in the 30+4 weeks of pregnancy and organ donation after brain death in early pregnancy." BMJ Case Reports 12, no. 9 (September 2019): e231601. http://dx.doi.org/10.1136/bcr-2019-231601.

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A 28-year-old woman suffered a traffic accident resulting in severe head injuries with deleterious prognosis. Diagnostics further revealed a hitherto unknown pregnancy, at suspected week 9. Based on the patient’s wish to donate organs, brain death protocol confirmed irreversible loss of brain function. Yet, vital pregnancy rendered organ transplantation impossible. Multiple ethical and legal issues arose, from invalidation of established legal care after brain death to the delivery of a healthy child after trauma and long-term critical care. After medicolegal and ethical counselling, pregnancy was sustained, and the goal of organ donation postponed. Critical care focused on foetal homeostasis. At 30+4 weeks, a viable girl was born via assisted vaginal delivery. Postpartal organ donation resulted in heart, kidney and pancreas transplantation. The case emphasises the medical, legal and ethical challenges to combine two apparently diametrical goals: the successful full-term pregnancy and the fulfilment of a patient’s wish to donate organs.

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Circelli, Alessandro, Etrusca Brogi, Emiliano Gamberini, Emanuele Russo, Marco Benni, Giovanni Scognamiglio, Andrea Nanni, et al. "Trauma and donation after circulatory death: a case series from a major trauma center." Journal of International Medical Research 49, no. 3 (March 2021): 030006052110005. http://dx.doi.org/10.1177/03000605211000519.

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Even with encouraging recipient outcomes, transplantation using donation after circulatory death (DCD) is still limited. A major barrier to this type of transplantation is the consequences of warm ischemia on graft survival; however, preservation techniques may reduce the consequences of cardiac arrest and provide better organ conservation. Furthermore, DCD in trauma patients could further expand organ donation. We present five cases in which organs were retrieved and transplanted successfully using normothermic regional perfusion (NRP) in trauma patients. Prompt critical care support and surgical treatment allowed us to overcome the acute phase. Unfortunately, owing to the severity of their injuries, all of the donors died. However, the advanced and continuous organ-specific supportive treatment allowed the maintenance of general clinical stability and organ preservation. Consequently, it was possible to retrieve and transplant the donors’ organs. Death was ascertained in accordance with cardio-circulatory criteria, which was followed by NRP. We consider that DCD in trauma patients may represent an important source of organs.

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DeJong, W., HG Franz, SM Wolfe, H. Nathan, D. Payne, W. Reitsma, and C. Beasley. "Requesting organ donation: an interview study of donor and nondonor families." American Journal of Critical Care 7, no. 1 (January 1, 1998): 13–23. http://dx.doi.org/10.4037/ajcc1998.7.1.13.

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BACKGROUND: Approximately half of the families asked to consider donation of a relative's organs decline to give consent. Understanding the difference between stated public support of organ donation and actual behavior is key to decreasing the shortage of donor organs. OBJECTIVES: To gain insight into the experiences of potential donor families and to define features of the donation-request process and other factors that are associated with consent for organ donation. METHODS: A structured telephone interview was conducted with the immediate next of kin of 164 medically suitable potential organ donors. Interviews 30 to 60 minutes long were held with members of both donor and nondonor families 4 to 6 months after the death of the study participant's relative. RESULTS: Several factors were associated with consent for organ donation: characteristics of the patient and the patient's family, beliefs and attitudes about organ donation and transplantation, whether the family knew the deceased's wishes about donation, the family's satisfaction with the hospital care that their relative received, specific aspects of the donation-request process, and the family's understanding of brain death. CONCLUSIONS: Organ donation rates could be increased by enhancing the quality of hospital care and ensuring that the request for donation is handled in a way that meets the families' informational and emotional needs.

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Mills, Patrick A. S., and David K. Mills. "Reduced Supply in the Organ Donor Market and How 3D Printing Can Address This Shortage: A Critical Inquiry into the Collateral Effects of Driverless Cars." Applied Sciences 10, no. 18 (September 14, 2020): 6400. http://dx.doi.org/10.3390/app10186400.

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Driverless cars, such as those currently operated by Uber and others as well as those being researched and developed by major and niche automobile manufacturers, are expected to dramatically reduce the number of highway fatalities in the coming years. While no one will fault any technology that safely and effectively protects and saves lives, many individuals with an array of medical conditions rely on organ donors to provide the liver, kidney, or other organs required to facilitate a life-saving organ transplant. Consequently, one collateral effect of the introduction of driverless car technology will be a reduction in the market supply of healthy organs for transplantation. In this paper, a venture capital lawyer, a medical researcher, and a bioengineer will establish the expected size of this reduction in supply, the associated harm resulting from this reduction, and discuss two promising technological solutions—bioprosthetics and 3D bioprinting of tissues and organs. In the case of both technologies, the authors will discuss the challenges and opportunities presented for institutional investors (private equity, venture capital, angel funds) and medical researchers in tackling the potential reduction in organ donations.

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Gobel, Barbara Holmes, William P. Hogle, and Roya J. Pourarian. "Sparing Critical Organs From the Effects of Radiation Therapy." Clinical Journal of Oncology Nursing 7, no. 5 (September 1, 2003): 587–89. http://dx.doi.org/10.1188/03.cjon.587-589.

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Moriano-Gutierrez, Silvia, Eric J. Koch, Hailey Bussan, Kymberleigh Romano, Mahdi Belcaid, Federico E. Rey, Edward G. Ruby, and Margaret J. McFall-Ngai. "Critical symbiont signals drive both local and systemic changes in diel and developmental host gene expression." Proceedings of the National Academy of Sciences 116, no. 16 (March 4, 2019): 7990–99. http://dx.doi.org/10.1073/pnas.1819897116.

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The colonization of an animal’s tissues by its microbial partners creates networks of communication across the host’s body. We used the natural binary light-organ symbiosis between the squidEuprymna scolopesand its luminous bacterial partner,Vibrio fischeri, to define the impact of colonization on transcriptomic networks in the host. A night-active predator,E. scolopescoordinates the bioluminescence of its symbiont with visual cues from the environment to camouflage against moon and starlight. Like mammals, this symbiosis has a complex developmental program and a strong day/night rhythm. We determined how symbiont colonization impacted gene expression in the light organ itself, as well as in two anatomically remote organs: the eye and gill. While the overall transcriptional signature of light organ and gill were more alike, the impact of symbiosis was most pronounced and similar in light organ and eye, both in juvenile and adult animals. Furthermore, the presence of a symbiosis drove daily rhythms of transcription within all three organs. Finally, a single mutation inV. fischeri—specifically, deletion of theluxoperon, which abrogates symbiont luminescence—reduced the symbiosis-dependent transcriptome of the light organ by two-thirds. In addition, while the gills responded similarly to light-organ colonization by either the wild-type or mutant, luminescence was required for all of the colonization-associated transcriptional responses in the juvenile eye. This study defines not only the impact of symbiont colonization on the coordination of animal transcriptomes, but also provides insight into how such changes might impact the behavior and ecology of the host.

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Belcaid, Mahdi, Giorgio Casaburi, Sarah J. McAnulty, Hannah Schmidbaur, Andrea M. Suria, Silvia Moriano-Gutierrez, M. Sabrina Pankey, et al. "Symbiotic organs shaped by distinct modes of genome evolution in cephalopods." Proceedings of the National Academy of Sciences 116, no. 8 (January 11, 2019): 3030–35. http://dx.doi.org/10.1073/pnas.1817322116.

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Microbes have been critical drivers of evolutionary innovation in animals. To understand the processes that influence the origin of specialized symbiotic organs, we report the sequencing and analysis of the genome ofEuprymna scolopes, a model cephalopod with richly characterized host–microbe interactions. We identified large-scale genomic reorganization shared betweenE. scolopesandOctopus bimaculoidesand posit that this reorganization has contributed to the evolution of cephalopod complexity. To reveal genomic signatures of host–symbiont interactions, we focused on two specialized organs ofE. scolopes: the light organ, which harbors a monoculture ofVibrio fischeri, and the accessory nidamental gland (ANG), a reproductive organ containing a bacterial consortium. Our findings suggest that the two symbiotic organs withinE. scolopesoriginated by different evolutionary mechanisms. Transcripts expressed in these microbe-associated tissues displayed their own unique signatures in both coding sequences and the surrounding regulatory regions. Compared with other tissues, the light organ showed an abundance of genes associated with immunity and mediating light, whereas the ANG was enriched in orphan genes known only fromE. scolopes. Together, these analyses provide evidence for different patterns of genomic evolution of symbiotic organs within a single host.

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Prabhu, Pradeep Kumar. "Is presumed consent an ethically acceptable way of obtaining organs for transplant?" Journal of the Intensive Care Society 20, no. 2 (May 21, 2018): 92–97. http://dx.doi.org/10.1177/1751143718777171.

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The near-universal acceptance of cadaveric organ donation has been based on the provision of explicit consent by the donor while alive, either in the form of a formal opt-in or informal discussion of wishes with next of kin. Despite the success of transplantation programmes based on explicit consent, the ongoing imbalance between demand and supply of organs for transplantation has prompted calls for more widespread introduction of laws validating presumed consent with facility for opt-out as a means of increasing organ availability. The Department of Health (UK) has recently concluded a consultation on the introduction of such a law for England. This article explores the debate on presumed consent from an ethical point of view and summarises the key arguments on both sides of the ethical divide.

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Voshart, Daniëlle C., Julia Wiedemann, Peter van Luijk, and Lara Barazzuol. "Regional Responses in Radiation-Induced Normal Tissue Damage." Cancers 13, no. 3 (January 20, 2021): 367. http://dx.doi.org/10.3390/cancers13030367.

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Normal tissue side effects remain a major concern in radiotherapy. The improved precision of radiation dose delivery of recent technological developments in radiotherapy has the potential to reduce the radiation dose to organ regions that contribute the most to the development of side effects. This review discusses the contribution of regional variation in radiation responses in several organs. In the brain, various regions were found to contribute to radiation-induced neurocognitive dysfunction. In the parotid gland, the region containing the major ducts was found to be critical in hyposalivation. The heart and lung were each found to exhibit regional responses while also mutually affecting each other’s response to radiation. Sub-structures critical for the development of side effects were identified in the pancreas and bladder. The presence of these regional responses is based on a non-uniform distribution of target cells or sub-structures critical for organ function. These characteristics are common to most organs in the body and we therefore hypothesize that regional responses in radiation-induced normal tissue damage may be a shared occurrence. Further investigations will offer new opportunities to reduce normal tissue side effects of radiotherapy using modern and high-precision technologies.

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Ely, E. Wesley. "Death by organ donation: euthanizing patients for their organs gains frightening traction." Intensive Care Medicine 45, no. 9 (August 23, 2019): 1309–11. http://dx.doi.org/10.1007/s00134-019-05702-1.

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Xiao, Li, Hiroshi Sakagami, and Nobuhiko Miwa. "ACE2: The key Molecule for Understanding the Pathophysiology of Severe and Critical Conditions of COVID-19: Demon or Angel?" Viruses 12, no. 5 (April 28, 2020): 491. http://dx.doi.org/10.3390/v12050491.

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Recently, the SARS-CoV-2 induced disease COVID-19 has spread all over the world. Nearly 20% of the patients have severe or critical conditions. SARS-CoV-2 exploits ACE2 for host cell entry. ACE2 plays an essential role in the renin–angiotensin–aldosterone system (RAAS), which regulates blood pressure and fluid balance. ACE2 also protects organs from inflammatory injuries and regulates intestinal functions. ACE2 can be shed by two proteases, ADAM17 and TMPRSS2. TMPRSS2-cleaved ACE2 allows SARS-CoV-2 cell entry, whereas ADAM17-cleaved ACE2 offers protection to organs. SARS-CoV-2 infection-caused ACE2 dysfunction worsens COVID-19 and could initiate multi-organ failure. Here, we will explain the role of ACE2 in the pathogenesis of severe and critical conditions of COVID-19 and discuss auspicious strategies for controlling the disease.

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Labuschagne, Debbie, and Pieter A. Carstens. "The Constitutional Influence on Organ Transplants with specific Reference to Organ Procurement." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 17, no. 1 (April 21, 2017): 251. http://dx.doi.org/10.17159/1727-3781/2014/v17i1a2211.

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This article assesses the influence of the Constitution of the Republic of South Africa, 1996 on the law pertaining to organ transplants with specific reference to methods of organ procurement. These methods include a system of opting-in, presumed consent, required request, required response, the sale of organs, and organ procurement from prisoners. It is argued, in view of the acute shortage of organs, that the various organ procurement methods are in need of review in the context of the question of whether they are acceptable and sustainable within the constitutional framework. To this end, the article deals with the application, limitation and interpretation of the rights in the Bill of Rights and its interface with the various organ procurement methods in the context of a discussion of applicable legislation and relevant case law. It is argued that a constitutional analysis of the topic is indicative that the State has indeed failed to provide a proper or satisfactory legislative and regulatory framework to relieve the critical shortage of human organs available for transplantation, by ultimately failing to uphold the applicable constitutional rights and values as discussed.

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BRYAN-BROWN, CHRISTOPHER W. "Blood flow to organs." Critical Care Medicine 16, no. 2 (February 1988): 170–78. http://dx.doi.org/10.1097/00003246-198802000-00016.

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Zhao, Qiancheng, Chuyue D. Yu, Rui Wang, Qian J. Xu, Rafael Dai Pra, Le Zhang, and Rui B. Chang. "A multidimensional coding architecture of the vagal interoceptive system." Nature 603, no. 7903 (March 16, 2022): 878–84. http://dx.doi.org/10.1038/s41586-022-04515-5.

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AbstractInteroception, the ability to timely and precisely sense changes inside the body, is critical for survival1–4. Vagal sensory neurons (VSNs) form an important body-to-brain connection, navigating visceral organs along the rostral–caudal axis of the body and crossing the surface–lumen axis of organs into appropriate tissue layers5,6. The brain can discriminate numerous body signals through VSNs, but the underlying coding strategy remains poorly understood. Here we show that VSNs code visceral organ, tissue layer and stimulus modality—three key features of an interoceptive signal—in different dimensions. Large-scale single-cell profiling of VSNs from seven major organs in mice using multiplexed projection barcodes reveals a ‘visceral organ’ dimension composed of differentially expressed gene modules that code organs along the body’s rostral–caudal axis. We discover another ‘tissue layer’ dimension with gene modules that code the locations of VSN endings along the surface–lumen axis of organs. Using calcium-imaging-guided spatial transcriptomics, we show that VSNs are organized into functional units to sense similar stimuli across organs and tissue layers; this constitutes a third ‘stimulus modality’ dimension. The three independent feature-coding dimensions together specify many parallel VSN pathways in a combinatorial manner and facilitate the complex projection of VSNs in the brainstem. Our study highlights a multidimensional coding architecture of the mammalian vagal interoceptive system for effective signal communication.

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Mazurkiewicz, Jacek, and Jan Mazurkiewicz. "Dlaczego jest tak źle, jeśli jest tak dobrze… Krytycznie o niektórych przepisach polskiej ustawy transplantacyjnej." Prawo 323 (December 29, 2017): 129–49. http://dx.doi.org/10.19195/0524-4544.323.13.

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Why is it so bad, if it is so good… Critical analysis of the Polish Organ Transplant ActDespite the Polish Organ Transplant Act is considered very advanced, the number of organs sourced from deceased donors in Poland is highly insufficient. We believe that this could be improved by modifying the existing Act. In this paper we present our findings and draft proposals for changes of law

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Sidana, Surbhi, Nidhi Tandon, Angela Dispenzieri, Morie A. Gertz, Francis Buadi, Martha Lacy, David Dingli, et al. "Factors predicting organ response in light chain amyloidosis (AL)." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 8048. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.8048.

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8048 Background: Organ response (OR) in AL is often delayed and difficult to predict early. Methods: We retrospectively analyzed 1308 patients (pts) with newly diagnosed AL from 2006 – 2015 to determine factors which could predict for OR. Results: Median age was 64 years (yr) and Mayo Stage was: 1 (22%); 2 (23%); 3 (25%); 4 (31%). Organ involvement was: cardiac (74%, n=932); renal (59%, n=738), liver (16%, n=205); gut (24%, n=310) and autonomic (12%, n=152). 59% (n=765) had > 1 organ involved, including 43% (n=567) with > 1 critical organ (heart, kidney, liver) involved. Treatment was: ASCT based (28%, n=330, N=1186), bortezomib based (24%, n=281), alkylator based (33%, n=392), others (5%, n=54) and none (10%). In evaluable pts, VGPR or better rates were: 53% at 6 months (m) (N=625), 72% at 12 m (N=465) and 57% overall (N=688). Table 1 lists OR at various time points. Complete OR in all involved critical organs was seen in: 51% (n=308, N=600), partial response (at least 1 OR when >1 organ involved) in 12% (n=73) and none in 37% (n=219). Complete OR was associated with better overall survival (OS) than partial or no OR (median OS: not reached vs 42 m vs 29 m; P <0.0001). In multivariate model the following variables at baseline or 1 yr mark were predictive of complete OR: lower Mayo Stage (p=0.01), fewer critical organs involved (p=0.007), higher baseline GFR (p=0.03), female sex (Complete OR 60% vs 47%; p=0.04) and VGPR at 1 yr (Complete OR 70% vs. 36%; p <0.0001). Other factors included in the model were age (p=0.9), bilirubin (p=0.1) and transplant (p=0.2). All aforementioned factors were significant in univariate analysis. Conclusions: Achievement of response in all involved critical organs is associated with better survival in AL pts than partial or no OR. Various baseline factors and VGPR at 1 yr can predict for achieving complete OR, with 70% pts who achieve VGPR at 1 yr having a complete OR. [Table: see text]

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Cipriani, Lynne, and Sarah A. Martin. "Current Controversies in Pediatric Transplantation." AACN Advanced Critical Care 5, no. 3 (August 1, 1994): 263–77. http://dx.doi.org/10.4037/15597768-1994-3006.

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Transplantation in children has become a therapeutic option for several end stage organ diseases. The kidney, liver, and heart are the most common organs transplanted; however, an increasing number of children are undergoing successful intestine, lung, and multiple organ transplant combinations. Through case study reports, emerging transplant options for the child experiencing end stage liver, intestine, heart, and lung failure are described. Critical care nurses play a crucial role in the postoperative recovery of these patients. An understanding of the transplant process and consequences of immunosuppression will help the critical care nurse identify signs of rejection, infection, and posttransplant lymphoprolifcrative disease

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Zhang, Ruirui, Yan Zhang, and Sheng Yi. "Identification of critical growth factors for peripheral nerve regeneration." RSC Advances 9, no. 19 (2019): 10760–65. http://dx.doi.org/10.1039/c9ra01710k.

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Sharir, Amnon, and Ophir D. Klein. "Watching a deep dive: Live imaging provides lessons about tooth invagination." Journal of Cell Biology 214, no. 6 (September 12, 2016): 645–47. http://dx.doi.org/10.1083/jcb.201608088.

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Invagination of epithelium into the surrounding mesenchyme is a critical step that marks the developmental onset of many ectodermal organs. In this issue, Ahtiainen et al. (2016. J. Cell. Biol. http://dx.doi.org/10.1083/jcb.201512074) use the mouse incisor as a model to advance our understanding of the cellular mechanisms underlying ectodermal organ morphogenesis.

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James Sarfeh, I., and Eric B. Rypins. "Physiology and Pathophysiology of the Digestive Organs in Critical Illness." Critical Care Clinics 3, no. 2 (April 1987): 395–404. http://dx.doi.org/10.1016/s0749-0704(18)30551-7.

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Agard, E. Theo, Gunther Ehlers, and Shirley Kirchberg. "Scattered Radiation Doses to Some Critical Organs During Pediatric Radiotherapy." Health Physics 48, no. 4 (April 1985): 447–51. http://dx.doi.org/10.1097/00004032-198504000-00007.

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HAWKINS, REGINA. "ANIMAL ORGANS." Nursing 24, no. 1 (January 1994): 6. http://dx.doi.org/10.1097/00152193-199401000-00001.

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Yaroustovsky, M. B., M. V. Abramyan, N. P. Krotenko, and E. V. Komardina. "Methods of Molecular Transfusion in the Intensive Therapy of Critical States." Annals of the Russian academy of medical sciences 71, no. 4 (September 8, 2016): 281–87. http://dx.doi.org/10.15690/vramn680.

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Development of extracorporeal blood purification acquires greater significance in the intensive care of multiple organ failures (MOF) with all the pathophysiological aspects of its constituent parts. MOF are the main cause of mortality among critically ill patients and treatment of these patients require significant investment. The purpose of the implementation of extracorporeal blood correction techniques today is multiple organ support therapy (MOST). Early extracorporeal therapy is used only in the treatment of renal failure. Today extracorporeal techniques are increasingly being used to replace the functions of various organs and systems. MOST includes diffusion, convection, filtration, sorption, apheresis methodic. They affect the molecular and electrolyte composition of blood, allow to correct, repair, replace, and maintain homeostasis in severe multiorgan dysfunction. Extracorporeal new molecular technologies have been successfully applied in the intensive care of severe heart and respiratory failure, acute kidney injury and acute hepatic dysfunction, in the treatment of severe sepsis, metabolic disorders, the correction of immune imbalance.

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Donoghue, Leslie, Khanh T. Nguyen, Caleb Graham, and Palaniappan Sethu. "Tissue Chips and Microphysiological Systems for Disease Modeling and Drug Testing." Micromachines 12, no. 2 (January 28, 2021): 139. http://dx.doi.org/10.3390/mi12020139.

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Tissue chips (TCs) and microphysiological systems (MPSs) that incorporate human cells are novel platforms to model disease and screen drugs and provide an alternative to traditional animal studies. This review highlights the basic definitions of TCs and MPSs, examines four major organs/tissues, identifies critical parameters for organization and function (tissue organization, blood flow, and physical stresses), reviews current microfluidic approaches to recreate tissues, and discusses current shortcomings and future directions for the development and application of these technologies. The organs emphasized are those involved in the metabolism or excretion of drugs (hepatic and renal systems) and organs sensitive to drug toxicity (cardiovascular system). This article examines the microfluidic/microfabrication approaches for each organ individually and identifies specific examples of TCs. This review will provide an excellent starting point for understanding, designing, and constructing novel TCs for possible integration within MPS.

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Abdulrazzaq, Najiba, Kashif Bin Naeem, Abdalla Alhajiri, Ayman Chkhis, Vinod Choondal, Mona Osman, and Kusay Almusa. "Multiple Organ Dysfunction Reduces In-Hospital Survival in COVID-19 Patients." International Journal of Innovative Research in Medical Science 5, no. 09 (September 14, 2020): 389–94. http://dx.doi.org/10.23958/ijirms/vol05-i09/951.

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Background: Although primarily a respiratory illness, COVID-19 involves multiple organs when the disease is severe or critical. Hence, we conducted this study to evaluate the incidence of multiple organ dysfunction in COVID-19 patients and its implications on survival. Methods: A retrospective analysis of laboratory-confirmed COVID-19 patients presenting to our center in Dubai, UAE between April 2020 and July 2020. Data was collected from the electronic medical records and analyzed to evaluate multiple organ damage observed during hospital admission. Findings: Five-hundred patients were studied. Overall mean age was 49.5 years (range 13-94), 76% males, 33% diabetics, 31% hypertensives. 97/500 (19.4%) had evidence of single organ damage; 37/500 (7.4%) had two organ damage; and 105/500 (21%) had more than two organ damage. Acute respiratory distress syndrome was the most prevalent organ damage,153/500 (30.6%); followed by acute cardiac injury, 120/500 (24%); acute kidney injury 107/500 (21.4%); acute liver injury 96/500 (19.2%); septic shock 93/500 (18.6%); disseminated intravascular coagulation 27/500 (5.4%), and heart failure 17/500 (3.4%). We found that in-hospital survival reduced as the number of organs involved increased; only 20% patients survived who had more than 2 organ damage. Also, the chances of survival reduced considerably once other organs were involved in addition to the acute respiratory distress syndrome (91.6% survival in ARDS alone vs. 28.6% survival in ARDS with acute kidney injury vs. 10.4% survival in ARDS with shock/acute cardiac injury/acute kidney injury). Conclusion: Multiple organ dysfunction is common in COVID-19 as 21% had evidence of more than two organ damage in our study. The survival in COVID-19 reduces significantly once multiple organs are involved. Early monitoring and recognition of multiple organ dysfunction is necessary to prevent adverse outcomes and improve survival.

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Journal articles on the topic 'Critical organs'

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