This book supports the emerging field of vascularized composite allotransplantation (VCA) for face and upper-limb transplants by providing a revised, ethically appropriate consent model which takes into account what is actually required of facial and upper extremity transplant recipients. In place of consent as permission-giving, waiver, or autonomous authorization (the standard approaches), this book imagines consent as an ongoing mutual commitment, i.e. as covenant consent. The covenant consent model highlights the need for a durable personal relationship between the patient/subject and the care provider/researcher. Such a relationship is crucial given the recovery period of 5 years or more for VCA recipients. The case for covenant consent is made by first examining the field of vascularized composite allotransplantation, the history and present understandings of consent in health care, and the history and use of the covenant concept from its origins through its applications to health care ethics today. This book explains how standard approaches to consent are inadequate in light of the particular features of facial and upper limb transplantation. In contrast, use of the covenant concept creates a consent model that is more appropriate ethically for these very complex surgeries and long-term recoveries.

Historically, clinical decisions in renal medicine have been challenged by the scarce availability of robust supportive evidence. Not only are the number of randomized controlled trials (RCTs) in Nephrology the third lowest amongst the medical specialties but in many instances the trials themselves are of poor quality. In addition, practice has been further influenced by extrapolation from the outcomes of general population clinical trials which exclude renal patients. The difference between the ideal trial participant and real complex cases encountered in daily practice is well recognized and further compounded in renal patients with complex pathophysiology - this ultimately makes decision making in this subset of patients a real challenge. Recently, there has been a growing interest in conducting well designed RCTs in different areas of renal medicine. However, though clinical guidelines are helpful in providing the clinicians with a frame of best available evidence for a clinical condition, it denies the unique nature of each individual patient. This book offers a thorough and critical appraisal and evaluation of the key published clinical trials that have shaped current practice in nephrology, dialysis and transplantation. It will help the practicing physician close the gap between the inflexible and generalized nature of clinical guidelines and the day-to-day clinical decision-making for individual patients. It will provide the clinician with the tools required to investigate and extract the appropriate guidance to apply to individual cases in daily practice. Moreover, it will help improve the ability of junior colleagues to appraise available evidence in a systematic way when there is lack of local guidelines or when the guidelines are difficult to apply due to logistic constraints or barriers. Lastly, this book will serve as a reference for key clinical trials in different areas of renal medicine together with literature and authors views of these trials and their impact on changing practice.​ 

After decades of research in clinical transplantation, new techniques have been developed that permit a further understanding of the immune mechanisms underlying immune recognition of allografts and a more accurate and thorough evaluation of compatibility between donors and recipients. The second edition of Transplantation Immunology: Methods and Protocols expands upon the previous edition with current, detailed methods in transplantation immunology. The new methods chapters cover four major areas that are being applied in compatibility evaluations and ongoing transplantation immunology research. Seven overview chapters provide reviews of the molecular basis for alloreactivity, current understanding of humoral and cellular mechanisms, as well as new developments in thoracic organ transplantation, composite tissue transplantation and in the transplantation of sensitized patients. Written in the highly successful Methods in Molecular Biology (TM) series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and key tips on troubleshooting and avoiding known pitfalls. Authoritative and practical, Transplantation Immunology: Methods and Protocol, Second Edition is devoted to transplantation immunology, both in the practice of compatibility testing and in transplantation research.

Hepatitis C Virus and Liver Transplantation is designed to provide a comprehensive and state-of-the-art overview of the major issues specific to the field of liver transplantation and hepatitis C virus infection. The sections of the book have been structured to review the overall scope of issues of recurrent hepatitis C in different complex settings, including retransplantation, HIV-coinfected patients or in the setting of suboptimal graft donors. This book provides up-to-date information on the application of new therapies to the field of liver transplantation. It provides the most recent data on their efficacy, the management of side effects, as well as the potential interactions and specific problems associated with their use in the transplant setting. Finally, an appraisal of the risks and benefits of using organs from anti-HCV positive donors is presented. This book provides concise and actual materials for several important topics that are simply not adequately covered by current available literature. Hepatitis C Virus and Liver Transplantation will provide a unique and valuable resource in the field of liver transplantation and will be of great value to Hepatologists, Transplant and Abdominal Surgeons, Oncologists, as well as Fellows and Residents training in these fields.

Organ transplantation is a much-discussed subject, and the importance of living organ donation is increasing significantly. Yet despite all efforts, too few donor organs are available to help all patients in need. This book analyses whether the national legal regulations are also partly responsible for the organ shortage in the Member States of the European Union. In addition to a detailed analysis of the various national regulations, the main arguments in favour of and against legal restrictions on living organ donation are considered. Furthermore, the European Union's authority is investigated, namely, whether it is entitled to establish statutory provisions for the Member States with respect to a harmonized regulation of living organ donation. Based on the results of the analysis, the author establishes a Best Practice Proposal for living organ donation.

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.

Periprosthetic Joint Infection of the Hip and Knee is a practical reference for the diagnosis and treatment of total joint infections following hip and knee arthroplasty. In addition to useful chapters presenting common tests and algorithms used for diagnosis, the book gives background on the epidemiology, risk factors, and prevention strategies of periprosthetic joint infection. Additionally, practical clinical information is given, including antibiotic treatment strategies and delivery methods and medical optimization techniques for physicians to follow for patient care and follow-up. Covering a topic that is currently underrepresented in the medical literature, Periprosthetic Joint Infection of the Hip and Knee will be useful to orthopedic surgeons, rheumatologists, and other physicians involved in the care of patients with hip and knee prosthetic implants.

In Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, Miller and Truog challenge fundamental doctrines of established medical ethics. They argue that the routine practice of stopping life support technology in hospitals causes the death of patients and that donors of vital organs (hearts, lungs, liver, and both kidneys) are not really dead at the time that their organs are removed for life-saving transplantation. These practices are ethically legitimate but are not compatible with traditional rules of medical ethics that doctors must not intentionally cause the death of their patients and that vital organs can be obtained for transplantation only from dead donors. In this book Miller and Truog undertake an ethical examination that aims to honestly face the reality of medical practices at the end of life. They expose the misconception that stopping life support merely allows patients to die from their medical conditions, and they dispute the accuracy of determining death of hospitalized patients on the basis of a diagnosis of "brain death" prior to vital organ donation. After detailing the factual and conceptual errors surrounding current practices of determining death for the purpose of organ donation, the authors develop a novel ethical account of procuring vital organs. In the context of reasonable plans to withdraw life support, still-living patients are not harmed or wronged by organ donation prior to their death, provided that valid consent has been obtained for stopping treatment and for organ donation. Recognizing practical difficulties in facing the truth regarding organ donation, the authors also develop a pragmatic alternative account based on the concept of transparent legal fictions. In sum, Miller and Truog argue that in order to preserve the legitimacy of end-of-life practices, we need to reconstruct medical ethics.

Post-transplant lymphoproliferative disorders are a group of conditions that straddle the borders between infection and malignancy. They were very rare prior to the mid-1980s but now can be expected to develop in 1-10% of transplant recipients. While some cases are reversible with reduction in immunosuppression, more severe forms are indistinguishable from frank lymphomas. This book sets out to cover in depth every aspect of these disorders, including both basic science and clinical topics. The epidemiology is reviewed, and careful attention is paid to the role of Epstein-Barr virus in their development. Clinical features are documented and clear guidance is provided on diagnosis, with thorough description of pathologic and imaging findings. Further chapters are devoted to treatment, prognosis, preventive and pre-emptive strategies, and organ-specific considerations. The state-of-the-art information contained in this book will aid researchers as well as the many different professionals involved in caring for patients with post-transplant lymphoproliferative disorders. The comprehensive and detailed coverage will appeal to those who already have some expertise in the field, yet the book will also serve as an invaluable resource for beginners in transplantation.

The book gives an account of results obtained from experiments where grafts of neuronal, glial and other tissues as well as artificial materials were placed into the spinal cord. It attempts to evaluate the contributions made by these studies to our understanding of basic neurobiologies questions. These include factors that regulate neuronal growth during development as well as regenera tion following injury to the nervous system. The model of neural transplanta tion is also useful for the study of cell-to-cell interactions, and this applies to interactions between glial cells and neurones, between various populations of neuronal cells and finally between axons and skeletal muscle fibres. The mecha nisms involved in the establishment of specific synaptic connections between neurones can also be investigated in this experimental paradigm. Important in formation regarding this issue was also obtained on systems other than the spinal cord, i. e. the cerebellum, hippocampus and striatum. Although such in formation of precise connections between the host and the grafted embryonic tissue is still lacking in the spinal cord, there is much information on the re sponse of the host nervous system to the grafted embryonic tissue, and that of the graft to its new host environment. It appears that embryonic grafts are able to induce repair processes follow ing injury to the nervous system.

The aim of this book is to present a unique compilation of lectures given by international speakers at the Hammersmith Hospital during the recent Meetings in Hepato-Pancreato-Biliary and Transplantation. New therapeutical approaches, advances in oncology and in diagnostic imaging, which reduce the need for invasive techniques and reach an improvement in survival and quality of life in cancer, are considered in this book. Modern literature has been reviewed with special reference to articles of general interest. In the clinical management of patients with liver, bile duct and pancreas diseases, it is important to assess the degree of disturbance and to diagnose the causative insult, and therefore clinical and laboratory methods of assessing each of these pathologies are of high interest. This version is an up-to-date account of diseases of the liver, biliary tract and pancreas, including transplantation, which we trust will be of value for surgeons, physicians and pathologists and also a reference book for medical students.

The book encompasses Dr Baranski's 20 year experience in the field of abdominal organ donation. It is a step-by-step guide with photographs and drawings with clear explanations highlighting pitfalls. The book quickly and easily guides the reader through the difficult steps during organ procurement. It is mainly illustration-based, without much text, and covers surgical technical mistakes and organ damage.

Bronchiolitis Obliterans Syndrome in Lung Transplantation presents the most current and up-to-date evidence regarding the diagnosis and management of BOS. In-depth chapters provide readers with a comprehensive understanding of the definition and changing perceptions of the nature of BOS as a clinical and pathologic entity, immune and non-immune mechanisms that have been identified as risk factors for the development of BOS, and interventions that may prove to be clinically useful for the prevention or treatment of BOS. In addition to outlining the current state of knowledge, each chapter provides the reader with the most current and ongoing research in the field as well as identifies areas where future research is needed. Written by an international group of expert authors, Bronchiolitis Obliterans Syndrome in Lung Transplantation is an important new text, that is essential reading for pulmonologists, primary care practitioners, respiratory care practitioners and clinical researchers.

Though kidney transplantation is considered a routine procedure, there are still significant challenges in post-transplant management. Core Concepts in Renal Transplantation is a clinically focused authoritative guide to the management of kidney transplantation. This comprehensive, state-of-the-art reference summarizes the recent changes in the field of transplantation, offering the complete range of up-to-date information on all the various aspects of basic immunobiology and the medical care of the transplant recipient. Written by a team of renowned authorities in renal transplantation, this concise resource is intended for both the nephrologist and the non-specialist with an interest in kidney transplantation.

This is an essential guide to the data, basic science, outcome studies and decision-making processes involved in blood and marrow stem cell transplantation. Organized according to disease types and procedures, it contains more than 100 tables, figures and algorithms that reflect up-to-date research and give guidance on the choices between different types of chemotherapy, autologous vs. allogeneic transplantation, peripheral blood vs. bone marrow stem cells, and standard vs. experimental treatments. This new edition summarizes the research of the last four years and gives mature data for all established indications, such as acute myeloid leukemia, myelodysplastic syndrome and Hodgkin and non-Hodgkin lymphomas. New chapters discuss global trends in stem cell transplantation, cellular therapies including donor lymphocytes, and pediatric neurologic and metabolic disorders. With an expanded complications section, links to electronic databases and discussion of new drugs and alternative stem cell sources, this text belongs in every transplant unit.

Stem Cell Biology in Health and Disease presents an up-to-date overview about the dual role of stem cells in health and disease. The Editors have drawn together an international team of experts providing chapters which, in this fully-illustrated volume, discuss: - the controversial debate on the great expectations concerning stem cell based regeneration therapies raised by the pluripotency of various stem cells. - the advantages and concerns about embryonic stem cells (ES cells), induced pluripotent stem cells (iPS cells) and adult stem cells, such as bone marrow-derived stem cells (BMDCs). - the type of stem cells, which has become of interest in the past decade, namely so-called cancer stem cells (CSCs). CSCs are now in the focus of cancer research since the eradication of tumour initiating cells would raise the changes of definitely cure cancer. Professor Dittmar and Professor Zanker have edited a must-read book for researchers and professionals working in the field of regenerative medicine and/or cancer.

The book includes recommendations for COPD from published guidelines (eg, the GOLD, ATS, and NICE guidelines) and presents them in the context of relevant clinical treatment issues. This is an in-depth guide on the management of COPD, concentrating on the impact of COPD on a patient as well as how healthcare professionals can intervene and educate the patient at an early stage and thereby slow the onset of severe symptoms.

For the first time a complete review of the research work done over the past 30 years by leading investigators around the world in targeting immunosuppressants to both solid-organ and cellular transplants is available in a single volume. One section consists of studies conducted in rat allograft models using osmotic minipumps for delivery of a variety of immunosuppressants. The book will be of great benefit to researchers in the fields of transplant immunology, pharmacology and drug delivery and targeting, particularly those involved in drug development.

This book - the first multicenter book on orthotopic liver transplantatio- reflects the progress in this field. The first 'experience in hepatic transplantation' was documented in 1969 by Starzl and his group in Denver in the classic of the same name. It was followed in 1983 by 'Liver transplantation', edited by Caine, in which the experience of the Cambridge-King's College Hospital team was laid down. Apart from these the book of Lie and Giitgemann appeared in 1974. These books are fundamental for all who want to become involved with experimental and clinical liver transplantation. Developments in liver transplantation are fast (faster than the production of this book) and new knowledge now not only is coming from the pioneer centers but also from their off-spring, scattered over the world. In only a few years there has been an enormous increase in the number of liver transplantations and certainly there have been performed at least as many transplants since 1980 as between 1963 -the start of clinical liver transplantation- and 1980. Even if our understanding is better, many problems are the same as twenty years ago and for some there may be a long way to go before they are solved.

The inadequate supply of organs in the United States and other countries continues to drive the reliance on living donor transplantation. In 2000, representatives of the transplant community convened for a meeting on living donation in an effort to provide guidelines to promote the welfare of living donors. The consensus statement that resulted from this meeting recommended that transplant centers retain an Independent Living Donor Advocate (ILDA) to focus on the best interest of the donor. A decade later, nearly every transplant center in the United States, performing living donor surgeries, has incorporated an ILDA into their living donor screening and/or evaluation process Living Donor Advocate provides an overview of living donation and its risks, ethical challenges and future developments , as well as details about the role a Living Donor Advocate plays in the transplantation process. This book will interest health professionals across various disciplines and patients undergoing transplantation or living donor surgery.

Despite the significant decline in heart disease mortaht>' rates over the last 25 years, heart failure has remained a significant problem. We are now confronted with large numbers of terminally ill patients for whom conventional therapies for heart failure have been exhausted and for whom repeated hospital visits are necessary. There now is a major thrust towards a management strategy which embraces a comprehensive approach including vigorous preventive measures and earlier surgical interventions. This book outlines the major surgical options for the treatment of heart failure and brings together a very broad base of opinions with contributions from several outstanding individuals. With the improved knowledge and techniques to control rejection, transplantation has become the central pillar in the surgical management of this group of patients. Unfortunately, because of limited donor supply the teclmique cannot be applied to large numbers of patients. A great deal of excitement, however, exists in the potential for xenotransplantation as a supplement to homotransplantation. The use of cardiac assist devices has become a reality with several hundred LVADS and BiVADS implanted throughout the world and cardiac replacement with total artificial hearts continues to be used successfully as a bridge to transplantation. We are on the thieshold of the broad application of assist devices to provide prolonged relief of heart failure and restore patients to an ambulatoiy home environment and hopefully return to the work force in significant numbers.

M. BENcovA Slovak Foundation Education in Immunogenetics Kopanice 25, 821 04 Bratislava Slovak Republic Short History of Slovakia After the end of the 5th century, the major part of Central Europe was dominated by Slavs (Slovaks). They had already in the 7th century settle ments in the vicinity of towns Bratislava, Devin, Nitra to create the Slovak's state formation with the name "The Empire of Sam", territory of which corresponded to that of Slovakia of present. The Empire of Sam was also the first state formation in the Central Europe (as present states Czech Republic, Poland, Hungary, Slovakia etc. ) Very important town of this state was Nitra, with the biggest Castle in the Central Europe with his Duke Pribina. The first Church of the Central Europe was built here in the year 830, and it is now considered to be the "Slovak Bethlehem". In the year 880, Nitra also became the first Office of Bishops. Later, the Slovak Duke Pribina and Moravian Duke Mojmir (Moravia corresponded to eastern part of the present Czech Republic) joined their formations to common state "Greate Moravian Empire". The strongest King of the Great Moravian Empire was Svatopluk (864 A. D. ), who spread his empire over Czech Republic, Hungary and part of Poland, Ukraine and eastern Germany of present, which at that time still did not exist as state formations.

Rejection and Tolerance is the latest subject in the Continuing Education series, organized by Fondation Marcel Merieux and Universite Claude Bernard in Lyon. The annual subject is chosen to reflect the status of the topical issues of the year, as taught by leading international experts. The contribution of transplantation and clinical immunology to advanced medicine is considerable and promising. The annual volumes in this series keep the reader abreast of these developments. "