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In his late 40s, Steve Burcham suddenly experienced inexplicable heart failure. The struggle to survive and finally get a heart transplant changed more than his physical health and well-being. How he managed to keep going through it all makes for an uplifting story of medical miracles and spiritual healing filled with humor, determination, prayer and ultimately unshakeable faith.
Liver-Directed Therapy for Primary and Metastatic Liver Tumors is a comprehensive examination of tumors of the liver. It provides a unique multi-modality approach to management of all types of primary and secondary liver tumors. The biology of liver cancers, state of the art radiologic imaging and novel, non-surgical interventional strategies are given. There is an in depth analysis of surgical options including transplantation, resection, interstitial ablation techniques and liver-directed chemotherapy for hepatocellular carcinoma, bile duct cancers, and colorectal and neuroendocrine liver metastases. Because of the unique and comprehensive examination of liver tumors, this work is an excellent resource for surgical, transplant and medical oncologists, surgeons, gastroenterologists, and radiologists.
Chronic liver failure is a frequent condition in clinical practice that encompasses all manifestations of patients with end-stage liver diseases. Chronic liver failure is a multiorgan syndrome that affects the liver, kidneys, brain, heart, lungs, adrenal glands, and vascular, coagulation, and immune systems. Chronic Liver Failure: Mechanisms and Management covers for the first time all aspects of chronic liver failure in a single book, from pathogenesis to current management. Each chapter is written by a worldwide known expert in their area and all provide the latest state-of-the-art knowledge. This volume is specifically designed to provide answers to clinical questions to all doctors dealing with patients with liver diseases, not only clinical gastroenterologists and hepatologists, but also to internists, nephrologists, intensive care physicians, and transplant surgeons.
Non-myeloablative allogeneic stem cell transplantation (also known as mini-transplantation or reduced-intensity conditioning transplantation) is a major advance in the field of hematopoietic transplantation within the last 5 years. This approach uses non-cytotoxic or reduced-intensity cytotoxic therapy to prepare patients for allografting of hematopoietic stem cells and lymphocytes. It has the potential to deliver the potent anti-tumor immunotherapy and bone marrow replacement capacity of allogeneic stem cell transplantation to patients with reduced treatment-related morbidity and mortality. It may also enable allogeneic transplantation in patients who would be considered ineligible for conventional transplants because of co-morbidity or advanced age. However, this approach may necessitate more careful monitoring of post-transplant chimerism and malignant disease-status than is usual with conventional allografting. There is also controversy regarding the best preparative regimen and graft-versus-host disease prophylaxis to use.
Parkinson's disease, a degenerative brain disorder, affects an estimated 0.25-0.50% of the population. Symptoms result from neuronal degeneration in the nigrostriatal dopaminergic pathway and include tremor, rigidity and gradual slow- ness of spontaneous movement. The cause of Parkinson's disease is only partially understood; both environmental factors and a genetic predisposition have been im- plicated in its etiopathogenesis. Neural transplantation is being used experimentally for providing an alternative biological source of dopamine both in animal studies and in experimental clinical trials. This book is the result of 15 years of research on the transplantation of dopaminergic neurons in the striatum of the weaver mouse, a neurological mutant characterized by genetically-determined degeneration of midbrain dopamine neurons. The weaver mouse constitutes the only available laboratory model with a chronic progressive disease that mimics Parkinsonism. The other two models currently used to investigate dopaminergic mechanisms rely on the use of the neurotoxins- hydroxydopamine and methylphenyltetrahydropyridine for the selective removal of dopaminergic neurons from an otherwise healthy organism. Structural and functional aspects of transplantation of mesencephalic dopamin- ergic grafts into the striatum of weaver mice are reviewed, including histochemical correlates of graft survival and integration, numerical aspects of donor neuron survival, ultrastructural findings on synaptogenesis, neurochemical indices of dopam- ine uptake function and receptor binding, gene expression of several structural and neurotransmitter-receptor related molecules, the levels of striatal amino acid receptors, and the behavioral effects of unilateral and bilateral neuronal transplantations.
General surgery consists ofa main corpus of propaedeutic elements and clinical problems, which has been modified over the years by the separate development of numerous sub-specialistic branches. Although a common basis on the physiopathology of surgical trauma and post- operative complications persists, as a result of general knowledge of surgical diseases, there is no doubt that in the spheres of doctrine and application, both research and clinical medicine have distinguished themselves autonomously in many surgical fields (orthopedics, neurosurgery, cardiovascular surgery, thoracic surgery, urology, etc.). It is therefore difficult to define the present configuration ofgeneral surgery, but without question abdominal surgery occupies a position of pre-eminent importance within the general framework. We are dealing, in fact, with pathological pictures which occur in a section ofthe body ofvast proportions, in which structures, organs, and morphologically complex spaces are arranged to carry out important functions. They are, therefore, subject to considerably complex pathological alterations, such as to establish an interesting field of diagnostic discussion and an exciting training-ground for surgical activity. It can be affirmed that the diagnosis and cures ofabdominal surgical diseases constitute a test ofthe surgeon's experience. Diagnosis is often entrusted to a differential process, the results ofwhich may be confirmed today by complementary diagnostics. This, however, must be guided by predominating clinical considerations, the exaggerated use of diagnostic techniques, detached from clinical examination, being the cause of very serious errors, which can mislead decision making and human contact, which is the basis ofcorrect medical practice.
It has been 15 years since the first report on the isolation of anti-Gal from human serum and the demonstration that this antibody is the most prevalent antibody in humans (Galili et al. , ]. Exp. Med. 160: 1519, 1984). Subsequent interdisciplinary studies in immunology, carbohydrate biochemistry, molecular biology, and evo- lution demonstrated the highly restricted specificity of anti-Gal for the carbohy- drate epitope Gal al-3Galpl-4GIcNAc-R, (termed here the a-gal epitope), the unprecedented evolutionary pattern of distribution of a-gal and anti-Gal in mam- mals, and explained the evolution of this antigen and antibody by analysis of the a 1 ,3galactosyltransferase gene, the gene that encodes the enzyme that synthesizes the a-gal epitope. These studies have suggested that a major selection process that occurred in the course of evolution of ancestral Old World primates resulted in the inactivation of the a1 ,3galactosyltransferase gene and the subsequent appearance of anti-Gal in these primates. Other studies in immunoparasitology have demon- strated the possible physiologic significance of anti-Gal in protection against cer- tain parasitic infections. Major scientific attention was focused on a-gal and anti-Gal with the real- ization in the early nineties that the interaction between this antigen and antibody is the major obstacle to xenotransplantation. The success of immunosuppressive drugs, in the last two decades of the 20th century, in preventing allograft rejection, has raised hopes for cure in many patients in need of organ transplant. Because of limited supply of allografts, only 20% of patients receive the needed organ.
Eine Alternative zu den etablierten Transplantationsmethoden konnte die Xenotransplantation sein, bei der von zu diesem Zweck gezuchteten, moglicherweise auch genetisch veranderten Tieren die benotigten Gewebe gewonnen werden konnten. Die vorliegende Studie ist das Arbeitsergebnis einer interdisziplinar zusammengesetzten Projektgruppe, die den aktuellen Stand der Xenotransplantationsmethodik und -technologie untersuchte und ihre Verwendung fur medizinische Zwecke beurteilte. Ausgehend von einer Analyse der Situation in der Transplantationsmedizin und einer Diskussion der Alternativen zur Allotransplantation werden in der vorliegenden Studie unter medizinischen, immunologischen, physiologischen, genetischen, virologischen, ethischen, rechtlichen und okonomischen Aspekten Anwendungsbedingungen und -moglichkeiten der Xenotransplantation gepruft und Handlungsempfehlungen fur die weitere Entwicklung der Xenotransplantation gegeben.
With approximately 8,000 liver transplant operations per year world-wide, this surgical procedure has become relatively routine. Improvements in surgical and anesthetic techniques and immunosuppression have resulted in improved outcomes, but cardiovascular events and sepsis remain the principal obstacles to further lowering morbidity and mortality rates. Consequently, cardiovascular assessment and optimisation are of increased interest to anaesthetists and other professionals involved in liver transplant programs. This book summarises the current knowledge on preoperative hemodynamic profiling and cardiovascular assessment of patients awaiting liver transplantation.
In this book, the authors gather and present topical research in the study of cell transplantation. Topics discussed in this compilation include cell transplantation in chronic kidney disease; dendritic cells in allogenic hematopoietic cell transplantation; islet cell transplantation replacing beta cells that produce insulin in a diabetes cure; ocular surface reconstruction using cellular therapies; cell therapy on ischemic flaps; and, new therapeutic strategy for veno-occlusive disease after hematopoietic stem cell transplantation.
A medical book need not be pretty, but it must be necessary and informative. This monograph on the clinical and diagnostic pathology of graft-versus-host disease, provid ing detailed visual information on the histo morphological and immunohistological fea tures of GvHD, is intended to close a gap in the otherwise comprehensive medical literature on GvHD. B. Heymer Acknowledgements No one accumulates knowledge alone. lowe thanks to: Prof. G. R. F. Kruger, Houston, for introducing me to the histomorphological analysis of GvHD Prof. R. Arnold, Berlin, for many fruitful clinico pathological discussions Prof. K. H. Muller-Hermelink, Wurzburg, for expert advice in difficult histological differential diagnoses Prof. W. Mohr, Ulm, for continuous support and encouragement in moments of fatigue Last, but by no means least, Mrs. R. Endres-Klein, Ulm, without whom the preparation of this book would have been impossible In addition, I am grateful to the editorial staff at Springer, Heidelberg. B. Heymer Contents 1 Introduction. . . . . . . . . . . . . 1 1. 1 What Is Graft-Versus-Host Disease? 1 1. 2 Has the Pathology of GvHD Changed in the Past Decades? . . . . 1 1. 3 Why Write a Synopsis of the Clinical and Diagnostic Pathology of GvHO? 2 2 Occurrence of GvHD . . . . . . . . . 5 2. 1 GvHD After Allogeneic Bone Marrow Transplantation . . . . . . . . . . . . . 6 2. 2 GvHD After Allogeneic Peripheral Blood Stem Cell Transplantation 6 2. 3 Alternative Donors . . . . . . . . . . . . 7 2. 4 Umbilical Cord Blood . . . . . . . . . . 7 2. 5 GvHD After Materno-fetal Transfusion 8 2. 6 GvHD After Blood Transfusion . . . . . 9 2."
Organ transplantation is an essential element of treatment for a wide range of diseases, but despite increasing surgical success rates there remain many other issues affecting selection of patients and clinical outcome with which clinicians and patients themselves must be familiar. Originally published in 2000, this book reviews psychosocial, psychiatric and ethical aspects of organ transplantation in a uniquely authoritative way. Drawing heavily on the pioneering work of the Pittsburgh transplant team, it surveys the essentials of transplantation biology before engaging with a range of topics fundamental to the success of the procedure and the quality of life of recipients and donors alike. The interdisciplinary approach and the authority of the contributors will make this book of value to anyone with an interest in organ transplantation procedures.
Intracerebral interventions raise particular ethical issues. For instance, attempts at replacing lost or altered brain cells with the help of stem cells or the therapeutic application of Deep Brain Stimulation would have morally relevant implications. Many medically relevant questions and ethical concerns need to be clarified before these intracerebral interventions can become routine procedure: If the brain is conceived as the carrier of an individual's personality or of the self then operations on the brain can be seen as intrusions upon one's personality. The book addresses historical, philosophical, social and legal implications of these new developments in the neurosciences and aims at resolving some of the dilemmas that go hand in hand with "implanted minds".
Internationally recognized scientists, clinicians, and technologists review and explain the fundamental molecular and cellular biology that has been applied to the emerging field of transplant immunology and xenotransplantation, and what impact these advances might optimally have on medicine and science. The authoritative experts writing here-many of whom made the basic discoveries underlying the recent advances-examine the biological and immunological hurdles to xenotransplantation, illuminating how the immune system interacts with the xenograft and laying a practical foundation for the use of genetic engineering and animal transplants in the treatment of human disease.
Liver transplantation or hepatic transplantation is the replacement of a diseased liver with a healthy liver allograft. The most commonly used technique is orthotopic transplantation, in which the native liver is removed and the donor organ is placed in the same anatomic location as the original liver. Liver transplantation nowadays is a well accepted treatment option for end-stage liver disease and acute liver failure. This book presents the latest research from around the world in this field.
With the success of organ transplantation and the declining number
of heart beating cadaver doctors, the number of patients awaiting a
transplant continues to rise. This means that alternative sources
of donors have been sought, including donors after cardiac death.
Such donors sustain rapid damage to their organs due to ischaemia,
and as a consequence, some organs do not work initially and some
none at all. The proportion of such transplants has increased
dramatically in recent years--25% of kidney transplants in the UK
were from such donors in 2006, highlighting how much progress has
Organ transplantation is one of the most dramatic interventions in
modern medicine. Since the 1950s thousands of people have lived
with 'new' hearts, kidneys, lungs, corneas, and other organs and
tissues transplanted into their bodies. From the beginning, though,
there was simply a problem: surgeons often encountered shortages of
people willing and able to give their organs and tissues. To
overcome this problem, they often brokered financial arrangements.
Yet an ethic of gift exchange coexisted with the 'commodification
of the body'. The same duality characterized the field of blood
transfusion, which was essential to the development of modern
Increased recognition of the overlap between critical care and renal medicine, and recent advances in the understanding of acute renal failure and the application of renal replacement therapies, have brought increased attention to the nephrologist's role in the intensive care unit (ICU). This book is written to provide an approach for the resident in nephrology, at any level of training, with regards to critically ill patients. This text provides the information necessary to provide care for the nephrology patient in the ICU.
This book provides a detailed account of the principles and practice of contemporary lung transplantation. An accomplished, international team of contributing authors have combined their expertise to provide scientific developments and clinical knowledge based on their extensive experience. The book covers pulmonary vascular and parenchymal lung disease, which necessitate transplantation, together with all aspects of the multidisciplinary management of lung transplant patients. It concludes by looking at future developments in the treatment of advanced respiratory failure. This multidisciplinary approach makes the publication suitable for several subspecialities in addition to pulmonary medicine and lung transplantation, including haematology, radiology and clinical psychology. It will serve as a valuable source of reference and practical information for medical specialists in transplantation and all those working in thoracic organ transplant units.
"Pediatric Solid Organ Transplantation" is a comprehensive and succinct text on all aspects of pediatric solid organ transplantation. It provides a ready source of reference, to both the basic science and organ specific surgical technique and after care. This second edition has been extensively updated in light of recent developments in this rapidly advancing area.
The only textbook devoted to the field of pediatric
Whether you are an established sub-specialist in pediatric transplantation, a transplant surgeon, or a pediatric specialist in a related area, this book will answer all your questions about care of the pediatric patient before, during, and after transplantation.
More Than Six Thousand Individuals Receive Liver Transplantations Each Year. Whether You Or A Loved One Is Contemplating Liver Transplantation, On The Waiting List For Liver Transplantation, Or Are A Transplant Recipient, The Options And Information About This Surgery Can Be Overwhelming. This Invaluable Resource Offers The Guidance And Advice You Need. Written By A Prominent Physician, 100 Questions & Answers About Liver Transplantation: A Lahey Clinic Guide Gives You Authoritative, Practical Answers To Your Pre- And Post-Surgery Questions About Indications, Evaluation, Medications And Side Effects, Living Donor Transplantation, And Much More.
From a background in ethnography, Israeli teacher Ben-David aims to understand the meaning of organ donation and transplantation from the perspectives of the three major partners involved: donors, recipients, and the medical teams. The participation of all partners, each with specific interests, enables human organs to become an exchangeable commodity with social significance. Applying the resulting information from her comprehensive study, Ben-David assesses the roles played by life and death in organ donation within the Israeli Jewish community. She also examines issues of social legitimacy connected to organ donation in the Israeli society, institutionalization of transplantations, and transplantation as a trigger for transformation to hero status.
Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them - in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded? Kidney for Sale by Owner contends that the market is indeed a legitimate - and humane - way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic. Rather than focusing on purported human exploitation and the irrational moral repugnance of selling organs, Cherry argues that we should focus on saving lives. Following on the thinking of the philosopher Robert Nozick, he demonstrates that, with regard to body parts, the important core humanitarian values of equality, liberty, altruism, social solidarity, human dignity, and, ultimately, improved health care are more successfully supported by a regulated market rather than by well meant but misguided, prohibitions.
This is the true story of a man who rose from the depth of poverty to become a pioneer in modern medicine. Born in a small village in Iraq, and raised by a poor family, he met and conquered many adversities in his pursuit of a better living and his goal of becoming a physician. His chosen path was briefly derailed when he was granted a full scholarship to study engineering in United Kingdom, but he eventually came back to a successful career in medicine, becoming a leader in organ transplantation, one of the most innovative fields in modern medicine. Unfortunately, he became the victim of his own success when his achievements created animosity in his colleagues, who waged a political war and booted him to another country thousands of miles away. In his voluntary exile, he refused to be defeated and ultimately emerged stronger than ever. When forced to relocate yet again, his fame preceded him to the United States of America, where he has continued his mission to the present day. This book is a snapshot of the professional and personal life of a surgical innovator and pioneer. It is set in the background of a previous era in British, North American and international surgery. But what was his life like? How did he reach the pinnacle of success? Find out in this book.
This book provides a summary of the various aspects of corneal transplantation - the clinical, experimental (including multimedia display of the surgical techniques), immunological, therapeutic and prosthetic components - in one volume. The interested specialist in one field can thus have access to information from the other fields and develop a broad concept of the challenges to be faced in achieving the ultimate goal, i.e. an optically clear, visually satisfactory, functioning corneal graft which is tolerated in the long term without the need for systemic immunosuppression. A second purpose of the book is to provide information regarding current immunological concepts of the process of corneal graft rejection. In particular, recent work in the fields of innate versus adaptive immunity, novel therapeutics and corneal xenografts is presented.
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