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This text, the proceedings of the 32nd International Conference on Transplantation and Clinical Immunology, held in Lyon, France, on May 25-26, 2000, addresses novel issues in terms of changing indications for transplantation in the management of organ failure, whether humans will remain the only source for organ procurement, prospects for engineering in organ replacement, and whether transplantation will remain the most appropriate approach to organ failure. Some promising treatments are approached, such as enzymic and biochemical replacement, gene therapy, tolerance induction, stem cell transplantation, and xenotransplantation. In addition to the constant improvement in conservative management of organ failure in general, ongoing research in selected fields is reported in the proceedings, such as: liver transplantation vs artificial liver; novel dialysis strategies vs evolving immunosuppression in kidney transplantation; islets transplantation and external implantable insulin pumps vs pancreas transplantation in diabetic patients and circulatory assistance and intramyocardial myoblast injection vs heart transplantation. Pivotal experience in selected emerging transplantations is included, that is, small bowel, limb, skin and neuronal transplantation. Such fascinating perspectives raise medical, economical, and ethical problems which are discussed in this book.
This guide addresses the identification and management of potential donors and the subsequent retrieval and preservation of various organs. Physiological changes that take place in the organ donor and in an organ during preservation are described, and several preservation techniques are evaluated for their ability to minimize these physiological changes. The book should be of interest to procurement coordinators, surgeons, residents and other health care professionals involved in organ retrieval.
This reference presents studies from leading researchers that are currently studying the effects of CNS transplants on neuronal plasticity and recovery of function after CNS injury. Topics covered include trophic influences, reinnervation patterns, and prevention of cell death that range from preclinical models of Parkinson', s disease in primates to studies of restoration of circadian rhythms in rats. Techniques of neurotransplantation are presented, including current limitations and future projections of advancement
This supplement to Transplant International contains the Proceedings of the successful 5th Congress of the European Society for Organ Transplantation held in Maastricht from 7-10 October 1991. Of 827 abstracts submitted to the congress, 548 were selected by the Scien- tific Committee for either oral or poster presentation. Of these 548 presenta- tions, the guest editors selected 212 full papers for publication in this book. Two aspects are important where proceedings are concerned-the quality of the papers and the speed of publication. I thank our authors and guest editors, whose combined expertise has given us a guarantee of quality. I also thank our editorial and production teams for their tremendous efforts to hasten editing, proofreading, printing, and publication. In particular, I would like to express my gratitude to Maurits Booster, M.D., and Sylvia van Roosmalen for their assist- ance and support in seeing this supplement through to completion. As a concession to time, we have waived some of our stringent rules of style and limited our correspondence with authors by, for example, page proofs being reviewed and corrected in house only. This enables us to publish two months earlier but has the disadvantage that, given the allotted time, we have not been able to ensure that each and every article has an abstract, nor that every "i" has been dotted in the reference lists or in the addresses/institute affiliations of all the authors.
This handbook is a therapeutic manual designed as a quick, practical guide and reference for house officers, fellows, pharmacists and nurses on the bone marrow transplant unit. Indications, complications, drug doses and approaches to clinical management problems are emphasized. Diseases requiring bone marrow transplants are reviewed along with patient evaluation, marrow processing, engraftment relapse and general patient care.
This supplement to "TRANSPLANT International" contains a most recent update of clinical and experimental research in transplantation and experiences with all modern immunosuppressive drugs, presented at the 7th Congress of the European Society of Organ Transplantation in Vienna in October 1995. The book has relevant information on clinical transplantation of kidneys, livers, hearts and pancreases as well as basic research data of immunbiology and organ preservation. More than 80% of the contributions were generated by respected European research institutions and therefore the book provides a comprehensive overview of European activities in transplantation research.
Papworth Hospital in Cambridgeshire, founded in 1916 to tackle the great killer disease of tuberculosis, is famous for carrying out the UK's first heart transplant operation in 1979. It followed this up not only with many other heart transplants but also with the UK's first heart and lung operation in 1984 and the world's first heart, lung and liver transplant in 1986. With unique access to Papworth's archives, historian Peter Pugh here tells the story of this ground-breaking hospital for the first time. Alongside the background to that first UK heart transplant - and the ethical controversies that surrounded it - Pugh explores the opposition to heart operations in general, Papworth's difficulties dealing with NHS authorities especially over funding, and the discussions for over 50 years as to whether the hospital should move alongside Addenbrooke's hospital in Cambridge. As an insight into the history of medicine and surgery in the UK, as well as a story literally of life and death, The Heart of the Matter will be compelling reading.
The subject of this book is salvage of kidney function in patients with various surgically correctable disorders affecting one or both kidneys. The focus is on methods of bench surgery and subsequent autotransplantation of the kidney(s) along with the applicability and excellent results of these procedures. The various techniques are well illustrated by drawings and X-rays. Physicians of the various disciplines will learn that renal autotransplantation might be considered in patients suffering from renovascular hypertension, renal cancer, complications of urinary calculous disease, or other complex renal/ureteral disorders.
When the surgeons informed us that our unborn child had a fatal heart condition I was devastated. The only hope they offered was an infant transplant which was not only experimental but it was also unlikely that a donor organ would be found in time. Five years earlier Dr. Leonard Bailey had rocked the world when he transplanted the heart of a baboon into a human baby. He went on to pioneer an infant transplant program but it was still very much in its infancy. The medical community was deeply divided on questions related to the ethics and efficacy of this approach. I came to the conclusion that a decision for or against a transplant would need to be based entirely on faith. I was ill-equipped to perform an act of faith but I remembered studying Kierkegaard in my first year at university. In his book, Fear and Trembling, he asserts that the first movement of faith is Infinite Resignation. Starting with my own very tentative movements of Infinite Resignation and progressing toward Moriah - this is a very personal story of an odyssey to save the life of our son.
Biliary tract complications are still the major cause of morbidity following orthotopic liver transplantation. This book deals systematically with the large variety of possible cholangiographic changes. The figures are the results of a review of cholangiograms from more than 280 patients who underwent orthotopic liver transplantation. The etiology, clinical aspects, and treatment of these complications are reviewed on the basis of the authors' experience in radiology, endoscopy, and transplant surgery.
International expertise in the rapidly developing field of bone marrow transplantation has been collected to provide a balanced overview of both the scientific basis and clinical practice of marrow transplantation. The early chapters dealing with biological background are followed by information relating to the practicalities of transplantation and a comprehensive review of clinical results from an extensive range of disease and graft match situations. Complications are discussed including graft-versus-host disease, infections, organ specific problems, disease recurrence and psychological reactions. The final chapters review such latest developments in the field as the role of novel antileukemic agents, haemopoietic growth factors and monoclonal antibodies. A uniquely detailed and complete reference text, this book will commend itself both to laboratory scientists and clinicians from many specialities, whether they are directly involved in carrying out marrow transplantation procedures or advising on pre and post transplant management and support.
Advances in Tissue Banking is the first authoritative publication to encompass this interdisciplinary field, which is now providing hundreds of thousands of tissue grafts for transplant surgery every year worldwide (400,000 grafts in the USA alone annually). There is no text book which can be consulted about the subject, since the field has moved so rapidly over the past few years. The scientific and medical publications are scattered throughout specialised literature and are not readily accessible to all the diverse practitioners.This book, volume 1 of the new series, is written by experts on the subject. It is designed to fill the gap and provide a vehicle of communication for those participating in various aspects of the subject. Regulators are still in the process of coming to grips with the requirements to ensure safety and find a suitable definition within the legislative system for a "transplant tissue". The various transplant donation systems in various countries differ. Allografts are used extensively in orthopaedic surgery, burns and wound healing. Heart valve banking has now established itself. Central to the subject is the prevention of the transmission of infection, with great emphasis being placed on the screening of donors, preservation and sterilisation of the tissues using the best and safest procedures.Nobody connected with regulating, producing, or using tissues can afford to be without the concentrated information so readily provided in this book, which is not available elsewhere. It will also be of great value to scientists and doctors who wish to learn about the subject and to introduce it into general scientific and medical education.
Though kidney transplantation is considered a routine procedure, there are still significant challenges in post-transplant management. Core Concepts in Renal Transplantation is a clinically focused authoritative guide to the management of kidney transplantation. This comprehensive, state-of-the-art reference summarizes the recent changes in the field of transplantation, offering the complete range of up-to-date information on all the various aspects of basic immunobiology and the medical care of the transplant recipient. Written by a team of renowned authorities in renal transplantation, this concise resource is intended for both the nephrologist and the non-specialist with an interest in kidney transplantation.
With the increased prevalence of kidney transplantation, transplant recipients are being treated in a variety of clinical settings - often beyond the transplant center. There is a greater need for clinicians and allied healthcare professionals to have appropriate guidance on managing these patients. Kidney Transplantation offers the latest evidence-based information on the full range of dilemmas in the medical management of kidney transplant recipients before, during and after transplantation. Beginning with the selection of patients who are candidates for transplantation, this authoritative guide covers the care of the patient on the waiting list and evaluation of donors, preoperative care, induction and immunosuppression maintenance. This wealth of new information and guidelines will serve as an important resource for the best possible care for transplant patients.
Hepatitis C Virus and Liver Transplantation is designed to provide a comprehensive and state-of-the-art overview of the major issues specific to the field of liver transplantation and hepatitis C virus infection. The sections of the book have been structured to review the overall scope of issues of recurrent hepatitis C in different complex settings, including retransplantation, HIV-coinfected patients or in the setting of suboptimal graft donors. This book provides up-to-date information on the application of new therapies to the field of liver transplantation. It provides the most recent data on their efficacy, the management of side effects, as well as the potential interactions and specific problems associated with their use in the transplant setting. Finally, an appraisal of the risks and benefits of using organs from anti-HCV positive donors is presented. This book provides concise and actual materials for several important topics that are simply not adequately covered by current available literature. Hepatitis C Virus and Liver Transplantation will provide a unique and valuable resource in the field of liver transplantation and will be of great value to Hepatologists, Transplant and Abdominal Surgeons, Oncologists, as well as Fellows and Residents training in these fields.
Few fields of medicine have witnessed such impressive progress as the diagnosis and treatment of liver tumors. Advances in imaging technology, the development of novel contrast agents, and the introduction of optimized scanning protocols have greatly facilitated the non-invasive detection and characterization of focal liver lesions. Furthermore, image-guided techniques for percutaneous tumor ablation have become an accepted alternative treatment for patients with inoperable liver cancer. This book provides a comprehensive and up-to-date overview of the role of diagnostic and interventional radiology in respect of liver tumors. The volume moves from background sections on methodology and segmental liver anatomy to the main sections on the diagnosis of benign and malignant liver lesions. An integrated approach, focused on the correlation of ultrasound, CT, and MR imaging findings, is presented. Finally, a full section describes the principles, methods, and results of percutaneous tumor ablation techniques.
This volume is a complete manual of operative techniques for battling a severe liver injury. It provides an easy pre-operative and intra-operative reference with clear illustrations, line drawings as well as actual intra-operative color pictures, supplemented by online video segments. The early sections of the book deal with the fundamentals of surgical anatomy and critical maneuvers in the resuscitation of the patient in extremis. The various technical maneuvers for manual control of hemorrhage, debridement-resection as well as formal lobectomy of the liver, the identification of biliary tract injuries and other miscellaneous techniques, such as balloon tamponade of missile tracts, are discussed in complete detail. The book also sketches the role of liver transplantation surgeons in the acute trauma setting. The final chapters focus on the urgent problem of teaching operative techniques to young trauma surgeons in an era of dwindling surgical experience. Written by authors who are world- renowned experts in trauma management, often termed "master-surgeons", Operative Techniques for Severe Liver Injury is required preparation for all surgeons who are likely to face a massive crush injury of the liver.
The book gives an account of results obtained from experiments where grafts of neuronal, glial and other tissues as well as artificial materials were placed into the spinal cord. It attempts to evaluate the contributions made by these studies to our understanding of basic neurobiologies questions. These include factors that regulate neuronal growth during development as well as regenera- tion following injury to the nervous system. The model of neural transplanta- tion is also useful for the study of cell-to-cell interactions, and this applies to interactions between glial cells and neurones, between various populations of neuronal cells and finally between axons and skeletal muscle fibres. The mecha- nisms involved in the establishment of specific synaptic connections between neurones can also be investigated in this experimental paradigm. Important in- formation regarding this issue was also obtained on systems other than the spinal cord, i. e. the cerebellum, hippocampus and striatum. Although such in- formation of precise connections between the host and the grafted embryonic tissue is still lacking in the spinal cord, there is much information on the re- sponse of the host nervous system to the grafted embryonic tissue, and that of the graft to its new host environment. It appears that embryonic grafts are able to induce repair processes follow- ing injury to the nervous system.
The transplant physicians and surgeons at Cleveland Clinic have collaborated to produce, Kidney and Pancreas Transplantation: A Practical Guide. This volume is devoted to kidney and pancreas transplantation and is well grounded in scientific principles, quantitative clinical reasoning, clinical pharmacology, tested clinical practices and overall clinical applicability. Also addressed are key aspects in the initiation, maintenance and sustained growth of viable clinical programs in kidney and pancreas transplantation. Kidney and Pancreas Transplantation: A Practical Guide will be of great value to transplant physicians as well as medical and surgical fellows who intend to pursue an interest in transplantation.
Transplantation is a medically successful and cost-effective way to treat people whose organs have failed-but not enough organs are available to meet demand. Ethics and the Acquisition of Organs is concerned with the major ethical problems raised by policies for acquiring organs. The main topics are the rights of the dead, the role of the family, opt in and opt out systems, the conscription of organs, living organ donation from adults and children, directed donation and priority for donors, and the sale of organs. In this ground-breaking work, T. M. Wilkinson uses concepts from moral and political theory such as autonomy, rights, posthumous interests, justice, and well-being, in a context informed by the clinical, legal, and policy aspects of transplantation. The result is a rigorous philosophical exploration of real problems and options. He argues that the ethics of acquiring organs for transplantation is not only of great intellectual interest, but also of practical importance. As such, this book will be of profit not only to students and academics who work in applied ethics and bioethics, but also to the lawyers, policy-makers, clinicians, and lobby groups interested in transplantation.
Virtually any disease that results from malfunctioning, damaged, or
failing tissues may be potentially cured through regenerative
medicine therapies, by either regenerating the damaged tissues in
vivo, or by growing the tissues and organs in vitro and implanting
them into the patient. Principles of Regenerative Medicine
discusses the latest advances in technology and medicine for
replacing tissues and organs damaged by disease and of developing
therapies for previously untreatable conditions, such as diabetes,
heart disease, liver disease, and renal failure.
Never before has a comprehensive history of the pancreas like History of the Pancreas been published. It not only is a historical review of the science of medicine, it is liberally interspersed with anecdotal vignettes of the researchers who have worked on this organ. Much of it, such as the discovery of the duct of Wirsung, of the islets of Langerhans, of insulin, gastrin and their tumors, reads like the adverture, which it is. This book, divided into 14 chapters, is written in a narrative style and is easily readable, as glimpses of the investigators, those who failed as well as those who succeeded, adds both perspective and human interest. Each chapter is completely referenced, totaling over 1500 references. As a reference book for students, teachers, investigators, writers, its detailed hjistorical documentation is unique. From the pre-Christian era of Asia Minor, to Greece, Rome, Europe and America, to the explosive progress in Japan, the history is there. History of the Pancreas: Mysteries of a Hidden Organ fills a gap.
This book brings together all the relevant available science behind face transplants. It is comprehensive in its coverage, encompassing patient and donor evaluation, ethics, legal issues, psychological issues, types of transplant, surgical technique, issues relating to immunosuppression, follow-up protocols, and current outcomes. Facial transplantation, which allows the replacement of missing anatomy with a perfect match based on transplant medicine principles, has become the most striking innovation in plastic surgery of the twenty-first century as surgeons and scientists progress from reconstructive surgery to restorative surgery. A robust team approach is, however, necessary to produce safe and efficient outcomes, and numerous questions are arising, from technical issues to ethical dilemmas. The reader will discover in this volume all the information required in order to understand this new discipline and to be able to set up a program of facial transplantation.
Nearly all patients with chronic kidney disease (CKD) have at least one significant dermatologic manifestation. This all-inclusive reference covers the wide array of cutaneous manifestations attributable to CKD, kidney transplantation and the pharmacological aspects of the disease process. Each chapter provides pathobiology, extensive clinical discussions, full-color images and in-depth treatment options. Dermatological Manifestations of Kidney Disease helps the practitioner, nephrologist, resident and student recognize, appropriately evaluate and treat these conditions more effectively.
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