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https://www.readbyqxmd.com/read/28430065/ethical-issues-in-fecal-microbiota-transplantation-in-practice
#1
Yonghui Ma, Jiayu Liu, Catherine Rhodes, Yongzhan Nie, Faming Zhang
Fecal microbiota transplantation (FMT) has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: (1) informed consent and the vulnerability of patients; (2) determining what a "suitable healthy donor" is; (3) safety and risk; (4) commercialization and potential exploitation of vulnerable patients; and (5) public health implications...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28430064/aesthetics-ethics-and-fecal-microbiota-transplantations
#2
Camilla Scanlan, Ian Kerridge
No abstract text is available yet for this article.
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28430054/ethical-issues-in-fecal-microbiota-transplantion-taking-into-account-identity-and-family-relations
#3
Suzanne Metselaar, Guy Widdershoven
No abstract text is available yet for this article.
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28426448/clinical-and-ethical-challenges-in-heart-transplantation-from-donation-after-circulatory-determined-death-donors
#4
Stephen Large, Steven Tsui, Simon Messer
PURPOSE OF REVIEW: The aim of this study was to describe the development of a clinical programme of heart transplantation from nonheart beating (or donation after circulatory determined death, DCD) donors. DCD is an established practice in abdominal and lung transplantation. The opportunity for sufferers of advanced heart failure provided by DCD heart transplantation is described. RECENT FINDINGS: Work shows that the arrested DCD heart is viable and has a 30-min tolerance to anoxia at normal body temperature making transplantation possible...
April 19, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28424230/a-quiet-revolution-in-organ-transplant-ethics
#5
Arthur Caplan, Duncan Purves
A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life...
April 19, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28386568/mesenchymal-stem-cells-improve-healing-of-diabetic-foot-ulcer
#6
REVIEW
Yue Cao, Xiaokun Gang, Chenglin Sun, Guixia Wang
Mesenchymal stem cells (MSCs), an ideal cell source for regenerative therapy with no ethical issues, play an important role in diabetic foot ulcer (DFU). Growing evidence has demonstrated that MSCs transplantation can accelerate wound closure, ameliorate clinical parameters, and avoid amputation. In this review, we clarify the mechanism of preclinical studies, as well as safety and efficacy of clinical trials in the treatment of DFU. Bone marrow-derived mesenchymal stem cells (BM-MSCs), compared with MSCs derived from other tissues, may be a suitable cell type that can provide easy, effective, and cost-efficient transplantation to treat DFU and protect patients from amputation...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28383624/use-of-corneas-for-transplant-after-self-inflicted-eyeballs-enucleation-in-the-italian-law
#7
G Montanari Vergallo, E Pacella, A Di Luca, N M Di Luca, R Cecchi, E Marinelli
The authors analyze from an ethical and legal point of view the case of a 37 year old man, hospitalized for four days because of a 'dissociative syndrome', who had introduced in both his orbits a portable radio antenna. Most likely, he completed the self-enuclation using his own hands. He was brought to the Ophtalmic Hospital by nurses who handed the two eyeballs to the physicians who ascertained that the corneas were intact. Then, they performed the conservative extraction. In the following days those corneas were transplanted (keratoplasty) on two subjects on the waiting list at that hospital...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28377365/-research-progress-of-skin-derived-precursor-cells
#8
Ruo-Si Chen, Yong Miao, Zhi-Qi Hu
As a novel population of neural crest-origin precursor cells, skin-derived precursor cells (SKPs) can be isolated from both embryonic and adult dermis. These cells have important values for research and potential clinical application in wound healing, organ regeneration and disease treatment for advantages in the abundance of cell sources, accessibility, potential of multipotent differentiation, and absence of ethical concerns. Here we review the developmental and anatomical origins of SKPs and their potential application in regenerative medicine...
March 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28369799/effect-of-dental-pulp-stem-cells-in-mptp-induced-old-aged-mice-model
#9
Nareshwaran Gnanasegaran, Vijayendran Govindasamy, Christopher Simon, Quan Fu Gan, Vui King Vincent-Chong, Vasudevan Mani, Kesavanarayanan Krishnan Selvarajan, Vellayan Subramaniam, Sabri Musa, Noor Hayaty Abu Kasim
Parkinson's disease (PD) is a neurodegenerative disease caused by the loss of dopaminergic (DA-ergic) neurons in the substantia nigra (SN) and represent as a huge threat to the geriatric population. Cell-replacement therapies (CRTs) have been proposed as a promising strategy to slow down or replace neuronal loss. Among the widely available cell sources, dental pulp stem cells (DPSCs) portray as an attractive source primarily due to their neural crest origin, ease of tissue procurement and less ethical hurdles MATERIALS AND METHODS: We first demonstrated the in vitro differentiation ability of DPSCs towards DA-ergic-like cells before evaluating their neuro-protection/neuro-restoration capacities in MPTP-induced mice...
March 30, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28364823/liver-retransplantation-how-much-is-too-much
#10
REVIEW
Jennifer Berumen, Alan Hemming
Hepatic retransplantation has been surgically challenging since the beginning of liver transplant. Outcomes have improved over time, but patient survival with retransplant continues to be significantly worse than that of primary transplant. Many studies have focused on factors to predict outcomes. Models have been developed to help predict risk, but the decision for retransplant must be a multidisciplinary transplant team decision. The question of "when is too much?" can be guided by recipient and donor factors but is an ethical decision that must be made by the liver transplant team...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28361899/towards-a-humanized-mouse-model-of-liver-stage-malaria-using-ectopic-artificial-livers
#11
Shengyong Ng, Sandra March, Ani Galstian, Nil Gural, Kelly R Stevens, Maria M Mota, Sangeeta N Bhatia
The malaria liver stage is an attractive target for antimalarial development, and preclinical malaria models are essential for testing such candidates. Given ethical concerns and costs associated with non-human primate models, humanized mouse models containing chimeric human livers offer a valuable alternative as small animal models of liver stage human malaria. The best available human liver chimeric mice rely on cellular transplantation into mice with genetically engineered liver injury, but these systems involve a long and variable humanization process, are expensive, and require the use of breeding-challenged mouse strains which are not widely accessible...
March 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28361801/uterus-transplants-and-their-ethical-implications
#12
Carlo Petrini, Assuntina Morresi
Early experiments in womb transplants have increased interest in the possibility of performing this procedure in women who have no womb, usually for congenital reasons. The present article describes past experiments and summarises the most relevant reference documents before indicating the key ethical implications involved in womb transplants.
January 2017: Annali Dell'Istituto Superiore di Sanità
https://www.readbyqxmd.com/read/28361077/extra-corporeal-membrane-oxygenation-support-ethical-dilemmas
#13
EDITORIAL
Tony Makdisi, George Makdisi
The vast expansion of patients treated with of extra corporeal membrane oxygenation (ECMO) emerge novel ethical questions about the use of this new technology. In regard the indications, duration of support and timing of withdrawal of support, these questions sometimes create disagreement among surrogates, between health care team and surrogates, and even disagreement among health care team, these disagreements occurs because of the extreme emergency of support initiation, the ambiguity of the outcome as well as lack of clarity on the intended treatment direction, whether it is ineffective, bridge to recovery or bridge to lifetime mechanical support or transplant...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28350643/delayed-referral-results-in-missed-opportunities-for-organ-donation-after-circulatory-death
#14
Kristina Krmpotic, Clare Payne, Cynthia Isenor, Sonny Dhanani
OBJECTIVES: Rates of organ donation and transplantation have steadily increased in the United States and Canada over the past decade, largely attributable to a notable increase in donation after circulatory death. However, the number of patients awaiting solid organ transplantation continues to remain much higher than the number of organs transplanted each year. The objective of this study was to determine the potential to increase donation rates further by identifying gaps in the well-established donation after circulatory death process in Ontario...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28341222/the-science-and-ethics-of-cell-based-therapies-for-parkinson-s-disease
#15
REVIEW
C R Towns
Parkinson's Disease (PD) is an age-related, disabling neurodegenerative disorder. Although sufferers usually respond to dopamine agonists for extended periods, the disease remains progressive and adverse drug effects can compromise effective long term treatment. Cell-based therapies have been the subject of much hype and optimism with regard to PD. Proof of principle was provided in the 1980s with fetal tissue transplantation trials demonstrating successful graft survival. Embryonic stem cells and reprogrammed or transdifferentiated somatic cells may provide alternative sources of tissue with the potential to overcome the material shortages and technical difficulties that have hindered fetal neural transplants...
January 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28331442/bioethics-in-practice-anonymous-living-donor-transplantation-ethical-or-medically-reckless
#16
Trevor W Reichman
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28326208/a-child-as-a-donor-for-hematopoietic-stem-cell-transplantation-bioethical-justification-a-case-study-on-sickle-cell-disease
#17
Andrea Z Pereira, Ricardo Hellman, Nelson Hamerschlak, Andrea Kondo, Polianna Mara Rodrigues de Souza, Wilson Leite Pedreira, Luiz Fernando Alves Lima Mantovani, Eduardo Juan Troster, Henrique Grunspun, Marco Aurélio Scarpinella Bueno
Hematopoietic stem cell transplantation (HSCT) is an important treatment option for children with severe and refractory sickle cell disease (SCD) with debilitating clinical complications. HSCT with cells from the bone marrow of a HLA-identical sibling used in SCD has a low mortality risk, high cure rate, and high event-free survival rate after a median follow-up of 5-6 years. However, matched donors are found in only about 20% of the patients. A boy aged 8 years with SCD had a sister, <2 years old, a fully compatible donor...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28321984/reciprocity-to-increase-participation-of-compatible-living-donor-and-recipient-pairs-in-kidney-paired-donation
#18
John S Gill, Kathryn Tinckam, Marie Chantal Fortin, Caren Rose, Kara Shick-Makaroff, Kimberly Young, Julie Lesage, Edward H Cole, Maeghan Toews, David N Landsberg, Jagbir Gill
Inclusion of compatible living donor and recipient pairs (CPs) in kidney paired donation (KPD) programs could increase living donor transplantation. We introduce the concept of a reciprocity based strategy in which the recipient of a CP that participates in KPD receives priority for a repeat deceased donor transplant in the event their primary living donor KPD transplant fails, and review the practical and ethical considerations of this strategy. The strategy limits prioritization to CPs already committed to living donation, minimizing the risk of unduly influencing donor behavior...
March 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28320774/3d-bioprint-me-a-socioethical-view-of-bioprinting-human-organs-and-tissues
#19
Niki Vermeulen, Gill Haddow, Tirion Seymour, Alan Faulkner-Jones, Wenmiao Shu
In this article, we review the extant social science and ethical literature on three-dimensional (3D) bioprinting. 3D bioprinting has the potential to be a 'game-changer', printing human organs on demand, no longer necessitating the need for living or deceased human donation or animal transplantation. Although the technology is not yet at the level required to bioprint an entire organ, 3D bioprinting may have a variety of other mid-term and short-term benefits that also have positive ethical consequences, for example, creating alternatives to animal testing, filling a therapeutic need for minors and avoiding species boundary crossing...
March 20, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28320531/global-trends-and-challenges-in-deceased-donor-kidney-allocation
#20
REVIEW
Diana A Wu, Christopher J Watson, J Andrew Bradley, Rachel J Johnson, John L Forsythe, Gabriel C Oniscu
Worldwide, the number of patients able to benefit from kidney transplantation is greatly restricted by the severe shortage of deceased donor organs. Allocation of this scarce resource is increasingly challenging and complex. Striking an acceptable balance between efficient use of (utility) and fair access to (equity) the limited supply of donated kidneys raises controversial but important debates at ethical, medical, and social levels. There is no international consensus on the recipient and donor factors that should be considered in the kidney allocation process...
March 17, 2017: Kidney International
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