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In 1997, the Institute of Medicine published a report entitled Non-Heart- Beating Organ Transplantation: Medical and Ethical Issues in Procurement. The findings and recommendations of that study defined the ethical and scientific basis for non-heart-beating organ donation and transplantation, and provided specific recommendations for practices that affirm patient welfare, promote patient and family choice, and avoid conflicts of interest. Following the 1997 study, the Department of Health and Human Services requested a follow up study to promote such efforts. The central activity for this study was a workshop held in Washington, D.C., on May 24-25, 1999. The workshop provided the opportunity for extensive dialogue on non-heart-beating organ donation among hospitals and organ procurement organizations (OPOs) that are actively involved in non-heartbeating organ and tissue donation and those with concerns about whether and how to proceed. The findings and recommendations of this report are based in large measure on the discussions and insights from that workshop. Non-Heart-Beating Organ Transplantation includes seven recommendations for developing and implementing non-heart-beating-donor protocols. These recommendations were based on the findings and recommendations from the 1997 IOM report and consensus achieved among participants at the national workshop. The committee developed these recommendations as steps towards an approach to non-heart-beating-donor organ donation and procurement consistent with underlying scientific and ethical guidelines, patient and family options and choices, and public trust in organ donation.
This book describes a practical approach to the diagnosis, management, and prevention of infectious complications in solid-organ transplant (SOT) candidates and recipients, based on both up-to-date clinical evidence and state of the art expert opinion from world-renowned experts in the field. The book is divided into three parts, the first of which explains risk assessment and the general approach to infectious diseases in the pre-, peri-, and early and late post-transplant periods. The remaining two sections address the prevention and treatment of infection with particular pathogens and the management of specific syndromes, such as pneumonia, CNS infections, UTIs, and skin infections. Infections in SOT recipients - often due to multidrug-resistant organisms - represent a major challenge. Preventive strategies need to be adapted according to the type of allograft and period after transplantation. Moreover, toxicity and drug interaction with immunosuppressive drugs must be taken into consideration when treating infectious complications. In explaining in depth how best to ensure allograft and patient survival, this book will be of value to infectious disease specialists and transplant physicians at all levels of experience.
This text serves as a convenient one-stop resource on the pathogenesis, diagnosis and treatment of kidney diseases in context of advanced heart failure and presence of ventricular assist devices. Advances in managing heart failure, evidence-based practices and therapies are covered, along with the management of this unique and complex subset of patients. The book also provides insights into combined heart and kidney transplantation. Authored by leaders in nephrology, cardiology and transplantation, this book fills a critical knowledge gap in understanding and treating patients with acute or chronic dysfunction of the heart and kidneys and how one induces dysfunction in the other organ.
This book focuses on patients with end-stage-liver disease (ESLD) who could possibly qualify for liver transplant. This patient cohort raises many problems: who should be treated and also, when is it too late for transplant? The authors are all dedicated experts in the field of ESLD/liver transplantation, but from different disciplines with different views of the problem. In the past 15 years many things have changed in the treatment for these patients: cardiac assessment, treatment of porto-pulmonary hypertension, hemodynamics, coagulation assessment and management, diagnosis of kidney failure, and the timing of dialysis. These issues are comprehensively discussed in this book, in order to provide physicians starting in the field of transplantation an overview of different areas of concern. This book is aimed at specialists and trainees in critical care, hepatology, anesthesia, surgery, and nephrology.
Part of the highly regarded Diagnostic Pathology series, this updated volume by Drs. Anthony Chang and Robert B. Colvin is an ideal point-of-care reference to guide you through the complex realm of transplant pathology. Concise, focused chapters, supported by tables, diagrams, radiographs, and photographs, provide essential information to keep you up to date with the impact of new viral infections, updates from the Banff Allograft Conference, new information on next-generation sequencing, and much more. More than 20 experts present their collective knowledge to assist you with different aspects of transplant pathology, including rare issues such as the impact of new viral infections (e.g., the Zika virus on transplant patients who are immunosuppressed) Packed with high-quality images that provide examples and potential pitfalls of diagnostic lesions that you are likely to encounter Time-saving reference features include bulleted text, tables of diagnostic criteria, annotated images, and an extensive index Thoroughly updated content keeps you current with all aspects of transplant immunology and pathology, guiding you expertly through diagnostic challenges such as donor disease, surgical complications, allograft rejection, drug toxicity, opportunistic infections, and/or recurrent or de novo diseases that can occur simultaneously or at different times New Banff classifications are integrated into all chapters, covering pathology of all clinical organ transplants, including kidney, heart, lung, liver, pancreas, small bowel, and vascularized composite allografts as well as bone marrow allografts New coverage includes next-generation sequencing, which is quickly becoming the standard for HLA testing, as well as new drugs that are in clinical trials for the treatment of antibody-mediated rejection Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices
The field of neural transplantation is at a crucial stage, with important clinical trials on transplantation in patients with Parkinson's disease nearing completion and novel, alternative approaches to fetal transplantation being developed.
This timely book brings together leading neuroscientists, clinicians, and cell and developmental biologists to discuss the use of neural transplants in neurodegenerative disorders, such as Parkinson's disease, Huntington's chorea, amyotrophic lateral sclerosis, multiple sclerosis and spinal cord injury. There is also extensive coverage of the potential alternatives to freshly derived fetal tissue as the source of transplants, for example xenografts, encapsulated cells and immortalized stem cells. With authoritative contributions and lively discussion sections, this book presents much new and exciting work in this field and identifies promising new research directions.
This comprehensive reference on the fundamentals of hemodialysis access creation and advanced management for maintenance is designed to meet the needs of all surgeons and physicians responsible for the treatment and care of patients undergoing dialysis. The book opens by discussing every aspect of dialysis access planning, including selection of the right access for the individual patient and access strategies. Hemodialysis access techniques, from the most basic to the most complex and unconventional, are then described step by step, and guidance is provided on follow-up. Detailed attention is also devoted to the challenging management of specific complications of dialysis access surgery, including failing hemodialysis access. The book includes a wealth of informative, high-quality images and illustrations, and the authors are prominent vascular surgeons, transplant surgeons, general surgeons, nephrologists, and interventional radiologists from across the United States.
This comprehensive textbook, covering all aspects of the perioperative management of patients undergoing organ transplantation, serves as the standard reference for clinicians who care for transplant patients on a day-to-day basis as well as those who encounter organ transplantation only occasionally in their clinical practice. Anesthesia and Perioperative Care for Organ Transplantation covers transplantation of the heart, lung, liver, pancreas, and kidney, as well as multivisceral and composite tissue graft transplantations. For each kind of transplantation, the full spectrum of perioperative considerations is addressed: preoperative preparation, intraoperative anesthesia management, surgical techniques, and postoperative care. Each chapter contains evidence-based recommendations, relevant society guidelines, management algorithms, and institutional protocols as tables, flow diagrams, and figures. Photographs demonstrating surgical techniques, anesthesia procedures, and perfusion management are included. Anesthesia and Perioperative Care for Organ Transplantation is for anesthesiologists and critical care physicians; transplantation surgeons; nurse anesthetists; ICU nurses; and trainees.
Pancreas transplantation has rapidly moved from an experimental
procedure associated with high rates of morbidity and mortality to
a mainstream technique with excellent patient and graft survival.
Over 30,000 pancreas transplants have already been performed. The
value of pancreas transplantation however must be balanced against
the risk of the operative procedure and the innovative long-term
immunosuppressive therapy. The indications for this procedure and
the selection of the patients are critical to ensure low mortality
and any improvements in quality of life.
Governments throughout the industrialized world make decisions that fundamentally affect the quality and accessibility of medical care. In the United States, despite the absence of universal health insurance, these decisions have great influence on the practice of medicine.
In "Medical Governance," David Weimer explores an alternative regulatory approach to medical care based on the delegation of decisions about the allocation of scarce medical resources to private nonprofit organizations. He investigates the specific development of rules for the U.S. organ transplant system and details the conversion of a voluntary network of transplant centers to one private rulemaker: the Organ Procurement and Transplantation Network (OPTN).
As the case unfolds, Weimer demonstrates that the OPTN is more efficient, nimble, and better at making evidence-based decisions than a public agency; and the OPTN also protects accountability and the public interest more than private for-profit organizations. Weimer addresses similar governance arrangements as they could apply to other areas of medicine, including medical records and the control of Medicare expenditures, making this timely and useful case study a valuable resource for debates over restructuring the U.S. health care system.
Providing the practicing and trainee hematologist with a practical and immediately applicable compendium of answers the Clinical Manual of Blood and Bone Marrow Transplantation covers the spectrum of the hematopoietic cell transplant specialty, in particular practical issues in transplant patient care, and the set up and functioning of a transplant program. * Supplies the practicing and trainee hematologist with a practical and immediately applicable compendium of answers to clinical questions * Covers the spectrum of the hematopoietic cell transplant specialty, in particular practical issues in transplant patient care, and the set up and functioning of a transplant program * Contains concise chapters written with a focus on tables, algorithms and figures to aid rapid referral * Benefits from expert contributions from an international authorship
This concise book provides an overview of the essential aspects of transplant nephrology. Chapters cover patient evaluation, treatment options, complications and post kidney transplant approaches to various common chronic diseases. The importance of proper immunosuppressants adjustment to improve the graft half-life and overall patient quality of life are also highlighted. Up to date and practical, this book gives nephrologists and providers that treat kidney transplant patients a succinct resource on management.
This comprehensive reference source will benefit all transplant specialists working with pharmacologic and biologic agents that modulate the immune system. Compiled by a team of world-renowned editors and contributors covering the fields of transplantation, nephrology, pharmacology, and immunology, the book covers all anti-rejection drugs according to a set template and includes the efficacy of each for specific diseases.
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.
There has been a substantial increase in the number of patients with end-stage renal disease world-wide over the last few decades. In Australia, over 2400 patients with end-stage renal disease started renal replacement therapy in 2011 with nearly 11,000 patients currently receiving dialysis treatment at the end of 2011. According to Kidney Health Australia, the costs of treating end-stage kidney disease from 2009 to 2020 is estimated to be around $12 billion, highlighting the fact that kidney disease is a major financial burden to the community. Kidney transplantation confers a survival benefit in patients with end-stage renal disease but transplantation has become increasingly more complex over the last decade. With the greater understanding of transplant immunology along with the introduction of more potent induction and maintenance immuno-suppression, clinicians are now in a better position to more accurately stratify each transplant candidate's immunological risk as well as the ability to safely transplant high-immunological risk transplant candidates. This book covers all major aspects of kidney transplantation and was put together with the hope of providing the readers with in-depth and current knowledge of important aspects of kidney transplantation, including donor and recipient assessments, innovative surgical techniques and understanding of surgical complications, the evolution of immunological techniques to identify anti-human leukocyte antigen antibodies, the management and preparation of high-risk transplant candidates for transplantation as well as the management of longer-term complications after kidney transplantation.
In recent years the `Tribology Day' has become a recognized highlight of the EFORT Congress, and at the 2012 Congress in Berlin an entire day was once again devoted to tribology in total hip arthroplasty. EFORT decided that, given the wide interest in tribology, publication of the presentations would be warmly welcomed by fellow professionals who were unable to attend. The resulting book includes all presentations delivered on the day and covers a range of interesting topics. Up-to-date information is provided on the various articulating materials, and all the articulations recently used in total hip arthroplasty are discussed, with provision of clinical data. The book will be of interest not only to experienced surgeons but also to trainees and residents who wish to extend their knowledge of total hip arthroplasty.
This book investigates a crucial-but forgotten-episode in the history of medicine. In it, Thomas Schlich systematically documents and analyzes the earliest clinical and experimental organ transplant surgeries. In so doing he lays open the historical origins of modern transplantation, offering a new and original analysis of its conceptual basis within a broader historical context. This first comprehensive account of the birth of modern transplant medicine examines how doctors and scientists between 1880 and 1930 developed the technology and rationale for performing surgical organ replacement within the epistemological and social context of experimental university medicine. The clinical application of organ replacement, however, met with formidable obstacles even as the procedure became more widely recognized. Schlich highlights various attempts to overcome these obstacles, including immunological explanations and new technologies of immune suppression, and documents the changes in surgical technique and research standards that led to the temporary abandonment of organ transplantation by the 1930s. Thomas Schlich is professor and Canada Research Chair in the History of Medicine at McGill University.
This book describes the multimodality imaging of cardiac, lung, liver, kidney, pancreas, and small bowel transplants in donors and recipients. The volume of transplantation of solid organs has increased substantially and has become common practice in medicine. Radiological evaluation of transplanted organs such as the heart, lungs, liver, pancreas, and kidneys is critical, both in potential donors (as is the case in liver and kidney transplantation) and in preoperative and postoperative evaluations of recipients. Understanding the often complex surgical anastomoses and unique pathology is necessary to inform radiologic interpretation. This book provides radiologists with the knowledge of the normal appearance of a transplanted organ, an understanding of imaging modalities that are best suited to answering clinical questions, an overview of the pathologies related to such organs and their appearance on various modalities, vascular and nonvascular complications, and techniques related to image-guided transplant interventions.
Biomedical scientists are the foundation of modern healthcare, from cancer screening to diagnosing HIV, from blood transfusion for surgery to food poisoning and infection control. Without biomedical scientists, the diagnosis of disease, the evaluation of the effectiveness of treatment, and research into the causes and cures of disease would not be possible. The Fundamentals of Biomedical Science series has been written to reflect the challenges of practicing biomedical science today. It draws together essential basic science with insights into laboratory practice to show how an understanding of the biology of disease is coupled to the analytical approaches that lead to diagnosis. Assuming only a minimum of prior knowledge, the series reviews the full range of disciplines to which a Biomedical Scientist may be exposed-from microbiology to cytopathology to transfusion science. The science of transfusion and transplantation demands a multifaceted understanding of immunology, haematology, and genetics from the biomedical scientist. Transfusion and Transplantation Science synthesizes the essential concepts of these subjects and presents them within the practical framework of the hospital banking and transplantation centre, providing you with the knowledge and skills to specialize in this discipline.
Many pathologists find the interpretation of biopsies and other surgical specimens from solid organ, stem cell and bone marrow transplants challenging. Pathology of Transplantation provides a practical structured and logical approach to the diagnostic interpretation of the range of specimens from patients with solid organ, stem cell and bone marrow transplants, including the assessment of native and donor organs, with emphasis on resolution of pathological and clinico-pathological differential diagnoses including the diverse forms of rejection, recurrent and de novo diseases, drug-induced alterations, infections and other pathologies relevant to the system or tissue. In addition, this provides information on some of the critical clinical consequences of pathological diagnoses and guidelines for interaction and effective communication with transplant clinicians thereby ensuring the best possible care to patients with transplants. Pathology of Transplantation provides a relatively simple but diagnostically comprehensive and practical book that the pathologist will keep on hand and pick up to rapidly find answers in daily practice of transplantation pathology.
This volume presents a comprehensive overview of the latest advances in basic and translational research in the field of reconstructive transplantation and its potential therapeutic implications. Dr. Thomas E. Starzl and Dr. Raimund Margreiter, both pioneers in the field of transplantation, have written the foreword for the book. The volume spans such topics as skin rejection, immune monitoring, stem cell-based immunomodulatory strategies, costimulatory blockade, tolerance induction, chronic rejection, ischemia reperfusion injury, nerve regeneration, cortical reintegration, and small and large animal models for reconstructive transplantation. The book is intended for biomedical researchers and basic scientists in the field of reconstructive transplantation, transplant immunology and regenerative medicine, as well as clinicians, surgeons and multidisciplinary specialists, who are practicing or interested in this novel and exciting field. Postgraduate fellows and students will also find it a valuable reference.
As there is a high incidence of disease recurrence after liver transplantation, this volume is designed around the need for a reference text dealing exclusively with this problem. The book places special emphasis on pre- and post-transplant predictors of recurrence, severity assessment, prophylaxis, and treatment. Pathobiology of disease recurrence is discussed in detail where applicable. Issues including quality of life and cost burden are also covered in the text. Written by well-known authorities in each field, Disease Recurrence After Liver Transplantation: Natural History, Treatment and Survival serves as a comprehensive reference for physicians and surgeons who take care of liver transplant recipients and a major addition to the literature detailing the current understanding of disease recurrence.
Are our identities attached to our faces? If so, what happens when the face connected to the self is gone forever or replaced? In Face/On, Sharrona Pearl investigates the stakes for changing the face and the changing stakes for the face in both contemporary society and the sciences. The first comprehensive cultural study of face transplant surgery, Face/On reveals our true relationships to faces and facelessness, explains the significance we place on facial manipulation, and decodes how we understand loss, reconstruction, and transplantation of the face. To achieve this, Pearl draws on a vast array of sources: bioethical and medical reports, newspaper and television coverage, performances by pop culture icons, hospital records, personal interviews, films, and military files. She argues that we are on the cusp of a new ethics, in an opportune moment for reframing essentialist ideas about appearance in favor of a more expansive form of interpersonal interaction. Accessibly written and respectfully illustrated, Face/On offers a new perspective on face transplant surgery as a way to consider the self and its representation as constantly present and evolving. Highly interdisciplinary, this study will appeal to anyone wishing to know more about critical interventions into recent medicine, makeover culture, and the beauty industry.
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