Passive immunisation with normal human immunoglobulin (NHIG) is recommended as post-exposure prophylaxis (PEP) for higher-risk measles contacts where vaccination is contraindicated. However, the concentration of measles-specific antibodies in NHIG depends on antibody levels within pooled donor plasma. There are concerns that measles immunity in the Australian population may be declining over time and that blood donors\' levels will progressively decrease, impacting levels required to produce effective NHIG for measles PEP. A cross-sectional study of Australian plasmapheresis donors was performed using an age-stratified, random sample of recovered serum specimens, collected between October and November 2019 (n = 1199). Measles-specific IgG antibodies were quantified by ELISA (Enzygnost anti-measles virus IgG, Siemens), and negative and equivocal specimens (n = 149) also underwent plaque reduction neutralisation testing (PRNT). Mean antibody levels (optical density values) progressively decreased from older to younger birth cohorts, from 2.09 [±0.09, 95% CI] to 0.58 [±0.04, 95% CI] in donors born in 1940-1959 and 1990-2001, respectively (p < 0.0001). This study shows that mean measles-specific IgG levels are significantly lower in younger Australian donors. While current NHIG selection policies target older donors, as younger birth cohorts become an increasingly larger proportion of contributing donors, measles-specific antibody concentrations of NHIG will progressively reduce. We therefore recommend monitoring measles-specific antibody levels in future donors and NHIG products in Australia and other countries that eliminated measles before the birth of their youngest blood donors.

OBJECTIVE: To evaluate donor gamete utilization, patient satisfaction, and fertility treatment outcomes of patients pursuing treatment with donor gametes stratified by the desired race as well as ethnicity of the gamete donor.
METHODS: Survey study.
METHODS: Clinic.
METHODS: Patients planning to undergo treatment using donor sperm and/or donor oocytes at a single academic fertility clinic in the Southeastern United States between 2015 and 2020.
METHODS: None.
METHODS: Utilization rates of donor gametes, satisfaction with donor gamete selection, and fertility treatment outcomes stratified by race and ethnicity of patient, as well as that of their gamete donor.
RESULTS: Four hundred fifty patients were eligible for inclusion and 170 (38%) responded to the survey. Among the respondents, 59% desired a non-Hispanic White gamete donor and 20% desired a non-Hispanic Black gamete donor. Patients seeking a non-Hispanic Black gamete donor had lower odds of using donor gametes (Odds ratio [OR], 0.13; 95% confidence interval [CI], 0.04-0.40) compared with individuals seeking a non-Hispanic White gamete donor. When evaluating satisfaction with donor gamete selection, patients seeking a non-Hispanic Black gamete donor reported lower satisfaction compared with individuals seeking a non-Hispanic White gamete donor (OR, 0.19; 95% CI, 0.09-0.43). When evaluating fertility outcomes, Non-Hispanic Black patients and those using non-Hispaninc Black gamete donors were found to have lower odds of successful conception compared with non-Hispanic White patients (OR, 0.18; 95% CI, 0.07-0.46) and individuals seeking non-Hispanic White gamete donors (OR, 0.26; 95% CI, 0.09-0.75), respectively.
CONCLUSIONS: Patients seeking non-Hispanic Black donor gametes have lower utilization rates, less satisfaction with gamete donor selection, and lower odds of conception when compared with those seeking non-Hispanic White gamete donors. These findings highlight the need for more racial diversity within donor gamete banks, as well as within the donor pools available through agencies and fertility clinics.

BACKGROUND: The availability of donated eye tissue saves and enhances vision in transplant recipients; however, the current demand for tissue surpasses the available supply. Corneal donor shortages lead to increased wait times, delayed surgeries, prolonged visual impairment, and increased inconvenience to patients requiring eye tissue transplantation. A web-based application was previously developed to facilitate easy and intuitive submission of potential donor information.
OBJECTIVE: The primary objectives of this study were to assess health care professionals\' attitudes toward the potential application and evaluate its effectiveness based on user feedback and donor registrations through the application.
METHODS: Researchers used a mixed methods approach, commencing with a literature review to identify challenges associated with donor procurement. Stakeholder interviews were conducted to gauge health care professionals\' perspectives regarding the application. User feedback was collected through questionnaires, surveys, and interviews to assess the application\'s usability and impact. An assessment of the reported potential donors and questionnaire responses were analyzed.
RESULTS: The final version of the application successfully reported 24 real cornea donors. Among 64 health care providers who used the application to communicate about potential donors, 32 of them submitted trial entries exclusively for testing purposes. The remaining 8 health care professionals reported potential donors; however, these individuals did not meet the donor qualification criteria. The majority of participants found the application user-friendly and expressed their readiness to use it in the future. Positive ratings were assigned to the layout, appearance, purpose, and specific features of the application. Respondents highlighted the automatic sending of notifications via SMS text messages and the integration of all necessary documents for donor qualification and tissue collection as the most valuable functions of the application.
CONCLUSIONS: The study indicates that donor reporting applications offer promising solutions to enhance tissue donor procurement. This application streamlined the reporting process, reduced paperwork, facilitated communication, and collected valuable data for analysis.

OBJECTIVE: Stress cardiomyopathy in donors can potentially affect graft function and longevity. This study aims to investigate the association between echocardiographic left ventricular ejection fraction (LVEF) < 50%, and/or the presence of left ventricular regional wall motion abnormalities (RWMA) in organ donors, and short- and long-term liver and kidney graft survival. Our secondary aim was to link graft survival with donor and recipient characteristics.
METHODS: All donors considered for liver and kidney donation with echocardiographic records at Sahlgrenska University Hospital between 2006 and 2016 were matched with their recipients through the Scandiatransplant register. The studied outcomes were graft survival, re-transplantation, and recipient death. Kaplan-Meier curves were used to plot time to event. Multivariate Cox-regression was used to test independence.
RESULTS: There were 370 liver donors and 312 kidney donors (matched with 458 recipients) with echocardiographic records at Sahlgrenska University Hospital between June 2006 and November 2016. Of patients with LV dysfunction by echocardiography, there were 102 liver- and 72 kidney donors. Univariate survival analyses showed no statistical difference in the short- and long-term graft survival from donors with LV dysfunction compared to donors without. Donor age > 65 years, recipient re-transplantation and recipient liver tumor were predictors of worse outcome in liver transplants (p < .05). Donor age > 65, donor hypertension, recipient re-transplantation, and a recipient diagnosis of diabetes or nephritis/glomerulonephritis had a negative association with graft survival in kidney transplants (p < .05).
CONCLUSIONS: We found no significant association between donor LV dysfunction and short- and long-term graft survival in liver and kidney transplants, suggesting that livers and kidneys from such donors can be safely transplanted.

OBJECTIVE: Sex-specific differences are observed in various liver diseases, but the influence of sex on the outcomes of hepatocellular carcinoma (HCC) after liver transplantation (LT) remains to be determined. This study is the first Chinese nationwide investigation of the role of sex in post-LT outcomes in patients with HCC.
METHODS: Data for recipients with HCC registered in the China Liver Transplant Registry between January 2015 and December 2020 were analyzed. The associations between donor, recipient, or donor-recipient transplant patterns by sex and the post-LT outcomes were studied with propensity score matching (PSM). The survival associated with different sex-based donor-recipient transplant patterns was further studied.
RESULTS: Among 3,769 patients enrolled in this study, the 1-, 3-, and 5-year overall survival (OS) rates of patients with HCC after LT were 96.1%, 86.4%, and 78.5%, respectively, in female recipients, and 95.8%, 79.0%, and 70.7%, respectively, in male recipients after PSM (P = 0.009). However, the OS was comparable between recipients with female donors and male donors. Multivariate analysis indicated that male recipient sex was a risk factor for post-LT survival (HR = 1.381, P = 0.046). Among the donor-recipient transplant patterns, the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival (P < 0.05).
CONCLUSIONS: Our findings highlighted that the post-LT outcomes of female recipients were significantly superior to those of male recipients, and the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival. Livers from male donors may provide the most benefit to female recipients. Our results indicate that sex should be considered as a critical factor in organ allocation.

UNASSIGNED: This study aimed to clarify the effect of donor and recipient age combinations on the short-term survival rates of patients undergoing lung transplantation.
UNASSIGNED: We retrospectively reviewed the 2017-2020 data of the Affiliated Wuxi People\'s Hospital of Nanjing Medical University database for all adults (≥18 years), lung transplant recipients, and their associated donors. The impact of donor and recipient ages on survival was analyzed using a multivariable Cox proportional hazards regression model. Subgroup analysis was also performed based on recipient and donor ages.
UNASSIGNED: Different donor and recipient age combinations affected the short-term postoperative survival rates. When recipients were ≤55 years, the survival rates of the younger donor age group were significantly higher than the older donor age group at 30 days after surgery (P = 0.040); when the donors were ≤40 years, the postoperative survival rates of the younger recipient age group were significantly higher than the older recipient age group (P = 0.031, P = 0.026, P = 0.034, and P = 0.018 for 30 days, 90 days, 180 days, and 1 year after surgery, respectively).
UNASSIGNED: Younger recipients had a higher survival rate after transplantation than older recipients, and this benefit could be compromised by older donors. Furthermore, the influence of donor age on patient survival rate was limited and more pronounced in younger recipients and shortly after surgery.

BACKGROUND: Donor-recipient size mismatching is commonly occurs in pediatric kidney transplantation (KT). However, its effect on graft survival remains unknown. This study aimed to determine the effect of donor-recipient size mismatch on the long-term survival rate of transplant kidneys in pediatric KT.
METHODS: A total of 241 pediatric patients who received KT were enrolled. The medical records of all patients were retrospectively reviewed, and the correlation between donor-recipient size mismatch and graft function and long-term graft outcome was analyzed according to donor-recipient size mismatch.
RESULTS: Recipients and donors\' mean body weight at the time of KT were 34.31 ± 16.85 and 56.53 ± 16.73 kg, respectively. The mean follow-up duration was 96.49 ± 52.98 months. A significant positive correlation was observed between donor-recipient body weight ratio (DRBWR) or donor-recipient body surface area ratio (DRBSR) and graft function until 1 year after KT. However, this correlation could not be confirmed at the last follow-up. The results of long-term survival analysis using Fine and Gray\'s subdistribution hazard model showed no significant difference of the survival rate of the transplant kidney according to DRBWR or DRBSR.
CONCLUSIONS: Donor-recipient size mismatch in pediatric KT is not an important factor in determining the long-term prognosis of transplant kidneys.

BACKGROUND: A major component of emergency medical care is blood. The Gaza Strip has faced repeated wars over the last few years, emphasizing the importance of blood donation even more. This study aims to assess medical students\' knowledge, attitudes, and practices regarding voluntary blood donation in Gaza (VBD).
METHODS: This cross-sectional study used stratified sampling method to survey medical students at Gaza\'s two medical schools, Al-Azhar and Islamic Universities, between March and April 2022. A 35-item self-administered questionnaire with four sections: demographics, knowledge, attitude, and practice, was used. The data were statistically analyzed using SPSS version 25.
RESULTS: A total of 329 students were surveyed (response rate of 89.6%). The median age was 20 (IQR = 3). Males made up 44.7% of the sample. Overall, 54.7% were found to have good knowledge about VBD, 68.1% did not know the time-to-wait between each whole blood donation, and in terms of blood donation criteria, only 30.7%, 25.2% were aware of the appropriate age and weight for donating. Moreover, school was the source of most information (66.6%). Meanwhile, 73.3% of participants expressed a positive attitude toward VBD. Only (17,6%) did not show a willingness to donate blood regardless of their relationship with the recipient. The vast majority (83.3%) had never donated blood before, and 12.5% had no plans to do so in the future. The two most common reasons for this were the lack of opportunity and health issues (31.0%, 11.9%, respectively).
CONCLUSIONS: The sampled medical students had a positive attitude toward VBD, but there were deficiencies in their knowledge of blood donation criteria, and most had not donated blood. Adequate awareness campaigns are required to increase awareness about this universally and locally important subject.

The anatomy laboratory can incite strong emotional reactions in students, which can in turn facilitate growth in empathy, care for vulnerable others, and professionalism. Despite this, little is known about the relative emotional impacts of different laboratory modalities. The response to the COVID-19 pandemic created an opportunity to compare the emotional experiences of students in similar courses in which one group of students dissected donors and the other group learned from prosected donors. The courses were otherwise the same in content, length, instructional design, and assessment. Students in the dissection-based (Fall 2019) and prosection-based (Fall 2020) courses completed a previously validated survey that used quantitative and qualitative questions to assess their feelings about the donors and the anatomy laboratory experience. Students in both cohorts reported overall appreciation for having had the experience. Negative themes experienced by both groups included feeling anxiety, worries about depersonalizing donors, and physical discomfort in the laboratory. Students in the dissection course reported stronger connections with the donors and the donors\' families but also more frequently felt negative feelings such as disgust, anxiety, and feeling alone. Students in the prosection course reported more consistently positive responses but worried about not using the donors to the fullest extent possible. Regardless of pedagogical design, students have complex emotional experiences in the anatomy laboratory and our results indicate that these feelings may be more intense in the context of dissection. Anatomists should foster educational settings that enable students to learn to process complex or challenging emotions.

UNASSIGNED: The illicit drug toxicity (overdose) crisis has worsened across Canada, between 2016 and 2021 more than 28 000 individuals have died of drug toxicity. Organ donation from persons who experience drug toxicity death has increased in recent years.
UNASSIGNED: This study examines whether graft loss after kidney transplantation differed by donor cause of death.
UNASSIGNED: Retrospective cohort.
UNASSIGNED: Provincial transplant program of British Columbia, Canada.
UNASSIGNED: Transplant recipients who received kidney transplantation from deceased donors aged 12 to 70 years between 2013 and 2019 (N = 1012).
UNASSIGNED: Transplant recipient all cause graft loss (graft loss due to any cause including death) was compared by donor cause of death from drug toxicity or other.
UNASSIGNED: Five-year Kaplan-Meier estimates of all-cause graft survival, and 3-year complete as well as stratified inverse probability of treatment weighted Cox proportional hazards models were conducted.
UNASSIGNED: Drug toxicity death donors donated to 25% (252/1012) of kidney transplantations. Drug toxicity death donors were more likely to be young, white, males, with fewer comorbidities such as diabetes or hypertension but were more likely to have a terminal serum creatinine ≥1.5 mg/dL or be hepatitis C virus (HCV) positive. Unadjusted 5-year estimate of all-cause graft survival was 97% for recipients of drug toxicity donor kidneys and 83% for recipients of non-drug toxicity donor kidneys (P < .001). Recipients of drug toxicity death donor kidneys had decreased risk of all cause graft loss compared to recipients of non-drug toxicity death donor kidneys (hazard ratio [HR]: 0.30, 95% confidence interval [CI]: 0.12-0.77, P = .012). This is primarily due to the reduced risk of all-cause graft loss for recipients of younger (≤35 years) drug toxicity death donor kidneys (HR: 0.05, 95% CI: 0.00-0.55, P = .015).
UNASSIGNED: Potential selection bias, potential unmeasured confounding.
UNASSIGNED: Donation after drug toxicity death is safe and should be considered more broadly to increase deceased donor kidney donation.
UNASSIGNED: La crise liée à la toxicité des drogues illicites (surdose) s’est aggravée partout au Canada. Entre 2016 et 2021, plus de 28 000 personnes sont mortes en raison de la toxicité des drogues. Les dons d’organes provenant de personnes décédées d’une surdose ont augmenté dans les dernières années.
UNASSIGNED: Déterminer si la cause de décès du donneur influe sur la survie du greffon après une transplantation rénale.
UNASSIGNED: Étude de cohorte rétrospective.
UNASSIGNED: Program provincial de transplantation de la Colombie-Britannique (Canada).
UNASSIGNED: Des receveurs (N=1012) d’une greffe de rein entre 2013 et 2019 dont l’organe provenait de donneurs décédés âgés de 12 à 70 ans.
UNASSIGNED: La perte du greffon toutes causes confondues (y compris le décès du receveur) a été comparée selon la cause de décès du donneur, que celle-ci soit attribuable à une surdose ou à une autre cause.
UNASSIGNED: Des estimations de Kaplan-Meier de la survie de la greffe toutes causes confondues à 5 ans et à 3 ans ont été réalisées, ainsi que des modèles de risques proportionnels de Cox à probabilité inverse de traitements pondérés.
UNASSIGNED: Les donneurs décédés par surdose comptaient pour 25 % (252/1012) des organes reçus pour les transplantations rénales. Les donneurs dont le décès était attribuable à une surdose étaient plus susceptibles d’être de jeunes hommes blancs présentant moins de comorbidités comme le diabète ou l’hypertension, mais plus susceptibles d’avoir un taux de créatinine sérique terminal d’au moins 1,5 mg/dl ou d’être positifs pour l’hépatite C. L’estimation non corrigée de la survie du greffon toutes causes confondues après 5 ans était de 97 % pour les reins provenant de donneurs décédés d’une surdose et de 83 % pour les reins provenant de donneurs décédés d’une autre cause (p < 0,001). Les receveurs d’un rein provenant d’un donneur décédé par surdose présentaient un plus faible risque de perte du greffon toutes causes confondues comparativement aux receveurs d’un rein de donneur décédé d’une autre cause (risque relatif [RR]: 0,30; intervalle de confiance à 95 % [IC 95 %]: 0,12-0,77; p=0,012). Ces résultats sont principalement attribuables à un plus faible risque de perte du greffon toutes causes confondues lorsque le rein provient d’un donneur plus jeune (≤ 35 ans) même si ce dernier est décédé de surdose (RR: 0,05; IC 95 %: 0,00-0,55; p=0,015).
UNASSIGNED: Possible biais de sélection; possibles facteurs de confusion non mesurés.
UNASSIGNED: Le don d’organes à la suite d’un décès par surdose est sans danger et devrait être envisagé plus largement afin d’augmenter les dons de reins par des donneurs décédés.