Ethical issues in Kidney Transplantation and “An” Islamic perspective

2021 ◽  
Vol 20 (2) ◽  
pp. 241-249
Author(s):  
Mohammad Yousuf Rathor ◽  
Azarisman SM Shah ◽  
Nur Raziana Bt Rozi ◽  
Che Rosle Draman ◽  
Wan Ahmad Syahril
Keyword(s):  
Kidney Transplantation ◽  
Organ Donation ◽  
Organ Transplantation ◽  
Islamic Law ◽  
Ethical Issues ◽  
Human Life ◽  
Medical Science ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Living Kidney Donor

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

Living Organ Donation Role of Ethics for Improved Clinical Practice

2018 ◽  
pp. 242-259
Author(s):  
Pierpaolo Di Cocco
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Financial Incentives ◽  
Ethical Issues ◽  
Supply And Demand ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Live Donor ◽  
Live Donation

Solid organ transplantation represents one of the most important achievements in history of medicine. Over the last decades, the increasing number of transplants has not been of the same extent of the number of patients in the waiting lists. Live donation has been implemented in order to reduce the gap between supply and demand. From an ethical standpoint, the donation process from a live donor seems to violate the traditional first rule of medicine—primum non nocere because inevitably exposes healthy persons to a risk in order to benefit another person. In the chapter will be presented the crucial role of ethics and specific ethical issues in the different forms of live donation, such as financial incentives for living donation, reimbursement in unrelated live donation, minor sibling-to-sibling organ donation. The ethical aspects of live donor organ transplantation are continuously evolving; in order to make this strategy more beneficial and lifesaving, everyone involved in the process should make every possible effort with in mind the best interests of the patients.

scholarly journals Ethical Issues of Organ Transplantation in Islam

1970 ◽  
Vol 21 (1) ◽  
pp. 97-103
Author(s):  
M Mostafa Kamal
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Islamic Law ◽  
Ethical Issues ◽  
Ethical Framework ◽  
Value Systems ◽  
Proxy Consent ◽  
Advantages And Disadvantages ◽  
The World ◽  
The Impact

Scientists and clinicians must become familiar with the factors that affect the emotional, physical, and spiritual health of their patients that are outside the ken of the traditionally dominant value systems. Although many researchers have addressed the cultural and ethnical factors, very few have considered the impact of religion. Islam, as the largest and fastestgrowing religion in the world, has adherents throughout the world, presents a complete moral, ethical, and medical framework, while it sometimes concurs conflicts with the conventional and secular ethical framework. This paper introduces to the Islamic principles of ethics in organ transplantation involving human subject to address issues of religion and religious ethics. Historical reflections are discussed as to why Muslim thinkers were late to consider contemporary medical issues such as organ donation. Islam respects life and values need of the living over the dead, thus allowing organ donation to be considered in certain circumstances. The sources of Islamic law are discussed in brief to see how the parameters of organ transplantation are derived. The Islamic perception, both Shiite and Sunni, is examined in relation to organ donation and its various sources. The advantages and disadvantages of brain dead and cadaveric donation are reviewed with technical and ethical considerations. The Islamic concept of brain death, informed and proxy consent are also discussed. The concept of rewarded donation as a way to alleviate the shortage of organs available for transplantation is assessed.    doi: 10.3329/taj.v21i1.3230 TAJ 2008; 21(1): 97-103

Treatment of Kaposi's sarcoma after solid organ transplantation.

1997 ◽  
Vol 15 (6) ◽  
pp. 2371-2377 ◽  
Author(s):  
F A Shepherd ◽  
E Maher ◽  
C Cardella ◽  
E Cole ◽  
P Greig ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Organ Transplantation ◽  
Combination Chemotherapy ◽  
Kaposi's Sarcoma ◽  
Solid Organ Transplantation ◽  
Kaposi’S Sarcoma ◽  
Skin Toxicity ◽  
Solid Organ ◽  
Duration Of Response ◽  
Italian Origin

PURPOSE This retrospective review of all patients who developed Kaposi's sarcoma (KS) after solid organ transplantation at a single institution was undertaken to define the clinical presentation of this malignancy in the setting of iatrogenic immunodeficiency, and to determine the most appropriate treatment for patients in this clinical setting. MATERIALS AND METHODS The records of 2,099 patients who underwent heart, lung, liver, or kidney transplantation at The Toronto Hospital between January 1, 1981 and June 30, 1995, were reviewed. Twelve patients were identified who developed biopsy-proven KS in the posttransplantation period. Five patients who had disseminated KS who had not responded to either reduction or withdrawal of immunosuppression or to local radiotherapy were treated with combination chemotherapy consisting of doxorubicin 20 to 30 mg/m2, bleomycin 10 mg/m2, and vincristine 2 mg (ABV) administered intravenously every 3 weeks. RESULTS Eight of 12 patients were male and nine were of Italian origin. KS was limited to a localized area of the skin for only six patients, all after kidney transplantation. Visceral KS was present in three patients. Four of five patients responded to ABV chemotherapy (two complete and two partial remissions). The fifth patient responded to second-line etoposide and cisplatin. The median duration of response was in excess of 13 months (range, 8+ to 45+ months). Toxicity was limited to grade 1 neurotoxicity and grade 1 skin toxicity. CONCLUSION KS is an uncommon but recognized complication of solid organ transplantation. Combination chemotherapy is a safe and effective treatment for patients with disseminated or visceral KS that fails to respond to changes in immunosuppression.

Ethical issues associated with solid organ transplantation and substance use: a scoping review

2019 ◽  
Vol 37 (3-4) ◽  
pp. 111-135 ◽  
Author(s):  
Lauren Notini ◽  
Denitsa Vasileva ◽  
Ani Orchanian-Cheff ◽  
Daniel Z. Buchman
Keyword(s):  
Substance Use ◽  
Organ Transplantation ◽  
Scoping Review ◽  
Ethical Issues ◽  
Solid Organ Transplantation ◽  
Solid Organ

scholarly journals The Maximus of Necessity and Its Application to Organ Transplantation: An Islamic Bioethical Perspective

2021 ◽  
Vol 20 (3) ◽  
pp. 511-524
Author(s):  
Fazli Dayan ◽  
Mian Muhammad Sheraz ◽  
Abu Kholdun Al Mahmood ◽  
Sharmin Islam
Keyword(s):  
Organ Transplantation ◽  
Islamic Law ◽  
Human Life ◽  
Medical Science ◽  
Biomedical Ethics ◽  
Legal Rights ◽  
Western World ◽  
World Religions ◽  
Human Needs ◽  
Other World

Islam is second largest religion being practiced around the globe. It is fastest growing believe and rapidly expanding in the western world despite several misunderstanding including Islamic standpoint on organ transplantation and tissue grafting. The objective of this study is to determine the Islamic view point on organ transplantation and tissue grafting with special reference pertaining to human needs under the ambit of Shariah doctrine of necessity and world religions. Since, Islam and other world religions have given immense consideration to humans whether they are alive or dead, and the desecration of human body is considered a violation sufficed to a great sin. Injunctions of the holy Quran and Sunnah have evidently expressed sanctity to human life/body. Hence, taking one’s life without a legal rights or even inflicting any sort of harm, injury, and aggression against an individual is terming an unlawful act. Notably, some scholars contended that, classical jurists’ are silent on the issue of organ transplantation predominantly the transfer of organs from one species to another species. But, in reality, our argument is that, the organ re-plantation can be seen in the Prophetic era. However, as per their view, the reason is obvious, since the organ transplantation associated with the advancement of science. Accordingly, the recent progress in transplant sciences were not totally known to the classical jurists, although, issues pertaining to the sale of human organs have been discussed by them (jurists). Similarly, many other innovative matters can be seen in Prophetic traditions, and that is why, as per jurist’s assertion, it can practically be traced in the Prophetic era.Consequently, this study argues that, the permissibility of organ donation and transplantation somehow mentioned in the main sources of Islamic law and biomedical ethics. Therefore, the basis and rules of permissibility will be derived while discussing organ transplantation, particularly in homo, allotransplant and other inter-related issues under the rubric of necessity doctrine. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.511-524

scholarly journals Donor-Derived Cell-Free DNA in Kidney Transplantation: Origins, Present and a Look to the Future

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 482
Author(s):  
Sam Kant ◽  
Daniel C. Brennan
Keyword(s):  
Kidney Transplantation ◽  
Organ Transplantation ◽  
Allograft Rejection ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Future Prospects ◽  
Cell Free Dna ◽  
Medical Specialties ◽  
Free Dna ◽  
The Future

Since its first detection in 1948, donor-derived cell-free DNA (dd-cfDNA) has been employed for a myriad of indications in various medical specialties. It has had a far-reaching impact in solid organ transplantation, with the most widespread utilization in kidney transplantation for the surveillance and detection of allograft rejection. The purpose of this review is to track the arc of this revolutionary test—from origins to current use—along with examining challenges and future prospects though the lens of transplant nephrology.

The Use of IVIG for Solid Organ Transplantation: An Evidence Based Practice Guideline

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4666-4666
Author(s):  
Nadine Shehata ◽  
Heather Ann Hume ◽  
Valerie Palda ◽  
Ralph Meyer ◽  
Patricia Campbell ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Organ Transplantation ◽  
Practice Guideline ◽  
Graft Rejection ◽  
Solid Organ Transplantation ◽  
Evidence Based ◽  
Solid Organ ◽  
Blood Products ◽  
Limited Data

Abstract Background Utilization of intravenous immune globulin (IVIG) is increasing in Canada and worldwide despite few and no new labeled indications. In 2007, Canadian Blood Services in collaboration with the National Advisory Committee on Blood and Blood Products convened a panel of solid organ transplantation (SOT) experts (kidney, heart, lung, and liver) and methodologists to develop an evidence-based practice guideline for the use of IVIG in patients undergoing SOT. The objectives of this guideline are to examine the evidence for the use of IVIG in patients who are candidates for SOT and are sensitized to HLA or ABO antigens, to provide guidance for Canadian practitioners involved in the care of these patients and transfusion medicine specialists on the use of IVIG. Methods: The panel identified clinical areas of SOT that would benefit from treatment with IVIG and generated key clinical questions. A systematic, expert and bibliography literature search up to July 2008 was conducted to ensure all relevant publications were included. The panel generated recommendations based on the evidence. The levels of evidence and grading of recommendations were adapted from the Canadian Task Force on Preventative Health Care. To validate conclusions and recommendations, the practice guideline will be sent to physicians involved in solid organ transplantation in Canada and a patient representative. Recommendations from practitioner feedback will be incorporated, and the guideline will be disseminated to all physicians involved in the care of patients receiving solid organ transplantation in Canada to aid implementation of the guideline. The National Advisory Committee of Blood and Blood Products in Canada will subsequently assess the performance of the guideline and will renew the guideline at timely intervals. Results and Conclusions: The research questions developed by the panel were: Is there evidence that the use of IVIG reduces morbidity and mortality for patients undergoing SOT who are sensitized (HLA or ABO) in the perioperative setting and are sensitized experiencing acute graft rejection or experiencing chronic graft rejection? 791 citations were retrieved, and panel members identified 3 additional citations. 51 reports and a systematic review were used for this guideline. These reports were limited by inconsistent definitions of sensitization, inconsistent reporting of the type and titre of the antibody, the assays used to detect HLA antibodies, the response criteria and dosing schedules for IVIG. Thus, a consensus process was used to account for the poor evidence. The use of IVIG was associated with decreased sensitization and acceptable morbidity and mortality in living donor kidney transplantation. IVIG has been used with several other modalities for ABO-incompatible kidney transplantation and it was difficult from the existing literature to separate outcomes based on a single modality. There was also limited data on the perioperative use of IVIG in renal transplantation. IVIG was shown to be effective in combination with plasmapheresis for acute antibody mediated rejection of the kidney; however the role of IVIG was not clear for other forms of rejection. There were also several methodological limitations in the literature assessing IVIG for cardiac transplantation and only limited data were available to assess the use of IVIG for lung or liver transplantation. Future studies are needed to define the role of IVIG in solid organ transplantation and should capture the following elements: impact on antibody (specificity and titres), transplant rates, time to transplantation, graft function, graft survival, and rejection (cellular and antibody mediated).

scholarly journals Guillain-Barre Syndrome after Kidney Transplantation: a Case Report

2013 ◽  
Vol 2 (1) ◽  
pp. 35-36
Author(s):  
Mohsen Farazdaghi ◽  
Anahita Zoghi ◽  
Afshin Borhani Haghighi
Keyword(s):  
Kidney Transplantation ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Guillain Barre Syndrome ◽  
Unusual Complication ◽  
Solid Organ ◽  
Hematopoietic Stem ◽  
Guillain Barré Syndrome ◽  
Associated Symptoms ◽  
Guillain Barré

Background: Guillain-Barre Syndrome is an unusual complication of hematopoietic stem cell transplantation but it is extremely rare after solid organ transplantation such as kidney or liver transplantationCase report: A 48-year-old man, a case of kidney transplantation presented with generalized weakness in an ascending pattern. History and examination were compatible with the diagnosis of Guillain-Barre Syndrome (GBS) and paraclinical studies confirmed this diagnosis. He was treated for Guillain-Barre syndrome but no significant response was observed.Conclusion: Guillain–Barre´ syndrome rarely appears after organ transplantation but it should be considered in a patient presenting with its associated symptoms after transplantation.

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