In response to persistent donor organ shortages, organs from
marginal donors, such as expanded criteria donors (ECD) and
donation after cardiac death (DCD) donors, are now accepted and
have been successfully transplanted, reducing the waiting times for
transplantation. Especially in Japan, transplantation of DCD
kidneys has a relatively long history because of the difficulty or
lack of national consensus in accepting brain death, which has made
it possible to accumulate considerable clinical experience. Thus,
the current organ shortage has stimulated interest in the use of
marginal donors for transplantation. On the other hand, however, it
is known that these organs have a high rate of delayed graft
function and a more complicated postoperative course. These
drawbacks have created the greatest clinical challenge in
transplantation to date because of the current shortage and
limitations of donors using ECD and DCD.
This book, prepared by distinguished authorities in their
fields, is intended for clinicians and researchers. It highlights
the use of marginal donors as a comparatively novel source of
transplantation organs and provides a thorough overview of marginal
donors from their historical origins to recent clinical
applications, including the state-of-the-art science of organ/donor
management, procurement, and preservation. Also provided is
valuable information on ABO-incompatible donors which extend the
availability of donor sources. Each chapter offers an individual
analysis of the optimal requirements for the safe management and
preservation of organs, including the heart, lung, liver, kidney,
pancreas, and pancreatic islets.
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