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The issue of living organ donation is important because it represents one important set of possibilities for balancing the needs of people seeking organs with one another, and with the needs of potential organ donors. On one side of the balance, the drive to increase the supply of transplantable organs is fueled by people awaiting organ transplants. They are, in a sense, competing with one another on waiting lists for potentially life-saving scarce resources. On the other side of the balance, the drive to ensure that the transplant system is ethical and equitable precludes some mechanisms that would increase the supply of transplantable organs. Some options that have been rejected to date in the United States include paying healthy persons to donate their organs, and mandating that transplantable organs be harvested from all cadavers. To maintain the most ideal balance for the organ transplantation system, Congress may now wish to clarify whether certain new types of living organ donation should be adopted to increase the supply of transplantable organs, or prohibited for ethical and/or equitable reasons.
Liver Transplantation: Clinical Assessment and Management is the perfect tool for all gastroenterologists, hepatologists and transplant surgeons managing patients with liver disease awaiting and undergoing transplantation. Led by James Neuberger, world experts in hepatology and transplantation provide a chronological, step-by-step approach to best clinical management and patient care. Evidence-based throughout and with reference to the very latest practice guidelines from major societies such as EASL and AASLD, the book covers: * When to refer a patient for liver transplantation * Selection, assessment and management on the list * Transplantation for acute liver failure * Donation and allocation * Care of the liver transplant recipient 80 high definition videos of transplant surgery allow you to watch the experts in action and provide an outstanding visual and teaching element. In addition, key points, potential pitfalls, management algorithms, and useful weblinks all help ensure rapid reference browsing. If you're managing patients requiring a liver transplant, this multimedia resource will save you time and effort by putting essential information within easy reach.
In recent years, transplantation immunology has evolved as a distinct field founded on the recognition that rejection of a transplanted organ or tissue is mediated by immune mechanisms in the host responding to antigens in the donor tissue. Included within the scope are T cell immunity; Antigen presentation; Alloreactivity; Pancreas and islet cell transplantation; Allogeneic bone marrow transplantation Models of tolerance induction; Xenotransplantation and The swine leukocyte antigen (SLA) complex. This book gathers the latest research in the exciting new field of transplantation immunology.
Practical Hematopoietic Stem Cell Transplantation is the only
comprehensive yet practical guide to the total care of the
transplant patient. It provides a ready source of reference to help
health care professionals involved in the management of patients
requiring bone marrow and stem cell transplantations - covering
many of the infections and complications that may arise.
Blood and Marrow Transplantation (BMT) has evolved over the past 20 years into a successful therapy for a variety of malignant and non-malignant diseases. BMT allows for safer use of very high doses of radiotherapy and/or combination chemotherapy and can also allow for immunomodulation. The bone marrow -- the sponge-like tissue found in the centre of certain bones-contains stem cells that are the precursors of white blood cells, red blood cells, and platelets. These blood cells are vital for normal body functions, such as oxygen transport, defence against infection and disease, and clotting. Blood cells have a limited lifespan and are constantly being replaced; therefore, healthy stem cells are vital. In association with certain diseases, stem cells may produce too many, too few, or otherwise abnormal blood cells. Also, medical treatments may destroy stem cells or alter blood cell production. The resultant blood cell abnormalities can be life threatening. Bone marrow transplantation involves extracting bone marrow containing normal stem cells from a healthy donor, and transferring it to a recipient whose body cannot manufacture proper quantities of normal blood cells. The goal of the transplant is to rebuild the recipient's blood cells and immune system and hopefully cure the underlying ailment. This book presents the latest research in this rapidly-growing field.
Kidney transplantation has revolutionised the treatment of end-stage renal failure. Not only does it offer the best hope for complete rehabilitation, but it has also proved to be the most cost-effective of all treatment options, including dialysis. The surgical techniques involved have been mastered for half a century and are now considered routine. Nevertheless, this should not prevent us from appreciating the range and complexity of the issues surrounding kidney transplantation. This book examines the latest research in this field including rejection.
The problems a transplant patient faces do not stop once the surgery is over; in addition to problems with the transplant itself, the host body reacts in a number of different ways to the arrival of a new organ and the immuno suppression required to sustain it. This pioneering text from an internationally known expert on the kidney details the problems that a patient faces with a kidney transplant and looks at how the physician can treat these; it will be an essential resource for all those involved in the initial and continuing treatment of kidney transplant patients.
This book offers a theoretical and practical overview of the specific ethical and legal issues in pediatric organ transplantation. Written by a team of leading experts, Ethical Issues in Pediatric Organ Transplantation addresses those difficult ethical questions concerning clinical, organizational, legal and policy issues including donor, recipient and allocation issues. Challenging topics, including children as donors, donation after cardiac death, misattributed paternity, familial conflicts of interest, developmental disability as a listing criteria, small bowel transplant, and considerations in navigating the media are discussed. It serves as a fundamental handbook and resource for pediatricians, transplant health care professionals, trainees, graduate students, scholars, practitioners of bioethics and health policy makers.
This book is the first to provide balanced examination of both pediatric liver disease and liver transplantation - two topics that are inherently related, given that most chronic liver disorders eventually require organ replacement. The different forms of liver disease encountered in the pediatric age group are first discussed in a series of disease-specific chapters that have a reader-friendly, uniform structure covering pathophysiology, diagnostic and treatment algorithms, clinical cases, and transition to adult care. Key topics in the field of liver transplantation are then addressed. Examples include indications and contraindications, surgical techniques and complications, immunosuppression, in pediatric liver transplantation, acute and chronic rejection and allograft dysfunction, and CMV and EBV infection in transplant recipients, long-term graft injury and tolerance. A section on pediatric hepatology across the world includes chapters presenting the features and management of pediatric liver disease in South-America, Africa and Asia. A closing section considers what the future holds for pediatric liver disease and its management, including novel genetic testing, cell therapy and gene therapy. Pediatric Hepatology and Liver Transplantation will be of value for a range of practitioners, from residents making their first approach to pediatric liver disease through to specialists working in transplantation centers.
This book analyzes the reasons for organ shortage and ventures innovative ideas for approaching this problem. It presents 29 contributions from a highly interdisciplinary group of world experts and upcoming professionals in the field. Every year thousands of patients die while waiting for organ transplantation. Health authorities, medical professionals and bioethicists worldwide point to the urgent and yet unsolved problem of organ shortage, which will be even intensified due to the increasing life expectancy. Even though the practical problem seems to be well known, the search for suitable solutions continues and often restricts itself by being limited through disciplinary and national borders. Combining philosophical reflection with empirical results, this volume enables a unique insight in the ethics of organ transplantation and offers fresh ideas for policymakers, health care professionals, academics and the general public.
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A comprehensive text from the leading transplant centres on the medical management of thoracic organ transplantation, covering the assessment of patients for possible transplantation, through to managing patients after transplantation including any possible complications and shared care aspects of long term management
Written by internationally acclaimed specialists, Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides pertinent and concise procedure descriptions spanning benign and malignant problems and minimally invasive procedures. Complications are reviewed when appropriate for the organ system and problem, creating a book that is both comprehensive and accessible. Stages of operative approaches with relevant technical considerations are outlined in an easily understandable manner. Forming part of the series, Surgery: Complications, Risks and Consequences, this volume Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides a valuable resource for all general surgeons and residents in training. Other healthcare providers will also find this a useful resource.
The skin is the largest human organ system. Loss of skin integrity due to injury or illness results in a substantial physiologic imbalance and ultimately in severe disability or death. The most common cause of significant skin loss is thermal injury, followed by trauma and chronic ulcerations.
Over the past decades extraordinary advances have been made in the understanding of cellular and molecular processes of wound healing and the pathobiology of chronic wounds. This knowledge has led to wound care innovations that facilitate more rapid closure of wounds with better functional and aesthetic outcome. A sensible and resource-saving utilization of these innovative technologies requires a broad knowledge of these processes and innovations.
This book intends to give an overview about today's wound care developments in tissue engineering and skin replacement. It presents a variety of indications and diversities of clinical applications to help the surgeon select a specific procedure for each clinical situation.
An up-to-date overview of blood and marrow transplantations, the book discusses in detail Indication to transplantation and pre-transplant considerations. An outlook on the latest developments and their future aspects is included, while problems and pre- and post-transplant complications are fully explored.
Th is book takes an integrated, evidence-based approach the psychiatricaspects of organ transplantation. Unlike any other text currently on the market, this title presents the core principles of transplant psychiatry through an organ-based structure that includes the heart, lungs, liver, GI organs, kidney, composite tissue, and other key areas of transplantation. Each section is divided into chapters discussing psychosocial, medical, and surgical considerations prior to and post-transplant, such as indications leading to a particular type of transplantation, medical course and complications aft er transplantation, psychiatric and psychosocial considerations before and aft er transplantation, history of each type of organ transplant, and any other special considerations. Th e text ends with special topics in care, including psychopharmacology, substance abuse, psychosocial evaluation of recipients and donors, ethical considerations, cross-cultural aspects, and building the transplant psychiatry practice. It includes excellent learning tools, including over 140 tables and figures for ease of use. Written by interdisciplinary experts, Psychosocial Care of End-Stage Disease and Transplant Patients is a valuable resource for students and medical professionals interested in psychiatry, psychology, psychosomatic medicine, transplant surgery, internists, hospital administrators, pharmacists, nurses, and social workers.
This book describes advances in implantable neural stimulation technology to restore partial sight to people who are blind from retinal degnerative diseases such as age-related macular degeneration and retintis pigmentosa. Many scientific, engineering, and surgical challenges must be surmounted before widespread practical applications can be realized. The book summarizes the state of research and clinical practice in the field and reviews the current ideas and approaches of its leading researchers and practitioners.
Heart transplantation remains one of the major scientific achievements of twentieth century medicine. During the past four decades, it has evolved from an unproven experimental surgical technique to the most effective form of therapy for refractory end-stage heart disease. It has captured the public's imagination and expanded our understanding of fundamental immunologic mechanisms that are responsible for cellular and humorally-mediated immunity. Despite its successes, many clinical and scientific problems remain. One or more bouts of acute cellular or humoral (vascular) rejection will occur in over 75% of transplant recipients despite current immunosuppressive strategies. Further, rejection directly results in approximately 20% of post-transplant deaths and is believed to play a major role in the development of late allograft dysfunction and coronary vasculopathy. This book by international experts in the fields of transplantation medicine, immunobiology and cardiac imaging provides the reader with an up-to-date, consise summary of the latest developments in the diagnosis and treatment of acute cardiac rejection. It is axiomatic that a more complete understanding of the pathogenic processes involved in rejection will ultimately lead to its prevention. This volume will be useful to transplant cardiologists, cardiovascular surgeons, cardiac pathologists and transplant scientists who seek to prolong the lifespan and improve the quality of life of their transplant recipients.
The title of this profound work conveys the bold, uncertain, and often dangerous adventure in which medical professionals and their organ transplant and dialysis patients are engaged. Built around a series of case studies developed through years of first-hand ethnographic research, The Courage to Fail is the product of collaborative first-hand research concerned with various social phenomena generated by transplantation and dialysis and also by the development and deployment of an artificial heart. The authors examine the individuals involved and the workings and atmosphere of some of the medical centers in which these forms of therapy have been developed. They examine "gift-exchange" dimensions of transplantation: the transcendent and tyrannical aspects of the "gift of life" that transplants entail for donors and recipients -- and for medical professionals as well. They also analyze the dilemma of uncertainty inherent in medicine, which occurs with particular force in the development of such experimental techniques.
Since publication of the original edition, the authors have continued to follow social and medical developments surrounding organ transplants and dialysis. In their new introduction, they discuss transplantation as a gift of life, how death is defined and when it occurs, efforts to procure more organs, and organ allocation and issues of equity. This book will be of interest to physicians, medical students, medical sociologists, and anyone interested in the history of and issues surrounding organ replacement.
This book supports the emerging field of vascularized composite allotransplantation (VCA) for face and upper-limb transplants by providing a revised, ethically appropriate consent model which takes into account what is actually required of facial and upper extremity transplant recipients. In place of consent as permission-giving, waiver, or autonomous authorization (the standard approaches), this book imagines consent as an ongoing mutual commitment, i.e. as covenant consent. The covenant consent model highlights the need for a durable personal relationship between the patient/subject and the care provider/researcher. Such a relationship is crucial given the recovery period of 5 years or more for VCA recipients. The case for covenant consent is made by first examining the field of vascularized composite allotransplantation, the history and present understandings of consent in health care, and the history and use of the covenant concept from its origins through its applications to health care ethics today. This book explains how standard approaches to consent are inadequate in light of the particular features of facial and upper limb transplantation. In contrast, use of the covenant concept creates a consent model that is more appropriate ethically for these very complex surgeries and long-term recoveries.
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