It is well known that during hepatic operative procedures, it is often critical that the irrigation is interrupted to avoid possible bleeding, blood transfusions, variable intensities, and their short and long-term consequences. It was believed in the past that the flow interruption should not exceed 20 minutes, which limited the use of this maneuver. However, it has been postulated that ischemia could be maintained for more than 60 minutes in healthy livers. The present paper review includes: 1) A brief introduction to justify the rationale of the review design; 2) Aspects of the pathophysiology of the three stages of the liver ischemia-reperfusion injury; 3) The innate and acquired immunity; 4) Oxidative stress; 5) Apoptosis and autophagy, Some essential biomarkers (Tumor Necrosis Factor-α, nitric oxide, metalloproteinases); and, finally; 6) Preventive ("cheating") strategies, non-pharmacological and pharmacological options to treat the liver IR injury.
Although the brain death diagnosis is scientifically and legally defined in Brazil and the maintenance of the potential organ donor for transplantation purposes has been addressed during the last years, there are still some doubts about the subject, as its understanding varies according to the personal beliefs, culture, and educational background of individuals, including those who work in this scenario.
At this point in time, there is no clear understanding of how widespread and impactful nursing or healthcare ageism is, and what can best be done to prevent or address it. Nurses need to be aware that ageism may be common and impactful, and guard against it.
This study aimed to analyze the opinion of health professionals that work in the organ donation and organ transplant process regarding the implementation of Law 10,211/2001, which deals with family consent for organ donation in Brazil. It is a qualitative study conducted in a university hospital in the state of São Paulo. The results show that the majority of health professionals agree with family consent to obtain organs for transplantation. However, there is disagreement as to how to obtain this consent. The study concludes that it is necessary to promote urgent actions for awareness regarding donation amongst the public and health professionals, aiming to achieve compliance with the law, and, most of all, to increase the number of organs available for transplant. Keywords: Organ transplantation. Directed tissue donation. Legislation. Bioethics. Resumo Doação de órgãos: tema bioético à luz da legislaçãoObjetivou-se analisar a opinião de profissionais de saúde que atuam no processo de doação e transplante de órgãos a respeito da implementação da Lei 10.211/2001, que regula o consentimento familiar para a doação de órgãos no Brasil. Trata-se de estudo qualitativo desenvolvido em hospital universitário do interior paulista. Os resultados mostram que a maioria dos profissionais de saúde concorda com o consentimento familiar para obtenção de órgãos para transplante. Contudo, há discordâncias quanto à forma de se obter esse consentimento. Conclui-se que são necessárias ações de conscientização urgentes direcionadas à população e a profissionais de saúde com relação à doação, buscando atingir o cumprimento efetivo da legislação e, sobretudo, aumentar substancialmente o número de órgãos disponíveis para transplante. Palavras-chave: Transplante de órgãos. Doação dirigida de tecido. Legislação. Bioética. Resumen Donación de órganos: tema bioético a la luz de la legislaciónEste estudio tuvo como objetivo analizar la opinión de los profesionales de la salud que trabajan en el proceso de donación y trasplante de órganos en relación a la aplicación de la Ley 10.211/2001, que se ocupa del consentimiento familiar para la donación de órganos en Brasil. Se trata de un estudio cualitativo realizado en un hospital universitario en el estado de São Paulo. Los resultados muestran que la mayor parte de los profesionales de la salud están de acuerdo con el consentimiento familiar para obtener órganos para trasplantes. Sin embargo, hay desacuerdo sobre cómo obtener este consentimiento. Se concluye que es necesario promover acciones de concientización urgentes sobre la donación de órganos, dirigidas a la población en general y a los profesionales de la salud, procurando alcanzar el cumplimiento efectivo de la legislación y, sobre todo, aumentar el número de órganos disponibles para trasplante. Palabras clave: Trasplante de órganos. Donación directa de tejido. Legislación. Bioética.
Purpose: To analyze the effect of methylene blue (MB) therapy during the liver ischemiareperfusion injury (I/R) process. Methods: Thirty-five male Wistar rats were used, (70%) submitted to partial ischemia (IR) or not (NIR) (30%) were obtained from the same animal. These animals were divided into six groups: 1) Sham (SH), 2) Sham with MB (SH-MB); 3) I/R, submitted to 60 minutes of partial ischemia and 15 minutes of reperfusion; 4
Resumo: Descrever a relação entre bioética, biodireito e o processo doação e transplante de órgãos no Brasil, considerando a complexidade desta temática que é responsável pela manutenção da qualidade de vida daqueles que aguardam por um novo órgão. Trata-se de um estudo qualitativo, descritivo. O Brasil possui hoje o maior programa público de transplantes de órgãos e tecidos do mundo, sendo as diretrizes da politica nacional de transplantes pautadas pela gratuidade da doação, beneficência em relação aos receptores e na não maleficência em relação aos doadores vivos, conforme os princípios norteadores da teoria principialista da bioética. O conhecimento da legislação por parte dos profissionais que atuam na área pode levar a transformações positivas no atual cenário brasileiro em que a maior barreira para a efetivação da doação de órgãos e tecidos é a recusa familiar. Nessa perspectiva, além do conhecimento técnico-científico-biológico, é preciso compreender a legislação vigente levando em consideração os princípios éticos, bioéticos e do biodireito de modo a assegurarem aos agentes envolvidos seus direitos fundamentais e o exercício pleno de sua dignidade humana. Palavras-chave:Bioética; Biodireito; Doação dirigida de tecidos; Transplante; Morte encefálica.Abstract: To describe the relationship between bioethics, biolaw and the organ donation and transplantation process in Brazil, considering the complexity of this issue which is responsible for the life quality of those who are waiting for a new organ. This is a qualitative, descriptive study. Nowadays, Brazil has the largest public program of organ and tissue transplant worldwide, and the guidelines of the national policy of guided transplants by the gratuity of the donation, charity in relation to recipients and non-maleficence in relation to
This was a pilot study as it used a newly devised survey tool to determine the views and attitudes of undergraduate nursing students to the shortage of organs for transplantation purposes, with this survey also gaining insight into any possible moral distress. The survey tool was distributed to 134 undergraduate nursing students who attended a mandatory nursing research course, with 104 (77.6%) participating. The data were analyzed through content analysis, with three main themes identified: right to life, impact on others, and emotions. A high level of moral distress among the participants were identified, which confirm the necessity of future studies on this topic.
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