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.

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

The role of radiotherapy in patients with solid tumours after solid organ transplantation: a systematic review

2021 ◽  
Vol 22 (3) ◽  
pp. e93-e104
Author(s):  
Rosario Mazzola ◽  
Francesco Cuccia ◽  
Alessandro Bertani ◽  
Slavisa Tubin ◽  
Pier Giulio Conaldi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Tumours ◽  
Solid Organ

scholarly journals Calcineurin Inhibitor-Based Immunosuppression and COVID-19: Results from a Multidisciplinary Cohort of Patients in Northern Italy

2020 ◽  
Vol 8 (7) ◽  
pp. 977 ◽  
Author(s):  
Lorenzo Cavagna ◽  
Elena Seminari ◽  
Giovanni Zanframundo ◽  
Marilena Gregorini ◽  
Angela Di Matteo ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Calcineurin Inhibitor ◽  
Clinical Course ◽  
Solid Organ Transplantation ◽  
Calcineurin Inhibitors ◽  
Infectious Complications ◽  
Study Data ◽  
Solid Organ ◽  
The North

The role of immunosuppression in SARS-CoV-2-related disease (COVID-19) is a matter of debate. We here describe the course and the outcome of COVID-19 in a cohort of patients undergoing treatment with calcineurin inhibitors. In this monocentric cohort study, data were collected from the COVID-19 outbreak in Italy up to 28 April 2020. Patients were followed at our hospital for solid organ transplantation or systemic rheumatic disorders (RMDs) and were on calcineurin inhibitor (CNI)-based therapy. Selected patients were referred from the North of Italy. The aim of our study was to evaluate the clinical course of COVID-19 in this setting. We evaluated 385 consecutive patients (220 males, 57%; median age 61 years, IQR 48–69); 331 (86%) received solid organ transplantation and 54 (14%) had a RMD. CNIs were the only immunosuppressant administered in 47 patients (12%). We identified 14 (4%) COVID-19 patients, all transplanted, mainly presenting with fever (86%) and diarrhea (71%). Twelve patients were hospitalized and two of them died, both with severe comorbidities. No patients developed acute respiratory distress syndrome or infectious complications. The surviving 10 patients are now fully recovered. The clinical course of COVID-19 patients on CNIs is generally mild, and the risk of superinfection seems low.

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 Deciphering the role of eosinophils in solid organ transplantation

2019 ◽  
Vol 20 (4) ◽  
pp. 924-930
Author(s):  
Oscar Okwudiri Onyema ◽  
Yizhan Guo ◽  
Atsushi Hata ◽  
Daniel Kreisel ◽  
Andrew E. Gelman ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ

Role of Chemotherapy and Rituximab for Treatment of Posttransplant Lymphoproliferative Disorder in Solid Organ Transplantation

2007 ◽  
Vol 41 (10) ◽  
pp. 1648-1659 ◽  
Author(s):  
Jin-Joo Lee ◽  
Masha SH Lam ◽  
Amy Rosenberg
Keyword(s):  
Organ Transplantation ◽  
Lymphoproliferative Disorder ◽  
Disease Onset ◽  
Solid Organ Transplantation ◽  
Response Rates ◽  
Data Sources ◽  
Solid Organ ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Early Disease

Objective: To evaluate the role of chemotherapy and/or rituximab for treatment of posttransplant lymphoproliferative disorder (PTLD) in solid organ transplantation. Data Sources: A MEDLINE search (1966–May 2007) was conducted using the key words posttransplant lymphoproliferative disorder, solid organ transplantation, chemotherapy, and rituximab. References of relevant articles and abstracts from recent hematology, oncology, and transplantation scientific meetings (2004–May 2007) were also reviewed. Study Selection and Data Extraction: Prospective and retrospective studies identified from the data sources were evaluated, and all information deemed relevant was included for this review. Data Synthesis: Overall response rates ranged from 53% to 68%, 25% to 83%, and 74% to 100% for rituximab monotherapy, chemotherapy, and chemotherapy plus rituximab, respectively. Positive response to treatment was influenced by prognostic factors, including presence of Epstein-Barr virus in tumor cells, normal lactate dehydrogenase levels, good performance status, early disease onset after transplantation, and early disease stages. These factors in study patients likely contribute to the variability in response rates seen between treatment options. Severe adverse effects, ranging from grade 3 neutropenia to infection resulting in death, occurred more frequently in patients receiving chemotherapy than in patients receiving only rituximab. Conclusions: Although reduction in immunosuppressive medications remains the first-line therapy for PTLD treatment, many cases do not respond to this treatment alone, especially monomorphic or more aggressive cases of lymphoma. Therefore, it is reasonable to begin active treatment including rituximab and/or chemotherapy initially, along with reduction in immunosuppression in many cases. Further prospective, comparative studies are urgently needed to confirm the efficacy of these treatment strategies as well as to clarify which subset of patients may benefit most from them.

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