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https://www.readbyqxmd.com/read/28795019/safe-and-ethical-living-kidney-donation-in-qatar-a-national-health-system-s-approach
#1
Muhammad Asim, Yousuf Al-Maslamani, Hassan Al-Malki
The increasing incidence of end-stage kidney disease in Qatar has led to growing demand for donor kidneys. The deceased donor kidney program has yet to achieve its full potential; hence, living kidney donation has been widely adopted as an appropriate alternative. The reliance on living kidney donors however, raises a number of social, ethical, and legal concerns surrounding informed consent, voluntarism, psychosocial evaluation, perioperative care, and long-term follow-up of living kidney donors. Many of these concerns become heightened in a multicultural, multilingual society within a Gulf country such as Qatar...
2017: Qatar Medical Journal
https://www.readbyqxmd.com/read/28767141/are-transplant-recipients-human-subjects-when-research-is-conducted-on-organ-donors
#2
Kate Gallin Heffernan, Alexandra K Glazier
Interventional research on deceased organ donors and donor organs prior to transplant holds the promise of reducing the number of patients who die waiting for an organ by expanding the pool of transplantable organs and improving transplant outcomes. However, one of the key challenges researchers face is an assumption that someone who receives an organ that was part of an interventional research protocol is always a human subject of that same study. The consequences of this assumption include the need for oversight by an institutional review board and for research-level informed consent from transplant recipients, all within the complex practical realities of the organ donation and transplantation process in the United States...
August 2, 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28760579/survival-of-ipsc-derived-grafts-within-the-striatum-of-immunodeficient-mice-importance-of-developmental-stage-of-both-transplant-and-host-recipient
#3
Colton M Tom, Shahab Younesi, Elana Meer, Catherine Bresee, Marlesa Godoy, Virginia B Mattis
Degeneration of the striatum can occur in multiple disorders with devastating consequences for the patients. Infantile infections with streptococcus, measles, or herpes can cause striatal necrosis associated with dystonia or dyskinesia; and in patients with Huntington's disease the striatum undergoes massive degeneration leading to behavioral, psychological and movement issues, ultimately resulting in death. Currently, only supportive therapies are available for striatal degeneration. Clinical trials have shown some efficacy using transplantation of fetal-derived primary striatal progenitors...
July 28, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28757883/emerging-ethical-perspectives-in-the-clustered-regularly-interspaced-short-palindromic-repeats-genome-editing-debate
#4
REVIEW
Silvia Camporesi, Giulia Cavaliere
This paper provides an overview of the ethical issues in the international clustered regularly interspaced short palindromic repeats (CRISPR) genome editing debate from March 2015 to September 2016. We present the regulatory framework for embryo research in the UK, and explain why CRISPR is not a significant break with the past. We discuss the ethical issues arising from CRISPR applications beyond human embryos, namely the use of gene drive-engineered mosquitoes to eradicate diseases, engineering nonhuman animals to harvest organs for human transplant and engineering crops...
November 2016: Personalized Medicine
https://www.readbyqxmd.com/read/28756397/penile-transplantation-as-an-appropriate-response-to-botched-traditional-circumcisions-in-south-africa-an-argument-against
#5
Keymanthri Moodley, Stuart Rennie
Traditional male circumcision is a deeply entrenched cultural practice in South Africa. In recent times, there have been increasing numbers of botched circumcisions by untrained and unscrupulous practitioners, leading to genital mutilation and often, the need for penile amputation. Hailed as a world's first, a team of surgeons conducted the first successful penile transplant in Cape Town, South Africa in 2015. Despite the euphoria of this surgical victory, concerns about the use of this costly intervention in a context of severe resource constraints have been raised...
July 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28755240/bridging-to-liver-transplantation-in-hcc-patients
#6
REVIEW
Dagmar Kollmann, Nazia Selzner, Markus Selzner
BACKGROUND: Liver transplantation (LT) is the only cure for patients diagnosed with unresectable hepatocellular carcinoma (HCC), and HCC has become the leading indication for LT in the USA. The shortage of liver grafts results in a significant waiting time for LT with the risk of tumour progression. Treating HCCs during the waiting time prior to transplantation (bridging therapy) is an attractive strategy to reduce the risk of exceeding the tumour criteria for transplantation. Studies on bridging therapy are heterogenous and due to ethical issues, mostly of retrospective design...
July 28, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28748278/-therapy-escalation-for-the-potential-organ-donor-are-all-intensive-care-measures-also-ethically-justifiable
#7
REVIEW
S-O Kuhn, K Hahnenkamp
The gap between the number of organs needed and the number available has dramatically increased in Germany in the last decade-for intensivists and transplantation specialists, it is challenging to cover the demand responsibly. It is therefore increasingly important to identify potential organ donors in order to realize organ donation. An escalation of intensive care measures is often required, which raises critical ethical questions. In Germany, organ donation is only allowed after brain death with prior informed consent from the deceased or his/her relatives...
July 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28744966/social-media-and-organ-donation-ethically-navigating-the-next-frontier
#8
Macey L Henderson, Kristel A Clayville, Jonathan S Fisher, Kristin K Kuntz, Harvey Mysel, Tanjala S Purnell, Randolph L Schaffer, Laurence A Sherman, Elizabeth P Willock, Elisa J Gordon
As the organ shortage continues to grow, the creation of social media communities by transplant centers and the public is rapidly expanding to increase the number of living donors. Social media communities are arranged in myriad ways, and without standardization, raising concerns about potential recipients' and potential donors' autonomy and quality of care. Social media communities magnify and modify extant ethical issues in deceased and living donation related to privacy, confidentiality, professionalism, and informed consent, and increase the potential for undue influence and coercion for potential living donors and transplant candidates...
July 25, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28740618/ethical-issues-associated-with-medical-tourism-in-africa
#9
REVIEW
John J O Mogaka, Lucia Mupara, Joyce M Tsoka-Gwegweni
Global disparities in medical technologies, laws, economic inequities, and social-cultural differences drive medical tourism (MT), the practice of travelling to consume healthcare that is either too delayed, unavailable, unaffordable or legally proscribed at home. Africa is simultaneously a source and destination for MT. MT however, presents a new and challenging health ethics frontier, being largely unregulated and characterized by policy contradictions, minority discrimination and conflict of interest among role-players...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28740510/hematopoietic-stem-cell-transplantation-a-bioethical-lens
#10
REVIEW
Arcangelo Liso, Margherita Neri, Francesca Maglietta, Raffaele La Russa, Emanuela Turillazzi
Hematopoietic stem cell transplantation (HSCT) is one of a range of therapeutic options available to patients suffering from various diseases. HSCT procedure involves important ethical and legal aspects that can occur at every phase of the procedure: the clinical choice of whether to perform the procedure, pretransplantation preparation regimens, donor selection, stem cell harvest procedure, transplantation phase, and short-term and long-term follow-up care. In this discussion paper, we outline the ethical issue-facing physicians involved in HSCT...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28737527/genitourinary-vascularized-composite-allotransplantation
#11
Ilse M Schol, Dicken S C Ko, Curtis L Cetrulo
PURPOSE OF REVIEW: Genitourinary vascularized allotransplantation (GUVCA) is gaining interest as a treatment option for patients with functional and aesthetic urogenital tissue loss. Only three cases have been done worldwide and research on the implementation and feasibility of this procedure is in an elementary state. RECENT FINDINGS: The psychosocial impact and ethical considerations with GUVCA are remote, particularly because of the intimate and personal nature of genital tissue...
July 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28736957/xenogeneic-chimera-generated-by-blastocyst-complementation-as-a-potential-unlimited-source-of-recipient-tailored-organs
#12
REVIEW
Graziano Oldani, Andrea Peloso, Stéphanie Lacotte, Raphael Meier, Christian Toso
Blastocyst complementation refers to the injection of cells into a blastocyst. The technology allows for the creation of chimeric animals, which have the potential to be used as an unlimited source of organ donors. Pluripotent stem cells could be generated from a patient in need of a transplantation and injected into a large animal blastocyst (potentially of a pig), leading to the creation of organ(s) allowing immunosuppression-free transplantation. Various chimera combinations have already been generated, but one of the most recent steps leads to the creation of human-pig chimeras, which could be studied at an embryo stage...
July 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28719391/pediatric-and-congenital-hand-transplantation
#13
Sandra Amaral, L Scott Levin
PURPOSE OF REVIEW: We review the approach and challenges associated with pediatric hand transplantation, including new knowledge gleaned from our recent case of bilateral hand-forearm transplantation in an 8-year old child. RECENT FINDINGS: Bilateral heterologous hand-forearm transplantation was performed in a child with a prior kidney transplant in July 2015. The initial surgery necessitated a large team of experts in microvascular surgery, transplant surgery, orthopedics and plastic surgery as well as pediatric anesthesia...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28698998/does-organ-selling-violate-human-dignity
#14
Zümrüt Alpinar-Şencan, Holger Baumann, Nikola Biller-Andorno
Shortages in the number of donated organs after death and the growing number of end-stage organ failure patients on waiting lists call for looking at alternatives to increase the number of organs that could be used for transplantation purposes. One option that has led to a legal and ethical debate is to have regulated markets in human organs. Opponents of a market in human organs offer different arguments that are mostly founded on contingent factors that can be adjusted. However, some authors have asked the question whether we still have a reason to believe that there is something wrong with offering human organs for sale for transplantation purposes, even if the circumstances under which the practice takes place are improved...
July 11, 2017: Monash Bioethics Review
https://www.readbyqxmd.com/read/28682718/the-ventricular-assist-device-in-the-life-of-the-child-a-phenomenological-pediatric-study
#15
Michael A van Manen
What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy...
May 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28680446/donor-selection-for-allogenic-hemopoietic-stem-cell-transplantation-clinical-and-ethical-considerations
#16
REVIEW
Irene Riezzo, Natascha Pascale, Raffaele La Russa, Arcangelo Liso, Monica Salerno, Emanuela Turillazzi
Allogenic hematopoietic progenitor cell transplantation (allo-HSCT) is an established treatment for many diseases. Stem cells may be obtained from different sources: mobilized peripheral blood stem cells, bone marrow, and umbilical cord blood. The progress in transplantation procedures, the establishment of experienced transplant centres, and the creation of unrelated adult donor registries and cord blood banks gave those without an human leucocyte antigen- (HLA-) identical sibling donor the opportunity to find a donor and cord blood units worldwide...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28677148/newspaper-coverage-of-human-pig-chimera-research-a-qualitative-study-on-select-media-coverage-of-scientific-breakthrough
#17
Abena Hagan-Brown, Maddalena Favaretto, Pascal Borry
BACKGROUND: A recently published article in the journal Cell by scientists from the Salk Institute highlighted the successful integration of stem cells from humans in pig embryos. This marks the first step toward the goal of growing human organs in animals for transplantation. There has, to date, been no research performed on the presentation of this breakthrough in the media. We thus assessed early newspaper coverage of the chimera study, looking into the descriptions as well as the benefits and concerns raised by the study mentioned by newspaper sources...
July 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28675357/the-european-policy-for-liver-allocation-in-patients-affected-by-hepatocellular-carcinoma
#18
Stefano Di Sandro, Fabio Ferla, Andrea Lauterio, Iacopo Mangoni, Riccardo De Carlis, Vincenzo Buscemi, Luciano De Carlis
The main goal of allocation system is to guarantee an equal access to the limited resource of liver grafts for every class of patients on the waiting list, balancing between the ethical principles of equity, utility, benefit, need, and fairness. The aim of this review was to analyze liver allocation policies among these organizations, focusing on HCC. The European area considered for this analysis included 6 macro-areas or countries, which are congregated from the same policy of liver sharing and allocation...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28663681/living-donor-liver-transplantation-for-acute-liver-failure-with-fixed-pupils-are-we-fixed
#19
Shweta A Singh, Anshuman Singh, Viniyendra Pamecha, Chandra Kant Pandey, Shiv Kumar Sarin
Living donor liver transplantation (LDLT) is fraught with the social and ethical dilemma of excising a part of the liver from a healthy first-degree relative. When LDLT is to be done for an acute liver failure (ALF), identification of a suitable donor is a race against time. Herein, we describe a unique challenge faced by the transplant team of whether to proceed with donor hepatectomy from a son, when the recipient (HBV-related ALF) developed non-reactive fully dilated pupils on the table, prior to beginning the surgery...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28661283/is-there-a-particular-ethical-practice-and-policy-space-in-north-america-for-uncontrolled-kidney-donation-after-circulatory-death
#20
Jeffrey Kirby
Despite successful transplantation outcomes in Europe, uncontrolled organ donation after circulatory determination of death (uDCDD) has essentially been a non-starter in North America. In this paper, I identify and explore a set of interesting, ethics-related considerations that are of relevance to this organ donation-transplantation practice. The analysis provides a theoretical platform for my development of a proposal for the creation of a particular ethical practice and policy space for kidney uDCDD in the U...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
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