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Transplantation ethics

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https://www.readbyqxmd.com/read/28545651/the-dichotomy-of-placenta-derived-cells-in-cancer-growth
#1
Antonietta R Silini, Sara Cancelli, Patrizia Bonassi Signoroni, Anna Cargnoni, Marta Magatti, Ornella Parolini
Placenta-derived mesenchymal stromal cells (MSC) have often been considered to linger behind their equivalents from other tissues, such as MSC from bone marrow, in many aspects including their therapeutic potential in regenerative medicine. Nowadays however, it is clear that certain aspects make placental MSC attractive as a cellular therapy, such as their lack of ethical concerns and ease of isolation from human term placenta, a material long regarded as biological waste. Moreover, placental MSC virtually lack expression of human leukocyte antigens and co-stimulatory molecules, making them very attractive for transplantation in allogeneic settings...
May 18, 2017: Placenta
https://www.readbyqxmd.com/read/28540229/ushering-in-the-era-of-penile-transplantation
#2
REVIEW
Alison M Rasper, Ryan P Terlecki
Penile transplantation is a novel approach to management of penile loss in the developing field of composite tissue allotransplantation (CTA). Prior management for significant penile loss has been free flap phalloplasty with issues related to function, cosmesis, and functional loss from the location of flap harvest. Transplantation has been an evolving field with advancement in CTA over the past several decades leading to the option of penile transplant. Management of penile injury with replantation provided some preliminary groundwork on the technical aspects for penile transplantation...
April 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28527046/on-harm-thresholds-and-living-organ-donation-must-the-living-donor-benefit-on-balance-from-his-donation
#3
Nicola Jane Williams
For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: (1) The living donor provides valid consent to donation. (2) Living donation produces an overall positive balance of harm-benefit for donors and recipients which cannot be obtained in a less harmful manner...
May 19, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28508541/opt-in-or-opt-out-to-increase-organ-donation-in-south-africa-appraising-proposed-strategies-using-an-empirical-ethics-analysis
#4
Harriet Etheredge, Claire Penn, Jennifer Watermeyer
Utilising empirical ethics analysis, we evaluate the merits of systems proposed to increase deceased organ donation in South Africa (SA). We conclude that SA should maintain its soft opt-in policy, and enhance it with 'required transplant referral' in order to maximise donor numbers within an ethically and legally acceptable framework. In SA, as is the case worldwide, the demand for donor organs far exceeds the supply thereof. Currently utilising a soft opt-in system, SA faces the challenge of how to increase donor numbers in a context which is imbued with inequalities in access to healthcare, multiplicitous personal beliefs and practices, distrust of organ transplant and varying levels of education and health literacy...
May 16, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28474177/evaluation-of-biliary-ductal-anatomy-in-potential-living-liver-donors-comparison-between-mrcp-and-gd-eob-dtpa-enhanced-mri
#5
D Santosh, A Goel, I W Birchall, A Kumar, K H Lee, V H Patel, G Low
PURPOSE: To compare magnetic resonance cholangiopancreatography (MRCP) and Gd-EOB-DTPA-enhanced MRI in the evaluation of the biliary anatomy in potential living liver donors (LLDs). METHODS: A retrospective study was conducted in a tertiary care liver transplant center after obtaining ethics and institutional approvals. A total of 42 potential LLD MRI examinations were performed between November 2013 and March 2016. All patients underwent a standard MRI protocol which included MRCP and Gd-EOB-DTPA-enhanced MRI sequences in a single session...
May 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28473952/liver-allocation-policies-for-patients-affected-by-hcc-in-europe
#6
Luciano De Carlis, Stefano Di Sandro, Leonardo Centonze, Andrea Lauterio, Vincenzo Buscemi, Riccardo De Carlis, Fabio Ferla, Raffaella Sguinzi, Stefano Okolicsanyi, Luca Belli, Mario Strazzabosco
The main goal of organ allocation systems is to guarantee an equal access to the limited resource of liver grafts for every patients on the waiting list, balancing between the ethical principles of equity, utility, benefit, need, and fairness. The European heath care scenario is very complex, as it is essentially decentralized and each Nation and Regions inside the nation, operate on a significant degree of autonomy. Furthermore the epidemiology of liver diseases and HCC, which is different among European countries, clearly inpacts on indications and priorities...
December 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28470333/extracorporeal-perfusion-of-isolated-organs-of-large-animals-bridging-the-gap-between-in-vitro-and-in-vivo-studies
#7
Carola R Daniel, Raphael Labens, David Argyle, Theresia F Licka
Since the early 20th century extracorporeal perfusion of large animal organs has been used to investigate a broad variety of research questions, thereby overcoming common draw backs of in vitro studies without suffering from ethical concerns associated with live animal research. The technique is in accordance with the 3R principles and represents an excellent opportunity to investigate in detail the physiology of organs under standardised conditions. It is also suitable for the translation of basic pre-clinical research into a more relevant arena prior to or avoiding altogether live animal research...
May 3, 2017: ALTEX
https://www.readbyqxmd.com/read/28469646/neural-grafting-for-parkinson-s-disease-challenges-and-prospects
#8
REVIEW
Thomas B Stoker, Nicholas F Blair, Roger A Barker
Parkinson's disease (PD) is a neurodegenerative condition which causes a characteristic movement disorder secondary to loss of dopaminergic neurons in the substanitia nigra. The motor disorder responds well to dopamine-replacement therapies, though these result in significant adverse effects due to non-physiological release of dopamine in the striatum, and off-target effects. Cell-based regenerative treatments offer a potential means for targeted replacement of dopamine, in a physiological manner. Dopaminergic neurons for cell-based therapies can be obtained from several sources...
March 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28457402/early-vascular-thrombosis-after-kidney-transplantation-can-we-predict-patients-at-risk
#9
R A P de Freitas, M L de Lima, M Mazzali
BACKGROUND: Renal transplant is the therapy of choice for patients with chronic renal disease. In recent years, improvement in immunosuppressive drugs reduced early graft loss associated with acute rejection. However, vascular thrombosis, accounting for 5% of early graft loss, can sensitize the recipient for human leukocyte antibodies, reducing the chance for a second transplant. The aim of this study was to identify risk factors for vascular thrombosis in a single transplant center, to design specific prevention protocol...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457388/brain-death-knowledge-of-future-brazilian-physicians
#10
F H A Dibo, Â A F Gravena, R A de Freitas, C M Dell'Agnolo, E de Almeida Benguella, S M Pelloso, M D de Barros Carvalho
BACKGROUND: Thousands of people die on the waiting list for transplants. The shortage of organs and tissues for transplantation is considered a serious global problem. Brain death (BD) is the main source of organs for transplantations. OBJECTIVE: Given that BD is assessed by medical staff and that this diagnosis is ethically relevant, the goal of this work was to analyze the knowledge of 5th- and 6th-year medical students of Southern Brazil regarding the process of determining BD...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457377/ethical-issues-in-uterine-transplantation-psychological-implications-and-informed-consent
#11
C Petrini, S Gainotti, A Morresi, A Nanni Costa
Since 2000, 13 uterine transplantations (UTxs) have been performed in women with absolute uterine infertility factor (AUIF), from both living and deceased donors, in different transplantation centers worldwide. At present the birth of 4 children following UTx is documented by the literature, and a woman was having a second pregnancy in October 2015. Following these successes it is likely that the procedure will become part of normal healthcare practice, even though at the moment it is still experimental and, as such, requires careful attention...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28434104/mullerian-dysgenesis-a-critical-review-of-the-literature
#12
REVIEW
Souzana Choussein, Dimitrios Nasioudis, Dimitrios Schizas, Konstantinos P Economopoulos
PURPOSE: To present an update of the genetic, clinical, diagnostic, and therapeutic aspects of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. METHODS: Studies were considered eligible if they have evaluated patients with MRKH syndrome. Eligible articles were identified by a search of MEDLINE bibliographical database from 1950 to August 2016. A purely descriptive approach was adopted concerning all outcomes examined by the individual studies. RESULTS: MRKH syndrome is defined as congenital aplasia of the upper vagina and impairment of uterine development in normal 46XX females...
April 22, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28430065/ethical-issues-in-fecal-microbiota-transplantation-in-practice
#13
Yonghui Ma, Jiayu Liu, Catherine Rhodes, Yongzhan Nie, Faming Zhang
Fecal microbiota transplantation (FMT) has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: (1) informed consent and the vulnerability of patients; (2) determining what a "suitable healthy donor" is; (3) safety and risk; (4) commercialization and potential exploitation of vulnerable patients; and (5) public health implications...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28430064/aesthetics-ethics-and-fecal-microbiota-transplantations
#14
Camilla Scanlan, Ian Kerridge
No abstract text is available yet for this article.
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28430054/ethical-issues-in-fecal-microbiota-transplantion-taking-into-account-identity-and-family-relations
#15
Suzanne Metselaar, Guy Widdershoven
No abstract text is available yet for this article.
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28426448/clinical-and-ethical-challenges-in-heart-transplantation-from-donation-after-circulatory-determined-death-donors
#16
Stephen Large, Steven Tsui, Simon Messer
PURPOSE OF REVIEW: The aim of this study was to describe the development of a clinical programme of heart transplantation from nonheart beating (or donation after circulatory determined death, DCD) donors. DCD is an established practice in abdominal and lung transplantation. The opportunity for sufferers of advanced heart failure provided by DCD heart transplantation is described. RECENT FINDINGS: Work shows that the arrested DCD heart is viable and has a 30-min tolerance to anoxia at normal body temperature making transplantation possible...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28424230/a-quiet-revolution-in-organ-transplant-ethics
#17
Arthur Caplan, Duncan Purves
A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life...
April 19, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28386568/mesenchymal-stem-cells-improve-healing-of-diabetic-foot-ulcer
#18
REVIEW
Yue Cao, Xiaokun Gang, Chenglin Sun, Guixia Wang
Mesenchymal stem cells (MSCs), an ideal cell source for regenerative therapy with no ethical issues, play an important role in diabetic foot ulcer (DFU). Growing evidence has demonstrated that MSCs transplantation can accelerate wound closure, ameliorate clinical parameters, and avoid amputation. In this review, we clarify the mechanism of preclinical studies, as well as safety and efficacy of clinical trials in the treatment of DFU. Bone marrow-derived mesenchymal stem cells (BM-MSCs), compared with MSCs derived from other tissues, may be a suitable cell type that can provide easy, effective, and cost-efficient transplantation to treat DFU and protect patients from amputation...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28383624/use-of-corneas-for-transplant-after-self-inflicted-eyeballs-enucleation-in-the-italian-law
#19
G Montanari Vergallo, E Pacella, A Di Luca, N M Di Luca, R Cecchi, E Marinelli
The authors analyze from an ethical and legal point of view the case of a 37 year old man, hospitalized for four days because of a 'dissociative syndrome', who had introduced in both his orbits a portable radio antenna. Most likely, he completed the self-enuclation using his own hands. He was brought to the Ophtalmic Hospital by nurses who handed the two eyeballs to the physicians who ascertained that the corneas were intact. Then, they performed the conservative extraction. In the following days those corneas were transplanted (keratoplasty) on two subjects on the waiting list at that hospital...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28377365/-research-progress-of-skin-derived-precursor-cells
#20
Ruo-Si Chen, Yong Miao, Zhi-Qi Hu
As a novel population of neural crest-origin precursor cells, skin-derived precursor cells (SKPs) can be isolated from both embryonic and adult dermis. These cells have important values for research and potential clinical application in wound healing, organ regeneration and disease treatment for advantages in the abundance of cell sources, accessibility, potential of multipotent differentiation, and absence of ethical concerns. Here we review the developmental and anatomical origins of SKPs and their potential application in regenerative medicine...
March 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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