OBJECTIVES: Our objective was to compare the measurement of residual white blood cell (rWBC) and residual red blood cell (rRBC) counts in blood products using the XN Blood Bank mode and the laboratory standard operating procedures for manual counts. In addition, to compare the whole blood complete blood count (CBC) values of blood donors and the quality of blood products using the Sysmex XN analyser versus the XS-1000i analyser. MATERIALS AND METHODS: For blood donors, 190 samples from blood or apheresis donors were analysed on both the Sysmex XS-1000i and XN-1000 analysers and the mean values of six CBC parameters were compared: the white blood cell count (WBC), the red blood cell count (RBC), haemoglobin (HGB), haematocrit (HCT), the mean corpuscular volume (MCV), the platelet count (PLT). For blood products, 164 samples were collected: 13 Plasma products - whole blood, 9 Plasma products - apheresis, 36 RBC concentrates - whole blood, 30 PLT concentrates - buffy coats, 36 PLT concentrates - buffy coats - pooled and 55 PLT concentrates - apheresis. RESULTS: All CBC parameters of the blood donors tested showed similar performance, with excellent correlation coefficients (r) ranging from 0.821 to 0.995. The majority of the blood products did not have a quantifiable number of residual cells, meaning the number of rWBC and rRBC, if present, was below the limit of quantitation (LoQ) of the different methods. rWBC were detected by Blood Bank mode in Plasma products - whole blood with a mean rWBC of 0.012 × 109 /L and in PLT concentrates - buffy coats with a mean rWBC of 0.19 × 109 /L. The correlation coefficient in both analysers for all three parameters (HGB, HCT, RBC) in RBC concentrates - whole blood was excellent, ranging from 0.95 to 0.99. For platelet count, r ranged from 0.98 to 0.99. CONCLUSION: The XN-Series analyser, equipped with a Blood Bank mode, demonstrated reliable performance when used for blood donor evaluation, rWBC enumeration and measurement of end blood products.
- MeSH
- dárci krve * MeSH
- erytrocyty MeSH
- krevní banky * MeSH
- krevní obraz metody MeSH
- lidé MeSH
- počet trombocytů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- dárci tkání * MeSH
- kostní dřeň MeSH
- lidé MeSH
- podpora zdraví MeSH
- Check Tag
- lidé MeSH
BACKGROUND: In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. METHODS: For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. RESULTS: Perspectives on the legal and ethical framework governing body donation in Europe. CONCLUSIONS: We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies.
- MeSH
- dárci tkání * MeSH
- lidé MeSH
- lidské tělo MeSH
- mrtvola MeSH
- získávání tkání a orgánů * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
The FOEDUS-EOEO platform was relaunched in 2015 to allocate deceased donor organs across European borders when there are no suitable recipients in the donor's country. We analyzed organ offers from 01.06.2015-31.12.2021 and present the number of offers and transplants, and utilization as percentage of transplanted organs. 1,483 organs were offered, 287 were transplanted (19.4% utilization). Yearly number of offers and transplants increased from 2017 to 2021, while utilization stabilized after 2018. Utilization was highest for organs offered by Slovakia (47.2%), followed for organs offered by Lithuania, France, Greece, and Czechia (19.3%-22.9%). The most frequently offered organ was the heart (n = 405; 27.3%), followed by the lungs (n = 369; 24.9%) and the liver (n = 345; 23.3%). Utilization differed significantly by organ type (highest for liver, 35.7%; followed by heart, 18.8%; and kidney, 18.3%) and by donor age (highest for 1 to 5 year-old donors (25.0%)). FOEDUS-EOEO allowed for many European patients receiving a long-awaited transplant, especially for very young pediatric patients waiting for a liver, a heart, or a kidney. The increasing number of participating countries has increased both the number of offered organs and, to a lesser extent, the number of transplanted organs.
Nádorová onemocnění jsou druhou nejčastější příčinou úmrtí transplantovaných pacientů. Jejich incidence stoupá s dobou od transplantace. Etiologie vzniku nádorového onemocnění je multifaktoriální, kdy se vedle tradičních rizikových faktorů uplatňuje i vliv imunosupresivní léčby a porušený imunitní dohled. K manifestaci nádorového onemocnění může u pacientů po transplantaci dojít v důsledku přenosu od dárce, vznikem de novo či relapsem. Kandidáti transplantace i potencionální dárci musí být pečlivě vyšetřeni k vyloučení aktivního nádorového onemocnění. Akceptace příjemce či dárce s onkologickou anamnézou k transplantaci ledviny je závislá na typu, stadiu a aktuálním restagingu nádorového onemocnění. Léčba nádorového onemocnění po transplantaci ledviny vedle konvenčních terapeutických přístupů zahrnuje i modifikaci imunosupresivní léčby. Součástí potransplantační péče je onkologický screening pacientů vycházející z mezinárodních odborných doporučení (KDIGO - Kidney Disease: Improving Global Outcomes) z roku 2009 a národních onkologických doporučení z roku 2023.
Cancer is the second cause of death in kidney transplant recipients. The incidence increases with the post-transplant period. The etiology is multifactorial; in addition to traditional risk factors, the effects of immunosuppressive treatment and impaired immunosurveillance play a decisive role. Posttransplant cancer can occur as a result of transmission from the donor, de novo or as a relapse. Both transplant candidates and donors must be carefully examined to rule out an active cancer. Eligibility of recipients and donors with a history of cancer depends on the cancer type, stage and current restaging. Along with conventional therapeutic approaches, the post-transplant cancer treatment also includes a modification of immunosuppressive treatment. Post-transplant care includes oncology screening based on the general KDIGO (Kidney Disease: Improving Global Outcomes) from 2009 and national oncological recommendations from 2023.
PURPOSE: The aim of our presentation is to introduce future eye bank product - corneal stromal lenticule from living donors, which can be used for allotransplantation. METHODS: ReLEx (refractive lenticule extraction) SMILE (small incision lenticule extraction) is a common approach in laser eye surgery. It is minimally invasive and flap-free procedure. During this procedure part of corneal stroma (lenticule) is created by femtosecond laser and consequently removed through small incision. The lenticule is basically waste material of the ReLEx SMILE procedure. In the International Eye Bank of Prague, we decided to establish new protocol for lenticule withdrawal, storage and release for transplantation. RESULTS: All donors signed an informed consent, and their serum was tested for the presence of infectious diseases. After ReLEx SMILE procedure the lenticule was stored in container with cryopreservation solution and frozen in the eye bank using the same protocol for frozen amniotic membrane. After 6 months in -80°C tissues were defrosted and examined histologically, using conventional light histology staining and electron microscopy. CONCLUSION: We believe, that lenticule from living donor is a safe and effective tissue, that can be used for many indications and in particular situations represents good alternative to whole donor cornea and amniotic membrane.
- MeSH
- lidé MeSH
- oční banky * MeSH
- rohovka MeSH
- stroma rohovky * chirurgie MeSH
- usmívání se MeSH
- žijící dárci MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The WAA apheresis registry contains data on more than 140,000 apheresis procedures conducted in 12 different countries. The aim is to give an update of indications, type and number of procedures and adverse events (AEs). MATERIAL AND METHODS: The WAA-registry is used for registration of apheresis procedures and is free of charge. The responsible person for a center can apply at the site www.waa-registry.org RESULTS: Data includes reported AEs from 2012 and various procedures and diagnoses during the years 2018-2022; the latter in total from 27 centers registered a total of 9500 patients (41% women) that began therapeutic apheresis (TA) during the period. A total of 58,355 apheresis procedures were performed. The mean age was 50 years (range 0-94). The most common apheresis procedure was stem cell collection for which multiple myeloma was the most frequent diagnosis (51%). Donor cell collection was done in 14% and plasma exchange (PEX) in 28% of patients; In relation to all performed procedures PEX, using a centrifuge (35%) and LDL-apheresis (20%) were the most common. The main indication for PEX was TTP (17%). Peripheral veins were used in 56% as the vascular access. The preferred anticoagulant was ACD. AEs occurred in 2.7% of all procedures and were mostly mild (1%) and moderate 1.5% (needed supportive medication) and, only rarely, severe (0.15%). CONCLUSION: The data showed a wide range of indications and variability in apheresis procedures with low AE frequency.
- MeSH
- dárci tkání MeSH
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- plazmaferéza MeSH
- předškolní dítě MeSH
- registrace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- separace krevních složek * metody MeSH
- výměna plazmy škodlivé účinky MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Over 16 000 children under the age of 15 died worldwide in 2017 because of liver disease. Pediatric liver transplantation (PLT) is currently the standard of care for these patients. The aim of this study is to describe global PLT activity and identify variations between regions. METHODS: A survey was conducted from May 2018 to August 2019 to determine the current state of PLT. Transplant centers were categorized into quintile categories according to the year they performed their first PLT. Countries were classified according to gross national income per capita. RESULTS: One hundred eight programs from 38 countries were included (68% response rate). 10 619 PLTs were performed within the last 5 y. High-income countries performed 4992 (46.4%) PLT, followed by upper-middle- (4704 [44·3%]) and lower-middle (993 [9·4%])-income countries. The most frequently used type of grafts worldwide are living donor grafts. A higher proportion of lower-middle-income countries (68·7%) performed ≥25 living donor liver transplants over the last 5 y compared to high-income countries (36%; P = 0.019). A greater proportion of programs from high-income countries have performed ≥25 whole liver transplants (52.4% versus 6.2%; P = 0.001) and ≥25 split/reduced liver transplants (53.2% versus 6.2%; P < 0.001) compared to lower-middle-income countries. CONCLUSIONS: This study represents, to our knowledge, the most geographically comprehensive report on PLT activity and a first step toward global collaboration and data sharing for the greater good of children with liver disease; it is imperative that these centers share the lead in PLT.
- MeSH
- dítě MeSH
- lidé MeSH
- nemoci jater * MeSH
- sčítání lidu MeSH
- smrt MeSH
- transplantace jater * škodlivé účinky MeSH
- žijící dárci MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Společně s vývojem medicíny se neustále vyvíjejí také možnosti transplantace tkání a orgánů, což s sebou přináší řadu etických konotací. V transplantační medicíně je nutné dodržovat vzájemně propojené legislativní požadavky a etické principy. Transplantace tkání a orgánů přináší etické aspekty i do běžné praxe. S potřebou řešení aktuálních etických souvislostí se setkáváme při vývoji technologií umožňujících rozvoj xenotransplantací. Uvažuje se také využití technologií umělé inteligence pro etické rozhodování v transplantační medicíně.
Along with the development of medicine and new therapeutic methods, the options of tissue and organ transplantation are constantly evolving, which brings a whole range of ethical connotations. The paper presents the legislative requirements and ethical principles that should be followed in transplant medicine, as well as their mutual connection. The article focuses on the ethical aspects which occur in connection with tissue and organ procurement and transplantation in everyday practice. The article also deals with modern methods that are currently being intensively developed and, in the future, could be helpful in solving contemporary issues in the field of transplantation. This concerns the ethical context of xenotransplantation, and the possibility of using artificial intelligence technologies for ethical decision-making in transplant medicine.
- MeSH
- dárci tkání etika zákonodárství a právo MeSH
- informovaný souhlas pacienta MeSH
- lékařská etika MeSH
- lidé MeSH
- transplantace heterologní etika MeSH
- transplantace orgánů * etika zákonodárství a právo MeSH
- zákonodárství lékařské MeSH
- získávání tkání a orgánů etika zákonodárství a právo MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: The aim of this study was to compare two immunosuppressive strategies, based on the use of either rabbit antithymocyte globulin (ATG) or posttransplant cyclophosphamide (PTCY), as a prophylaxis of graft-versus-host disease (GVHD) for patients with acute lymphoblastic leukemia (ALL) in first complete remission who underwent hematopoietic cells transplantation from matched unrelated donors. METHODS: Overall, 117 and 779 adult patients who received PTCY and ATG, respectively, between the years 2015 and 2020 were included in this retrospective study. The median patient age was 40 and 43 years in the PTCY and ATG groups, respectively, and 37% and 35% of patients, respectively, had Philadelphia chromosome-positive ALL. RESULTS: In univariate analysis, the cumulative incidence of acute and chronic GVHD did not differ significantly between the study groups. The cumulative incidence of relapse at 2 years was reduced in the PTCY group (18% vs. 25%; p = .046) without a significant impact on nonrelapse mortality (11% vs. 16% in the ATG group; p = .29). The rates of leukemia-free survival (LFS) and overall survival were 71% versus 59%, respectively (p = .01), and 82% versus 74%, respectively (p = .08). In multivariate analysis, the receipt of ATG compared with PTCY was associated with a reduced risk of extensive chronic GVHD (hazard ratio, 0.54; 95% confidence interval, 0.3-0.98; p = .04) and an increased risk of low LFS (hazard ratio, 1.57; 95% confidence interval, 1.01-2.45; p = .045). CONCLUSIONS: The receipt of ATG compared with PTCY, despite the reduced risk of extensive chronic GVHD, is associated with inferior LFS in adults with ALL who undergo hematopoietic cell transplantation from 10/10 human leukocyte antigen-matched unrelated donors. These findings warrant verification in prospective trials.
- MeSH
- akutní lymfatická leukemie * farmakoterapie MeSH
- akutní myeloidní leukemie * farmakoterapie MeSH
- akutní nemoc MeSH
- antilymfocytární sérum terapeutické užití MeSH
- cyklofosfamid terapeutické užití MeSH
- dospělí MeSH
- kostní dřeň MeSH
- lidé MeSH
- nemoc štěpu proti hostiteli * etiologie prevence a kontrola MeSH
- nepříbuzný dárce MeSH
- příprava pacienta k transplantaci MeSH
- prospektivní studie MeSH
- retrospektivní studie MeSH
- transplantace hematopoetických kmenových buněk * škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
