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Patients “dry weight” is initially set determining at diagnosis.
Before every treatment patients are weighed to determine how much excess fluid and waste must be taken off to arrive at the “dry weight.”
Hemodialysis removes wastes and water by circulating blood outside the bod through an external filter, called a dialyzer.
Blood flows in one direction and dialysate flows in the opposite maximizing the filtering between the blood and dialysate, which removes waste and excess fluid.
This type of dialysis is normally done at a facility where patients sit for treatment three times a week for three to four hours per visit.
Peritoneal Dialysis (PD) Device
PD uses the peritoneum in the abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood.
Peritoneal dialysis has better outcomes than hemodialysis during the first couple of years after diagnosis.
A specific solution is introduced through a permanent tube in the lower abdomen and then removed.
Kidney failure patients enjoy greater flexibility and better tolerability.
It can be done at regular intervals throughout the day or at night with the assistance of a machine, known as automated peritoneal dialysis.
Cold Solution Storage
Simple cold storage (SCS) with solution is the preservation solution infused into the organ and then stored statically at hypothermic temperatures.
Hypothermia is to reduce the metabolic activities that would otherwise lead to cellular damage when oxygen is removed from the organ.
Typical storage times are 30 hours or less (kidney), less than 12 hours (pancreas or liver) and less than 6 hours (heart or lungs).
Times vary because of the relative speed at which deterioration begins in the organs' tissues.
This solution was developed in the late 1980s by Folkert Belzer and James Southard.
Kidneys on a pump can remain viable for up to 24-36 hours.
The technical term for pumping kidneys is Machine Profusion(MP).
Mostly kidneys recovered from Extended Criteria Donors (ECD) and Donation after Circulatory Death (DCD) donors are being pumped.
MP entails providing circulation of preservation solution to the attached kidney and improves function making more kidneys available for transplantation.
Kidney pumps weigh approximately forty pounds and are completely portable.
Total Artificial Heart (TAH)
A pump that is surgically installed to provide circulation and replace heart ventricles that are diseased or damaged.
Machines outside the body control the implanted pumps, helping blood flow to and from the heart.
A doctor may recommend a TAH for heart failure caused by ventricles that no longer pump blood well enough, and you need long-term support.
TAH surgery may be an alternative treatment in certain patients who are unable to receive a heart transplant.
In some cases, people with a TAH can leave the hospital to wait for a heart transplant.
Heart In A Box
Still in its first clinical trial study but first tried in 2017.
A donated heart can now be transported and preserved for longer than what has previously been possible.
New method, which consists of a specially designed box where it is supplied with important substances in an oxygenated, blood-mixed solution.
The hope is that in the future, hearts can be preserved in the specially designed box for up to 12 hours.
So far in tests, it extends preservation by one half hour than other methods.
Coolers For Transport
Currently, donor organ preservation in clinical organ transplantation consists of 3 plastic bags and an ice box or cooler.
The first plastic bag includes the organ itself immersed in preservation solution, then put in a second bag filled with saline, and then these two are put in a third bag filled with saline which is then put in the cooler.
If the organ/organs are slated for transit they likely will be tagged with an electronic monitoring device.
Coolers are moved via vehicles, helicopters and jets are used for private transport as well as commercial airline flights.
Surgeons from the transplant center(hospital) usually travel to donor hospital to recover the organs in person and bring supplies like coolers.
A tissue bank collects and recovers human deceased donor tissue for the purposes of medical research, education, and allograft transplantation.
Organ donation and whole body donation are not one and the same.
“Tissue” that can be donated includes: corneas, skin, hematopoietic stem cells,(bone marrow) and blood.
There are 120 accredited tissue banks in the United States according to American Association of Tissue Banks (AATB).
Unlike organs, there is not a shortage of donated tissue. This is because more people can become tissue donors and one tissue donor can help 100 people. Organ donors only come from patients who are on a ventilator. Less than 1% of all deaths are medically suitable for organs.