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The Indian Journal of Medical Research Apr 2015Organ transplantation has emerged as the saving grace for those who are suffering from end organ disease. Advent of modern surgical procedures and immunosuppressants... (Review)
Review
Organ transplantation has emerged as the saving grace for those who are suffering from end organ disease. Advent of modern surgical procedures and immunosuppressants further decrease morbidity and mortality. Meta-analyses have shown that post-organ transplantation quality of life improves for social, physical and daily activity functioning, but not consistently for psychological health. Psychiatrists can play a useful role not only in selecting the best suitable candidate for the procedure by psychosocial screening but also to tackle post-operation psychological issues that trouble patients as well as caretakers and decrease their quality of life. Issues like selection of patients with psychiatric disorders and substance abuse for transplantation process and their treatment both pre- and post- operation, risky health behaviours, treatment adherence for immunosuppressants and psychological support for caretakers can be better addressed by a psychiatrist who is sensitive towards these issues. Prescribing various psychotropics and immunosuppressants in the background of impaired organ function and drug-drug interaction is further challenging. Thus, psychiatrists need to be knowledgeable about these issues and should be an integral part of organ transplantation team for overall better outcome.
Topics: Humans; Immunosuppressive Agents; Organ Transplantation; Postoperative Period; Psychiatry; Quality of Life; Social Support; Substance-Related Disorders
PubMed: 26112841
DOI: 10.4103/0971-5916.159268 -
BMC Anesthesiology Nov 2022In this review, we describe the major milestones in the development of organ transplantation with a specific focus on hepatic transplantation. For many years, the... (Review)
Review
In this review, we describe the major milestones in the development of organ transplantation with a specific focus on hepatic transplantation. For many years, the barriers preventing successful organ transplantation in humans seemed insurmountable. Although advances in surgical technique provided the technical ability to perform organ transplantation, limited understanding of immunology prevented successful organ transplantation. The breakthrough to success was the result of several significant discoveries between 1950 and 1980 involving improved surgical techniques, the development of effective preservative solutions, and the suppression of cellular immunity to prevent graft rejection. After that, technical innovations and laboratory and clinical research developed rapidly. However, these advances alone could not have led to improved transplant outcomes without parallel advances in anesthesia and critical care. With increasing organ demand, it proved necessary to expand the donor pool, which has been achieved with the use of living donors, split grafts, extended criteria organs, and organs obtained through donation after cardiac death. Given this increased access to organs and organ resources, the number of transplantations performed every year has increased dramatically. New regulatory organizations and transplant societies provide critical oversight to ensure equitable organ distribution and a high standard of care and also perform outcome analyses. Establishing dedicated transplant anesthesia teams results in improved organ transplantation outcomes and provides a foundation for developing new standards for other subspecialties in anesthesiology, critical care, and medicine overall. Through a century of discovery, the success we enjoy at the present time is the result of the work of well-organized multidisciplinary teams following standardized protocols and thereby saving thousands of lives worldwide each year. With continuing innovation, the future is bright.
Topics: Humans; Anesthesiology; Liver Transplantation; Anesthesia; Organ Transplantation; Living Donors
PubMed: 36435747
DOI: 10.1186/s12871-022-01904-1 -
Current Opinion in Organ Transplantation Oct 2019The availability of organs for transplant fails to meet the demand and this shortage is growing worse every year. As the cost of not getting a suitable donor organ can... (Review)
Review
PURPOSE OF REVIEW
The availability of organs for transplant fails to meet the demand and this shortage is growing worse every year. As the cost of not getting a suitable donor organ can mean death for patients, new tools and approaches that allows us to make advances in transplantation faster and provide a different vantage point are required. To address this need, we introduce the concept of using the zebrafish (Danio rerio) as a new model system in organ transplantation. The zebrafish community offers decades of research experience in disease modeling and a rich toolbox of approaches for interrogating complex pathological states. We provide examples of how already existing zebrafish assays/tools from cancer, regenerative medicine, immunology, and others, could be leveraged to fuel new discoveries in pursuit of solving the organ shortage.
RECENT FINDINGS
Important innovations have enabled several types of transplants to be successfully performed in zebrafish, including stem cells, tumors, parenchymal cells, and even a partial heart transplant. These innovations have been performed against a backdrop of an expansive and impressive list of tools designed to uncover the biology of complex systems that include a wide array of fluorescent transgenic fish that label specific cell types and mutant lines that are transparent, immune-deficient. Allogeneic transplants can also be accomplished using immune suppressed and syngeneic fish. Each of these innovations within the zebrafish community would provide several helpful tools that could be applied to transplant research.
SUMMARY
We highlight some examples of existing tools and assays developed in the zebrafish community that could be leveraged to overcome barriers in organ transplantation, including ischemia-reperfusion, short preservation durations, regeneration of marginal grafts, and acute and chronic rejection.
Topics: Animals; Humans; Models, Animal; Organ Transplantation; Regenerative Medicine; Tissue Donors; Tissue and Organ Procurement; Zebrafish
PubMed: 31483338
DOI: 10.1097/MOT.0000000000000696 -
Biomedica : Revista Del Instituto... Jun 2017
Topics: Colombia; Humans; Organ Transplantation; Time Factors; Tissue and Organ Procurement
PubMed: 28527275
DOI: 10.7705/biomedica.v37i2.3909 -
BioMed Research International 2017Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation... (Review)
Review
Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation. To perform elective nontherapeutic ventilation (ENTV), a patient's anticipated willingness to donate organs and/or explicit acceptance by his/her relatives is required. This process should focus exclusively on those patients with catastrophic brain injuries and imminent risk of death which, due to its acute damage, are not considered treatable. This article defends ENTV as an effective strategy to improve donation rate, analyzing its ethical and legal basis.
Topics: Brain Death; Brain Injuries; Humans; Intensive Care Units; Organ Transplantation; Tissue and Organ Procurement
PubMed: 28182115
DOI: 10.1155/2017/7518375 -
Arquivos Brasileiros de Cardiologia Aug 2022
Topics: Exercise Therapy; Humans; Organ Transplantation
PubMed: 35946687
DOI: 10.36660/abc.20220373 -
Inflammation Research : Official... Dec 2022Ischemia and reperfusion injury (IRI) is an ineluctable immune-related pathophysiological process during organ transplantation, which not only causes a shortage of donor... (Review)
Review
BACKGROUND
Ischemia and reperfusion injury (IRI) is an ineluctable immune-related pathophysiological process during organ transplantation, which not only causes a shortage of donor organs, but also has long-term and short-term negative consequences on patients. Severe IRI-induced cell death leads to the release of endogenous substances, which bind specifically to receptors on immune cells to initiate an immune response. Although innate and adaptive immunity have been discovered to play essential roles in IRI in the context of organ transplantation, the pathway and precise involvement of the immune response at various stages has not yet to be elucidated.
METHODS
We combined "IRI" and "organ transplantation" with keywords, respectively such as immune cells, danger signal molecules, macrophages, neutrophils, natural killer cells, complement cascade, T cells or B cells in PubMed and the Web of Science to search for relevant literatures.
CONCLUSION
Comprehension of the immune mechanisms involved in organ transplantation is promising for the treatment of IRI, this review summarizes the similarities and differences in both innate and adaptive immunity and advancements in the immune response associated with IRI during diverse organ transplantation.
Topics: Humans; Organ Transplantation; Reperfusion Injury; Adaptive Immunity; T-Lymphocytes; Ischemia
PubMed: 36282292
DOI: 10.1007/s00011-022-01651-6 -
Transplantation Aug 2016Transplantation is often the only choice many patients have when suffering from end-stage organ failure. Although the quality of life improves after transplantation,... (Review)
Review
Transplantation is often the only choice many patients have when suffering from end-stage organ failure. Although the quality of life improves after transplantation, challenges, such as organ shortages, necessary immunosuppression with associated complications, and chronic graft rejection, limit its wide clinical application. Nanotechnology has emerged in the past 2 decades as a field with the potential to satisfy clinical needs in the area of targeted and sustained drug delivery, noninvasive imaging, and tissue engineering. In this article, we provide an overview of popular nanotechnologies and a summary of the current and potential uses of nanotechnology in cell and organ transplantation.
Topics: Animals; Cell Transplantation; Delayed-Action Preparations; Diffusion of Innovation; Drug Carriers; Drug Compounding; Graft Rejection; Humans; Immunosuppressive Agents; Molecular Imaging; Nanomedicine; Nanoparticles; Organ Transplantation; Predictive Value of Tests; Treatment Outcome
PubMed: 27257995
DOI: 10.1097/TP.0000000000001100 -
Cellular Immunology Sep 2020
Topics: Humans; Organ Transplantation; Transplantation Immunology
PubMed: 32619810
DOI: 10.1016/j.cellimm.2020.104156 -
Current Opinion in Organ Transplantation Jun 2023There is no widely accepted single ethical principle for the fair allocation of scarce donor organs for transplantation. Although most allocation systems use... (Review)
Review
PURPOSE OF REVIEW
There is no widely accepted single ethical principle for the fair allocation of scarce donor organs for transplantation. Although most allocation systems use combinations of allocation principles, there is a particular tension between 'prioritizing the worst-off' and 'maximizing total benefits'. It is often suggested that empirical research on public preferences should help solve the dilemma between equity and efficiency in allocation policy-making.
RECENT FINDINGS
This review shows that the evidence on public preferences for allocation principles is limited, and that the normative role of public preferences in donor organ allocation policy making is unclear. The review seeks to clarify the ethical dilemma to the transplant community, and draws attention to recent attempts at balancing and rank-ordering of allocation principles.
SUMMARY
This review suggests that policy makers should make explicit the relative weights attributed to equity and efficiency considerations in allocation policies, and monitor the effects of policy changes on important ethics outcomes, including equitable access among patient groups. Also, it draws attention to wider justice issues associated not with the distribution of donor organs among patients on waiting lists, but with barriers in referral for transplant evaluation and disparities among patient groups in access to waiting lists.
Topics: Humans; Organ Transplantation; Waiting Lists; Tissue and Organ Procurement; Tissue Donors; Resource Allocation
PubMed: 36787240
DOI: 10.1097/MOT.0000000000001058