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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/28922656/impact-of-the-number-of-anti-thrombosis-agents-in-hemodialysis-patients-boreas-hd2-study
#5
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/28921938/prostate-cancer-treatment-in-renal-transplant-recipients-a-systematic-review
#6
REVIEW
Giancarlo Marra, Ettore Dalmasso, Marco Angello, Stefania Munegato, Andrea Bosio, Omidreza Sedigh, Luigi Biancone, Paolo Gontero
BACKGROUND: The majority of kidney transplants are performed in recipients (RTR) over 50; simultaneously their life expectancy is improving. The increasing age and number of RTR is likely to be paralleled by an increase of prostate cancer (PCa) incidence. However, little is known on the optimal management of these patients who represent a therapeutic challenge due to medical and anatomical graft-related issues. METHODS: AMED, Medline and Embase were searched until November 17(th) , 2016 adhering to the PRISMA guidelines and the AMSTAR checklist to investigate oncological and functional outcomes of PCa treatment in RTR...
September 18, 2017: BJU International
https://www.readbyqxmd.com/read/28921838/robotic-kidney-transplantation-comparison-of-the-first-40-cases-of-open-vs-robotic-transplantations-by-a-single-surgeon
#7
Volkan Tuğcu, Nevzat Can Şener, Selçuk Şahin, Abdullah Hızır Yavuzsan, Fatih Gökhan Akbay, Süheyla Apaydın
OBJECTIVE: To compare the outcomes of the first 40 cases who underwent robotic kidney transplantation (RKT) with those of the first 40 cases who underwent open kidney transplantation (KT) in the Dr. Sadi Konuk Training Hospital. MATERIAL AND METHODS: Between January 2016 and February 2017, we prospectively collected the data of the first 40 RKT cases (RKT group) and compared them with those of the first 40 open KT cases (OKT group). Comparisons were made using One-way ANOVA or the Kruskal-Wallis test for continuous variables, and the Chi-square or Fisher Exact test for categorical variables...
September 16, 2017: BJU International
https://www.readbyqxmd.com/read/28921783/barriers-to-listing-for-hiv-infected-patients-being-evaluated-for-kidney-transplantation
#8
Dong Heun Lee, Suzanne M Boyle, Gregory E Malat, Christopher Kern, Charles Milrod, Shannon DeBellis, Meera N Harhay, Karthik Ranganna, Stephen Guy, Sindhura Talluri, Tiffany Bias, Alden Doyle
BACKGROUND: Human immunodeficiency virus (HIV)-infected patients have excellent outcomes following kidney transplantation (KT) but still might face barriers in the evaluation and listing process. The aim of this study was to characterize the patient population, referral patterns, and outcomes of HIV-infected patients who present for KT evaluation. METHODS: We performed a single-center retrospective cohort study of HIV-infected patients who were evaluated for KT...
September 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28921748/increased-risk-organ-transplantation-in-the-pediatric-population
#9
Sean M Wrenn, Peter W Callas, Trishul Kapoor, Alia F Aunchman, Adam N Paine, Jaime A Pineda, Carlos E Marroquin
IRD organs are classified by the Public Health Service to be at above-average risk for harboring human immunodeficiency virus, hepatitis C, and hepatitis B. Traditionally underutilized, there exists even greater reluctance for their use in pediatric patients. We performed a retrospective analysis via the United Network for Organ Sharing database of all pediatric renal and hepatic transplants performed from 2004 to 2008 in the United States. Primary outcomes were patient and graft survival. Proportional hazards regression was performed to control for potentially confounding factors...
September 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28921746/identification-of-occult-active-infection-using-pet-ct-in-a-combined-liver-kidney-transplant-candidate
#10
Julien Al Shakarchi, Desley Neil, Graham Lipkin, Ahmed Elsharkawy, Nicholas Inston
This case describes a patient being considered for combined liver-kidney transplantation for Caroli's disease with a failed renal transplant. A chronic septic focus could not be located with standard imaging techniques, such as ultrasonography and computed tomography. This case report highlights the observation that a retained non-functioning transplant can be the cause of fever of unknown origin and PET-CT can be useful in diagnosing these challenging cases. This article is protected by copyright. All rights reserved...
September 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28921709/kidney-allograft-failure-in-the-steroid-free-immunosuppression-era-a-matched-case-control-study
#11
Mohamad M Alkadi, Jim Kim, Meredith J Aull, Joseph E Schwartz, John R Lee, Anthony Watkins, Jun B Lee, Darshana M Dadhania, Surya V Seshan, David Serur, Sandip Kapur, Manikkam Suthanthiran, Choli Hartono, Thangamani Muthukumar
We studied the causes and predictors of death-censored kidney allograft failure among 1670 kidney recipients transplanted at our center in the corticosteroid-free maintenance immunosuppression era. As of January 1, 2012, we identified 137 recipients with allograft failure; 130 of them (cases) were matched 1-1 for recipient age, calendar year of transplant and donor type with 130 recipients with functioning grafts (controls). Median time to allograft failure was 29 months (interquartile range 18-51). Physician validated and biopsy confirmed categories of allograft failure were: acute rejection (21%), glomerular disease (19%), transplant glomerulopathy (13%), interstitial fibrosis tubular atrophy (10%), and polyomavirus-associated nephropathy (7%)...
September 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28920846/detection-of-the-incx3-plasmid-carrying-blakpc-3-in-a-serratia-marcescens-strain-isolated-from-a-kidney-liver-transplanted-patient
#12
Floriana Gona, Carla Caio, Gioacchino Iannolo, Francesco Monaco, Giuseppina Di Mento, Nicola Cuscino, Ignazio Fontana, Giovanna Panarello, Gaetano Maugeri, Maria Lina Mezzatesta, Stefania Stefani, Pier Giulio Conaldi
Dissemination of resistance to carbapenems among Enterobacteriaceae through plasmids is an increasingly important concern in health care worldwide. Here we report the first description of an IncX3 plasmid carrying the blaKPC-3 gene in a strain of Serratia marcescens isolated from a kidney-liver transplanted patient at the transplantation centre ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy). To localize the transposable element containing the resistance-associated gene Next-Generation Sequencing of the bacterial DNA was performed...
September 18, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28920721/-changes-in-carbohydrate-metabolism-after-kidney-transplantation-and-their-effects-on-cardiovascular-risk
#13
Bernadett Borda, Edit Szederkényi, Zoltán Hódi, Aurél Ottlakán, Viktor Szabó, György Lázár
INTRODUCTION: Cardiovascular disease is the major cause of deaths after transplantation, with diabetes mellitus being the main risk factor in development. AIM: The aim of our study was to assess the prevalence of new onset diabetes mellitus in connection with the cardiovascular risk predicted by the HEART Score. METHOD: 44 patients were involved in our study; after overview of baseline data, OGTT was performed, followed by patient classification into the following groups: normal, impaired fasting glucose/impaired glucose tolerance, and new onset diabetes mellitus...
September 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28919594/fifteen-year-analysis-of-deceased-kidney-donation-a-single-transplant-center-experience-in-a-region-of-northern-italy
#14
Vania Cuna, Giorgia Comai, Maria Cappuccilli, Olga Baraldi, Irene Capelli, Matteo De Liberali, Lorenzo Gasperoni, Diletta Conte, Matteo Ravaioli, Antonio D Pinna, Gaetano La Manna
BACKGROUND The rising number of patients on waiting lists for kidney transplant and the shortage of available organs has intensified efforts to increase the number of potential donors. MATERIAL AND METHODS This study investigated changes in clinical parameters among potential deceased donors in the 15-year period between 1999 and 2013 and their impact on transplantation procedure and outcomes. A total of 1634 potential deceased donors were examined and divided into 2 groups: 707 of them identified from 1999 to 2005 (Group A), and 927 from 2006 to 2013 (Group B)...
September 18, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28918589/isolated-pancreas-rejections-do-not-have-an-adverse-impact-on-kidney-graft-survival-whereas-kidney-rejections-are-associated-with-adverse-pancreas-graft-survival%C3%A2-in-simultaneous-pancreas-kidney-transplantation
#15
Irfan Moinuddin, Muhammad Sohail Yaqub, Tim Taber, John Powelson, Jonathan Fridell, Asif Sharfuddin
BACKGROUND AND OBJECTIVES: Diabetic Kidney Disease is associated with excessive mortality and morbidity. Simultaneous pancreas kidney transplantation (SPK) significantly improves quality of life and increases life expectancy of uremic diabetic patients. It is not known whether pancreas and kidney rejections in these transplant patients is concordant or discordant. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We analyzed clinical data on all SPK transplants performed between 2003 and 2014 at Indiana University to assess the impact of isolated or combined pancreas and kidney rejections on patient and allograft outcomes...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28918445/pre-emptive-intestinal-transplant-the-surgeon-s-point-of-view
#16
REVIEW
Augusto Lauro, Ignazio R Marino, Kishore R Iyer
Pre-emptive transplantation is a well-established practice for certain types of end-organ failure such as in the use of kidney transplantation. For irreversible intestinal failure, total parenteral nutrition (TPN) remains the gold standard, due to the suboptimal long-term results of intestinal transplantation. As such, the only role for pre-emptive transplantation, if at all, will be for patients identified to be at high risk of complications and mortality while on definitive long-term TPN. In these patients, the timing of early listing and transplantation could become life-saving, taking into account that mortality on the waiting list is still the highest for intestinal candidates...
September 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28917674/prognostic-value-of-risk-factors-calcium%C3%A2-score-coronary-cta-myocardial%C3%A2-perfusion-imaging-and-invasive%C3%A2-coronary-angiography-in-kidney%C3%A2-transplantation-candidates
#17
Simon Winther, My Svensson, Hanne Skou Jørgensen, Laust Dupont Rasmussen, Niels Ramsing Holm, Lars Christian Gormsen, Kirsten Bouchelouche, Hans Erik Bøtker, Per Ivarsen, Morten Bøttcher
OBJECTIVES: This study sought to perform a prospective head-to-head comparison of the predictive value of clinical risk factors and a variety of cardiac imaging modalities including coronary artery calcium score (CACS), coronary computed tomography angiography (CTA), single-photon emission computed tomography (SPECT), and invasive coronary angiography (ICA) on major adverse cardiac events (MACE) and all-cause mortality in kidney transplantation candidates. BACKGROUND: Current guidelines recommend screening for coronary artery disease in kidney transplantation candidates...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28916408/robot-assisted-kidney-transplantation-the-european-experience
#18
Alberto Breda, Angelo Territo, Luis Gausa, Volkan Tuğcu, Antonio Alcaraz, Mireia Musquera, Karel Decaestecker, Liesbeth Desender, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Giampaolo Siena, Sergio Serni, Luis Guirado, Carma Facundo, Nicolas Doumerc
BACKGROUND: Robot-assisted kidney transplantation (RAKT) has recently been introduced to reduce the morbidity of open kidney transplantation (KT). OBJECTIVE: To evaluate perioperative and early postoperative RAKT outcomes. DESIGN, SETTING AND PARTICIPANTS: This was a multicenter prospective observational study of 120 patients who underwent RAKT, predominantly with a living donor kidney, in eight European institutions between July 2015 and May 2017, with minimum follow-up of 1 mo...
September 12, 2017: European Urology
https://www.readbyqxmd.com/read/28914777/the-usefulness-of-contrast-enhanced-ultrasound-in-the-assessment-of-early-kidney-transplant-function-and-complications
#19
REVIEW
Sara Álvarez Rodríguez, Vital Hevia Palacios, Enrique Sanz Mayayo, Victoria Gómez Dos Santos, Víctor Díez Nicolás, María Dolores Sánchez Gallego, Javier Lorca Álvaro, Francisco Javier Burgos Revilla
OBJECTIVES: The routine diagnostic method for assessment of renal graft dysfunction is Doppler ultrasound. However, contrast-enhanced ultrasound (CEUS) may provide more information about parenchymal flow and vascular status of kidney allografts. The aim of the study was to assess the effectiveness of CEUS in the immediate post-transplant period, focusing on acute vascular complications. A brief review of available literature and a report of our initial experience is made. MATERIAL AND METHODS: 15 kidney transplant (KT) cases with clinical suspicion of acute surgical complication were assessed with CEUS and conventional Doppler ultrasound (US)...
September 15, 2017: Diagnostics
https://www.readbyqxmd.com/read/28914398/characteristics-and-prognosis-of-breast-cancer-after-liver-or-kidney-transplantation
#20
I-Ji Jeong, Sung-Gyu Lee, Young Hoon Kim, Beom Seok Ko, Jong Won Lee, Byung Ho Son, Se-Hyun Ahn, Hee Jeong Kim
PURPOSE: Immunoediting is crucial in cancer development and progression. This study compared the characteristics and prognosis of post-transplant breast cancer (PTBC) patients receiving immunosuppressants and general breast cancer patients. METHODS: Data from the Asan Medical Center Breast Cancer (AMCBC), kidney transplantation, and liver transplantation databases recorded during 1989-2013 were retrospectively analyzed. Four controls of AMCBC cohort per one case of PTBC cohort were selected based on tumor size, lymph node metastasis, and age...
September 15, 2017: Breast Cancer Research and Treatment
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