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Olivia S. Kates Cynthia E. Fisher Robert M. Rakita Jorge D. Reyes Ajit P. Limaye 《American journal of transplantation》2020,20(7):1787-1794
In the context of a rapidly evolving pandemic, multiple organizations have released guidelines stating that all organs from potential deceased donors with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection should be deferred, including from otherwise medically eligible donors found to have mild or asymptomatic SARS‐CoV‐2 discovered on routine donor screening. In this article, we critically examine the available data on the risk of transmission of SARS‐CoV‐2 through organ transplantation. The isolation of SARS‐CoV‐2 from nonlung clinical specimens, the detection of SARS‐CoV‐2 in autopsy specimens, previous experience with the related coronaviruses SARS‐CoV and MERS‐CoV, and the vast experience with other common RNA respiratory viruses are all addressed. Taken together, these data provide little evidence to suggest the presence of intact transmissible SARS‐CoV in organs that can potentially be transplanted, specifically liver and heart. Other considerations including ethical, financial, societal, and logistical concerns are also addressed. We conclude that, for selected patients with high waitlist mortality, transplant programs should consider accepting heart or liver transplants from deceased donors with SARS‐CoV‐2 infection. 相似文献
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Marian G. Michaels Ricardo M. La Hoz Lara Danziger-Isakov Emily A. Blumberg Deepali Kumar Michael Green Timothy L. Pruett Cameron R. Wolfe 《American journal of transplantation》2020,20(7):1768-1772
The recent identification of an outbreak of 2019‐ novel Coronavirus is currently evolving, and the impact on transplantation is unknown. However, it is imperative that we anticipate the potential impact on the transplant community in order to avert severe consequences of this infection on both the transplant community and contacts of transplant patients. 相似文献
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Malay B. Shah Raymond J. Lynch Hanine El‐Haddad Brianna Doby Diane Brockmeier David S. Goldberg 《American journal of transplantation》2020,20(7):1795-1799
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has rapidly become an unprecedented pandemic that has impacted society, disrupted hospital functions, strained health care resources, and impacted the lives of transplant professionals. Despite this, organ failure and the need for transplant continues throughout the United States. Considering the perpetual scarcity of deceased donor organs, Kates et al present a viewpoint that advocates for the utilization of coronavirus disease 2019 (COVID‐19)–positive donors in selected cases. We present a review of the current literature that details the potential negative consequences of COVID‐19–positive donors. The factors we consider include (1) the risk of blood transmission of SARS‐CoV‐2, (2) involvement of donor organs, (3) lack of effective therapies, (4) exposure of health care and recovery teams, (5) disease transmission and propagation, and (6) hospital resource utilization. While we acknowledge that transplant fulfills the mission of saving lives, it is imperative to consider the consequences not only to our recipients but also to the community and to health care workers, particularly in the absence of effective preventative or curative therapies. For these reasons, we believe the evidence and risks show that COVID‐19 infection should continue to remain a contraindication for donation, as has been the initial response of donation and transplant societies. 相似文献
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Super-Closeness Between the Ritz Projection and the Finite Element Solution for Some Elliptic Problems 下载免费PDF全文
Ruosi Liang Yue Yan Wenbin Chen & Yanqiu Wang 《Communications In Computational Physics》2020,28(2):803-826
We prove the super-closeness between the finite element solution and the
Ritz projection for some second order and fourth order elliptic equations in both the $H^1$and the $L^2$norms. For the fourth order problem, a Ciarlet-Raviart type mixed formulation is used in the analysis. The main tool in the proof is a negative norm estimate
of the Ritz projection, which requires $H^{q+1}$ regularity for second order elliptic equations. Therefore, the analysis is done on a domain Ω with smooth boundary, and hence
we only consider the pure Neumann boundary problems which can be discretized
naturally on such domains, if ignoring the effect of numerical integrals. For the fourth
order problem, our results amend the gap between the theoretical estimates and the
numerical examples in a previous work [22]. 相似文献
59.
Christopher P. Michetti 《American journal of transplantation》2020,20(6):1503-1507
The opportunity for a critically ill patient to be an organ donor depends on a complex interplay of factors (the Donation Process), one of which is the treating medical team's perspective of the importance and priority of donation during end‐of‐life care. Medical providers frequently are hesitant to administer treatments to preserve organ function in patients whose death is imminent for fear of invoking a conflict of interest. The basis of the perceived conflict is that organ donation is a process done for the sole benefit of organ transplant recipients and not for the donor, and therefore care directed toward donation prior to death is not for the donor patient's benefit. In this report, it is argued that the Donation Process is indeed a patient‐centered process for the potential organ donor and that organ donation serves the donor's best interests. In addition, key elements of the Donation Process are described. 相似文献
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