Living Donor Organ Transplantation

"This is a book about living solid organ donors as patients in their own right. This book is premised on the supposition that the field of living donor organ transplantation is ethical, even if some specific applications are not. Living donor organ transplantation is controversial at its core because it exposes one patient (the living donor) to clinical risks for the clinical benefit of another (the candidate recipient). It is different than obstetrics which also involves 2 patients-a pregnant woman and her fetus-- because transplantation involves two physically individuated patients who, in most cases, individually consent to the medical interventions. And in many cases, the donor-recipient interdependence is optional because deceased donor organs may be available. So before one can begin, one must ask, even if only rhetorically: Is living donation ethical? The question is not new: one of the first to ask about the ethics of living donor transplantation was Joseph Murray, the surgeon credited with performing the first successful living donor kidney transplant which paved the way for the broad adoption of kidney and other solid organ transplantation around the world"--

Living Organ Donor Transplantation, Second Edition puts the entire discipline in perspective while guiding readers step-by-step through the most common organ transplant surgeries. Organized into four cohesive parts and featuring numerous surgical illustrations, this sourcebook delivers an incisive look at every key consideration for general surgeons who perform transplantations, from patient selection to recipient workup and outcomes, and emphasizes the most humanitarian approaches. Sections provide content on living donor uterus transplantation, new operative techniques, including the use of robotic and minimally invasive transplant procedures, new immunosuppressive regimens, new protocols of tolerance induction including stem cell therapy and transplantation, and much more.Chapter authors are international leaders in their fields and represent institutions from four continents (Americas: USA, Argentina, Brazil, Canada; Europe: France, Germany, Italy, Spain, Sweden, UK; Asia: China, Japan, Korea, Taiwan; Australia). Provides an A-Z, operation-oriented guide to the field of living donor organ transplantation Examines a wide spectrum of solid organ transplantation procedures (liver, pancreas, kidney, intestine), with accompanying chapters on the history of the procedure, the donor, the recipient, and cost analysis Covers techniques that explain adequate pretransplant workup and posttransplant care Covers cultural differences, ethical and legal issues, social issues, current financial incentives, and the illegal organ trade

This book was originally published in 1999. When one or more essential organs failed, the consequence used to be death. However, conventional medicine has developed artificial means of extending life, the most successful of which is transplantation. The most common form of organ to be transplanted is a kidney which will, on average, function for about a decade in its recipient. Organ transplantation as a whole is widely practiced in most countries. However, few can procure enough organs to meet demand. Many people who are suitable for a transplant die without getting one. Many kidney patients can access and stay alive on dialysis until a suitable organ becomes available. However, even here, sufficiency of organs would be beneficial because lesser reliance on dialysis would reduce healthcare costs and be better for patient quality of life. This invaluable book shows that in the light of current practice and attitudes, increasing living donor transplantation (LDT) levels is feasible. It is one of the few works to systematically analyse the ethical and legal issues involved in LDT use in the light of empirical evidence, including new data derived from a unique programme of interviews and questionnaires with transplant professionals, living donors and recipients. Readers are led to an understanding of when LDT is ethically and legally acceptable and to the strong case for using it much more extensively.

This book provides a complete guide to the evaluation, care, and follow-up of living kidney donors. Living donor kidney transplantation is established as the best treatment option for kidney failure. However, despite the tremendous benefits of living donation to recipients and society, the outcomes and optimal care of donors themselves have received relatively less attention. Fortunately, things are changing – including recent landmark developments in living donor risk assessment, policy and guidance. This volume offers authoritative, evidence-based guidance on the full range of clinical scenarios encountered in the evaluation and care of living kidney donors. The approach to key elements of risk assessment, ethical considerations and informed consent is accompanied by recommendations for patient-centered care before, during, and after donation. Advocacy initiatives and policies to remove disincentives to donation and advance a defensible system of practice are also discussed. General and transplant nephrologists, as well as related allied health professionals, can look to this book as a comprehensive resource addressing contemporary clinical topics in the practice of living kidney donation.

Edited by leaders at one of the acclaimed transplant institutions in the United States, this reference covers all aspects of living donor solid organ and cellular transplantation in current clinical practice, including the kidney, liver, pancreas, lung, small bowel, islet, and hematopoietic stem cell transplantation. Detailed, engaging, and organ-

Advances in the science of immunology have improved the success rate of organ transplantations since the mid twentieth century. Organ transplantation is now a lifesaving medical procedure for thousands of patients around the world with end-organ diseases. The lifesaving potential of transplantation has been limited by the number and quality of appropriate organ donors. The evolution of brain death criteria by the Harvard Ad-Hoc Committee Report has opened the door to understanding the importance of medical, legal and ethical challenges of organ donation in support of the growth of the transplant science. The possibility of organ donation from living donors has enhanced organ availability for patients with kidney failure. Modern inotropes and immunosuppression regimens have been critical to the success of other organ transplant procedures. However, the cornerstone of successful transplantation continues to be the appropriate selection, evaluation, preservation of organ tissues and the successful surgical procurement process to mitigate the impact of tissue ischemia and reperfusion. In this textbook, the art and science of organ donation and tissue preservation is examined. Through this authoritative text by leaders in the field, the editors provide a state of the art review of modern preservation techniques, patient selection and screening criteria, as well as best practices for multi-organ procurement. Information presented in the book will familiarize readers with the initial steps of determining organ availability which ultimately enables health care professionals to realize the extraordinary potential of successful multi-organ transplant procedures. This guide is intended to be a fundamental resource for students, residents, faculty and staff for all disciplines allied to health care delivery and organ donation.

Living donor kidney (LDK) transplantation has become the definitive approach to the treatment of end-stage renal failure, providing a better quality of life and the best opportunity for survival when compared with dialysis or transplantation from a deceased donor. A timely compendium of the modern day practice of LDK transplantation from a group of outstanding international experts, this text explores a number of controversial aspects of this innovative new technique. Discussing in detail the current situation, the authors also focus on the responsibility of the medical community to the live kidney donor as a patient, and the potential for complacency regarding donor risk. Emphasizing the ethical principles that must dictate medical practice in LDK transplantation for the foreseeable future - voluntarism, informed consent and medical follow-up - this book comprehensively records the best practices currently available.

Rates of organ donation lag far behind the increasing need. At the start of 2006, more than 90,000 people were waiting to receive a solid organ (kidney, liver, lung, pancreas, heart, or intestine). Organ Donation examines a wide range of proposals to increase organ donation, including policies that presume consent for donation as well as the use of financial incentives such as direct payments, coverage of funeral expenses, and charitable contributions. This book urges federal agencies, nonprofit groups, and others to boost opportunities for people to record their decisions to donate, strengthen efforts to educate the public about the benefits of organ donation, and continue to improve donation systems. Organ Donation also supports initiatives to increase donations from people whose deaths are the result of irreversible cardiac failure. This book emphasizes that all members of society have a stake in an adequate supply of organs for patients in need, because each individual is a potential recipient as well as a potential donor.