The Professional Education Package (PEP) was introduced in Australia in 2012. It was developed by the Organ and Tissue Authority (OTA) in consultation with the DonateLife Network, peak professional bodies, and the Gift of Life Institute (GoLI) in Philadelphia. The education model adopted and implemented is a modular, sequential learning model which comprises the following units of training: Introductory Donation Awareness Training (IDAT) Workshop; Core Family Donation Conversation (FDC) Workshop; Practical FDC Workshop; and an e-learning program to support the FDC training and encourage ongoing learning. The PEP has supported a positive practice change amongst many of the health care professionals working in the Australian donation sector. It has provided health care professionals with the training and skills to support grieving families during donation conversations and more broadly during end-of-life conversations.
Progressive multifocal leukoencephalopathy (PML) is associated with John Cunningham Polyomavirus (JCV) infection of the central nervous system oligodendrocytes, resulting in demyelination and progressive focal neurologic deficits. In the setting of immunosuppression, reactivation of dormant JCV has been noted in patients with human immunodeficiency virus (HIV)1. This is a case review of a 66-year-old female who received a single lung transplant for chronic obstructive pulmonary disease (COPD). She is cytomegalovirus (CMV) seropositive and Epstein-Barr virus (EBV) seropositive who presented with symptoms of aphasia associated with word-finding difficulties and swaying to one side when walking lasting one week, which was progressively worsening. A diagnosis of PML was established via brain biopsy and correlating brain images three years post lung transplant. This case outlines the difficulty of balancing immunosuppression for a post lung transplant patient in the setting of an established diagnosis of PML.
Patients from the Jehovah’s Witness (JW) faith are considered high-risk surgical candidates as their religious beliefs forbid them from accepting most blood components, even if it is deemed lifesaving treatment. A blood group incompatible (ABOi) kidney transplant recipient and living donor pair, who are both of JW faith, were referred for assessment to the Royal Prince Alfred Hospital renal transplant unit that raised multiple medical, surgical and ethical considerations. The risks of blood loss and the inability to provide lifesaving blood transfusion is a common risk of surgery on JW patients. Recent studies from overseas show that peri-operative mortality in JW is 6% and predominantly due to anaemia secondary to blood loss. The aim of this case review is to explore the transplant options available to ABOi living donor pairs who are Jehovah’s Witnesses. It also aims to explore common strategies to optimise their haemoglobin prior to their surgery to mitigate this risk.