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https://www.readbyqxmd.com/read/29149331/the-ethics-of-organ-tourism-role-morality-and-organ-transplantation
#1
Marcus P Adams
Organ tourism occurs when individuals in countries with existing organ transplant procedures, such as the United States, are unable to procure an organ by using those transplant procedures in enough time to save their life. In this paper, I am concerned with the following question: When organ tourists return to the United States and need another transplant, do US transplant physicians have an obligation to place them on a transplant list? I argue that transplant physicians have a duty not to relist organ tourists...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29140549/improving-pancreas-graft-utilization-through-importation
#2
Julia Torabi, Juan P Rocca, Krystina Choinski, Katherine Lorenzen, Camille Yongue, Michelle L Lubetzsky, Melvon E Herbert, Attasit Chokechanachaisakul, Maria Ajaimy, Layla Kamal, Enver Akalin, Milan Kinkhabwala, Jay A Graham
BACKGROUND: We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation. METHODS: This is an observational retrospective cohort of 26 recipients who received either a locally procured (n=16) or an imported pancreas graft (n=10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data was also reviewed to analyze the cost effectiveness of this strategy...
November 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29132994/countries-interest-in-a-hepatitis-b-vaccine-licensed-for-the-controlled-temperature-chain-survey-results-from-african-and-western-pacific-regions
#3
Dörte Petit, Carole Tevi-Benissan, Joseph Woodring, Karen Hennessey, Anna-Lea Kahn
Chronic hepatitis B infection can be prevented by hepatitis B vaccine birth dose (hepB-BD) given within 24 h after birth, followed by two hepatitis B vaccinations within the first year of life. Yet nearly half of World Health Organization (WHO) Member States do not provide a hepB-BD. Barriers are primarily attributed to vaccine storage and transportation, as well as high rates of home births. Delivering the vaccine outside the cold chain could potentially increase coverage. To do this, WHO recommends vaccines be licensed for use in a "controlled temperature chain" (CTC), which requires a given product to tolerate temperature excursions up to at least 40 °C for a minimum of three days...
November 10, 2017: Vaccine
https://www.readbyqxmd.com/read/29128023/evaluation-and-management-of-the-potential-lung-donor
#4
REVIEW
Andrew Courtwright, Edward Cantu
The expansion of the donor lung pool has involved an evidence-driven redefinition of acceptable donors. Proceeding with transplantation with an acceptable rather than ideal donor depends on specific patient-related and organ-related risk factors as well as the severity of recipient illness. Although the physiologic optimization of brain-dead donors has not changed significantly in recent years, the use of donor management protocols has improved procurement rates. Ex vivo lung perfusion is an increasingly viable strategy to recondition lungs that would otherwise fall below the acceptable threshold for transplant...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29127685/the-first-case-of-ischemia-free-organ-transplantation-in-humans-a-proof-of-concept
#5
Xiaoshun He, Zhiyong Guo, Qiang Zhao, Weiqiang Ju, Dongping Wang, Linwei Wu, Lu Yang, Fei Ji, Yunhua Tang, Zhiheng Zhang, Shanzhou Huang, Linhe Wang, Zebin Zhu, Kunpeng Liu, Yanling Zhu, Yifang Gao, Wei Xiong, Ming Han, Bing Liao, Maogen Chen, Yi Ma, Xiaofeng Zhu, Wenqi Huang, Changjie Cai, Xiangdong Guan, Xian Chang Li, Jiefu Huang
Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man...
November 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29126447/hypoglycemic-and-hypolipidemic-effects-of-different-parts-and-formulations-of-bitter-gourd-momordica-charantia
#6
Mahwish, Farhan Saeed, Muhammad Sajid Arshad, Mahr Un Nisa, Muhammad Tahir Nadeem, Muhammad Umair Arshad
BACKGROUND: Cardiovascular diseases and diabetes are responsible for large number of deaths throughout the globe. Bitter gourd has the potential to become a component of the diet or a dietary supplement for diabetic and pre-diabetic patients owing to the presence of insulin like molecules. Recent investigations have suggested that bitter gourd extracts may ameliorate high fat diet induced obesity and hyperlipidemia in animal models. Moreover, its supplements in food result in lowering weight gain and visceral fat mass...
November 10, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/29125676/decreasing-mortality-and-disease-severity-in-hepatitis-c-patients-awaiting-liver-transplantation-in-the-united-states
#7
Allison Kwong, W Ray Kim, Ajitha Mannalithara, Nae-Yun Heo, Prowpanga Udompap, Donghee Kim
BACKGROUND: Hepatitis C virus (HCV) infection has been the leading indication for liver transplantation (LT) in the United States. Since 2013, interferon-free antiviral therapy has led to sustained virologic response in many LT candidates. We compared the waitlist mortality of HCV patients with that of patients with other chronic liver diseases. METHODS: Data for primary LT candidates were obtained from the Organ Procurement and Transplantation Network database...
November 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29122376/explaining-regional-variation-in-home-care-use-by-demand-and-supply-variables
#8
Olivier van Noort, Fredo Schotanus, Joris van de Klundert, Jan Telgen
In the Netherlands, home care services like district nursing and personal assistance are provided by private service provider organizations and covered by private health insurance companies which bear legal responsibility for purchasing these services. To improve value for money, their procurement increasingly replaces fee-for-service payments with population based budgets. Setting appropriate population budgets requires adaptation to the legitimate needs of the population, whereas historical costs are likely to be influenced by supply factors as well, not all of which are necessarily legitimate...
May 26, 2017: Health Policy
https://www.readbyqxmd.com/read/29108142/euthanasia-in-belgium-legal-historical-and-political-review
#9
Toni C Saad
This article describes and evaluates the Belgian euthanasia experience by considering its practice and policy, both before and after the formal decriminalisation of euthanasia in 2002. The pre-legal practice of euthanasia, the evolution of euthanasia legislation, criticism of this legislation, the influence of politics, and later changes to the 2002 Act on Euthanasia are discussed, as well as the subject of euthanasia of minors and the matter of organ procurement. It is argued that the Belgian euthanasia experience is characterised by political expedition, and that the 2002 Act and its later amendments suffer from practical and conceptual flaws...
2017: Issues in Law & Medicine
https://www.readbyqxmd.com/read/29105843/the-liver-recipient-with-acute-renal-dysfunction-a-single-institution-evaluation-of-the-simultaneous-liver-kidney-transplant-candidate
#10
Kunal Yadav, Oscar K Serrano, Kent J Peterson, Timothy L Pruett, Raja Kandaswamy, Ananta Bangdiwala, Hassan Ibrahim, Ajay Israni, John Lake, Srinath Chinnakotla
The Organ Procurement Transplant Network (OPTN) listing criteria for simultaneous liver-kidney transplant (SLK) are not well defined. Concerns remain about rising numbers of SLKs, which divert quality kidneys from candidates awaiting kidney transplants (KT). We performed a retrospective review of liver transplants (LT) at our center from 2004-14; 127 recipients (Liver transplant alone; 102 LTA, 25 SLK) were identified with short-term preoperative kidney dysfunction (creatinine >4 mg/dL or preoperative hemodialysis [HD] for <6 wks)...
November 4, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29100021/factors-associated-with-mortality-within-24h-of-liver-transplantation-an-updated-analysis-of-65-308-adult-liver-transplant-recipients-between-2002-and-2013
#11
Kyota Fukazawa, Ernesto A Pretto, Seigo Nishida, Jorge D Reyes, Edward Gologorsky
STUDY OBJECTIVES: Intracardiac and pulmonary thromboembolism (ICPTE), its risk factors and contribution to 24-hour mortality after adult liver transplantation for end-stage liver disease. DESIGN: Retrospective analysis of Standard Transplant Analysis and Research electronic database files. SETTING: Perioperative. PATIENTS: Electronic files of 65,308 adult liver transplant recipients between 2002 and 2013 obtained from Organ Procurement and Transplantation Network...
October 31, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29096343/non-anastomotic-strictures-after-transplanting-a-liver-graft-with-an-accidentally-ligated-and-unflushed-common-bile-duct-a-case-report
#12
Nicolas Meurisse, Jacques Pirenne, Diethard Monbaliu
INTRODUCTION: Non-anastomotic biliary strictures (NAS) represent a major cause of morbidity, graft loss, and mortality after liver transplantation (LTx). NAS can result from an ischemic/immune-mediated injury, or from the cytotoxic effect that bile salts have on the biliary mucosa under hypothermic conditions. For this reason it is crucial to flush the bile duct at the time of procurement. PRESENTATION OF CASE: We report a case of an imported liver with an accidentally ligated and subsequently completely unflushed common bile duct...
October 26, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29093176/kleptopredation-a-mechanism-to-facilitate-planktivory-in-a-benthic-mollusc
#13
Trevor J Willis, Kimberly T L Berglöf, Rona A R McGill, Luigi Musco, Stefano Piraino, Claire M Rumsey, Tomás Vega Fernández, Fabio Badalamenti
Predation occurs when an organism completely or partially consumes its prey. Partial consumption is typical of herbivores but is also common in some marine microbenthic carnivores that feed on colonial organisms. Associations between nudibranch molluscs and colonial hydroids have long been assumed to be simple predator-prey relationships. Here we show that while the aeolid nudibranch Cratena peregrina does prey directly on the hydranths of Eudendrium racemosum, it is stimulated to feed when hydranths have captured and are handling prey, thus ingesting recently captured plankton along with the hydroid polyp such that plankton form at least half of the nudibranch diet...
November 2017: Biology Letters
https://www.readbyqxmd.com/read/29073953/temporary-circulatory-support-in-u-s-children-awaiting-heart-transplantation
#14
Vamsi V Yarlagadda, Katsuhide Maeda, Yulin Zhang, Sharon Chen, John C Dykes, Mary Alice Gowen, Paul Shuttleworth, Jenna M Murray, Andrew Y Shin, Olaf Reinhartz, David N Rosenthal, Doff B McElhinney, Christopher S Almond
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has long served as the standard of care for short-term mechanical circulatory support in pediatrics. It is unknown whether newer-generation temporary circulatory support (TCS) devices afford children a meaningful survival advantage over ECMO. OBJECTIVES: This study sought to determine whether bridge-to-heart transplant survival with a TCS device is superior to ECMO after adjusting for patient differences. METHODS: All children ≤21 years of age listed for heart transplant from 2011 to 2015 who received a TCS device or ECMO as a bridge to transplant were identified using Organ Procurement and Transplantation Network data...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29067599/legislative-enforcement-of-nonconsensual-determination-of-neurological-brain-death-in-muslim-patients-a-violation-of-religious-rights
#15
Mohamed Y Rady, Joseph L Verheijde
Death is defined in the Quran with a single criterion of irreversible separation of the ruh (soul) from the body. The Quran is a revelation from God to man, and the primary source of Islamic knowledge. The secular concept of death by neurological criteria, or brain death, is at odds with the Quranic definition of death. The validity of this secular concept has been contested scientifically and philosophically. To legitimize brain death for the purpose of organ donation and transplantation in Muslim communities, Chamsi-Pasha and Albar (concurring with the US President's Council on Bioethics) have argued that irreversible loss of capacity for consciousness and breathing (apneic coma) in brain death defines true death in accordance with Islamic sources...
October 24, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29054231/lung-procurement-after-cardiac-death-in-a-donor-with-previous-median-sternotomy
#16
Chitaru Kurihara, Masashi Kawabori, Masahiro Ono, Syed T Hussain, Amit D Parulekar, Jeffrey A Morgan, Gabriel Loor
The shortage of lungs for organ donation is problematic, and meeting the demand by expanding the donor pool in lung transplantation is critical. Donation after cardiac death (DCD) is an under-used approach that could be a valuable source of organs. However, procuring lungs from donors with a previous median sternotomy is technically difficult and is usually avoided. Here, we describe the procurement of lungs from a DCD patient with a previous median sternotomy.
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29032604/the-impact-of-inter-center-sharing-on-the-outcomes-of-pediatric-split-liver-transplantation
#17
Ahmed M Elsabbagh, Cassie Williams, Raffaele Girlanda, Jason Hawksworth, Alexander Kroemer, Cal S Matsumoto, Thomas M Fishbein
BACKGROUND: Split liver transplantation allows for expansion of the pool of organs available for pediatric liver transplantation. The impact of sharing segments of the same liver between centers has not been studied. STUDY DESIGN: Retrospective analysis of 24 pediatric split liver transplant cases in a recent cohort. We evaluated the outcomes of pediatric recipients who shared organs with adult patients in our own center (group A) compared to recipients who shared organs with adult patients in other centers...
October 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29031659/validity-of-skin-cancer-malignancy-reporting-to-the-organ-procurement-transplant-network-a-cohort-study
#18
Giorgia L Garrett, Joyce T Yuan, Thuzar M Shin, Sarah T Arron
BACKGROUND: The Organ Procurement Transplant Network (OPTN) registry collects data on posttransplant malignancies in solid organ transplant recipients. Complete and accurate registry data on skin cancer is critical for research on epidemiology and interventions. OBJECTIVE: The study goal was to determine the validity of Organ Procurement Transplant Network skin cancer data. METHODS: This cohort study compared reporting of posttransplant squamous cell carcinoma (SCC) and malignant melanoma (MM) in OPTN to medical-record review-derived data from the Transplant Skin Cancer Network (TSCN) database...
October 11, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29029891/imaging-findings-within-the-first-12%C3%A2-months-of-hepatocellular-carcinoma-treated-with-stereotactic-body-radiation-therapy
#19
Mishal Mendiratta-Lala, Everett Gu, Dawn Owen, Kyle C Cuneo, Latifa Bazzi, Theodore S Lawrence, Hero K Hussain, Matthew S Davenport
PURPOSE: To correlate the imaging findings of treated hepatocellular carcinoma (HCC) after stereotactic body radiation therapy (SBRT) with explant pathology and alpha-fetoprotein (AFP) response. METHODS AND MATERIALS: From 2007 to 2015, of 146 patients treated with liver SBRT for Barcelona Clinic Liver Cancer stage A hepatocellular carcinoma, 10 were identified with inclusion criteria and had regular interval follow-up magnetic resonance imaging/triple phase computed tomography and explant pathology or declining AFP values for radiology-pathology response correlation...
August 24, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28990205/developing-a-protocol-for-normothermic-ex-situ-limb-perfusion
#20
Eliana F R Duraes, Maria Madajka, Russell Frautschi, Basem Soliman, Cagri Cakmakoglu, Addison Barnett, Kashyap Tadisina, Qiang Liu, Patrick Grady, Cristiano Quintini, Toshihiro Okamoto, Francis Papay, Antonio Rampazzo, Bahar Bassiri Gharb
BACKGROUND: Ischemia time represents a significant limitation for successful extremity transplantation because of the rapid deterioration of ischemic muscle. Normothermic ex-situ preservation is an emergent method to prolong the organ viability following procurement, by replicating the physiologic conditions. The aim of this study was to develop an ex-situ normothermic limb perfusion system to preserve the viability and function of porcine limbs for 12 hours following procurement. METHODS: A total of 18 swine limbs were perfused...
October 9, 2017: Microsurgery
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