Explanted Organ

Abstract: During the biennial ISNCTC Symposia held in Bremen (1988)1 and Kobe (1994)2 we introduced the idea of a novel BNCT application. Its basic concept is the thermal neutron treatment of an explanted organ previously isolated and maintained in an extra-corporeal condition before reimplantation in the same donor patient (organ autotrans-plant). In those years some of us were refining the liver autotransplant technique later applied to several clinical cases.2 Therefore our efforts were directed to the liver metastases therapy as the first application of the method;2,16,17 in the future such a therapy could be extended to every organ suitable for autotransplant surgery.

Abstract: Background The German post-mortem organ donation rate has dropped by one third since 2010. Furthermore, 958 patients died in 2015 in Germany while waiting for an organ. To decrease organ shortage, an amendment of the transplantation law was established in 2012. An information package including an organ donor card is sent to all German citizens via the postal service. A voluntary national transplantation register was introduced in 2016 to improve transparency in the organ donation process. The influence of several transplantation scandals starting in 2012 on organ donation rates is in question. Therefore, the objective of this article is to discuss approval and objections to post-mortem organ donation among the next of kin of potential donors and the general public in Germany. Methods Binary logistic regression of data from the 2014 survey by the Federal Centre for Health Education on attitudes towards organ and tissue donation in Germany was conducted, aiming to identify influencing factors on the likelihood of organ donor card possession. Additionally, data of the German Organ Transplantation Foundation on post-mortem organ donations in Germany in 2014 were studied to highlight reasons for approval and objections by next of kin of potential and explanted post-mortem organ donors. Methods of documentation of the deceased's will according to data of the German Organ Transplantation Foundation were analyzed. Results Male gender and lack of knowledge about organ donation decrease the likelihood of having an organ donor card. Of the respondents in the survey of the Federal Centre for Health Education 71.0% would donate their own organs, whereas only one third possess an organ donor card. Health insurances and physicians are the most important providers of organ donor cards in Germany. An increase in the percentage of organ donor card possession following the amendment of the transplantation law could not be observed by 2016. Fear of organ trade and unjust organ allocation are the main reasons for rejecting organ donation among the general public. Previous transplantation scandals are a primary reason for a negative change in attitudes. Main reasons for objection among the next of kin of potential organ donors are known objections of the deceased and the lack of knowledge about the will of the deceased. In addition, only 58.1% of all explanted organ donors documented their will in written or verbal form. Conclusion Education on organ donation can be a means to increase organ donation rates. The effects of the change in legislation and the establishment of the transplant register need to be evaluated. Further research regarding the influence of religion, especially among religious minorities, on organ donation rates in Germany needs to be conducted to identify possible obstacles. Moreover, the use of social networks to address potential organ donors has proven to increase registration numbers and could easily be implemented in Germany.

Abstract: Diseased human organs explanted during liver transplantation can be used as a cell source for basic research and future therapeutic applications in regenerative medicine. Enzymatic digestion using the perfusion technique has become the gold standard in liver cell isolation. Usually the portal vein is used as a vascular access for liver cell isolation from explanted livers, that were rejected from whole organ transplantation. No special techniques are required for cannulation; the cannulas are simply introduced into the vessels and a ligature is then thrown around the vessel to secure the cannulation. This method is not applicable to organs explanted during liver transplant surgery, because as much of the vessels as possible has to be kept in situ, to facilitate anastomosis of the new organ. Therefore, when perfusing the explanted organ, normal perfusion catheters are easily displaced and a more complex “vascular reconstruction” must be performed to secure hold of the catheters. We established a novel cannulation technique using commercially available Foley catheters for liver cell isolation from diseased whole organs explanted during transplant surgery. We evaluated this technique in 15 diseased organs. 5 were isolated in the conventional setting and 10 were cannulated using Foley catheters. The average cannulation time was significantly shortened using Foley catheters compared with the conventional approach (12 ± 5.2 min vs 40 ± 14.1 min; P = .0001). Foley catheter cannulation is fast, simple, and efficient. It appears to be favorable for hepatocyte isolation from diseased whole livers or from explanted organs with technically difficult vascular access.