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Transplantation ethics

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https://www.readbyqxmd.com/read/28210847/ethical-considerations-in-the-long-term-ventricular-assist-device-patient
#1
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
https://www.readbyqxmd.com/read/28208553/re-the-ethics-of-penile-transplantation-preliminary-recommendations
#2
David A Goldfarb
No abstract text is available yet for this article.
March 2017: Journal of Urology
https://www.readbyqxmd.com/read/28207553/laparoscopic-living-donor-right-hemihepatectomy-with-venous-outflow-reconstruction-using-cadaveric-common-iliac-artery-allograft-case-report-and-literature-review
#3
Jiaxin Li, Jiwei Huang, Hong Wu, Yong Zeng
RATIONALE: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. PATIENT CONCERNS AND DIAGNOSES: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28199003/applications-of-induced-pluripotent-stem-cell-technologies-in-spinal-cord-injury
#4
REVIEW
Narihito Nagoshi, Hideyuki Okano
Numerous basic research studies have suggested the potential efficacy of neural precursor cell (NPC) transplantation in spinal cord injury (SCI). However, in most such studies the origin of the cells used was mainly fetal tissue or embryonic stem cells, both of which carry potential ethical concerns with respect to clinical use. The development of induced pluripotent stem cells (iPSCs) opened a new path toward regenerative medicine for SCI. iPSCs can be generated from somatic cells by induction of transcription factors, and induced to differentiate into NPCs with characteristics of cells of the central nervous system...
February 15, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28187013/the-effectiveness-and-safety-of-tranexamic-acid-in-orthotopic-liver-transplantation-clinical-practice-a-propensity-score-matched-cohort-study
#5
Adam Badenoch, Anand Sharma, Simon Gower, Markus Selzner, Coimbatore Srinivas, Marcin Wasowics, Stuart A McCluskey
BACKGROUND: Randomized trials have demonstrated the efficacy of Tranexamic acid (TXA) in reducing blood loss and transfusion requirements during liver transplantation. However, clinical utilization is limited due to a perceived lack of generalizable effectiveness and concerns regarding its thromboembolic risks. The aim of this study was to describe the clinical use of TXA and to provide a pragmatic re-appraisal of its effectiveness and safety. METHODS: Following ethics approval, data was collected from 1,799 consecutive liver transplant recipients between January 1st 2002 and December 31st 2015 using retrospectively collected electronic databases...
February 10, 2017: Transplantation
https://www.readbyqxmd.com/read/28186117/amelioration-of-experimental-autoimmune-encephalomyelitis-through-transplantation-of-placental-derived-mesenchymal-stem-cells
#6
Hong Jiang, Yuanyuan Zhang, Kewei Tian, Beibei Wang, Shu Han
Placental derived mesenchymal stem cells (PMSCs) have been suggested as a possible source of cells to treat multiple sclerosis (MS) due to their immunomodulatory functions, lack of ethical concerns, and potential to differentiate into neurons and oligodendrocytes. To investigate whether PMSCs share similar characteristics with embryonic mesenchymal stem cells (EMSCs), and if transplanted PMSCs have the ability to integrate and replace degenerated neural cells, we transplanted rat PMSCs and EMSCs into the central nervous system (CNS) of Lewis rats with experimental autoimmune encephalomyelitis (EAE), an animal model of MS...
February 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28185142/print-me-an-organ-ethical-and-regulatory-issues-emerging-from-3d-bioprinting-in-medicine
#7
Frederic Gilbert, Cathal D O'Connell, Tajanka Mladenovska, Susan Dodds
Recent developments of three-dimensional printing of biomaterials (3D bioprinting) in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments...
February 9, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/28182115/organ-donation-and-elective-ventilation-a-necessary-strategy
#8
REVIEW
Dolores Escudero, Jesus Otero, Begoña Menéndez de León, Marcos Perez-Basterrechea
Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28178953/human-rights-violations-in-organ-procurement-practice-in-china
#9
Norbert W Paul, Arthur Caplan, Michael E Shapiro, Charl Els, Kirk C Allison, Huige Li
BACKGROUND: Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China's organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained. DISCUSSION: We have collected and analysed available evidence on human rights violations in the organ procurement practice in China...
February 8, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28170193/human-menstrual-blood-derived-stem-cells-ameliorate-liver-fibrosis-in-mice-by-targeting-hepatic-stellate-cells-via-paracrine-mediators
#10
Lijun Chen, Chunfeng Zhang, Lu Chen, Xiaojun Wang, Bingyu Xiang, Xiaoxing Wu, Yang Guo, Xiaozhou Mou, Li Yuan, Bo Chen, Jinfu Wang, Charlie Xiang
Mesenchymal stem cells (MSCs) may have potential applications in regenerative medicine for the treatment of chronic liver diseases (CLDs). Human menstrual blood is a novel source of MSCs, termed menstrual blood-derived stem cells (MenSCs). Compared with bone marrow MSCs, MenSCs exhibit a higher proliferation rate and they can be obtained through a simple, safe, painless procedure without ethical concerns. Although the therapeutic efficacy of MenSCs has been explored in some diseases, their effects on liver fibrosis are still unclear...
January 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28157165/stem-cell-therapies-in-retinal-disorders
#11
REVIEW
Aakriti Garg, Jin Yang, Winston Lee, Stephen H Tsang
Stem cell therapy has long been considered a promising mode of treatment for retinal conditions. While human embryonic stem cells (ESCs) have provided the precedent for regenerative medicine, the development of induced pluripotent stem cells (iPSCs) revolutionized this field. iPSCs allow for the development of many types of retinal cells, including those of the retinal pigment epithelium, photoreceptors, and ganglion cells, and can model polygenic diseases such as age-related macular degeneration. Cellular programming and reprogramming technology is especially useful in retinal diseases, as it allows for the study of living cells that have genetic variants that are specific to patients' diseases...
February 2, 2017: Cells
https://www.readbyqxmd.com/read/28151810/are-geographic-differences-in-transplantation-inherently-wrong
#12
Keren Ladin, Douglas W Hanto
PURPOSE OF REVIEW: Geographic variation in liver transplantation has been the subject of extensive scrutiny, reflecting concerns that location is unfairly determinative for people needing organ transplantation. Drawing upon a number of established ethical approaches, we examine whether geographic differences in access to livers are inherently unethical. RECENT FINDINGS: We posit that the ethical imperative for redistribution largely hinges upon the belief that access to organs systematically disadvantages certain identifiable groups of patients over others...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28147426/-spontaneous-bacterial-peritonitis
#13
Ľubomír Skladaný, Silvia Kasová, Anna Purgelová, Natália Bystrianska, Svetlana Adamcová-Selčanová
AIM OF STUDY: Spontaneous bacterial peritonitis (SBP) is the most frequent infectious complication of liver cirrhosis with serious consequences. Initially, SBP is always treated with empirical, not targeted, antibiotic therapy. Since a retrospective study performed in our department showed suboptimal effectiveness (only 40 %) of empirical antibiotic therapy in accordance with the EASL guidelines, a decision was made to change the protocol. The aims of this prospective study were to determine: (1) the incidence and characteristics of SBP in real clinical practice - in a liver unit of a tertiary hospital, (2) the effectiveness of new antibiotic therapy selected based on analysis of the spectrum of pathogens and their resistance to antibiotics as identified in a retrospective cohort study on SBP carried out in our department, (3) mortality, and to compare these findings with the literature data...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28130926/penile-transplantation-an-emerging-option-for-genitourinary-reconstruction
#14
Sami H Tuffaha, Damon S Cooney, Nikolai A Sopko, Trinity J Bivalacqua, Denver M Lough, Carisa M Cooney, Gerald Brandacher, W P Andrew Lee, Arthur L Burnett, Richard J Redett
Penile transplantation is an emerging option for patients with severe genital defects not amenable to traditional reconstructive options. In this article, we discuss the burgeoning problem of severe male genitourinary trauma in the military, the limitations of traditional reconstructive options in addressing these problems, and the potential for penile transplantation to provide improved outcomes. We also review the preclinical research and limited worldwide experience with penile transplantation to date, including lessons learned, and discuss the many important technical, logistical and ethical considerations pertaining to penile transplantation that must be addressed to maximize the likelihood of successful implementation...
January 28, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28130190/the-immunologic-considerations-in-head-transplantation
#15
REVIEW
Mark A Hardy, Allen Furr, Juan P Barret, John H Barker
The idea of head transplantation appears at first as unrealistic, unethical, and futile. Here we discuss immunological considerations in head transplantation. In a separate accompanying article we discuss surgical, physiologic, anatomic, and ethical issues concerned in body-to-head transplantation (BHT) [1]. The success of such an unusual allograft, where the donor and the recipient can reject each other, depends on prevention of complex immunologic reactions, especially rejection of the head by the body (graft-vs-host) or probably less likely, the possibility of the head rejecting the total body allograft (host-vs-graft)...
January 24, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28115333/clinical-efficacy-of-%C3%AE-lactam-%C3%AE-lactamase-inhibitor-combinations-for-the-treatment-of-bloodstream-infection-due-to-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-haematological-patients-with-neutropaenia-a-study-protocol-for-a-retrospective-observational
#16
C Gudiol, C Royo-Cebrecos, C Tebe, E Abdala, M Akova, R Álvarez, G Maestro-de la Calle, A Cano, C Cervera, W T Clemente, P Martín-Dávila, A Freifeld, L Gómez, T Gottlieb, M Gurguí, F Herrera, A Manzur, G Maschmeyer, Y Meije, M Montejo, M Peghin, J Rodríguez-Baño, I Ruiz-Camps, T C Sukiennik, J Carratalà
INTRODUCTION: Bloodstream infection (BSI) due to extended-spectrum β-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although β-lactam/β-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated...
January 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28115329/protocol-of-a-randomised-controlled-open-label-trial-of-ex-vivo-normothermic-perfusion-versus-static-cold-storage-in-donation-after-circulatory-death-renal-transplantation
#17
Sarah A Hosgood, Kourosh Saeb-Parsy, Colin Wilson, Christopher Callaghan, Dave Collett, Michael L Nicholson
INTRODUCTION: Ex vivo normothermic perfusion (EVNP) is a novel technique that reconditions the kidney and restores renal function prior to transplantation. Phase I data from a series of EVNP in extended criteria donor kidneys have established the safety and feasibility of the technique in clinical practice. METHODS AND ANALYSIS: This is a UK-based phase II multicentre randomised controlled trial to assess the efficacy of EVNP compared with the conventional static cold storage technique in donation after circulatory death (DCD) kidney transplantation...
January 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28111066/enabling-donation-after-cardiac-death-in-the-emergency-department-overcoming-clinical-legal-and-ethical-concerns
#18
Michael Dailey, Sean P Geary, Stefan Merrill, Marleen Eijkholt
BACKGROUND: In light of the growing gap between candidates for organ donation and the actual number of organs available, we present a unique case of organ donation after cardiac death. We hope to open a discussion regarding organ procurement from eligible donors in the prehospital and emergency department setting. CASE: This case study, involving an otherwise healthy man who, after suffering an untimely death, was able to successfully donate his organs, highlights the need to develop an infrastructure to make this type of donation a viable and streamlined option for the future...
January 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28110028/surgical-ethical-and-psychosocial-considerations-in-human-head-transplantation
#19
REVIEW
Allen Furr, Mark A Hardy, Juan P Barret, John H Barker
Transplanting a head and brain is perhaps the final frontier of organ transplantation. The goal of body-to-head transplantation (BHT) is to sustain the life of individuals who suffer from terminal disease, but whose head and brain are healthy. Ideally BHT could provide a lifesaving treatment for several conditions where none currently exists. BHT is no ordinary experiment, to transfer a head to another body involves extraordinarily complex medical challenges as well as ethical and existential dilemmas that were previously confined to the imagination of writers of fiction...
January 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28109580/cardiac-transplantation-in-friedreich-ataxia-extended-follow-up
#20
Ashley McCormick, Julianna Shinnick, Kim Schadt, Rose Rodriguez, Linda Addonizio, Michio Hirano, Susan Perlman, Kimberly Y Lin, David R Lynch
Friedreich Ataxia (FRDA) is an autosomal recessive neurodegenerative disorder most commonly caused by guanine-adenine-adenine (GAA) trinucleotide repeat expansions in both alleles of the FXN gene. Although progressive ataxia remains the hallmark clinical feature, patients with FRDA are at high risk of developing cardiomyopathy, often resulting in premature death. There is no specific treatment for FRDA-associated cardiomyopathy; even in advanced cardiac failure cardiac transplantation is not commonly pursued...
January 10, 2017: Journal of the Neurological Sciences
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