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Ethics transplantation

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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
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28306592/bridging-the-gap-in-heart-transplantation
#5
Jacqueline M Smits, Undine Samuel, Guenther Laufer
PURPOSE OF REVIEW: Countries in Europe and in the USA are proclaiming their need for an objective allocation system that can cope with distribution of a scarce resource in a changing environment of an older donor and recipient population and of an increased number of patients on mechanical circulatory support, whose prospects are increasing. RECENT FINDINGS: The current heart allocation systems in Eurotransplant, France and the USA are all urgency tier systems, where within the same tier a first-come, first-served principle is applied...
March 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28303433/the-decade-of-face-transplant-outcomes
#6
Maria Siemionow
At the 10th year anniversary of the first face transplantation, 37 patients worldwide, were the recipients of faces coming from human donors. Five patients died due to complications, noncompliance with immunosuppressive medications and development of cancer. Despite the initial debates and ethical concerns, face transplantation became a clinical reality with satisfactory functional outcomes. The areas of controversy still include the impact of life-long immunosuppression on otherwise healthy patients as well as the selection process of face transplant candidates...
May 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28286074/human-penile-transplantation-an-emerging-therapy-for-genitourinary-reconstruction
#7
REVIEW
Nikolai A Sopko, Sami H Tuffaha, Denver Lough, Gerald Brandacher, W P Andrew Lee, Trinity J Bivalacqua, Richard J Redett, Arthur L Burnett
PURPOSE: Reconstruction of complex functional structures is increasingly being performed with vascularized composite allo-transplantation (VCA). Penile transplantation is a novel VCA treatment option for severe penile tissue loss and disfigurement. Three allogeneic human penile transplantations have been reported. We review these cases as well as penile transplant indications, pre-clinical models, and immunosuppression therapy. MATERIALS AND METHODS: We performed a comprehensive literature review for the years 1970 to 2016 via MEDLINE, PubMed, and Google with the key words "penis transplantation", "penile rejection", "penile replantation", "penile tissue loss", and "penis vascularized composite allo-transplantation"...
March 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28266864/recent-advances-in-therapeutic-applications-of-induced-pluripotent-stem-cells
#8
Farzaneh Rami, Shamsi Naderi Beni, Mahboobeh Mojaver Kahnamooi, Ilnaz Rahimmanesh, Ahmad Reza Salehi, Rasoul Salehi
Induced pluripotent stem (iPS) cells are generated by reprogramming of differentiated somatic cells. These cells are identical to human embryonic stem cells (hESCs) in gene expression pattern and the ability to differentiate. iPS cells can be used in in vitro modeling of diseases, testing drugs, assessing gene therapy methods, and cell therapy. Yet, the most important and promising application of iPS cells is in regenerative medicine. Regenerative medicine is a novel area in medicine aiming at the treatment of impaired or lost tissues by replacing them with functional and healthy ones...
March 7, 2017: Cellular Reprogramming
https://www.readbyqxmd.com/read/28264580/-ethical-aspects-of-uterus-transplantation
#9
Roman Chmel, Marta Nováčková, Zlatko Pastor, Jan Matěcha, Miloš Čekal, Jiří Froněk
Uterus transplantation is an experimental treatment method with an ambition to become accepted treatment modality for women with absolute uterine factor infertility. The only legal alternative for these women to get parenthood is adoption which is accepted by most world societies and countries. Surrogate pregnancy is connected with many medical, ethical, legal, religious and social controversies in the great part of the world.Donors (in living donation), recipients, partners and also unborn children must be incorporated into the analysis of ethical risks and benefits of uterus transplantation...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28260450/questionnaire-on-brain-death-and-organ-procurement
#10
Saleh Hammad, Manal Alnammourah, Farah Almahmoud, Mais Fawzi, Abdel-Hadi Breizat
OBJECTIVES: The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution. MATERIALS AND METHODS: We administered 2682 questionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28258071/opting-out-a-single-centre-pilot-study-assessing-the-reasons-for-and-the-psychosocial-impact-of-withdrawing-from-living-kidney-donor-evaluation
#11
Carrie Thiessen, Zainab Jaji, Michael Joyce, Paula Zimbrean, Peter Reese, Elisa J Gordon, Sanjay Kulkarni
Understanding why individuals opt out of living donation is crucial to enhancing protections for all living donors and to identify modifiable barriers to donation. We developed an ethical approach to conducting research on individuals who opted out of living kidney donation and applied it in a small-scale qualitative study at one US transplant centre. The seven study participants (64% response rate) had varied reasons for opting out, the most prominent of which was concern about the financial burden from lost wages during the postoperative period...
March 3, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28255068/genomic-contraindications-for-heart-transplantation
#12
Danton S Char, Gabriel Lázaro-Muñoz, Aliessa Barnes, David Magnus, Michael J Deem, John D Lantos
Genome sequencing raises new ethical challenges. Decoding the genome produces new forms of diagnostic and prognostic information; however, the information is often difficult to interpret. The connection between most genetic variants and their phenotypic manifestations is not understood. This scenario is particularly true for disorders that are not associated with an autosomal genetic variant. The analytic uncertainty is compounded by moral uncertainty about how, exactly, the results of genomic testing should influence clinical decisions...
March 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28244829/regenerative-capacity-of-autologous-stem-cell-transplantation-in-elderly-a-report-of-biomedical-outcomes
#13
Maria Teresa Gonzalez-Garza, Delia Elva Cruz-Vega
The occurrence of chronic diseases such as neurological, metabolic and cardiovascular degenerative disorders increases with age. Cell therapy is an emerging approach to the treatment of these conditions. Of particular interest is the application of autologous stem cells because it eliminates post-transplantation immune rejection and there are less ethical concerns associated with their use. The regenerative capacity of stem cells harvested from elderly people is however controversial. In this review, we analyze if self-renewal potential, differentiation capability and expression of stemness genes in stem cells collected from elderly patients validate their application in clinical trials and examine the results...
March 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/28240838/liver-transplantation-for-patients-with-alcoholic-hepatitis
#14
Florent Artru, Alexandre Louvet, Philippe Mathurin
Alcoholic liver disease, considered as a self-inflected disease, is an example of how moral judgment may affect ethical exercise of medicine which requires equity and fair utilization of a scarce resource in a context of organ shortage. Some consider that selection process should prioritize access to liver transplantation (LT) for patients who develop liver failure "through no fault of their own" even if limiting care because of a patient's perceived responsibility has been considered unethical. The absence of improvement after alcohol withdrawal, the high short-term mortality risk and the poor predictability of the 6-month rule in post-LT relapse in alcohol consumption in AH patients not responding to medical therapy led to recommend an evaluation of LT...
March 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28238113/franklin-g-miller-and-robert-d-truog-death-dying-and-organ-transplantation-reconstructing-medical-ethics-at-the-end-of-life-oxford-university-press-2012-196%C3%A2-pp-isbn-978-0199739172
#15
https://www.readbyqxmd.com/read/28237959/comparison-of-efficacy-and-safety-between-benidipine-and-hydrochlorothiazide-in-fosinopril-treated-hypertensive-patients-with-chronic-kidney-disease-protocol-for-a-randomised-controlled-trial
#16
Cheng Xue, Chenchen Zhou, Bo Yang, Jiayi Lv, Bing Dai, Shengqiang Yu, Yi Wang, Guanren Zhao, Changlin Mei
INTRODUCTION: Co-administration of a diuretic or calcium channel blocker with an ACE inhibitor are both preferred combinations in patients with hypertensive chronic kidney disease (CKD). According to the available evidence, it is still unknown which combination plays a more active role in renal protection. We hypothesised that a combination of fosinopril and benidipine may delay the progression of CKD more effectively than a combination of fosinopril and hydrochlorothiazide (HCTZ). METHODS AND ANALYSIS: This study will be a multicentred, prospective, double-blind, randomised parallel controlled trial for hypertensive CKD patients in China...
February 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28222038/evidence-based-ethically-justified-counseling-for-fetal-bilateral-renal-agenesis
#17
Alana N Thomas, Laurence B McCullough, Frank A Chervenak, Frank X Placencia
BACKGROUND: Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. AIM: To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. STUDY DESIGN: A systematic literature search was performed using multiple databases...
February 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28219959/randomised-prospective-medico-economic-nationwide-french-study-of-islet-transplantation-in-patients-with-severely-unstable-type-1-diabetes-the-stabilot-study-protocol
#18
Sandrine Lablanche, Sandra David-Tchouda, Jennifer Margier, Edith Schir, Anne Wojtusciszyn, Sophie Borot, Laurence Kessler, Emmanuel Morelon, Charles Thivolet, François Pattou, Marie Christine Vantyghem, Thierry Berney, Pierre-Yves Benhamou
INTRODUCTION: Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy...
February 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28219582/a-study-on-the-directed-living-non-related-donor-kidney-transplantation-submitted-to-the-hospital-transplant-ethics-committee-at-the-national-kidney-and-transplant-institute
#19
G Suguitan, M-H I Arakama, R Danguilan
BACKGROUND: In the latter part of 2009, the Department of Health of the Philippines prohibited kidney transplantation with non-related kidney donors. Hence, the National Kidney and Transplant Institute created a Hospital Transplant Ethics Committee. This study describes directed non-related kidney donation at the National Kidney and Transplant Institute. METHODS: This retrospective study reviewed the profiles of recipients and directed living non-related kidney transplant donors submitted to the Hospital Transplant Ethics Committee...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28210847/ethical-considerations-in-the-long-term-ventricular-assist-device-patient
#20
REVIEW
Amanda Cai, Howard J Eisen
PURPOSE OF REVIEW: As the heart failure population continues to age, the need for definitive therapies such as ventricular assist devices (VADs) to extend life and alleviate suffering from end-stage disease directly increases. The goal of this article is to examine the ethical principles of autonomy, beneficence, non-maleficence, and justice within the context of long-term VAD patients. RECENT FINDINGS: Survival rates in VAD-implanted patients have improved in parallel with modernization of device design and surgical technique, reaching that of cardiac transplantation at 1 year post-procedure...
February 16, 2017: Current Heart Failure Reports
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