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Transplantation Feb 2021
Topics: Cyprus; Health Policy; Humans; Organ Transplantation; Policy Making; Program Development; Program Evaluation; Tissue and Organ Procurement
PubMed: 33492110
DOI: 10.1097/TP.0000000000003386 -
Neurologic Clinics Nov 2017Among patients receiving solid organ transplants, approximately one-third will develop neurologic symptoms. Most of these neurologic symptoms will occur within 30 days... (Review)
Review
Among patients receiving solid organ transplants, approximately one-third will develop neurologic symptoms. Most of these neurologic symptoms will occur within 30 days of their transplantation. These neurologic symptoms include neurotoxicity of immunosuppressive agents, seizures, encephalopathy, cerebrovascular events, opportunistic infections, posttransplant lymphoproliferative disorder, and central pontine myelinosis. Some neurologic complications are seen more frequently in specific organ transplant recipients. For example, ischemic stroke is seen more frequently in heart and kidney transplant patients compared with other solid organ transplant recipients. This article is a review of the main neurologic complications after solid organ transplantation.
Topics: Humans; Nervous System Diseases; Organ Transplantation
PubMed: 28962815
DOI: 10.1016/j.ncl.2017.06.013 -
Transplantation Oct 2017
Topics: Czech Republic; Delivery of Health Care, Integrated; Health Services Accessibility; History, 20th Century; History, 21st Century; Humans; Models, Organizational; Organ Transplantation; Process Assessment, Health Care; Tissue Donors; Treatment Outcome
PubMed: 28926517
DOI: 10.1097/TP.0000000000001871 -
Gastroenterology Clinics of North... Jun 2018Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific... (Review)
Review
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols. In the case of available identical twins or HLA-identical sibling, LDIT has a significant immunologic advantage and should be offered.
Topics: Composite Tissue Allografts; Donor Selection; Humans; Intestinal Diseases; Intestines; Liver Transplantation; Living Donors; Organ Transplantation; Time Factors; Tissue and Organ Harvesting; Treatment Outcome; Waiting Lists
PubMed: 29735030
DOI: 10.1016/j.gtc.2018.01.008 -
Experimental and Clinical... Apr 2015The risk for respiratory complications after solid-organ transplantation continues to be high, even though progress has been achieved with surgical techniques,... (Review)
Review
The risk for respiratory complications after solid-organ transplantation continues to be high, even though progress has been achieved with surgical techniques, immunosuppressive agents, and perioperative treatment of transplant recipients. This review is an overview of infectious and noninfectious respiratory complications in liver, kidney, heart, and lung transplant patients. Postoperative respiratory complications are more frequent after liver, heart, and lung transplant recipients, but the incidence is lower in kidney transplant recipients. Lung infiltrates due to multidrug-resistant bacterial infections are increasing and may cause respiratory failure associated with high morbidity and mortality. Treatment strategies including early, broad-spectrum empiric antibiotic therapy, lung protective mechanical ventilation, and appropriate timing of tracheotomy for patients who need prolonged mechanical ventilation. Early recognition and aggressive treatment of these respiratory complications may improve outcomes.
Topics: Heart Transplantation; Humans; Kidney Transplantation; Liver Transplantation; Lung Transplantation; Organ Transplantation; Postoperative Complications; Respiratory Insufficiency; Respiratory Tract Infections
PubMed: 25871362
DOI: No ID Found -
JACC. Heart Failure Apr 2018
Topics: Allografts; Heart Diseases; Heart Failure; Heart Transplantation; Humans; Organ Transplantation
PubMed: 29598940
DOI: 10.1016/j.jchf.2017.12.015 -
Current Opinion in Organ Transplantation Apr 2020The development and implementation of 'increased risk donor' (IRD) status by the Centers for Disease Control (CDC) was intended to guide patients and providers in... (Review)
Review
PURPOSE OF REVIEW
The development and implementation of 'increased risk donor' (IRD) status by the Centers for Disease Control (CDC) was intended to guide patients and providers in decision making regarding risk of infectious transmission via solid organ transplantation. Several contemporary studies have shown underutilization of these organs. This review summarizes the issues surrounding IRD status as well as recent advances in our understanding of the risks and benefits of increased risk organs and their appropriate utilization.
RECENT FINDINGS
Risk of window-period infection remains exceedingly low, and implementation of nucleic acid testing for HIV and hepatitis C virus (HCV) has resulted in decreasing risk of window-period infection often by an order of magnitude or more. Surgeons remain hesitant to utilize IRD organs. In addition, surgeon assessment of risk by donor behaviour was often discordant with known risks of those behaviours. Studies investigating outcomes of utilization of IRD organs suggest long-term mortality and graft survival is at least equivalent to non-IRD organs. Contemporary results suggest that IRD organs continue to be underutilized, particularly adult kidneys and lungs, with hundreds of wasted organs per year.
SUMMARY
CDC IRD labelling has led to an underutilization of organs for transplantation. The risks associated with acceptance of an IRD organ are inflated by surgeons and patients, and outcomes for patients who undergo transplantation with increased risk organs are similar to or better than those for patients whom accept standard risk organs. The rate of transmission of window-period infection from IRD organs is exceptionally low. The harms regarding the utility of Public Health Service increased risk classification outweigh the benefits for patients in need of transplant.
Topics: Humans; Organ Transplantation; Risk Factors; Tissue Donors
PubMed: 32073497
DOI: 10.1097/MOT.0000000000000735 -
Harefuah Nov 2023Organ transplantation is an innovative field that was pioneered in the middle of the last century with the development of surgical techniques, advances in the... (Review)
Review
Organ transplantation is an innovative field that was pioneered in the middle of the last century with the development of surgical techniques, advances in the understanding of immunological processes that cause rejection, introduction of drugs to prevent rejection and improved methods for organ preservation. In Israel, the first heart transplantation and kidney transplantation were performed in the mid-1960's followed by pancreas, lung and liver transplantation that were conducted for the first time in the late 1980's and early 1990's. The significant change that has led to an increase in the number of transplants in Israel and rising success rates after transplant has occurred with the introduction of the new generation of anti-rejection drugs, Cyclosporine and subsequently Tacrolimus (Prograf ®). Another milestone was the founding of The National Transplant Center in 1994. This led to the formation of national transplant candidate lists for each organ, the establishment of professional committees that determine organ allocation policy and the creation of a governmental ethics committee to oversee the performance of live-donor transplantation. In 2008, about a month before the signing of the Istanbul Declaration, the Transplantation Law was enacted to regulate organ transplantation in Israel, which included clauses restricting organ trade in the spirit of the Istanbul Declaration. These measures increased the number of transplants performed in Israel and significantly reduced the number of transplants of Israelis abroad. The establishment of Matanat Chaim Organization in 2012 is another milestone that has led to a significant increase in the number of kidney transplants, most of which are currently performed from altruistic donations. However, today there is still a shortage of organs for transplantation from deceased donors and there is a long way to go to close the gap between organ need and supply. This review will indicate the introduction of the first transplants performed in Israel and the measures undertaken to increase the number of transplants. In addition, the review will note the laws and regulations of organ allocation.
Topics: Humans; Israel; Tissue and Organ Procurement; Organ Transplantation; Kidney Transplantation; Living Donors
PubMed: 37965853
DOI: No ID Found -
Transplant International : Official... Jun 2019Transplantation is the only curative treatment option available for patients suffering from end-stage organ failure, improving their quality of life and long-term... (Review)
Review
Transplantation is the only curative treatment option available for patients suffering from end-stage organ failure, improving their quality of life and long-term survival. However, because of organ scarcity, only a small number of these patients actually benefit from transplantation. Alternative treatment options are needed to address this problem. The technique of whole-organ decellularization and recellularization has attracted increasing attention in the last decade. Decellularization includes the removal of all cellular components from an organ, while simultaneously preserving the micro and macro anatomy of the extracellular matrix. These bioscaffolds are subsequently repopulated with patient-derived cells, thus constructing a personalized neo-organ and ideally eliminating the need for immunosuppression. However, crucial problems have not yet been satisfyingly addressed and remain to be resolved, such as organ and cell sources. In this review, we focus on the actual state of organ de- and recellularization, as well as the problems and future challenges.
Topics: Animals; Bioreactors; Extracellular Matrix; Humans; Immunosuppression Therapy; Intestines; Kidney; Kidney Transplantation; Liver; Liver Transplantation; Lung; Lung Transplantation; Organ Transplantation; Pancreas; Pancreas Transplantation; Tissue Engineering; Tissue Scaffolds; Tissue and Organ Procurement; Waiting Lists
PubMed: 31099920
DOI: 10.1111/tri.13462 -
Developing World Bioethics Sep 2023In Nepal, live donor organ transplantation is only 14 years old with the first successful kidney transplant made in 2008 and a successful liver and bone marrow...
In Nepal, live donor organ transplantation is only 14 years old with the first successful kidney transplant made in 2008 and a successful liver and bone marrow transplant made in 2016. However, transplantation of cadaveric cornea dates back to 1998. There are still no cases of animal-to-human organ transplantation in Nepal. There are stringent laws to regulate human body organ transplantation in Nepal which are amended from time to time. However, there is a racket of human traffickers who lure rural people from this low-income country into the illegal organ trade. Furthermore, there is a substantial lack of awareness of organ donation among the general public. This article focuses on the stipulations of ethical, legal, and practical issues of obtaining organs procured from living and brain-dead donors that support the process of transplantation in Nepal. In addition, the article also explores the legal and practical issues of organ trafficking and organ donation awareness in Nepal on the basis of factual data and findings from other studies.
Topics: Humans; Adolescent; Nepal; Organ Transplantation; Kidney Transplantation; Living Donors; Tissue and Organ Procurement
PubMed: 36170150
DOI: 10.1111/dewb.12371