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https://www.readbyqxmd.com/read/28922907/organ-vouchers-and-barter-markets-saving-lives-reducing-suffering-and-trading-in-human-organs
#1
Mark J Cherry
The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: (1) What are the direct and indirect health care costs and benefits of such a voucher system in human organs? (2) Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? (3) Do vouchers contribute to the inappropriate commodification of human body parts? (4) Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges (e...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922905/kidney-vouchers-and-inequity-in-transplantation
#2
Samuel J Kerstein
This article probes the voucher program from an ethical perspective. It focuses mainly on an issue of inequity. A disparity exists in US kidney transplantation. Although African-Americans suffer far higher rates of ESRD than whites, African-Americans are much less likely than whites to get a transplant (Ilori et al., 2015, 1). The article explores the voucher program in light of this disparity. It motivates the view that, at least in the short term, more whites than African-Americans are likely to take advantage of the voucher program...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922903/banking-on-living-kidney-donors-a-new-way-to-facilitate-donation-without-compromising-on-ethical-values
#3
Dominique E Martin, Gabriel M Danovitch
Public surveys conducted in many countries report widespread willingness of individuals to donate a kidney while alive to a family member or close friend, yet thousands suffer and many die each year while waiting for a kidney transplant. Advocates of financial incentive programs or "regulated markets" in kidneys present the problem of the kidney shortage as one of insufficient public motivation to donate, arguing that incentives will increase the number of donors. Others believe the solutions lie-at least in part-in facilitating so-called "altruistic donation;" harnessing the willingness of relatives and friends to donate by addressing the many barriers which serve as disincentives to living donation...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922902/from-directed-donation-to-kidney-sale-does-the-argument-hold-up
#4
James Stacey Taylor
The UCLA Medical Center has initiated a "voucher program" under which a person who donated a kidney would receive a voucher that she could provide to someone of her choosing who could then use it to move to the top of the renal transplantation waiting list. If the use of such vouchers as incentives for donors is morally permissible, then cash payments for kidneys are also morally permissible. But, that argument faces five objections. First, there are some goods whose nature allows them to be exchanged for similar goods but renders them monetarily inalienable...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922671/impact-of-elevated-donor-troponin-i-as-predictor-of-adverse-outcome-in-adult-heart-transplantation-a-single-center-experience
#5
Miriam Freundt, Alois Philipp, Philipp Kolat, Leopold Rupprecht, Christine Friedrich, Stephan W Hirt, Assad Haneya
No abstract text is available yet for this article.
September 18, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28922656/impact-of-the-number-of-anti-thrombosis-agents-in-hemodialysis-patients-boreas-hd2-study
#6
Marenao Tanaka, Norihito Moniwa, Hirofumi Ohnishi, Tomohisa Yamashita, Masayuki Koyama, Yufu Gocho, Keitaro Nishizawa, Yukishige Kimura, Hirohito Sugawara, Sayaka Murakami, Yusuke Okazaki, Masato Furuhashi, Hideaki Yoshida, Tetsuji Miura
BACKGROUND/AIMS: Relationships between the number of anti-thrombosis agents, clinical benefits and adverse events in hemodialysis (HD) patients are unclear. METHODS: All patients on HD in 22 institutes (n = 1,071) were enrolled and followed up for 3 years. After exclusion of patients with missing data, kidney transplantation or retraction of consent during the follow-up period (n = 204), mortality rate and ischemic and hemorrhagic events were compared between different regimens of anti-thrombosis agents...
September 18, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28922546/single-dose-local-administration-of-teriparatide-with-a-octacalcium-phosphate-collagen-composite-enhances-bone-regeneration-in-a-rodent-critical-sized-calvarial-defect
#7
Fumihiko Kajii, Atsushi Iwai, Hidenori Tanaka, Keiko Matsui, Tadashi Kawai, Shinji Kamakura
Octacalcium phosphate and collagen composite (OCP/Col) achieves stable bone regeneration without cell transplantation in preclinical studies. Recently, a sponsor-initiated clinical trial was conducted to commercialize the material. The present study investigated bone regeneration by OCP/Col with the single local administration of teriparatide (parathyroid hormone 1-34; TPTD). OCP/Col was prepared by mixing sieved granules of OCP and atelocollagen for medical use and a disk was molded. After the creation of a rodent critical-sized calvarial defect, OCP/Col or OCP/Col with dripped TPTD solution (1...
September 18, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28922518/accelerated-epithelialization-and-improved-wound-healing-metrics-in-porcine-full-thickness-wounds-transplanted-with-full-thickness-skin-micrografts
#8
Christina L Rettinger, John L Fletcher, Anders H Carlsson, Rodney K Chan
Split-thickness skin grafting (STSG) is the current gold standard for treatment of extensive burn and traumatic skin injuries. However, STSG is limited by donor-site morbidity and availability, and often leads to scarring and wound contracture. Furthermore, these thin grafts lack dermal elements such as nerves and adnexa which are important in recapitulating normal skin function. Methods of fractional skin replacement either as minced STSGs or microscopic skin tissue columns (MSTCs) have been proposed, though these techniques have not been fully-characterized and lack evidence of regenerated adnexal structures...
September 18, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28922455/stem-cell-mobilization-in-patients-with-dialysis-dependent-multiple-myeloma-report-of-the-polish-multiple-myeloma-group
#9
Anna Waszczuk-Gajda, Joanna Drozd-Sokołowska, Piotr Boguradzki, Jarosław Dybko, Tomasz Wróbel, Grzegorz Władysław Basak, Krzysztof Mądry, Emilian Snarski, Grzegorz Charliński, Ewa Frączak, Joanna Matuszkiewicz-Rowińska, Marian Klinger, Hanna Augustyniak-Bartosik, Magdalena Krajewska, Paweł Żebrowski, Maria Król, Elżbieta Urbanowska, Artur Jurczyszyn, Michał Taszner, Wieslaw Wiktor Jędrzejczak, Jadwiga Dwilewicz-Trojaczek
INTRODUCTION: High-dose chemotherapy with autologous hematopoietic stem cell transplantation (auto-HSCT) improves the outcome of patients with multiple myeloma (MM). It seems that auto-HSCT is also a feasible therapeutic option in MM dialysis-dependent (MMDD) patients. However, to perform transplantation, a sufficient number of stem cells must be collected. MATERIALS AND METHODS: Given that data on mobilization of auto-HSC efficacy and safety in dialysis-dependent patients are limited, we report data from all Polish Centers belonging to the Polish Multiple Myeloma Group...
September 18, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28922437/molecular-biomarkers-as-predictors-for-biliary-complications-following-liver-transplantation-a-prospective-study
#10
Bogdan Dorobantu, Irinel Popescu, Simona Dima, Anca Nastase, Speranta Iacob
BACKGROUND: The biliary complications (BC) have been always considered the "Achilles' heel" of liver transplantation (LT), being one of the leading causes of postoperative morbidity. AIM: To analyse predictors of BC, by monitoring in the peripheral blood the biomarkers involved in the inflammation and hepatic fibrosis, such as the matrix metalloproteinases (MMP 2, 9) and their tissue inhibitors (TIMP1), the interleukins (IL 2, 8), alfa-TNF, the endothelins and their receptors...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28922436/genetic-risk-factors-for-autoimmune-thyroid-disease-might-affect-the-susceptibility-to-and-modulate-the-progression-of-primary-biliary-cholangitis
#11
Aleksander Kuś, Magdalena Arłukowicz-Grabowska, Konrad Szymański, Ewa Wunsch, Małgorzata Milkiewicz, Rafał Płoski, Zakera Shums, Gary L Norman, Piotr Milkiewicz, Tomasz Bednarczuk, Marcin Krawczyk
BACKGROUND AND AIMS: Patients with primary biliary cholangitis (PBC) frequently suffer from extrahepatic autoimmune conditions, of which autoimmune thyroid disease (AITD) is one of the most common. Previous studies identified several genetic variants increasing the odds of developing AITD. Here we investigate whether AITD-associated polymorphisms might also play a role in the development and clinical course of PBC and PBC associated with AITD (PBC-AITD). METHODS: To this end, we prospectively recruited 230 patients with PBC and 421 healthy controls...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28922328/minor-salivary-gland-transplantation-for-severe-dry-eyes
#12
Tais Hitomi Wakamatsu, Ana Estela Besteti Pires Ponce SantʼAnna, Priscila Cardoso Cristovam, Venâncio Avancini Ferreira Alves, Alda Wakamatsu, José Alvaro Pereira Gomes
Dry eye is a multifactorial disease comprising a wide spectrum of ocular surface alterations and symptoms of discomfort. In most patients with aqueous-deficient dry eye, pharmaceutical tear substitutes are used to control symptoms and prevent ocular surface damage. However, in severe dry eye conditions caused by cicatricial disorders, such as Stevens-Johnson syndrome and ocular cicatricial mucous membrane pemphigoid, noninvasive treatments are insufficient, and patients are at risk of developing complications that can lead to blindness...
September 15, 2017: Cornea
https://www.readbyqxmd.com/read/28922325/metacarpal-like-hand-classification-and-treatment-guidelines-for-microsurgical-reconstruction-with-toe-transplantation
#13
Fu-Chan Wei, Nidal F Al Deek, Yu-Te Lin, Chung-Chen Hsu, Cheng-Hung Lin
The metacarpal-like hand is a severe hand injury, never addressed before. It describes a hand that lost a significant degree of prehension through a wide array of amputations, involving all digits proximal to the functional length except in one finger or in two digits, including the thumb.Thumb condition can be used to differentiate between two types.In type I, the thumb is intact or amputated at/or distal to the interphalangeal joint (functional length); and therefore, the reconstruction is focused on fingers mainly...
September 14, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28922324/biological-properties-and-therapeutic-value-of-cryopreserved-fat-tissue
#14
Takanobu Mashiko, Szu-Hsien Wu, Koji Kanayama, Rintaro Asahi, Takako Shirado, Masanori Mori, Ataru Sunaga, Shunji Sarukawa, Hirokazu Uda, Kotaro Yoshimura
BACKGROUND: Fat grafting frequently requires multiple treatments and thus repeated liposuction to achieve treatment goals. The purpose of this study is to evaluate whether cryopreservation of adipose tissue may facilitate future fat grafting. METHODS: Lipoaspirates were harvested from six adult females and preserved using two cryopreservation methods: 1) simple cooling to -80˚C (cryo-1); or 2) programmed cooling to -190˚C (cryo-2). Fresh fat, cryo-1 fat, and cryo-2 fat were analyzed both in vitro and in vivo...
September 14, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28922301/hypothermic-liver-perfusion
#15
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
PURPOSE OF REVIEW: The review describes recent developments in hypothermic machine liver perfusion with a special focus on underlying protective mechanisms, and the role of this perfusion technique in high-risk donor-recipient combinations. RECENT FINDINGS: To maximize the number of transplantable donor livers, several centres are exploring new machine preservation techniques. In this context, hypothermic machine perfusion has been recently introduced into the clinical setting of human liver transplantation, and the effect of endischemic cold liver perfusion on posttransplant complications is currently under investigation in two multicentre, randomized controlled trials...
September 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28922300/recent-advances-in-the-field-of-warm-ex-vivo-liver-perfusion
#16
Dagmar Kollmann, Markus Selzner
PURPOSE OF REVIEW: Organ shortage remains a major obstacle for liver transplantation, resulting in an increased mortality on the liver transplant waiting list. The usage of extended criteria donors (ECD) is a strategy to increase the number of available donor organs, however, with the risk of a higher rate of posttransplant graft dysfunction. Novel preservation strategies, such as warm ex-vivo liver perfusion, could improve the outcome of liver transplantation with ECD grafts. The present review summarizes the advances in the field of warm ex-vivo liver perfusion over the last 12 months...
September 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28922292/advances-in-delivery-of-ambulatory-autologous-stem-cell-transplantation-for-multiple-myeloma
#17
Jack Khouri, Navneet S Majhail
PURPOSE OF REVIEW: Autologous stem cell transplantation (ASCT) is generally performed in the inpatient setting in its entirety. Several centers have demonstrated the feasibility of performing ASCT for myeloma in the ambulatory setting. We review the safety, cost-effectiveness, complications and outcomes of outpatient ASCT for myeloma. RECENT FINDINGS: Published studies are heterogeneous but suggest that outpatient ASCT for myeloma is cost-effective and associated with a shorter or no initial hospitalization, albeit there is a high rate of readmission for complications...
September 15, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28922286/nocardia-infections-in-solid-organ-and-hematopoietic-stem-cell-transplant-recipients
#18
Julien Coussement, David Lebeaux, Claire Rouzaud, Olivier Lortholary
PURPOSE OF REVIEW: Nocardia spp. is a gram-positive bacteria that may cause infections in humans. Nocardiosis has been described since the early years of transplantation. This review aims to provide an overview of present knowledge regarding posttransplant nocardiosis, with a focus on recent findings. RECENT FINDINGS: Nocardiosis is not rare among transplant recipients, especially after thoracic transplantation and/or in case of intense immunosuppressive regimen or use of tacrolimus...
September 15, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28922255/systematic-review-and-meta-analysis-fecal-microbiota-transplantation-for-treatment-of-active-ulcerative-colitis
#19
Neeraj Narula, Zain Kassam, Yuhong Yuan, Jean-Frederic Colombel, Cyriel Ponsioen, Walter Reinisch, Paul Moayyedi
BACKGROUND: Changes in the colonic microbiota may play a role in the pathogenesis of ulcerative colitis (UC) and restoration of healthy gut microbiota may ameliorate disease. A systematic review and meta-analysis was conducted to assess fecal microbiota transplantation (FMT) as a treatment for active UC. METHODS: A literature search was conducted to identify high-quality studies of FMT as a treatment for patients with UC. The primary outcome was combined clinical remission and endoscopic remission or response...
August 23, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28922238/primary-central-nervous-system-lymphoma-time-for-diagnostic-biomarkers-and-biotherapies
#20
Louis Royer-Perron, Khê Hoang-Xuan, Agusti Alentorn
PURPOSE OF REVIEW: Primary central nervous system lymphoma (PCNSL) is a rare cancer with a somber prognosis in older patients, which it affects predominantly. Only in recent years have molecular alterations characterizing PCNSL been thoroughly described. This opens possibilities for the use of targeted therapies. Developments in imaging and biomarkers have also great potential to help clinicians faced with diagnostic and prognostic uncertainties. RECENT FINDINGS: Several biomarkers for PCNSL, such as different microRNAs, which could be tested in cerebrospinal fluid and vitreous fluid, and IL-10, which has been shown to have excellent sensitivity and specificity in the cerebrospinal fluid, have emerged in the last years...
September 15, 2017: Current Opinion in Neurology
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