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Transplantation ethics

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https://www.readbyqxmd.com/read/28932650/gene-editing-gene-therapy-and-cell-xenotransplantation-cell-transplantation-across-species
#1
REVIEW
Nizar I Mourad, Pierre Gianello
PURPOSE OF REVIEW: Cell xenotransplantation has the potential to provide a safe, ethically acceptable, unlimited source for cell replacement therapies. This review focuses on genetic modification strategies aimed to overcome remaining hurdles standing in the way of clinical porcine islet transplantation and to develop neural cell xenotransplantation. RECENT FINDINGS: In addition to previously described genetic modifications aimed to mitigate hyperacute rejection, instant blood-mediated inflammatory reaction, and cell-mediated rejection, new data showing the possibility of increasing porcine islet insulin secretion by transgenesis is an interesting addition to the array of genetically modified pigs available for xenotransplantation...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28932574/lung-allocation
#2
REVIEW
Jens Gottlieb
Shortage of donor lungs in most western countries and broadening of indications for lung transplantation (LTx) has led increased waiting list mortality in the past. Usually donor lungs and recipients are matched by size as measured by total lung capacity and blood type in first order. In some countries regional allocation comes first, in other countries a national wait list exists and some nations are organized in supranational allocation systems. Organ distribution should respect the ethical principles of equity, justice, beneficence and utility...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28930707/re-evaluating-the-ethics-of-uterine-transplantation
#3
Danish Zaidi
In February 2016, the Cleveland Clinic initiated the first attempt at cadaveric uterine transplantation (UTx) in the United States. The transplantation was ultimately unsuccessful, but it opened doors for further research on both live and cadaveric UTx. While initial strides toward successful transplantation have been made, questions persist on the ethics of UTx: whether the uterus is a vital organ, whether we should prioritize live or cadaveric options, and how the procedure should be covered by health insurance...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28928775/assessment-of-safety-and-functional-efficacy-of-stem-cell-based-therapeutic-approaches-using-retinal-degenerative-animal-models
#4
REVIEW
Tai-Chi Lin, Magdalene J Seiler, Danhong Zhu, Paulo Falabella, David R Hinton, Dennis O Clegg, Mark S Humayun, Biju B Thomas
Dysfunction and death of retinal pigment epithelium (RPE) and or photoreceptors can lead to irreversible vision loss. The eye represents an ideal microenvironment for stem cell-based therapy. It is considered an "immune privileged" site, and the number of cells needed for therapy is relatively low for the area of focused vision (macula). Further, surgical placement of stem cell-derived grafts (RPE, retinal progenitors, and photoreceptor precursors) into the vitreous cavity or subretinal space has been well established...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28927307/biological-therapy-for-non-obstructive-azoospermia
#5
Sarah C Vij, Edmund Sabanegh, Ashok Agarwal
Most male patients with non-obstructive azoospermia (NOA) have no therapeutic options outside of assisted reproductive techniques to conceive a biological child. If mature sperm cannot be obtained from the testes, these patients must rely on options of donor sperm or adoption. Several techniques are in the experimental stage to provide this patient population alternatives for conceiving. Areas covered: This review discusses three of the experimental techniques for restoring fertility in men with NOA: spermatogonial stem cell transplantation, the use of adult and embryonic stem cells to develop mature gametes and gene therapy...
September 19, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28923074/expression-of-concern-to-therapeutic-potential-of-human-embryonic-stem-cell-transplantation-in-patients-with-cerebral-palsy
#6
Geeta Shroff, Anupama Gupta, Jitender Kumar Barthakur
The Editor-in-Chief of the Journal of Translational Medicine is issuing an editorial expression of concern to alert readers that concerns have been raised regarding the ethics of this study [1] and the potential association of the risk of teratoma formation with the transplantation of embryonic stem cells. Appropriate editorial action will be taken once this has been fully investigated. The authors disagree with this notice.
September 18, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28922905/kidney-vouchers-and-inequity-in-transplantation
#7
Samuel J Kerstein
This article probes the voucher program from an ethical perspective. It focuses mainly on an issue of inequity. A disparity exists in US kidney transplantation. Although African-Americans suffer far higher rates of ESRD than whites, African-Americans are much less likely than whites to get a transplant (Ilori et al., 2015, 1). The article explores the voucher program in light of this disparity. It motivates the view that, at least in the short term, more whites than African-Americans are likely to take advantage of the voucher program...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922903/banking-on-living-kidney-donors-a-new-way-to-facilitate-donation-without-compromising-on-ethical-values
#8
Dominique E Martin, Gabriel M Danovitch
Public surveys conducted in many countries report widespread willingness of individuals to donate a kidney while alive to a family member or close friend, yet thousands suffer and many die each year while waiting for a kidney transplant. Advocates of financial incentive programs or "regulated markets" in kidneys present the problem of the kidney shortage as one of insufficient public motivation to donate, arguing that incentives will increase the number of donors. Others believe the solutions lie-at least in part-in facilitating so-called "altruistic donation;" harnessing the willingness of relatives and friends to donate by addressing the many barriers which serve as disincentives to living donation...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28921476/expression-of-concern-to-role-of-physiotherapy-in-the-mobilization-of-patients-with-spinal-cord-injury-undergoing-human-embryonic-stem-cells-transplantation
#9
Geeta Shroff, Dipin Thakur, Varun Dhingra, Deepak Singh Baroli, Deepanshu Khatri, Rahul Dev Gautam
The Editors-in-Chief of Clinical and Translational Medicine are issuing an editorial expression of concern to alert readers that concerns have been raised regarding the ethics of this study [1]. Appropriate editorial action will be taken once this has been fully investigated. Geeta Shroff disagrees with this notice. Dipin Thakur, Varun Dhingra, Deepak Singh Baroli, Deepanshu Khatri and Rahul Dev Gautam have not responded to our correspondence about this article.
September 18, 2017: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/28890445/challenging-the-conventional-wisdom-i-from-philosophy-to-bioethics-i
#10
Franklin G Miller
Philosophy is a core discipline that has contributed importantly to bioethics. In this essay, the author traces his trajectory from philosophy to bioethics, oriented around the theme of challenging the conventional wisdom. Three topics are discussed to illustrate this theme: the ethics of randomized trials, determination of death and organ transplantation, and pragmatism as a method of bioethics. In addition, the author offers some general reflections on the relationship between philosophy and bioethics. Philosophy recovers itself when it ceases to be a device for dealing with the problems of philosophers and becomes a method, cultivated by philosophers, for dealing with the problems of men...
2017: Perspectives in Biology and Medicine
https://www.readbyqxmd.com/read/28884418/altruism-and-religion-a-new-paradigm-for-organ-donation
#11
Aviad Rabinowich, Alan Jotkowitz
Activity of NGO's supporting living donor kidney donations can affect the shortage of kidneys. Matnat Chaim is a Jewish orthodox organization active in Israel since 2009. This is a voluntary organization with aims to shorten and eliminate the waiting list for kidneys. Since the beginning of its activity, it has said to play a key role in 379 kidney transplantations. In 2015, out of 174 live donor kidney transplantations that took place in Israel, Matnat Chaim had a key role in 88 of them (50.6%). We found some ethical issues concerning the organization's activity...
September 7, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28878671/a-pilot-study-evaluating-the-safety-of-intravenously-administered-human-amnion-epithelial-cells-for-the-treatment-of-hepatic-fibrosis
#12
Rebecca Lim, Alexander Hodge, Gregory Moore, Euan M Wallace, William Sievert
Liver cirrhosis is the 6th leading cause of death in adults aged 15-59 years in high-income countries. For many who progress to cirrhosis, the only prospect for survival is liver transplantation. While there is some indication that mesenchymal stem cells may be useful in reversing established liver fibrosis, there are limitations to their widespread use - namely their rarity, the need for extensive serial passaging and the associated potential for genomic instability and cellular senescence. To this end, we propose the use of allogeneic amnion epithelial cells...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28873231/medical-innovation-in-a-children-s-hospital-diseases-desperate-grown-by-desperate-appliance-are-relieved-or-not-at-all
#13
Vic Larcher, Helen Turnham, Joe Brierley
A balance needs to be struck between facilitating compassionate access to innovative treatments for those in desperate need, and the duty to protect such vulnerable individuals from the harms of untested/unlicensed treatments. We introduced a principle-based framework (2009) to evaluate such requests and describe its application in the context of recently evolved UK, US and European regulatory processes. 24 referrals (20 individual; four group) were received by our quaternary children's hospital Clinical Ethics Committee (CEC) over the 5-year period (2011-16)...
September 5, 2017: Bioethics
https://www.readbyqxmd.com/read/28872452/retraction
#14
(no author information available yet)
Since the following case report was found not to meet the ethical standards of Juntendo University, as previously stated by the authors, the article has been retracted from Regenerative Medicine: Kantake M, Hirano A, Sano M, Urushihata N, Tanemura H, Oki K, Suzaki E. Transplantation of allogeneic adipose-derived mesenchymal stem cells in a cerebral palsy patient. Regenerative Medicine doi:10.2217/rme-2017-0043 (2017) (Epub ahead of print). The authors and editors of Regenerative Medicine regret any negative consequences this publication might have caused in the scientific and medical communities...
September 5, 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/28872416/retraction
#15
(no author information available yet)
Since the following case report was found not to meet the ethical standards of Juntendo University, as previously stated by the authors, the article has been retracted from Regenerative Medicine: Kantake M, Hirano A, Sano M, Urushihata N, Tanemura H, Oki K, Suzaki E. Transplantation of allogeneic adipose-derived mesenchymal stem cells in a cerebral palsy patient. Regenerative Medicine doi:10.2217/rme-2017-0043 (2017) (Epub ahead of print). The authors and editors of Regenerative Medicine regret any negative consequences this publication might have caused in the scientific and medical communities...
July 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/28870775/ethical-challenges-in-hematopoietic-cell-transplantation-for-sickle-cell-disease-a-review
#16
REVIEW
Robert Sheppard Nickel, Naynesh R Kamani
Hematopoietic cell transplantation (HCT) using an HLA-identical sibling donor offers a very high likelihood of cure with good outcomes for patients with sickle cell disease (SCD), and alternative donor HCT for SCD is an area of active clinical research. HCT is thus potentially an option for a growing number of patients with SCD, but this expanded use of HCT has raised several ethical questions. Specifically, who is eligible for HCT, both in terms of disease severity and psychosocial factors? Should affected children with matched sibling donors be transplanted only when they have declared themselves as having significant symptomatology? In regards to donors, special ethical challenges include the use of pre-implantation genetic diagnosis to conceive an HLA-identical sibling...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864134/rationale-and-design-of-a-prospective-study-to-assess-the-effect-of-left-cardiac-sympathetic-denervation-in-chronic-heart-failure
#17
Ashley Chin, Mpiko Ntsekhe, Charle Viljoen, Johan Rossouw, Tim Pennel, Peter J Schwartz
BACKGROUND: The main causes of mortality in patients with chronic heart failure include sudden cardiac death (SCD) and progressive heart failure. Autonomic dysfunction plays a detrimental role in the progression of chronic heart failure. Left cardiac sympathetic denervation (LCSD) is an inexpensive and safe procedure which modifies autonomic innervation of the heart and is associated with a significant antifibrillatory effect. Whether LCSD reduces the risk of SCD, delays progression of heart failure and improves quality of life in patients with heart failure with reduced ejection fraction (HFrEF) is not known...
August 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28857844/the-ethical-challenges-of-uterus-transplantation
#18
Giuliano Testa, Liza Johannesson
PURPOSE OF REVIEW: As the techniques of uterus transplantation have evolved, culminating in a birth in 2014, the ethical debate has been enriched by several considerations. Uterus transplantation raises issues because of its unique features of being temporary, nonlifesaving, experimental, and expensive, with established alternatives. RECENT FINDINGS: Uterus transplantation entails risks for the recipient related to multiple surgeries and immunosuppression, yet studies have shown that women see infertility as a distressing element in their lives, justifying the risks...
August 28, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28845920/ethical-issues-in-pediatric-face-transplantation
#19
Ana-Gabriela Benghiac, Jeremy R Garrett, Brian S Carter
Facial transplantation has become a reality in adult medicine. Children are subject to congenital craniofacial differences, disease-related, traumatic, or thermochemical craniofacial changes and might be suitable for face transplantation. This manuscript addresses unique ethical issues in considering potential pediatric face transplant. These challenges are operant at the individual, technologic, and psychosocial level for clinicians, investigators, and society.
August 28, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28838898/protocol-for-a-pilot-randomised-controlled-trial-of-metformin-in-pre-diabetes-after-kidney-transplantation-the-transplantation-and-diabetes-transdiab-study
#20
Basil Alnasrallah, Helen Pilmore, Paul Manley
INTRODUCTION: Post-transplant diabetes mellitus (PTDM) is a common complication of kidney transplantation and is associated with significant morbidity and mortality. In the general population, metformin has been used for diabetes prevention in high-risk individuals. Improving insulin sensitivity is one of many proven favourable effects of metformin. Despite the high incidence of PTDM in kidney transplant recipients, there is a lack of evidence for the role of metformin in the prevention of diabetes in this setting...
August 23, 2017: BMJ Open
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