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Journal articles on the topic 'Transplantation organe'
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1
Bockhorn, Frilling, Nadalin, Weber, Beckebaum, Malago, and Broelsch. "Neue Techniken in der Lebertransplantation." Praxis 94, no. 18 (May 1, 2005): 735–41. http://dx.doi.org/10.1024/0369-8394.94.18.735.
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Innovative chirurgische Techniken, gezielte Immunsuppression und verbessertes postoperatives Management haben bei der Lebertransplantation ein Patienten- und Organüberleben von 80% bis 90% ermöglicht. Dies hat nicht nur zu einer Erweiterung der Indikation zur Transplantation, sondern auch zu einer Vergrösserung der Anzahl potenzieller Empfänger für ein Organ auf der Warteliste geführt. Demgegenüber steht ein wachsender Organmangel. Trotz unterstützender Gesetzgebung, medialer Präsenz und Versuchen, Aufklärungsarbeit innerhalb der Bevölkerung zu leisten, bleibt die Anzahl der Spenderorgane konstant, ohne den wachsenden Bedarf an Organen ausreichend decken zu können. 2002 betrug die Mortalität auf der Warteliste für eine Spenderleber 20%. Mittlerweile existieren eine Reihe von Therapieverfahren, um dem wachsenden Organmangel zu begegnen. Die Transplantation marginaler Organe oder die Durchführung von Domino-Transplantationen gehören ebenso dazu wie die Lebendspendelebertransplantation (LSLT) oder die Split-Lebertransplantation (SLT).
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Lichtenstern, C., M. Müller, J. Schmidt, K. Mayer, and M. A. Weigand. "Intensivtherapie nach Transplantation solider Organe." Der Anaesthesist 59, no. 12 (December 2010): 1135–54. http://dx.doi.org/10.1007/s00101-010-1822-7.
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Hoyer, J. "Rehabilitation nach Transplantation abdomineller Organe." Der Diabetologe 6, no. 6 (August 19, 2010): 477–82. http://dx.doi.org/10.1007/s11428-010-0568-9.
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Popescu, Nicolae, Grigore-Alexandru Popescu, and Ramona îdea. "Human personality and organ transplantation." Romanian Medical Journal 66, no. 2 (June 30, 2019): 166–70. http://dx.doi.org/10.37897/rmj.2019.2.15.
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Glyantsev, S. P., and A. Werner. "PHENOMENON OF DEMIKHOV. In the Sklifosovsky Institute (1960–1986). Demichow W. Die experimentelle Transplantation lebenswichtiger Organe. Berlin: VEB Verlag Volk und Gesundheit, 1963." Transplantologiya. The Russian Journal of Transplantation 12, no. 1 (March 18, 2020): 61–75. http://dx.doi.org/10.23873/2074-0506-2020-12-1-61-75.
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The article has discussed V.P. Demikhov's views on a homoplastic transplantation of tissues and organs in 1963 and his achievements in experimental transplantation by that time. The authors first translated the monograph Die experimentelle Transplantation lebenswichtiger Organe (1963) from German into Russian and presented V.P. Demikhov's Preface to it. In this text, having critically analyzed the current provisions in the field of immunobiology, V.P. Demikhov came to the conclusion that a number of his achievements contradicted those provisions and did not fit into the framework of existing immunobiological laws. In 1963, confessing the primacy of function over structure, V.P. Demikhov believed that the restoration of blood circulation in transplanted organs played the main role in their survival, and the subsequent functioning of the transplanted organ for a long time meant its engraftment. In this text V.P. Demikhov for the first time substantiated the model of a “physiological organism” he had invented for reviving a human in a state of agony, for creating a bank of organs, growing it in infants and rejuvenating the elderly.Authors declare no conflict of interest.
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Greve, Susanne, and Thomas Palmaers. "Anästhesie für Patienten nach Transplantation abdomineller Organe." AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 55, no. 07/08 (July 2020): 442–52. http://dx.doi.org/10.1055/a-0987-2096.
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ZusammenfassungEine immer weiterentwickelte und erfolgreiche Transplantationsmedizin sorgt für eine große Zahl an lebenden transplantierten Patienten. Ein anästhesiologisch tätiger Arzt muss damit rechnen, mit einem solchen Patienten in Berührung zu kommen. Neben der präoperativen Beurteilung der Vorerkrankungen, inklusive der Funktion des transplantierten Organs, kommt auch der Immunsuppression eine bedeutende Rolle zu. Diese muss perioperativ immer sorgfältig fortgeführt werden. Ein striktes Einhalten aller hygienischen Vorschriften ist bei diesen Patienten aufgrund der Immunsuppression und des damit verbundenen erhöhten Infektionsrisikos essenziell. Dazu gehört auch die strenge Nutzen-Risiko-Bewertung aller invasiven Maßnahmen.Bei der Durchführung der Anästhesie und dem Einsatz der Anästhetika zeigen sich für diese Patienten keine wesentlichen Unterschiede zu nicht transplantierten Patienten, vielmehr muss hier das Augenmerk auf eine ausgeglichene Homöostase aller Organsysteme gerichtet werden.
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Lichtenstern, C., J. Pratschke, U. Schulz, M. Schmoeckel, W. Knitsch, P. Kaskel, K. J. Krobot, M. A. Weigand, and M. Winkler. "Caspofungin nach Transplantation solider Organe in Deutschland." Der Anaesthesist 59, no. 12 (November 12, 2010): 1083–90. http://dx.doi.org/10.1007/s00101-010-1795-6.
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Weber, L. T., and F. Zepp. "Transplantation solider Organe im Kindes- und Jugendalter." Monatsschrift Kinderheilkunde 160, no. 4 (March 28, 2012): 333–34. http://dx.doi.org/10.1007/s00112-011-2564-6.
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Schiffer, M. "Renale Ko-Morbidität nach Transplantation solider Organe." DMW - Deutsche Medizinische Wochenschrift 137, no. 45 (October 30, 2012): 2332–35. http://dx.doi.org/10.1055/s-0032-1327253.
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Mayr. "Management nach Transplantation." Therapeutische Umschau 62, no. 7 (July 1, 2005): 487–501. http://dx.doi.org/10.1024/0040-5930.62.7.487.
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In der folgenden Übersicht werden wichtige, nicht organspezifische Punkte der ambulanten Nachbetreuung transplantierter Patienten besprochen. Das Erkennnen und die Behandlung kardiovaskulärer Risikofaktoren ist elementar. Durch eine gute Prävention und Therapie transplantations-assoziierter Knochenschäden kann die Morbidität transplantierter Patienten gesenkt werden. Malignome und Infekte – beide mit einer gehäuften Inzidenz nach Transplantation – beeinflussen das Langzeitüberleben. Bei (unklaren) Zustandsverschlechterungen sind beide Krankheitsgruppen neben einer potentiellen Abstoßung des transplantierten Organs immer in die differentialdiagnostischen Überlegungen mit einzubeziehen. Eine Übersicht zeigt die wichtigsten Malignome, deren Ursache, Inzidenz und Verhalten nach erfolgter Transplantation. Infektionen, deren verschiedene Keimspektren und deren Bezug zum zeitlichen Transplantationsverlauf werden skizziert. Weiter ist es hilfreich, die wichtigsten Wirkungsmechanismen immunsuppressiver Medikamente und deren Nebenwirkungsprofil zu kennen. Zur Vermeidung von gefährlichen, teils lebensbedrohlichen Abstoßungen oder einer Medikamentenintoxikation müssen alle Medikamente im Hinblick auf ihr mögliches Interaktionspotential mit den jeweiligen Immunsuppressiva geprüft werden. Die häufigsten Interaktionen werden besprochen. Eine sinnvolle Impfstrategie ist notwendig zur Prävention von Infektionskrankheiten und zur Vermeidung potentieller Impfschäden bei immunsupprimierten Patienten. Die häufigsten Indikationen und Kontraindikationen für Impfstoffe werden angegeben. Gemeinsames Ziel der Nachbetreuung ist es, ein möglichst gutes Langzeitüberleben mit bestmöglichster Lebensqualität unter Erhaltung des oder der transplantierten Organe zu gewährleisten.
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Haniel, Anja. "Organe um jeden Preis?" Zeitschrift für Evangelische Ethik 44, no. 1 (February 1, 2000): 269–84. http://dx.doi.org/10.14315/zee-2000-0147.
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Abstract Asthereisa permanent shortage of human organs for transplantation purposes new methods to provide organs are being developed. The author deals with these new developments as there are artificial organs, genetically engineered animal organs (i.e. xenotransplantation) and therapeutical cloning or embryonie stem cells to cultivate human organs. The goal of the article is to give an overview on these approaches and to summarize ethical aspects related to research, development and application of these methods
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Gratwohl. "New developments in hematopoetic stem cell transplantation." Therapeutische Umschau 59, no. 11 (November 1, 2002): 571–76. http://dx.doi.org/10.1024/0040-5930.59.11.571.
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Die Transplantation hämatopoietischer Stammzellen umfasst heute Stammzellen aus Knochenmark, peripherem Blut oder Nabelschnurblut. Leukämien, Lymphoproliferative Erkrankungen, aplastische Anämie und schwere angeborene Erkrankungen des Knochenmarkes sind Hauptindikationen für allogene, lymphoproliferative Erkrankungen, Leukämien, solide Tumoren und schwere Autoimmunkrankheiten Hauptindikationen für autologe Transplantationen. Neue Verfahren wie reduzierte Konditionierung und selektive Gabe von Spenderlymphozyten eröffnen die Stammzelltransplantation auch für ältere Patienten und für solche mit vorbestehender Komorbidität. Wenn immer möglich, wird die Transplantation ab Diagnose in den Behandlungsplan integriert. Die Wahl des Verfahrens und des geeigneten Zeitpunktes wird nach individuellem Risikoprofil erstellt. Alter oder Diagnose sind nicht mehr alleinige Entscheidungskriterien. Als etablierte Therapieform dürfte die hämatopoietische Stammzelltransplantation als Modell dienen für Stammzelltransplantationen auch anderer Organe.
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Welker, M. W., and A. A. Schnitzbauer. "Aktuelle Aspekte der Immunsuppression nach Transplantation solider Organe." Der Gastroenterologe 14, no. 4 (May 7, 2019): 289–95. http://dx.doi.org/10.1007/s11377-019-0357-y.
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Linkermann, A. "Bedeutung regulierter Zelltodprogramme für die Transplantation solider Organe." Der Nephrologe 10, no. 2 (March 2015): 100–106. http://dx.doi.org/10.1007/s11560-014-0914-9.
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Welker, Martin-Walter, and Andreas A. A. Schnitzbauer. "Aktuelle Aspekte der Immunsuppression nach Transplantation solider Organe." Wiener klinisches Magazin 22, no. 6 (November 8, 2019): 272–77. http://dx.doi.org/10.1007/s00740-019-00315-2.
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Reichenspurner, Hermann. "Herztransplantation in Kombination mit der Transplantation anderer Organe." Zeitschrift für Herz-,Thorax- und Gefäßchirurgie 35, no. 2 (February 23, 2021): 81–82. http://dx.doi.org/10.1007/s00398-021-00419-0.
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Birem, M. A., M. Bensaida, H. Merad, N. Abdaoui, and A. Guedidi. "Troubles de l’identité et transplantations d’organe." European Psychiatry 29, S3 (November 2014): 549. http://dx.doi.org/10.1016/j.eurpsy.2014.09.338.
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Les transplantations d’organe peuvent, d’une part, contraindre les bénéficiaires de se représenter leur propre mort ou celles d’une de leurs fonctions vitales, et, d’autre part, à avoir le sentiment de revenir plus puissants. Transplanter un organe signifie symboliquement la transgression de l’intimité corporelle et celle du respect des formes du vivant. Penser la transplantation, relève de l’inquiétante étrangeté, du monstrueux dans le fonctionnement psychique. Ce travail essayera de revisiter la problématique de l’identité à partir de l’expérience que constituent les transplantations d’organe.
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Rauchfuß, Falk, Felix Dondorf, Felix Braun, Peter Schemmer, Andreas Anton Schnitzbauer, Thomas Vogel, and Christina Schleicher. "Ausbildung von Entnahmechirurgen abdomineller Organe in Deutschland – Herausforderungen und Lösungsansätze." Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie 146, no. 04 (March 29, 2021): 392–99. http://dx.doi.org/10.1055/a-1346-0346.
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ZusammenfassungDie Entnahme abdomineller Organe zur Transplantation ist ein hochspezialisierter Eingriff, der den 1. Schritt zu einer erfolgreichen Transplantation darstellt. Im folgenden Artikel soll ein Überblick über die organisatorischen Rahmenbedingungen, die derzeitige Ausbildung der Entnahmechirurgen in Deutschland sowie die damit einhergehenden Herausforderungen gegeben und diese auch im internationalen Kontext diskutiert werden.
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Aenderl, Isabel. "Transplantation: Der Weg der Organe – Neues Leben im Gepäck." Via medici 12, no. 04 (December 3, 2009): 34–38. http://dx.doi.org/10.1055/s-0029-1243391.
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Pansa, C., M. Scharl, J. Zeitz, M. Sterneck, O. Bachmann, T. Zimmermann, M. Hohmann, P. Grunert, and A. Stallmach. "De-novo Colitis bei Patienten nach Transplantation solider Organe." Zeitschrift für Gastroenterologie 56, no. 08 (August 2018): e263-e263. http://dx.doi.org/10.1055/s-0038-1668819.
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Welker, M. W., and A. A. Schnitzbauer. "Erratum zu: Aktuelle Aspekte der Immunsuppression nach Transplantation solider Organe." Der Gastroenterologe 15, no. 6 (October 28, 2020): 520. http://dx.doi.org/10.1007/s11377-020-00485-0.
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Elisabeth, Eberling. "Widerspruchslösung – ein Weg zu höheren Organspenderaten?" Vierteljahrshefte zur Wirtschaftsforschung 87, no. 2 (April 1, 2018): 153–68. http://dx.doi.org/10.3790/vjh.87.2.153.
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Zusammenfassung: In Deutschland sterben im Durchschnitt pro Tag drei Menschen, die vergeblich auf eine Organspende warten, so die Deutsche Stiftung Organtransplantation. In diesem Beitrag wird die Wirksamkeit eines Nudges mit der Einstellung des Defaults „Organe werden gespendet“ (Widerspruchslösung) diskutiert. Nachgegangen wird der Frage, ob dieser Nudge zu signifikant höheren Organspenderaten führt als der Default „Organe werden nicht gespendet“ anhand von Daten der acht Mitgliedsländer der Organisation Eurotransplant. Anhand der Analysen kann ausgeschlossen werden, dass eine höhere Organspenderate lediglich auf eine höhere Sterberate zurückzuführen ist. Separat vorgestellt werden zudem Ergebnisse für die Länder Deutschland, Niederlande, Belgien und Österreich. Diese Länder weisen ähnliche sozioökonomische Merkmale auf. Erörtert werden Einflussfaktoren auf die Organspenderaten und mögliche Probleme und Verzerrungen der Raten. Darüber hinaus wird diskutiert, inwiefern ein Nudge im Bereich der Organspende ethisch zu legitimieren ist. Das Ergebnis der Analysen: In Ländern mit Widerspruchsregelung ist die Organspenderate signifikant höher als in Ländern ohne entsprechende Regelung; die gesetzliche Regelung ist aber nicht eindeutig als Ursache isolierbar. Summary: According to the German Foundation for Organ Transplantation, on average, three people die each day in Germany while waiting for an organ donation. This article discusses the effectiveness of a nudge to the default setting “organs are donated” (presumed consent). It is explored whether this nudge leads to significantly higher organ donation rates than the default setting “organs are not donated“ based on data from the eight member countries of the Eurotransplant organization. The analysis shows that higher organ donation rates are not driven by higher mortality rates alone. The results for Germany, the Netherlands, Belgium and Austria are presented separately. These countries share similar socio-economic characteristics. Factors influencing organ donor rates are discussed as are possible problems and distortions of the donation rates. In addition, it is discussed to what extent a nudge in the field of organ donation can be ethically legitimized. The analyses show that, in countries with presumed consent, organ donation rates are significantly higher than in countries without this rule. However, it was not possible to identify the legal regulation as the sole cause of this difference.
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Aehling, Niklas F., Daniel Seehofer, and Thomas Berg. "Aktuelle Entwicklungen bei der Lebertransplantation – Wo stehen wir?" DMW - Deutsche Medizinische Wochenschrift 145, no. 16 (August 2020): 1124–31. http://dx.doi.org/10.1055/a-0982-0737.
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Was ist neu? Indikation zur Transplantation – aktuelle Entwicklungen Der Wandel in den Indikationen zur Transplantation setzt sich weiter fort, Hauptindikationen werden die Spätfolgen der nichtalkoholischen und alkoholassoziierten Lebererkrankungen und das hepatozelluläre Karzinom (HCC) sein. Zirrhosen auf dem Boden von Virushepatitiden spielen zunehmend eine untergeordnete Rolle. Ist die 6-Monats-Alkoholkarenz eine zwingende Voraussetzung für die Transplantation? Die Richtlinien der Bundesärztekammer fordern grundsätzlich eine Alkoholabstinenzperiode von 6 Monaten. Wissenschaftliche Daten zeigen, dass insbesondere Patienten mit Erstmanifestation einer akuten Alkoholhepatitis, die nicht auf die medikamentöse Therapie anspricht, in besonderer Weise von einer Transplantation profitieren können. Für diese Patienten kann eine individuelle Ausnahme für eine Transplantationslistung beantragt werden. Das hepatozelluläre Karzinom außerhalb der Mailand-Kriterien – Transplantation nach „Downstaging“ Zahlreiche Studien belegen, dass mithilfe effektiver „Downstaging“-Therapien und unter Berücksichtigung des Biomarkers AFP eine Subgruppe von Patienten mit initialem HCC außerhalb der Mailand-Kriterien definiert werden kann, die eine sehr günstige und der von Patienten innerhalb der Mailand-Kriterien vergleichbare postoperative Prognose besitzt. Zu krank für eine Transplantation? Das akut-auf-chronische Leberversagen (ACLF) Selbst Patienten mit dekompensierter Zirrhose mit Mehrorganversagen, wie es im Rahmen eines ACLF definiert ist, können erfolgreich und mit einer guten Langzeitprognose transplantiert werden. Das Zeitfenster, in welchem dies möglich ist, ist jedoch kurz. Spenderorganmangel – Verwendung HBV- und HCV-positiver Organe und neue Chancen durch die Maschinenperfusion Die Transplantation von Organen chronisch HCV- und HBV-infizierter Spender stellt durch die exzellenten Behandlungsmöglichkeiten bei diesen viralen Infektionen eine relevante Strategie zur Vergrößerung des Spenderpools dar. Zusätzlich gewinnt die Maschinenperfusion als neuartige Methode der Organkonservierung bzw. der Organaufbereitung an Bedeutung.
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Glyantsev, S. P. "Phenomenon of Demikhov. In the Sklifosovsky Institute (1960–1986). Fighting "windmills" or lack of conditions (1961)." Transplantologiya. The Russian Journal of Transplantation 10, no. 4 (December 21, 2018): 336–46. http://dx.doi.org/10.23873/2074-0506-2018-10-4-336-346.
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The article describes the results of V.P. Demikhov's working at N.V. Sklifosovsky Institute for Emergency Medicine in 1961. We have presented a brief report of his laboratory activities and a prospective working plan that included preparing for vital organ transplantations in clinic, conducting immunological and morphological studies, resolving resuscitation issues, all aimed at: 1) revitalizing dead people and their organs for transplantatio, and 2) preserving the vitality of the isolated organs before transplantation. For the first time in the history of national surgery, the question of "brain death" was raised as a criterion for the possibility of organ harvesting. However, the documents we have reviewed demonstrated that such a plan was impossible to be realized with the efforts of a single institution. V.P. Demikhov was advised to revise the plan, abridge it, and bring it into line with the modest potential of the Institute to organ transplantations.
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Le Boudec, A. "Des greffes d’organe au cœur artificiel : quelle évaluation en psychologie de liaison ?" European Psychiatry 29, S3 (November 2014): 587–88. http://dx.doi.org/10.1016/j.eurpsy.2014.09.301.
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De longue date, le psychologue de liaison occupe une place importante dans l’évaluation et l’accompagnement du patient bénéficiant d’une transplantation cardiaque. La nature de cette évaluation tend toutefois à évoluer devant la spécificité des problématiques psychiques posées par l’implantation de nouveaux dispositifs d’assistance cardiaque, comme l’assistance ventriculaire gauche ou le cœur artificiel total.Une partie de l’évaluation psychologique paraît transposable aux patients bénéficiant de ces avancées techniques. En effet, on portera une égale attention aux ajustements psychiques du patient devant l’évolution grave de sa maladie (capacité à intégrer les pertes, vécu de la dépendance, ressources psychiques et mécanismes de défense), à la qualité de l’investissement du projet chirurgical, à la qualité du soutien social et aux répercussions de la maladie sur la dynamique familiale. De même, au regard des nombreuses contraintes thérapeutiques futures, on évaluera les zones de vulnérabilité potentielles liées à l’histoire du patient, à son fonctionnement de personnalité et ses antécédents psychopathologiques, ainsi qu’à la qualité de son observance thérapeutique, fondamentale dans le suivi ultérieur.Toutefois, la question de l’intégration du corps étranger et du rejet sera traitée différemment selon que le patient bénéficie d’un « organe vivant » ou d’une prothèse entièrement mécanique. Si la transplantation cardiaque « relie psychiquement » le patient à un donneur vivant puis décédé, support de nombreuses projections, qu’en est-il de celui qu’on « dépossède » de son précieux organe au profit d’une machine, dont une partie demeure visible et qui nécessite une prise en charge technique constante ? De même, quelles sont les angoisses suscitées par ces différents dispositifs, chez le patient lui-même, mais également chez ses proches ?
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Černiauskienė, Viktorija, Monika Čiplytė, and Saulius Vosylius. "Organų donoro priežiūra intensyviosios terapijos skyriuje." Lietuvos chirurgija 8, no. 1 (January 1, 2010): 0. http://dx.doi.org/10.15388/lietchirur.2010.1.2122.
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Viktorija Černiauskienė, Monika Čiplytė, Saulius VosyliusVilniaus universiteto Anesteziologijos ir reanimatologijos klinika, Vilniaus greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: saulius.vosylius@gmail.com Įvadas / tikslasDonorinių organų poreikis gerokai viršija atliktų organų transplantacijų skaičių. Dažniausios priežastys, dėl kurių potencialūs donorai netampa efektyviais donorais, yra donoro artimųjų prieštaravimas donorystei, medicininės kontraindikacijos, logistikos problemos, neadekvatus potencialių donorų gydymas iki eksplantacijos operacijos. Šio straipsnio tikslas yra apžvelgti naujausius medicinos mokslo laimėjimus atliekant potencialių organų donorų priežiūrą reanimacijos ir intensyviosios terapijos skyriuose. Metodai ir rezultataiIšliekant žymiam atotrūkiui tarp organų pasiūlos ir poreikio, būtina kuo efektyviau panaudoti esamus resursus, daugiau dėmesio skiriant tinkamai potencialaus organų donoro intensyviajai terapijai. Dėl smegenų mirties įvyksta sunkūs daugelio organizmui svarbių funkcijų sutrikimai: kraujotakos ir kvėpavimo sistemų, endokrininiai, elektrolitų balanso sutrikimai, hipotermija, koagulopatija ir intensyvus sisteminis uždegimo atsakas. IšvadosPasirinkta tinkama intensyviosios terapijos taktika galėtų padidinti transplantacijai tinkamų organų skaičių, išlaikyti geresnę jų funkciją po transplantacijos. Reikšminiai žodžiai: smegenų mirtis, intensyviosios terapijos skyriai, audinių ir organų donorystė, gairės Organ donor management in the intensive care unit Viktorija Černiauskienė, Monika Čiplytė, Saulius VosyliusClinic of Anaesthesiology and Intensive Care, Vilnius University,Šiltnamių Str. 29, LT-04130 Vilnius, LithuaniaE-mail: saulius.vosylius@gmail.com Background / objectiveThe demand for donor organs greatly exceeds the number of transplantations. Many reasons may determine this inadequacy, such as family refusal, medical contraindications, logistics problems and inadequate management of the organ donor. The aim of the study was to present the recent achievements of medical practice in the management of organ donors in intensive care units. Methods and resultsWhile the discrepancy between the number of organ donations and transplantations persists, it is essential to use available resources more effectively, paying more attention to the intensive care management of the organ donor. Many physiological changes follow after brain death, such as cardiovascular and pulmonary dysfunction, endocrine and homeostasis disturbances, hypothermia, coagulopathy and an enhanced inflammatory response. ConclusionsOptimal intensive care could increase the number of organs available for transplantation and improve their function after it. Keywords: brain death, intensive care units, tissue and organ procurement, guidelines as topic
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Rahmel, Axel. "Organspende in Deutschland braucht eine höhere Wertschätzung." Gesundheits- und Sozialpolitik 73, no. 4-5 (2019): 84–90. http://dx.doi.org/10.5771/1611-5821-2019-4-5-84.
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Seit 35 Jahren unterstützt die Deutsche Stiftung Organtransplantation (DSO) die Krankenhäuser bei der Koordinierung der Organspende. Aus medizinischer Sicht ist die Transplantationsmedizin eine Erfolgsgeschichte. So könnte noch wesentlich mehr Patienten auf den Wartelisten geholfen werden, wenn mehr Organe für eine Transplantation zur Verfügung stünden. Die Entwicklung der Organspendezahlen hatte in 2017 ihren niedrigsten Stand der letzten 20 Jahre erreicht. Bereits auf ihrem Jahreskongress im November 2017 forderte die DSO einen Initiativplan mit Maßnahmen zur Förderung der Organspende. In diesem Jahr wurden gesetzliche Rahmenbedingungen geschaffen, die an den Schwachstellen ansetzen, die die DSO gemeinsam mit den Kliniken identifiziert hatte.
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Nitschke, Martin, Hryhoriy Lapshyn, and Tobias Keck. "40 Jahre Interdisziplinäres Transplantationszentrum am Universitätsklinikum Schleswig-Holstein, Campus Lübeck – Team Spirit at its Best." Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie 146, no. 04 (April 21, 2021): 413–16. http://dx.doi.org/10.1055/a-1447-0769.
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ZusammenfassungIn der Transplantationsmedizin bilden sich in den letzten Jahrzehnten vermehrt fächerübergreifende Organzentren, die im Rahmen einer interdisziplinären Kooperation eine optimale Versorgung vor, während und nach der Transplantation solider Organe gewährleisten können. Am Standort Lübeck wurde seit der Gründung des Zentrums vor 40 Jahren die Interdisziplinarität zwischen der Transplantationschirurgie und der Nephrologie gelebt, sodass sich ein auf die Nierentransplantation spezialisiertes Zentrum entwickeln konnte. Neben der medizinisch-fachlichen konnte eine organisatorische und baulich-infrastrukturelle Zentrumsbildung realisiert werden, die Vorbildcharakter für interdisziplinäre Transplantationszentren erreichte. Eine hohe Expertise minimalinvasiver Operationstechniken gemeinsam mit einer spezialisierten Transplantationsnephrologie bilden dabei die Basis für eine höchstmögliche Patientenzufriedenheit.
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Opoku, John Kwaku. "ORGAN TRANSPLANTATION MEDICINE: RELIGIOUS AND ETHICAL CONSIDERATIONS." Volume-1: Issue-9 (November, 2019) 1, no. 9 (December 7, 2019): 13–21. http://dx.doi.org/10.36099/ajahss.1.9.2.
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There are not enough solid organs available to meet the needs of patients with organ failure. Thousands of patients every year die on the waiting lists for transplantation. Yet there is currently available, underutilized, potential source of organs. Many patients die in intensive care following withdrawal of life-sustaining treatment whose organs could be used to save the lives of others. At present the majority of these organs go to waste. In this paper, I consider and evaluate a range of religious and ethical responses to improve the quality of organ transplantations available today. The responses of four world religions (Christianity, Islam, Buddhism and Hinduism) towards organ transplantation are considered. We argue that religious involvement in medical technologies like transplantation medicine gives to individuals the greatest chance of being able to help others with their organs after death under well-guided means. It is believed that attempts to increase patient autonomy will be realised in the light of religion and ethics.
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Tokalak, Ibrahim, Hamdi Karakayali, Gökhan Moray, Nevzat Bilgin, and Mehmet Haberal. "Coordinating Organ Transplantation in Turkey: Effects of the National Coordination Center." Progress in Transplantation 15, no. 3 (September 2005): 283–85. http://dx.doi.org/10.1177/152692480501500313.
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In January 2001, the National Coordination Center, which brought tissue and organ procurement and transplantation under the Turkish Health Ministry, was established in Turkey. The main aims of this organization are to expand cadaveric donation and increase the number of transplantable organs supplied by cadaveric donors. We compared the proportions of cadaveric organ transplantations that were performed in Turkey before and after the national coordination system was established. Of all the cadaveric transplantations completed to date, 91.6% of kidney and 71.5% of liver procedures were done before implementation of the new system, and 8.4% and 28.5%, respectively, were performed after the system was established. The data show that the frequency of cadaveric donation has increased, as well as the number of cadaveric organ transplantations performed annually. The new national transplantation coordination system is making a good start at increasing cadaveric transplantation in Turkey. This system will hopefully lead to a larger organ pool and shorter waiting lists in future.
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Vukovic, Milivoje, Nebojsa Moljevic, Zoran Milosevic, Nenad Katanic, and Dragan Krivokuca. "Multiple organ procurement." Medical review 60, no. 7-8 (2007): 339–42. http://dx.doi.org/10.2298/mpns0708339v.
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Introduction. Liver transplantation is the most demanding of all solid organ transplantations. It requires perfect organization and motivation of health care professionals, patients and their families. This article deals with the procedure for multiple organ procurement, reviews criteria for organ donation and describes the surgical technique for multiple organ procurement. Discussion. Adequate selection and evaluation of cadaveric donors and of organs for transplantation should include early identification of potential donors, and early diagnosis of brain death. The procurement of the highest number of viable organs for transplantation requires excellence in each of the phases. Early and aggressive physiologic support in the maintenance of potential donors can reduce organ donor loss due to irreversible asystole or multiorgan failure (it is almost always possible to maintain organ perfusion pressure) and increase the number of organs without increasing post-transplant morbidity or mortality. The ideal donor is a young, previously healthy, brain dead, victim of an accident. Conclusion. The surgical procedure for multiple organ procurement from brain death donors must be performed without intraopertive organ damage. .
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Gautier, S. V., and S. M. Khomyakov. "Organ donation and transplantation in the Russian Federation in 2016 9th report of the National Registry." Russian Journal of Transplantology and Artificial Organs 19, no. 2 (June 23, 2017): 6–26. http://dx.doi.org/10.15825/1995-1191-2017-2-6-26.
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Aim. To carry out monitoring of the organization and tendencies in the development of organ donation and transplantation in the Russian Federation in 2016. Materials and methods. Questioning of the heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics of the years, between certain regions of the Russian Federation and transplantation centers is done. Results. According to the register 35 centers of kidney transplantation, 22 centers of liver transplantation and 11 centers of heart transplantation were functioning in the Russian Federation in 2016. The waiting list of kidney transplantation in 2016 included 4818 potential recipients that make 14% of total number of the patients (35 000) receiving dialysis. The rate of donor activity in 2016 made 3.3 p. m. p. Efficiency of donor programs in 2016 continued to increase: the share of multiorgan retrieval made 64.1%, average number of organs received from one effective donor made 2.7. In 2016 the rate of kidney transplantation made 7.4 p. m. p., the rate of liver transplantation made 2.6 p. m. p.; the rate of heart transplantation made 1.5 p. m. p. In 2016 the number of transplantations in the Russian Federation increased by 14.8% in comparison with 2015 having overcome the level of 1700 organs transplantation. The Moscow region still remains to be the core of stability and development of the organ donation and transplantation in the country where 10 centers of transplantation function and half of all kidney transplantations and more than 70% of all liver and heart transplantations are carried out. Conclusion. The results of 2016 were positively affected by the introduction of targeted financial support of medical activity, related to organ donation, from federal budget resources. Among unresolved problems which constrain the development there are collision of legal regulation of licensing of medical activities for organ donation and transplantation, lack of the state order for the organization of transplantological medical care in each region, lack of responsibility of the heads of the regions and medical organizations for the organization of organ donation. Positive tendencies of the development of organ donation and transplantation in Russia call for further monitoring, strengthening and building.
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Gautier, S. V., and S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN RUSSIAN FEDERATION IN 2015. 8th report of National Register." Russian Journal of Transplantology and Artificial Organs 18, no. 2 (June 25, 2016): 6–26. http://dx.doi.org/10.15825/1995-1191-2016-2-6-26.
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Aim. To carry out monitoring of the organization and development of the organ donation and transplantation in theRussian Federationaccording to 2015.Materials and methods. Questioning of heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics by years, between certain regions of theRussian Federation, the transplantation centers is done.Results. According to the register in2015 inthe Russian Federation 36 centers of renal transplantation, 17 centers of liver transplantation and 10 centers of heart transplantation were functioning. The waiting list of kidney transplantation in 2015 included 4167 potential recipients that make 13% of the total number of the patients (31 500) receiving a dialysis. The rate of donor activity in 2015 made 3.0 pmp. Efficiency of donor programs in 2015 continues to increase: the share of multiorgan retrievals made 57.8%, average number of organs, received from one effective donor, made 2.7. In 2015 the rate of kidney transplantation made 6.5 pmp; the rate of liver transplantation made 2.2 pmp; the rate of heart transplantation made 1.2 pmp. The number of transplantations of liver and heart in theRussian Federationcontinues to increase. The number of transplantations of kidney remains approximately at one level in the range of 950–1050.Moscowcapital region continues to be the center of stability and development of the organ donation and transplantation in the country, in which 10 centers of transplantation are functioning and nearly a half from all kidney transplantations and more than 65% of all liver and heart transplantations are carried out.Conclusion. The potential for further development of the transplantation care in theRussian Federationcontinues to persist. In particular, at the expense of increasing efficiency of regional donation programs, expanding practices of multiorgan recuperation and transplantations of extrarenal organs, through interregional transplant coordination. It is critical to keep the volumes of the state order to deliver transplantological medical care to the population and to implement federal funding to conduct donation programs.
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Rodrigues-Filho, Edison Moraes, Cristiano Augusto Franke, and José Roque Junges. "Lung transplantation and organ allocation in Brazil." Revista de Saúde Pública 53 (March 7, 2019): 23. http://dx.doi.org/10.11606/s1518-8787.2019053000445.
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The philosophy of organ allocation is the result of two seemingly irreconcilable principles: utilitarianism and distributive justice. The process of organ donation and transplantation in Brazil reveals large inequalities between regions and units of the Federation, from the harvesting of organs to their implantation. In this context, lung transplantation is performed in only a few centers in the country and is still a treatment with limited long-term results. The allocation of the few organs harvested for the few procedures performed is defined mainly by chronology, a criterion that is not linked to necessity, which is a criterion of distributive justice, and neither to utility, a criterion of utilitarianism. This article reviews the organ allocation philosophy focusing on the case of lung transplantations in Brazil.
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Gautier, S. V., Ya G. Moysyuk, and S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN THE RUSSIAN FEDERATION IN 2014 7th REPORT OF NATIONAL REGISTER." Russian Journal of Transplantology and Artificial Organs 17, no. 2 (May 26, 2015): 7–22. http://dx.doi.org/10.15825/1995-1191-2015-2-7-22.
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Aim. To carry out monitoring of the organization and development of organ donation and transplantation in the Russian Federation according to 2014. Materials and methods. Questioning of heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics of years, between certain regions of the Russian Federation, the transplantation centers, and also with data of the international registers is made. Results. According to the Register in 2014 in the Russian Federation functioned 36 centers of kidney transplantation, 14 centers of liver transplantation and 9 centers of heart transplantation. The waiting list of kidney transplantation in 2014 included 4636 potential recipients that makes 16% of total number of the patients 29 000 receiving dialysis. The rate of donor activity in 2014 made 3.2 per million population (pmp). Efficiency of donor programs in 2014 continued to increase: the share of effective donors after brain death in 2014 increased to 77.2%, the share of multiorgan explantation made 50.5%, average number of organs received from one effective donor made 2.6. In 2014 the rate of kidney transplantation made 7.0 pmp, the rate of liver transplantation made 2.1 pmp and the rate of heart transplantation made 1.1 pmp. In the Russian Federation the number of transplantations of liver and heart continues to increase. The significant contribution to development of the organ donation and transplantation brings the Moscow region in which 11 centers of transplantation function and nearly a half from all kidney transplantations and more than 65% of all liver and heart transplantations are carried out. Conclusion. In theRussian Federation the potential for further development of the transplantology remains. In particular, at the expense of increase in the efficiency of regional donation programs, introduction of technologies, expansion of the practices of multiorgan donation and transplantations of extrarenal organs, interregional transplant coordination. Preservation of volumes of public funding for transplantological medical care and federal financing of donation programs in regions are of great importance.
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Rathor, Mohammad Yousuf, Azarisman SM Shah, Nur Raziana Bt Rozi, Che Rosle Draman, and Wan Ahmad Syahril. "Ethical issues in Kidney Transplantation and “An” Islamic perspective." Bangladesh Journal of Medical Science 20, no. 2 (February 1, 2021): 241–49. http://dx.doi.org/10.3329/bjms.v20i2.51530.
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Kidney transplantation (KT) is currently the most realistic treatment option for patients with end-stage renal disease (ESRD) as it enables them to live longer and provides better quality of life post-transplantation. Before the 1960s, all these patients would die as there was no treatment available. It is the commonest solid organ transplantation carried out in the world at the moment. Organs are harvested from living or cadaveric donors, with living kidney donor organs generally functioning better and for longer periods of time compared to the latter. Issues surrounding organ transplantation in general and kidney transplantation in particular, are fraught with ethical dilemmas due to the shortage of organs, the logistics behind the acquisition of organs, use of living donors including minors and the black market that has sprouted thereof. Entwined in this quagmire are the legal, social and psychological consequences for the individuals involved and the society at large. It is further compounded by religious concerns, which have a significant influence on the society’s acceptance of the practice of organ donation. The practice of organ transplantation is generally accepted by most Islamic scholars as it is concordant to the objectives of Islamic Law (maqasid al Sharī’ah) which prioritize the preservation of human life. However, resistances do arise from some jurists and even physicians of the same Islamic faith despite a fatwas decreeing that organ and tissue transplantations are permissible in Islam under certain conditions. The take-up of organ-donation is still largely poor especially among Muslims. This article therefore hopes to explore the various moral and ethical issues surrounding KT as well as the Islamic viewpoints emanating from it. We hope that this knowledge and understanding will benefit both health-care personnel and the public in general.
Bangladesh Journal of Medical Science Vol.20(2) 2021 p.241-249
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Langer, Róbert. "Az Eurotransplant-csatlakozás első öt éve Magyarországon." Orvosi Hetilap 159, no. 42 (October 2018): 1695–99. http://dx.doi.org/10.1556/650.2018.31230.
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Abstract: The author concludes lessons learned from Hungary joining Eurotransplant five years ago through the more than half a century history of the Hungarian organ transplantation. The result of the stepwise evolution is that today’s transplantation activity can be measured by a European benchmark. In comparison to the era before the membership, there are 40% more transplantations in the country. First the numbers of the living donor kidney transplantations significantly raised, followed by the organs transplanted from brain-dead donors: kidney, heart, pancreas, then liver and finally also lung. The ratio of the multiorgan donors changed from about 40% to more than 70%. A reassuring solution was found for the high urgent cases, for the paediatric transplants and for the highly immunized patients, who would have been in a desperate situation without Eurotransplant, but now every Hungarian end-stage organ failure patient has similar chances for getting a potential life-saving organ as their former luckier West-European counterparts. Orv Hetil. 2018; 159(42): 1695–1699.
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Golsteyn, Bart H. H., and Annelore M. C. Verhagen. "Deceased by default: Consent systems and organ-patient mortality." PLOS ONE 16, no. 3 (March 17, 2021): e0247719. http://dx.doi.org/10.1371/journal.pone.0247719.
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Previous research shows that countries with opt-out consent systems for organ donation conduct significantly more deceased-donor organ transplantations than those with opt-in systems. This paper investigates whether the higher transplantation rates in opt-out systems translate into equally lower death rates among organ patients registered on a waiting list (i.e., organ-patient mortality rates). We show that the difference between consent systems regarding kidney- and liver-patient mortality rates is significantly smaller than the difference in deceased-donor transplantation rates. This is likely due to different incentives between the consent systems. We find empirical evidence that opt-out systems reduce incentives for living donations, which explains our findings for kidneys. The results imply that focusing on deceased-donor transplantation rates alone paints an incomplete picture of opt-out systems’ benefits, and that there are important differences between organs in this respect.
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Shafiee, Ashkan, Elham Ghadiri, Jareer Kassis, and Anthony Atala. "Nanosensors for therapeutic drug monitoring: implications for transplantation." Nanomedicine 14, no. 20 (October 2019): 2735–47. http://dx.doi.org/10.2217/nnm-2019-0150.
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The number of patients requiring organ transplantations is exponentially increasing. New organs are either provided by healthy or deceased donors, or are grown in laboratories by tissue engineers. Post-surgical follow-up is vital for preventing any complications that can cause organ rejection. Physiological monitoring of a patient who receives newly transplanted organs is crucial. Many efforts are being made to enhance follow-up technologies for monitoring organ recipients, and point-of-care devices are beginning to emerge. Here, we describe the role of biosensors and nanosensors in improving organ transplantation efficiency, managing post-surgical follow-up and reducing overall costs. We provide an overview of the state-of-the-art biosensing technologies and offer some perspectives related to their further development.
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Milijić, Svetlana, and Aleksandar Nikolić. "Ethics in Organ Transplantation." Acta Facultatis Medicae Naissensis 35, no. 2 (June 1, 2018): 87–93. http://dx.doi.org/10.2478/afmnai-2018-0010.
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Abstract Organ transplantation is specific medical procedure which is used as a way of treatment. Transplantation is often the only way of curing a patient. Today, hundreds of people in the world live successfully with donor organs, and transplantations as medical interventions are performed routinely. In Europe, about 10,000 patients are saved annually by transplantation, but there are far larger numbers of those waiting for their so-called rescue organ. In all countries, transplant medicine is regulated by special laws, regulations and conventions that provide medical, legal, and ethical regulations. Organ donation is an act of charity and giving, and not a contract on movement. Righteousness and fairness are emphasized in transplantation medicine. The question of organ transplanting affects the most intimate issues of human integrity, human dignity, health and illness. That is why certain instructions, rules of conduct and treatment are required from ethics. Today, in ethical dilemmas regarding organ transplantation, less emphasis is placed on imperative ethics, which emphasizes the idea of obligation, and more emphasis is placed on the so-called indicative ethics in which the idea of general accountability and solidarity is in the foreground. In cases of transplanting organs from a living patient, it is a doctor`s duty to provide complete information to the donor and the recipient about the purpose and nature of the procedure itself, success probability, consequences, possible risks and noted adverse reactions. In cases of transplanting from a cadaver, the basic ethical question is defining brain death and respect for the deceased. The main reason of a small number of donors is lack of information, fear of organ donating and ethical questions related to transplantation.
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Copcă, Narcis, and Constanța Mihăescu-Pinţia. "Multi-organ Transplantation Center in Romania: a story of persuasion for a controverted issue." Proceedings of the International Conference on Business Excellence 13, no. 1 (May 1, 2019): 421–34. http://dx.doi.org/10.2478/picbe-2019-0037.
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Abstract Many countries built their own models of transplantation, collaborating to exchange knowledge and donor organs for effectively help their patients in need. Despite great clinical research on transplantation, literature regarding its management is scarce. Transplantation is quite a controverted issue in Romania, without a culture of donation, within a poor healthcare system. Yet, first attempts were in early 20th century, and modern transplantation started since 1995. There was always a shortage of organs, but after recent press scandals, people became more reluctant to donate, therefore transplantations went down, dramatically impacting patients.Our objective is to emphasize opportunity, need and sustainability for developing a multi-organ transplantation center in Romania, of regional importance, in order to better serve our patient needs in an effective and efficient manner. This research used descriptive analysis, secondary data compilation and review, legislative diagram, case study. Currently there are 68 transplantation centers accredited in Romania with 13,702 transplants accomplished (organs, tissues, cells), at a rate of 19.3/million, covering 19.4 millions of people living just 75.5 years in average (EU=80.2). But 5,400 Romanian patients wait for a transplant, while 550 died waiting... After modernization and building a great surgical center and team, Clinical Hospital St. Maria of 300 beds started complex surgery and successful liver transplantation in 2014, continued with lung transplant in 2018 – Romanian premiere, after many struggles. Next step is a modern multi-organ transplantation center. Vision, persuasion and effective leadership are crucial. Romanian potential for overspecialized surgery is greater than actual practice. Experience indicates that multi-organ transplantation centers are more effective and efficient than separated ones, by concentrating the best specialists, technology, knowledge and resources available for harvest, transplant and care, thus improving health outcomes (donors, successful transplants, lives saved, quality of life), prestige, retention of excellent professionals, and trust in healthcare system, at lower costs than in developed countries.
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Gautier, S. V., and S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN RUSSIAN FEDERATION IN 2017 10TH REPORT OF THE NATIONAL REGISTRY." Russian Journal of Transplantology and Artificial Organs 20, no. 2 (June 27, 2018): 6–28. http://dx.doi.org/10.15825/1995-1191-2018-2-6-28.
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Aim. To analyse the status and trends in the development of organ donation and organ transplantation in the Russian Federation according to 2017 data.Materials and methods. The survey of heads of transplantation centers was conducted. A comparative analysis of the data obtained in the dynamics of years, between individual subjects of the Russian Federation, the centers of transplantation is performed.Results. According to the register in 2017 in Russia there were only 41 centers for kidney transplantation, 24 liver and 16 hearts. The waiting list for kidney transplantation in 2017 included 5,531 potential recipients, which is approximately 13.8% of the total number of 40,000 patients receiving dialysis. The level of donor activity in 2017 was 3.8 per million of the population, while the share of multiorgan seizures was 66.5%, the average number of organs received from one effective donor was 2.8. In 2017, the level of kidney transplantation was 8.0 per million of the population, the liver transplantation index was 3.0 per million of the population; the rate of heart transplantation is 1.7 per million of the population. In 2017 the number of transplants in Russia increased by 11.3% compared to 2016. There are 11 transplantation centers on the territory of Moscow and the Moscow Region, and half of all kidney transplants and 70% of all liver and heart transplantations are performed. The number of patients with transplanted organs in the Russian Federation is approaching 13,000.Conclusion. In the Russian Federation there is a strong tendency to increase the number of effective donors and to increase the number of organ transplants, and the number of transplant centers is also increasing. In recent years, the country has created prerequisites for the development of organ donation and transplantation: the regulatory and legal framework, public donation funding, material and technical base, etc. In the coming years, positive experience and organizational patterns of organ donation and transplantation from successful regions in Other subjects of the Russian Federation for building effective programs. The leading role in this process should be played by the Academician V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs.
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Yu, Andy S., Aijaz Ahmed, and Emmet B. Keeffe. "Liver Transplantation: Evolving Patient Selection Criteria." Canadian Journal of Gastroenterology 15, no. 11 (2001): 729–38. http://dx.doi.org/10.1155/2001/743019.
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The widespread recognition of the success of liver transplantation as a treatment for most types of acute and chronic liver failure has led to increased referrals for transplantation in the setting of a relatively fixed supply of cadaver donor organs. These events have led to a marked lengthening of the waiting time for liver transplantation, resulting in increased deaths of those on the waiting list and sicker patients undergoing transplantation. Nearly 5000 liver transplantations were performed in the United States in 2000, while the waiting list grew to over 17,000 patients. The mounting disparity between the number of liver transplant candidates and the limited supply of donor organs has led to reassessment of the selection and listing criteria for liver transplantation, as well as revision of organ allocation and distribution policies for cadaver livers. The development of minimal listing criteria for patients with chronic liver disease based on a specific definition for decompensation of cirrhosis has facilitated the more uniform listing of patients at individual centres across the United States. The United Network for Organ Sharing, under pressure from transplant professionals, patient advocacy groups and the federal government, has continuously revised allocation and distribution policies based on the ethical principles of justice for the individual patient versus optimal utility of the limited organ supply available annually. Beginning in 2002, it is likely that the Model for End-stage Liver Disease (MELD) score will be implemented to determine disease severity and direct donor organs to the sickest patients rather than to those with the longest waiting times.
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Siraj, Md Sanwar. "Why Is Family-Oriented Organ Transplantation Policy and Practice Necessary for Bangladesh?" Bangladesh Journal of Bioethics 11, no. 1 (March 9, 2020): 1–9. http://dx.doi.org/10.3329/bioethics.v11i1.49191.
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In the West, in countries such as the US and UK, people are equally encouraged to donate organs both to their relatives and nonrelatives. In practice, although family is the priority in the US and UK, anybody can donate organs to anyone else lawfully. Contrastingly, in Bangladesh, people are only legally allowed to donate organs for transplantation to close relatives. Bangladesh’s living organ transplantation policy and practice is in stark contrast with the Western secular biomedical perspective. In this artcile, I address that the notion of individual freedom and liberty in regard to the donation of organs for transplantation in the West is consistent with secular culture and biomedical perspectives, but such biomedical policy and practice is at odds with the Bangladeshi Muslim culture, socio-economic reality and biomedical perspective. As Bangladesh is a family-oriented collective society, the kinship relation and strong familial bonds may encourage relatives into donating organs to a patient. More than 20% of people still live below the poverty line, and the COVID-19 pandemic has pushed poor people into extreme poverty. The practice of allowing unrelated altruistic donors as is done in the West and Iran, or even in the special circumstance in Paksitan, the act of donating organs will comprehensievly increase organ trade in Bangladesh, which in turn will cause more harms than benefits. This study conludes that the government should uphold family-oriented biomedical policy and practice in Bangladesh until poverty is eliminated. It implies that patients who do not have close relatives, or whose poetntial relative donors are medically unsuitable for transplantations should wait for deceased organs for transplantation.
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Gautier, S. V., and S. M. Khomyakov. "Organ donation and transplantation in the Russian Federation in 2019. 12th report from the Registry of the Russian Transplant Society." Russian Journal of Transplantology and Artificial Organs 22, no. 2 (July 12, 2020): 8–34. http://dx.doi.org/10.15825/1995-1191-2020-2-8-34.
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Objective: to monitor current trends and developments in organ donation and transplantation in the Russian Federation based on the 2019 data. Materials and methods. Heads of organ transplant centers were surveyed. Data obtained over years from federal subjects of the Russian Federation and from organ transplant centers in the country were analyzed and compared. Results. Based on data retrieved from the 2019 Registry, only 46 kidney, 31 liver and 17 heart transplant centers were functioning in Russia. In 2019, there were 6,878 potential recipients in the kidney transplant waitlist. This represents 13.7% of the 50,000 dialysis patients in the country. Donation activity in 2019 reached 5.0 per million population; multi-organ procurement rate was 71.6%; 2.9 organs on average were procured from one effective donor. In 2019, there were 10.0 kidney transplants per million population, 4.0 liver transplants per million population and 2.3 heart transplants per million people. Same year, the number of transplant surgeries performed in Russia rose 10.7% from the previous year. Moscow and Moscow Oblast alone have 13 functioning organ transplantation centers. They account for half of all kidney transplant surgeries and 70% of all liver and heart transplants performed in the country. Organ recipients in the Russian Federation have exceeded 16,000 in number. Conclusion. Organ transplantations in Russia keep on increasing – 10–15% per year. Donor and transplant programs are also becoming more effective and efficient. However, the demand for organ transplants far exceeds the current supply of available organs in the Russian Federation. Peculiarities of the development of organ donation and organ transplantation in Russia in 2019 were associated with some factors, such as structure and geographical location of transplant centers, waitlisting of patients, funding sources and amount, and management of donor and transplant programs. The national transplantation registry will be developed taking into account new monitoring and analysis challenges.
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Langer, Róbert. "Milestone in Hungarian organ transplantation: joining Eurotransplant." Orvosi Hetilap 154, no. 22 (June 2013): 844–45. http://dx.doi.org/10.1556/oh.2013.29621.
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Hungarian organ transplantation reached a new milestone after half-a-century history, when becoming a full member of the 135-million Eurotransplant community this year. The transplantation of the five organs: kidney, liver, pancreas, heart and lung became a routine procedure. A handful of specialists performed nearly 7000 transplantations and doing so supported the evolution of a special branch of the Hungarian health care system. The author reports the latest results of the preliminary membership year, looking forward with great optimism by seeing new horizons with the advantages of the full membership. Orv. Hetil., 2013, 154, 844–845.
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Ratkovic, Marina, Nikolina Basic Jukic, Danilo Radunovic, Vladimir Prelevic, and Branka Gledovic. "Kidney Transplantation Program in Montenegro." BANTAO Journal 13, no. 2 (December 1, 2015): 68–72. http://dx.doi.org/10.1515/bj-2015-0015.
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AbstractIntroduction.There was no transplantation program in Montenegro until 2012. On the other hand, there were 93 patients with transplanted kidney. These transplantations were performed abroad; 15% in areas of black organ markets (India, Pakistan, Russian Federation). Beside the ethical problems, these transplantations carried a high risk of complications.Methods.Our health system had to ensure solution for patients with terminal organ failure. Preparation of all neccessary conditions for the beginning of transplantation program in Montenegro started in 2006 with different activities including public, legal, medical, educational and international cooperation aspects.Results.The first kidney transplantation from living donor in Montenegro was preformed on September 25th, 2012. In the period from 2012 until now 23 kidney transplantations from living related donor were performed and one kidney transplantation from deceased donor in the Clinical Center of Montenegro. In the a two year-follow-up period, all patients to whom kidney transplantation was performed are in a good condition and without serious complications in posttransplant period.Conclusion.Development of the transplantation program allowed controlled transplantation and safety of patients. Our next steps are development of deceased organ donor transplantation and achievement of higher rate of deceased donor organ transplantation and individualization of immunosuppressive therapy.
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Engelhardt, H. Tristram. "The Injustice of Enforced Equal Access to Transplant Operations: Rethinking Reckless Claims of Fairness." Journal of Law, Medicine & Ethics 35, no. 2 (2007): 256–64. http://dx.doi.org/10.1111/j.1748-720x.2007.00134.x.
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This essay does not directly address organ transplantation or even issues of justice, fairness, or equality in access to organs for transplantation. Instead, it engages a higher-order question: the justice of coercively and globally imposing any particular contentfull view of justice, fairness, and/or equality (i.e., a view grounded in a particular ranking of primary human goods and/or right-making conditions) under circumstances that would violate peaceable, consensual choice. It is argued that state coercion, as in the prohibition of the sale of organs or the coercive imposition of equal access to transplantations or health care, is unjust when there are insufficient grounds to establish with certainty the canonical normative character of the particular account of justice, fairness, or equality, as well as the warrant for the use of coercive force to impose such an account.
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Scherstén, Tore, Hans Brynger, Ingvar Karlberg, and Egon Jonsson. "Cost-Effectiveness Analysis of Organ Transplantation." International Journal of Technology Assessment in Health Care 2, no. 3 (July 1986): 545–52. http://dx.doi.org/10.1017/s0266462300002622.
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In 1958 Joseph Murray and associates reported the first successful kidney transplantation between two identical twins at Peter Bent Brigham Hospital in Boston (14). Since then organ transplantation has advanced rapidly. Renal transplantation is now a standard treatment for irreversible renal failure, and liver transplantation is an accepted method for treating end-stage liver disease. A number of patients have survived more than 20 years after renal transplantation and more than 10 years after liver transplantation (20). Very few liver transplantations have been performed in Sweden but this method is expected to become more common in the near future.
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Puślecki, Mateusz, Marcin Ligowski, Marek Dąbrowski, Maciej Sip, Sebastian Stefaniak, Tomasz Kłosiewicz, Łukasz Gąsiorowski, et al. "The role of simulation to support donation after circulatory death with extracorporeal membrane oxygenation (DCD-ECMO)." Perfusion 32, no. 8 (June 27, 2017): 624–30. http://dx.doi.org/10.1177/0267659117716533.
Full textAbstract:
Maintaining the viability of organs from donors after circulatory death (DCD) for transplantation is a complicated procedure, from a time perspective in the absence of appropriate organizational capabilities, that makes such transplantation cases difficult and not yet widespread in Poland. We present the procedural preparation for Poland’s first case of organ (kidney) transplantation from a DCD donor in which perfusion was supported by extracorporeal membrane oxygenation (ECMO). Because this organizational model is complex and expensive, we used advanced high-fidelity medical simulation to prepare for the real-life implementation. The real time scenario included all crucial steps: prehospital identification, cardiopulmonary resuscitation (CPR), advanced life support (ALS); perfusion therapy (CPR-ECMO or DCD-ECMO); inclusion and exclusion criteria matching, suitability for automated chest compression; DCD confirmation and donor authorization, ECMO organs recovery; kidney harvesting. The success of our first simulated DCD-ECMO procedure in Poland is reassuring. Soon after this simulation, Maastricht category II DCD procedures were performed, involving real patients and resulting in two successful double kidney transplantations. During debriefing, it was found that the previous simulation-based training provided the experience to build a successful procedural chain, to eliminate errors at the stage of identification, notification, transportation, donor qualifications and ECMO organ perfusion to create DCD-ECMO algorithm architecture.