Thank you, everybody, for your comments. Establishing a cadaveric programme is essential. Imagine a young patient on dialysis who is just 19 years old with no family member suitable for donation for various reasons. Will you keep him on dialysis forever? Imagine he/she is your son, brother, sister, or daughter. We must think positively, learn how to save this young life, and promote this programme in your country.
Thank you Prof Ahmed A cadaveric program is really helpful & attractive, but unfortunately difficult to establish in many countries like ours. But, sometimes, i used to ask myself: Do we really need such a program? in a country where people are very willing to donate kidneys for their relatives? I am concerned that this might encourage the living donation which is already widely established.
Thanks you very much our Prof.Halawa the very important and informative lecture .
In our center only depended on living donor in Palestaine.
We hope that a member bank will be available so that we can relieve our patients from the waiting list, and that it will be implemented in our country.
I totally agree with you prof Halawa, a lot of organs not just kidney is being wasted daily in my country due to religious, and cultural belief systems. The Nephrology association in my country is making strong effort by pushing legislation of cadaveric organ donation though with a lot of resistance for now
rindhabibgmail-com
2 years ago
excellent professor.
Hussam Juda
2 years ago
Thank you
Mu'taz Saleh
2 years ago
thanks for this nice lecture
MILIND DEKATE
2 years ago
thank you sir…. Establishing cadaveric program is also require to minimize the gap between demand and supply of donor organ.
Dalia Ali
2 years ago
Thanks
saja Mohammed
2 years ago
dear prof ahmed for confirmation of brain stem death, do we need CT angiogram in all cases or just bed side clinical tests to be done by at least two senior members?
saja Mohammed
2 years ago
Thank you prof Ahmed for the excellent presentation, establishing a deceased donor program will be complementary to the LD program and would help those young with hereditary kidney diseases but need manpower, logistics, and most important public awareness and education at the level of the community about this program not only by health authority need the media and religious people help to bridge the educational gap about the importance of such program we are trying since many years but the main obstacles are the people still not accepting the concept of organ donation after death.
Thank you for this lecture, I think we need such a program in a low in-come and a developing country such as Palestine.
Hope we can make a better change in patients’ lives.
Yashu Saini
2 years ago
Thanks Professor Halawa for brilliant lecture
manal jamid
2 years ago
thank you professor Ahmed for comprehensive and informative lecture but we did not established such program despite of its importance to extend the renal transplantation
abosaeed mohamed
2 years ago
thank you, professor
Mahmoud Hamada
2 years ago
Thank you Dr. Halawa for this brilliant lecture
Ahmed Omran
2 years ago
Thanks for a standard model of lecture
general population awareness needs enhancement and religious support
Huda Saadeddin
2 years ago
Thank prof Ahmed for this informative lecture,we hope to be in our country as still not available
Hussein Bagha baghahussein@yahoo.com
2 years ago
Thank you Professor Halawa for an excellent lecture
In Kenya we don’t have the deceased organ program. We have just recently set up the Kenya Tissue and Transplant Authority 2 months ago. We are now working to set up the legal and ethical frameworks for the program
One of the problems I foresee is brain death. We have the criteria for brain death but we don’t switch off the ventilator after making the diagnosis. We de-escalate to the minimum possible settings and then wait. So we will need to educate health care workers and the public that brain death is death.
We also realized that a lot of sensitization of the public is needed to understand about deceased donation. This is because of the culture and beliefs in my country.
We hope to involve the religious leaders as well to help us educate the public
Thank you, Hussein. This is true; public awareness and education are needed.
CARLOS TADEU LEONIDIO
2 years ago
Thank you teacher for the lecture.
It calls my attention that in Brazil it is necessary to have a complementary exam that proves one of three situations: a) absence of encephalic blood perfusion or
b) absence of brain metabolic activity or
c) absence of brain electrical activity, lack of cerebral flow (CT angiography, Doppler US, electroencephalogram). Do you know if this is common in any other country/program?
Hamdy Hegazy
2 years ago
Thanks Professor Halawa for this lecture.
Many transplant co-ordinators will be involved to facilitate organ retrieval and delivery of this organs to potential donors (heart, lung, liver, kidneys, pancreas, intestine, cornea).
complex arrangements and highly sophisticated system is needed.
Just quick question? how many surgeons are needed just for organs retrieval
do we co-ordinators arrange for Cardiothoracic, hepatobiliary, urology, vascular, ophthalmology surgeons? or is there an organ retrieval surgical team they deal with all organs?
Thank you, Hamdy It is a team of surgeons from different subspecialties. I used to retrieve kidneys, liver and pancreas. Another team retrieve the small bowel and another team for the heart and the lungs. Ophthalmologists used to come for the eyes the next day (in the morg)
Mohammed Sobair
2 years ago
Thanks professor. Halaw
For the nice lecture. For us still the program not done in our center.inshalh will be in near future.
Farah Roujouleh
2 years ago
thank you so much prof for the informative lecture
i have seen 2 DD kidney transplants on peds nephrology which went smoothly and very well one from adult after car accident and other one from ped patient after cardiac arrest
Ramy Elshahat
2 years ago
Thanks professor Halawa for this excellent presentation.
My question is what is the parameters on which i can decide to discard the organs
Is there check list or it depends on donor and recipient coordinator experience???
Also i would like to ask regarding retrieval
Can be done on beating heart or i should stop all machine and waiting until patient arrested then start retrieval??
Thank you, Ramy Discarding kidneys will be discussed in the next week. DBD, you switch off the ventilator just before clamping the kidneys and the other organs. DCD, you switch off the ventilator and wait for cardiac arrest.
Great lecture but unfortunately we have not deceased program in our centre but really this program help many group of patients willing Transplant but no donors
Mahmud Islam
2 years ago
Thank you for the informative lecture. Regarding the apnea test. What about the criteria for the increase of pCO2> 60. Many patients are with comorbidities leading to hypercapnia. Overvolemia and COPD may contribute. Is it obligatory or additive? Isn’t vestibular-ocular reflex enough???
Thank you, Mahmoud. We do not rely on one test, but we do many tests. For example, a potential donor with massive trauma to the head involves an eardrum rupture. We can not do the caloric test on this patient. Also, the apnea test may be invalid for those patients with high PaCO2 due to other reasons.
Mugahid Elamin
2 years ago
Thanks prof about this lecture.
i ask from the solution was used to preserve the kifney while moving from area to other.
Thank u
Thank you prof Halawa for this great lecture.
Having cadaveric program is very important and complementary to living donor one. It is essential for those with strong family history of renal disease, diabetes and no available willing donors to accept the established risk of living donation. From our experience it needs public awareness, intensivist and ER physician involvement , active MDT, specially active donor team, etc.
Thank you for the excellent comment. This is why we should promote such programme.
Batool Butt
2 years ago
Great lecture, but we don’t have a deceased donor program here in our country.
dina omar
2 years ago
Thank you dear prof for informative lecture regarding cadaveric donors
unfortunately I have no experience in that issue
because it’s not present yet in our country although its advantages regarding decreasing the waiting list number and the reasonable survival of graft in comparable with living donors.
Zahid Nabi
2 years ago
Thanks for a nice lecture.
unfortunately in my country still there is no DD program.
Rahul Yadav rahulyadavdr@gmail.com
2 years ago
Thank You Prof Halawa for an informative lecture.
You mentioned an initial notch depicting graft loss in DBD compared to DCD/Live kidney Donation, when graft survival over years plotted on the graph.
Are the reasons similar as mentioned for better graft survival in DCD compared to DBD/Living Donor kidney or any other particular reason?
Thank you, Dr Patil It is illegal and also, to pay respect to the dead, but you are right, there are some dommies used for training.
Filipe prohaska Batista
2 years ago
Here in Brazil, due to the great problem we have regarding violence by bladed weapons, firearms, and automobiles, we have a much higher proportion (above 80%) of donations from deceased donors.
Due to the size of Brazil, logistics is naturally a big challenge, but there are often obstacles due to religious issues and even ignorance since we have half of the population of 230 million unable to interpret a text.
The first case of KPD was last year and almost all centers are unable to perform transplantation with ABO and HLA mismatched donors. We end up immunosuppressing our patients a lot and leaving them at the mercy of infections and rejections.
This class of this module and of living donors should be given to all politicians in our country to understand the impact that organ donation has on people’s lives and on the costs of the unified health system.
Thank you, Filipe These politicians will support organ donation if they or a close family member suffers from end-stage renal disease and need a transplant
Mahmoud Wadi
2 years ago
Thanks you very much our Prof.Halawa the very important and informative lecture .
In our center only depended on living donor in Palestaine.
We hope that a member bank will be available so that we can relieve our patients from the waiting list, and that it will be implemented in our country.
thank you prof; Ahmed Halawa
for this valuable and integrated lecture
Isaac Abiola
2 years ago
Thanks, Prof Halawa, for discussion, though largely new as we don’t do diseased kidney donor transplantation in Nigeria for now.
Nevertheless, it was a good information for me
Mohammad Alshaikh
2 years ago
Thank you Prof. Ahmad Halawa; for this valuable clear precise lecture.
Thank you Prof. i think the outcome form DBD will be better !, this might be due to circulatory compromise that might directly affect the blood supply to the kidney.
MICHAEL Farag
2 years ago
really, I enjoyed this informative lecture.
Still, Do we need to take the family’s consent, even if the patient has an official donation will card?
Thank you, Mohamed In Sheffield, we use standard basiliximab induction unless highly sensitised. In Liverpool and Leeds, they use Campath with a reduced dose of CNI.
many thanks Dr Ahmed, elegant and conclusive as usual but I couldn’t get certain points -why not every retrieved single kidney could be transplanted?
-why DBD better than DCD? is it due to the autonomic storm?
the time available for organs retrival is only 3 hours after diagnosis of DBD and 1 hour for the liver?
Thank you, Radwa DBD is associated with much longer warm ischaemia time compared to DCD. When you withdraw treatment, this period is called the agonal period where the donor is hypoxic and hypotensive. This incurs damage to the organ, especially the liver.
Sahar elkharraz
2 years ago
Thank you prof Ahmed for informative lecture
Ghalia sawaf
2 years ago
thank you professor halawa for your valuable lecture.
it will be a good opportunity for me to learn about renal transplantation from deceased donor because it still not available in Syria.
Last edited 2 years ago by Ghalia sawaf
Huda Mazloum
2 years ago
Very thanks prof Ahmad for this lecture
In syria till now we haven’t deceased donor transplant programme
Thank you, everybody, for your comments. Establishing a cadaveric programme is essential. Imagine a young patient on dialysis who is just 19 years old with no family member suitable for donation for various reasons. Will you keep him on dialysis forever?
Imagine he/she is your son, brother, sister, or daughter.
We must think positively, learn how to save this young life, and promote this programme in your country.
Thank you Prof Ahmed
A cadaveric program is really helpful & attractive, but unfortunately difficult to establish in many countries like ours.
But, sometimes, i used to ask myself: Do we really need such a program? in a country where people are very willing to donate kidneys for their relatives?
I am concerned that this might encourage the living donation which is already widely established.
Thank you. Do not forget that living donation is not without risk
Erratum
…..discourage the…..
Thank you sir for your concern.
Deceased donor transplantation is the option here.
Thank you Prof Ahmed
Actually we are suffering from this problem. Many patients on dialysis do not have donors, and we do not have Cadaveric program.
Thanks you very much our Prof.Halawa the very important and informative lecture .
In our center only depended on living donor in Palestaine.
We hope that a member bank will be available so that we can relieve our patients from the waiting list, and that it will be implemented in our country.
I totally agree with you prof Halawa, a lot of organs not just kidney is being wasted daily in my country due to religious, and cultural belief systems. The Nephrology association in my country is making strong effort by pushing legislation of cadaveric organ donation though with a lot of resistance for now
excellent professor.
Thank you
thanks for this nice lecture
thank you sir…. Establishing cadaveric program is also require to minimize the gap between demand and supply of donor organ.
Thanks
dear prof ahmed for confirmation of brain stem death, do we need CT angiogram in all cases or just bed side clinical tests to be done by at least two senior members?
Thank you prof Ahmed for the excellent presentation, establishing a deceased donor program will be complementary to the LD program and would help those young with hereditary kidney diseases but need manpower, logistics, and most important public awareness and education at the level of the community about this program not only by health authority need the media and religious people help to bridge the educational gap about the importance of such program we are trying since many years but the main obstacles are the people still not accepting the concept of organ donation after death.
. This is amust read article
JAMA Network Open. 2022;5(10):e2234971. doi:10.1001/jamanetworkopen.2022.34971
Thank you
Thank you
Thank you for this lecture, I think we need such a program in a low in-come and a developing country such as Palestine.
Hope we can make a better change in patients’ lives.
Thanks Professor Halawa for brilliant lecture
thank you professor Ahmed for comprehensive and informative lecture but we did not established such program despite of its importance to extend the renal transplantation
thank you, professor
Thank you Dr. Halawa for this brilliant lecture
Thanks for a standard model of lecture
general population awareness needs enhancement and religious support
Thank prof Ahmed for this informative lecture,we hope to be in our country as still not available
Thank you Professor Halawa for an excellent lecture
In Kenya we don’t have the deceased organ program. We have just recently set up the Kenya Tissue and Transplant Authority 2 months ago. We are now working to set up the legal and ethical frameworks for the program
One of the problems I foresee is brain death. We have the criteria for brain death but we don’t switch off the ventilator after making the diagnosis. We de-escalate to the minimum possible settings and then wait. So we will need to educate health care workers and the public that brain death is death.
We also realized that a lot of sensitization of the public is needed to understand about deceased donation. This is because of the culture and beliefs in my country.
We hope to involve the religious leaders as well to help us educate the public
Thank you, Hussein. This is true; public awareness and education are needed.
Thanks Professor Halawa for this lecture.
Many transplant co-ordinators will be involved to facilitate organ retrieval and delivery of this organs to potential donors (heart, lung, liver, kidneys, pancreas, intestine, cornea).
complex arrangements and highly sophisticated system is needed.
Just quick question? how many surgeons are needed just for organs retrieval
do we co-ordinators arrange for Cardiothoracic, hepatobiliary, urology, vascular, ophthalmology surgeons? or is there an organ retrieval surgical team they deal with all organs?
Regards
Thank you, Hamdy
It is a team of surgeons from different subspecialties. I used to retrieve kidneys, liver and pancreas. Another team retrieve the small bowel and another team for the heart and the lungs. Ophthalmologists used to come for the eyes the next day (in the morg)
Thanks professor. Halaw
For the nice lecture. For us still the program not done in our center.inshalh will be in near future.
thank you so much prof for the informative lecture
i have seen 2 DD kidney transplants on peds nephrology which went smoothly and very well one from adult after car accident and other one from ped patient after cardiac arrest
Thanks professor Halawa for this excellent presentation.
My question is what is the parameters on which i can decide to discard the organs
Is there check list or it depends on donor and recipient coordinator experience???
Also i would like to ask regarding retrieval
Can be done on beating heart or i should stop all machine and waiting until patient arrested then start retrieval??
Thank you, Ramy
Discarding kidneys will be discussed in the next week.
DBD, you switch off the ventilator just before clamping the kidneys and the other organs. DCD, you switch off the ventilator and wait for cardiac arrest.
Thanks alot professor Halawa
Great lecture but unfortunately we have not deceased program in our centre but really this program help many group of patients willing Transplant but no donors
Thank you for the informative lecture. Regarding the apnea test. What about the criteria for the increase of pCO2> 60. Many patients are with comorbidities leading to hypercapnia. Overvolemia and COPD may contribute. Is it obligatory or additive? Isn’t vestibular-ocular reflex enough???
Thank you, Mahmoud. We do not rely on one test, but we do many tests. For example, a potential donor with massive trauma to the head involves an eardrum rupture. We can not do the caloric test on this patient. Also, the apnea test may be invalid for those patients with high PaCO2 due to other reasons.
Thanks prof about this lecture.
i ask from the solution was used to preserve the kifney while moving from area to other.
Thank u
Thank you, this is addressed in the next lecture
Thank you prof Halawa for this great lecture.
Having cadaveric program is very important and complementary to living donor one. It is essential for those with strong family history of renal disease, diabetes and no available willing donors to accept the established risk of living donation. From our experience it needs public awareness, intensivist and ER physician involvement , active MDT, specially active donor team, etc.
Thank you for the excellent comment. This is why we should promote such programme.
Great lecture, but we don’t have a deceased donor program here in our country.
Thank you dear prof for informative lecture regarding cadaveric donors
unfortunately I have no experience in that issue
because it’s not present yet in our country although its advantages regarding decreasing the waiting list number and the reasonable survival of graft in comparable with living donors.
Thanks for a nice lecture.
unfortunately in my country still there is no DD program.
Thank You Prof Halawa for an informative lecture.
You mentioned an initial notch depicting graft loss in DBD compared to DCD/Live kidney Donation, when graft survival over years plotted on the graph.
Are the reasons similar as mentioned for better graft survival in DCD compared to DBD/Living Donor kidney or any other particular reason?
Thank you Rahul
The initial notch is mainly due to the increased incidence of primary non-function in DCD.
Thanks prof Halawa for the nice lecture.
what are the orders for organ retrieval, which one will be first and which one will be the last
Many Thanks Professor Halawa for this to the point practical lecture.
Thanks a lot sir for very short as well as informative lecture. In our country, we are yet to start diseased donor transplantation .
Thanks alot Prof Halawa for this beautiful lecture , highly appreciated and very informative
Thank you, sir, for an enlightening lecture on deceased donor.
Sir, can we have a step-by-step video of organ retrieval, either a link or webinar.
Thank you, Dr Patil
It is illegal and also, to pay respect to the dead, but you are right, there are some dommies used for training.
Here in Brazil, due to the great problem we have regarding violence by bladed weapons, firearms, and automobiles, we have a much higher proportion (above 80%) of donations from deceased donors.
Due to the size of Brazil, logistics is naturally a big challenge, but there are often obstacles due to religious issues and even ignorance since we have half of the population of 230 million unable to interpret a text.
The first case of KPD was last year and almost all centers are unable to perform transplantation with ABO and HLA mismatched donors. We end up immunosuppressing our patients a lot and leaving them at the mercy of infections and rejections.
This class of this module and of living donors should be given to all politicians in our country to understand the impact that organ donation has on people’s lives and on the costs of the unified health system.
Thank you, Filipe
These politicians will support organ donation if they or a close family member suffers from end-stage renal disease and need a transplant
Thanks you very much our Prof.Halawa the very important and informative lecture .
In our center only depended on living donor in Palestaine.
We hope that a member bank will be available so that we can relieve our patients from the waiting list, and that it will be implemented in our country.
Living and related donor
thank you prof; Ahmed Halawa
for this valuable and integrated lecture
Thanks, Prof Halawa, for discussion, though largely new as we don’t do diseased kidney donor transplantation in Nigeria for now.
Nevertheless, it was a good information for me
Thank you Prof. Ahmad Halawa; for this valuable clear precise lecture.
Is there difference in graft survival between DBD and DCD?
Thank you,
What do you think?
This will be discussed next week
Thank you Prof. i think the outcome form DBD will be better !, this might be due to circulatory compromise that might directly affect the blood supply to the kidney.
really, I enjoyed this informative lecture.
Still, Do we need to take the family’s consent, even if the patient has an official donation will card?
Thank you, Mike
Yes, however, it is not necessary.
thank you .
first time to attend lecture about deceased donor .
new information for me .
Thank you Professor for the comprehensive lecture
My question:
Induction therapy/CNIs in DCD (UK)?
Thank you, Mohamed
In Sheffield, we use standard basiliximab induction unless highly sensitised. In Liverpool and Leeds, they use Campath with a reduced dose of CNI.
Thank you Professor
Thank you prof Ahmed.
We depend only on living donor in Sudan so far.
Any extra information about kidney preservation ?
Thank you, Wadia
Next week, it will be discussed.
many thanks Dr Ahmed, elegant and conclusive as usual but I couldn’t get certain points -why not every retrieved single kidney could be transplanted?
-why DBD better than DCD? is it due to the autonomic storm?
Thank you, Radwa
DBD is associated with much longer warm ischaemia time compared to DCD.
When you withdraw treatment, this period is called the agonal period where the donor is hypoxic and hypotensive. This incurs damage to the organ, especially the liver.
Thank you prof Ahmed for informative lecture
thank you professor halawa for your valuable lecture.
it will be a good opportunity for me to learn about renal transplantation from deceased donor because it still not available in Syria.
Very thanks prof Ahmad for this lecture
In syria till now we haven’t deceased donor transplant programme
Very valuable and informative lecture our Prof.
Thank you very much
Thanks for great lecture