Marginal Donors

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

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This supplement to TRANSPLANT International contains a most recent update of clinical and experimental research in transplantation and experiences with all modern immunosuppressive drugs, presented at the 7th Congress of the European Society of Organ Transplantation in Vienna in October 1995. The book has relevant information on clinical transplantation of kidneys, livers, hearts and pancreases as well as basic research data of immunbiology and organ preservation. More than 80% of the contributions were generated by respected European research institutions and therefore the book provides a comprehensive overview of European activities in transplantation research.

Cardiopulmonary Transplantation and Mechanical Circulatory Support provides a comprehensive review of the field. Written for all tiers of healthcare professionals managing such complex patients. The handbook tackles all topics within this field, including heart failure, heart transplantation, lung transplantation, and all tiers of mechanical circulatory support in adults and paediatric patients. The chapters are written by prominent and globally respected experts in Europe and North America, providing their evidence base as well as personal, practical hints and tips for all practitioners.

The first textbook on the subject, this is a practical, clinically comprehensive guide to ethical issues in surgical practice, research, and education written by some of the most prominent figures in the fields of surgery and bioethics. Discussions of informed consent, confidentiality, and advance directives--core concepts integral to every surgeon-patient relationship--open the volume. Seven chapters tackle the ethical issues in surgical practice, covering the full range of surgical patients--from emergency, acute, high-risk, and elective patients, to poor surgical risk and dying patients. The book even considers the special relationship between the surgeon and patients who are family members or friends. Chapters on surgical research and education address innovation, self-regulation in practice and research, and the prevention of unwarranted bias. Two chapters focus on the multidisciplinary nature of surgery, including the relationships between surgery and other medical specialties and the obligations of the surgeon to other members of the surgical team. The economic dimensions of surgery, especially within managed care, are addressed in chapters on the surgeons financial relationships with patients, conflicts of interest, and relationships with payers and institutions. The authors do not engage in abstract discussions of ethical theory; instead, their discussions are always directly relevant to the everyday concerns of practicing surgeons. This well-integrated volume is intended for practicing surgeons, medical educators, surgical residents, bioethicists, and medical students.

With color illustrations throughout, this book analyzes the implications that transplantation and immunosuppression can hold for patients. Discussing the many complications that may occur after kidney transplantation, this source is a must for anyone caring for patients recovering from this type of procedure.

Liver transplantations require a complex and varied, multidisciplinary approach involving not only hepatologists and surgeons but also pathologists, psychologists, professional educators, nurses and, in the case of young patients, also pediatricians and development experts. This textbook provides an overview of the management problems involved in liver transplantation for acute and chronic liver disease, pediatric liver transplantation and the psychosocial aspects of liver transplantation. A closing chapter, focusing on the developments and future prospects in liver transplantation, outlines the potential offered by donors after cardiac death, cell therapies and organogenesis. The multidisciplinary approach is also maintained in the selection of authors, all experts actively engaged in the various disciplines involved in liver transplantations. This aspect, together with its precise and didactic descriptions of all phases of liver transplantation for chronic and acute diseases – from managing waiting lists to post-transplant complications – make the book a valuable tool for fellows, trainees, and specialists in the field seeking accurate framework for liver transplantation in its many facets.

With the increased prevalence of kidney transplantation, transplant recipients are being treated in a variety of clinical settings – often beyond the transplant center. There is a greater need for clinicians and allied healthcare professionals to have appropriate guidance on managing these patients. Kidney Transplantation offers the latest evidence-based information on the full range of dilemmas in the medical management of kidney transplant recipients before, during and after transplantation. Beginning with the selection of patients who are candidates for transplantation, this authoritative guide covers the care of the patient on the waiting list and evaluation of donors, preoperative care, induction and immunosuppression maintenance. This wealth of new information and guidelines will serve as an important resource for the best possible care for transplant patients.