Cirrhosis from hepatitis C (HCV) is now the most common indication for liver transplant (LT) in the U.S., but between 2004 and 2013, new LT listings for NASH increased by 170%. Unfortunately, fibrosis progression leading to cirrhosis, liver cancer, and liver decompensation continues to occur after transplantation. Once cirrhosis and decompensation are evident, patient survival is poor and repeat LT is considered to improve outcomes. Therefore, the never-ending thirst for new approaches in the management of patients pre- and post-transplant has led to a very promising future in transplantation, thought there is much to learn to achieve better patient outcomes. This issue of Clinics in Liver Disease addresses the core areas to achieve better patient outcomes, with articles devoted to coagulopathy before liver transplant, challenges in renal failure before LT, LT for acute alcoholic hepatitis, LT in the pregnant patient, bariatric surgery and LT,and MELD Scores in prioritization of LT, to name a few. Readers will place a high value on the current state of liver transplantation in this issue.

This issue of Radiologic Clinics of North America focuses on Topics in Transplantation Imaging. Articles will include: Surgical and imaging workup of the liver pre-transplantation donor and recipient; Surgical techniques and imaging complications of liver transplantation; Surgical and imaging workup of the renal pre-transplantation donor and recipient; Imaging complications of renal transplantation; Surgical and imaging workup of the pancreas pre-transplantation donor and recipient; Interventional and surgical techniques in solid organ transplantation; Complications of immunosuppresive therapy in solid organ transplantation; Pediatric thoracic organ transplantation: current indications, techniques, and imaging findings; Pediatric abdominal organ transplantation: update on current practical imaging assessment; Surgical issues of lung transplantation; Imaging complications of lung transplantation; Current indications, techniques, and imaging findings of stem cell treatment and bone marrow transplant; and more!

More than any other altruistic gesture, blood and organ donation exemplifies the true spirit of self-sacrifice. Donors literally give of themselves for no reward so that the life of an individual--often anonymous--may be spared. But as the demand for blood and organs has grown, the value of a system that depends solely on gifts has been called into question, and the possibility has surfaced that donors might be supplemented or replaced by paid suppliers.
"Last Best Gifts" offers a fresh perspective on this ethical dilemma by examining the social organization of blood and organ donation in Europe and the United States. Gifts of blood and organs are not given everywhere in the same way or to the same extent--contrasts that allow Kieran Healy to uncover the pivotal role that institutions play in fashioning the contexts for donations. Procurement organizations, he shows, sustain altruism by providing opportunities to give and by producing public accounts of what giving means. In the end, Healy suggests, successful systems rest on the fairness of the exchange, rather than the purity of a donor's altruism or the size of a financial incentive.

This unique book details a multidisciplinary approach for providers caring for the Mechanical Circulatory Support (MCS) patient. Authors discuss the history of MCS, patient selection, surgical and post-operative care, mobility and nutritional issues for this subgroup of patients, along with outpatient management. They are expert clinicians in the field of MCS and Extracorporeal Membrane Oxygenation (ECMO), who provide direct patient care, conduct research, publish and maintain current leadership positions within the International Society of Heart and Lung Transplant and International Consortium of Circulatory Assist Clinicians.Non-clinical issues including Regulatory, Reimbursement, Administration, Program Development and links to Professional Organizations supporting MCS Clinicians are presented in the book that will be of great value to Nurses first, but also to Advanced Practice Providers (NP/PA), Dieticians, Physical Therapists and Administrators.

Organ transplantation has revolutionized the treatment for end-stage organ failure. Immunosuppression is still a major approach currently used in the prevention and treatment of allograft rejection. Both editors Dr. Chen and Dr. Qian have been contributing to preclinical evaluation of immunosuppressants for more than 25 years in North America. Experts from the United States, Canada, the United Kingdom, China, Japan, Germany, Sweden, Hungary and Brazil contributed 23 chapters to this book, providing details of immunological basis in transplantation. They also describe six classes of immunosuppressive agents (calcineurin inhibitors, mTOR inhibitors, JAK-STAT inhibitors, antiproliferative agents, costimulation blockers and corticosteroids), as well as ischemia/reperfusion injury treated agents. Additionally, the new development of cell therapy in the induction of transplant tolerance is introduced. This book provides many important references for the research direction of novel immunosuppressants. Readers that will find this book useful include transplant physicians, surgeons, nurses, immunologists, pharmacologists, pharmacists, medical students, residents and trainees in transplantation.

Brought to you by the world s leading transplant clinicians, Textbook of Organ Transplantation provides a complete and comprehensive overview of modern transplantation in all its complexity, from basic science to gold-standard surgical techniques to post-operative care, and from likely outcomes to considerations for transplant program administration, bioethics and health policy. Beautifully produced in full color throughout, and with over 600 high-quality illustrations, it successfully: * Provides a solid overview of what transplant clinicians/surgeons do, and with topics presented in an order that a clinician will encounter them. * Presents a holistic look at transplantation, foregrounding the interrelationships between transplant team members and non-surgical clinicians in the subspecialties relevant to pre- and post-operative patient care, such as gastroenterology, nephrology, and cardiology. * Offers a focused look at pediatric transplantation, and identifies the ways in which it significantly differs from transplantation in adults. * Includes coverage of essential non-clinical topics such as transplant program management and administration; research design and data collection; transplant policy and bioethical issues. Textbook of Organ Transplantation is the market-leading and definitive transplantation reference work, and essential reading for all transplant surgeons, transplant clinicians, program administrators, basic and clinical investigators and any other members of the transplantation team responsible for the clinical management or scientific study of transplant patients.

Dumfries and Galloway Life Magazine's 'Book of the Month' for April 2014 (Southwest Scotland) ..".an excellent read." National Kidney Federation's Kidney Life Magazine - Summer 2013 You don't remember your childhood in detail, so your memories thirty or forty years on have become hazy; times you had back then are painted in colours that have become distorted, and you find yourself recalling conversations you have created in your head. Through living in the false world of remembering, you can deal with the past in such a way that the things that happened, they appear to matter less. This is a love story. In the end, anyway, that's what it will be. A love story gives you hope: whatever you have lost; whatever you have to gain. For me, as someone on daily kidney dialysis, when an offer of a kidney came along which I couldn't possibly refuse, there was everything to gain. But the past has a way of interfering with what seems as though it is the right path... and how do you ever in this life repay a debt so huge? Clare Cogbill was born in the mid-1960s and has spent much of her adult life working with animals, and as a lecturer. In this book, from personal experience, she explores the issues of organ donation, generosity, grief. and the human-animal bond. It is a story that readers will find thought-provoking and captivating. This book is an autobiography of love, loss, grief and what can happen when you dare to hope. By the author of 'A Dog Like Ralph'

There has been a substantial increase in the number of patients with end-stage renal disease world-wide over the last few decades. In Australia, over 2400 patients with end-stage renal disease started renal replacement therapy in 2011 with nearly 11,000 patients currently receiving dialysis treatment at the end of 2011. According to Kidney Health Australia, the costs of treating end-stage kidney disease from 2009 to 2020 is estimated to be around $12 billion, highlighting the fact that kidney disease is a major financial burden to the community. Kidney transplantation confers a survival benefit in patients with end-stage renal disease but transplantation has become increasingly more complex over the last decade. With the greater understanding of transplant immunology along with the introduction of more potent induction and maintenance immuno-suppression, clinicians are now in a better position to more accurately stratify each transplant candidate's immunological risk as well as the ability to safely transplant high-immunological risk transplant candidates. This book covers all major aspects of kidney transplantation and was put together with the hope of providing the readers with in-depth and current knowledge of important aspects of kidney transplantation, including donor and recipient assessments, innovative surgical techniques and understanding of surgical complications, the evolution of immunological techniques to identify anti-human leukocyte antigen antibodies, the management and preparation of high-risk transplant candidates for transplantation as well as the management of longer-term complications after kidney transplantation.

Everyone knows that transplantation can save and transform lives, but thousands die every year on waiting lists because there are not enough organs available. If more people could be persuaded to donate, more lives could be saved. But is individual reluctance to donate the root of the problem? Individual choices are made against the background of prevailing laws, conventions and institutions, and many of those present direct or indirect obstacles to organ procurement, from both the living and the dead. If any of those cannot be justified, the deaths they cause are similarly unjustified. In The Ethics of Transplants, Janet Radcliffe Richards, a leading moral philosopher and author of The Sceptical Feminist and Human Nature after Darwin, casts a sharp critical eye over these institutional barriers to organ procurement, and the logic of the arguments offered in their defence. Her incisive reasoning forces us to confront the implications of unexamined intuitions, leads to several unexpected conclusions, and in doing so demonstrates the crucial importance of clear thinking in public debate. Originally published in hardback as The Ethics of Transplants.

In his late 40s, Steve Burcham suddenly experienced inexplicable heart failure. The struggle to survive and finally get a heart transplant changed more than his physical health and well-being. How he managed to keep going through it all makes for an uplifting story of medical miracles and spiritual healing filled with humor, determination, prayer and ultimately unshakeable faith.

Organ transplantation is one of the best therapeutic options for patients with end-stage organ failure. Experimental organ transplantation is an important link between basic science and clinical practice. Both editors, Dr Chen and Dr Qian, have been working in this area for over 20 years. Experts from the United States, Canada, China, Japan, Italy, Span, Turkey, Switzerland, Hungary, and Brazil contributed 25 chapters in this book, and provided detailed descriptions of techniques for vascularised organ allografts in mice, rats, pigs, and non-human primates, as well as detailed descriptions of non-vascularised pancreatic islet and spleen allografts. Furthermore, they discussed new advances in transplantation immunology. This book provides numerous important references which were carefully selected by the authors to extend their visions and knowledge. The appropriate readers of this book include medical students, graduate students, residents, surgeons, physicians and immunologists interested in the transplantation area.

Clinical transplantation is still in the infancy stage with less than 60 years history. Despite recent successes, there are still several unresolved problems. This book tries to tackle some of these problems such as organ shortage, live donation, expanding the donor pool, ethical and legal issues regarding brain death concepts, the consent for donation process, and the use of human tissue for transplantation. The diversity of authors with different backgrounds such as physicians, philosophers, and ethicists, makes this book unique. The book tries to comprehensively discuss different issues from different angles that transplantation faces today. This book has 12 chapters discussing a wide variety of topics related to organ donors and donation.

Hematopoietic Stem Cell Transplantation (HSCT) is an established treatment for a variety of malignant and nonmalignant conditions. In autologous HSCT, the stem cells are collected from the patient then infused back after high dose chemotherapy. On the other hand, in allogeneic HSCT, the stem cells are donated from another individual (who may be related or unrelated and unmatched or matched). In this book, the authors present new research in the study of hematopoietic stem cells including pulmonary complications following HSCT; psychological health and adjustment of families of children who undergo HSCT; the immunogenetics of unrelated HSCT for thalassemia; HSCT for inflammatory bowel diseases; and extramedullary hematopoiesis leading to the production of a novel antigen-presenting cell type in the murine spleen.

More Than Six Thousand Individuals Receive Liver Transplantations Each Year. Whether You Or A Loved One Is Contemplating Liver Transplantation, On The Waiting List For Liver Transplantation, Or Are A Transplant Recipient, The Options And Information About This Surgery Can Be Overwhelming. This Invaluable Resource Offers The Guidance And Advice You Need. Written By A Prominent Physician, 100 Questions & Answers About Liver Transplantation: A Lahey Clinic Guide Gives You Authoritative, Practical Answers To Your Pre- And Post-Surgery Questions About Indications, Evaluation, Medications And Side Effects, Living Donor Transplantation, And Much More.

This comprehensive, 270-page book, written by lung transplant recipient Karen A. Couture, covers the entire transplantation process from beginning to end for both lung and heart-lung transplants.
This book introduces the reader, in easy-to-understand language, to the complex process of getting on the transplant waiting list and how the list works; preparing for surgery and the surgery itself; financing the operation and the recovery afterward; and the complications of rejection and the medications. It also includes precautions a transplant recipient should take in order to live a long and healthy life; returning to work or school; future trends in transplantation; and writing to your donor family.
Scattered throughout this book are excerpts from the stories of pre-transplant patients, recipients and caregivers, to offer the unique perspective only a person going through the process could furnish.
This edition also provides a wealth of information in an extensive, up-to-date resource section; glossary; appendix of all lung transplant centers, including waiting time and the number of transplants performed; bibliography; and worksheets. This publication is a must-read for transplant candidates, recipients, family members, as well as social workers, and nurse transplant coordinators.

This is the true story of a man who rose from the depth of poverty to become a pioneer in modern medicine. Born in a small village in Iraq, and raised by a poor family, he met and conquered many adversities in his pursuit of a better living and his goal of becoming a physician. His chosen path was briefly derailed when he was granted a full scholarship to study engineering in United Kingdom, but he eventually came back to a successful career in medicine, becoming a leader in organ transplantation, one of the most innovative fields in modern medicine. Unfortunately, he became the victim of his own success when his achievements created animosity in his colleagues, who waged a political war and booted him to another country thousands of miles away. In his voluntary exile, he refused to be defeated and ultimately emerged stronger than ever. When forced to relocate yet again, his fame preceded him to the United States of America, where he has continued his mission to the present day. This book is a snapshot of the professional and personal life of a surgical innovator and pioneer. It is set in the background of a previous era in British, North American and international surgery. But what was his life like? How did he reach the pinnacle of success? Find out in this book.

The organ procurement system in the United States has failed patients awaiting transplants, as evidenced by years-long waiting lists, with many patients declining in health or dying before a suitable organ donor is found. The cadaveric organ shortage can be remedied by allowing for organ purchases and sales, to encourage families of the deceased to donate the organs. This monograph is part of AEI's Evaluative Studies Series. The series aims to enhance understanding of government programs and to prompt continual review of their performance. David L. Kaserman is the Torchmark Professor and chairman of the Department of Economics at Auburn University. A. H. Barnett is a professor in, as well as the chairman of, the Department of Economics, International Studies, and Public Administration at the American University of Sharjah in the United Arab Emirates. A summary of the book follows. The first successful human organ transplant in the United States was performed on December 23, 1954, when a kidney was transplanted from a living donor who was an identical twin of the recipient. Since then, the ability to use organ transplants to save the lives and improve the health of thousands of patients suffering from kidney, heart, liver, and other organ failures has improved dramatically. New immunosuppressive drugs and advanced surgical techniques have allowed the successful use of cadaveric donor organs and, thereby, expanded the set of organs for which transplantation is a viable treatment. As a result, the number of organ transplants performed in this country has now grown to approximately 22,000 each year. Despite the tremendous successes that have been achieved, transplantation technology has failed to realize its full promise because of a chronic shortage of cadaveric organs that are made available for that use. The sad fact is that every year for the past three decades the number of cadaveric organs supplied has fallen well short of the number demanded. As a consequence, many patients are denied timely access to this life-saving treatment modality. Those who are deemed medically suitable candidates for transplantation are placed on organ waiting lists, where they often remain for one or more years before an acceptable organ becomes available. While they wait, these patients' health declines, making successful treatment increasingly problematic. Indeed, many of them die before a suitable donor organ is found. As of June 25, 2001, more than 77,000 patients were waiting for an organ transplant. Approximately 7,000 patients died in the preceding year as still more were added to the lists. And as the shortage continues, the length of the lists grows, waiting times increase, and the death toll rises. Importantly, the cadaveric organ shortage is not attributable to an inadequate number of potential organ donors. Of the 2 million or so deaths that occur in the United States each year, estimates indicate that somewhere between 13,000 and 29,000 occur under circumstances that would allow the organs of the deceased to be transplanted. Of these, only 5,843 (or 28 percent of the midrange of the estimates of the number of potential donors) yielded organ donations in 1999. Given the number of potential donors, then, organ collections could easily double or perhaps even triple without exhausting the existing potential supply. Thus, the organ shortage is the product of an ill-conceived public policy that fails to achieve higher collection rates from the available pool of donors. That policy, often referred to as the "altruistic system" of organ procurement, operates (as this name implies) entirely on the basis of unpaid donors. In the typical situation, the families of recently deceased accident or stroke victims who have been declared brain dead are asked for permission to remove the organs of the deceased for use in transplantations. Under the National Organ Transplant Act of 1984, any payment or other form of compensation to encourage the family to donate the organs is strictly proscribed by federal law. As a result, while the suppliers of all other inputs used in a transplant operation are paid market-determined prices, the parties who hold the key that makes transplantation possible cannot be paid. History of the Transplant System Notably, this system has evolved more by historical accident than conscious design. It grew out of a public policy that was intended for use with living, related kidney donors only. Because the earliest transplants were performed exclusively with kidneys donated by the recipients' living relatives, all organ transplant candidates brought the necessary donor with them when they checked into the hospital. If there was no acceptable living donor, there could be no transplant operation. As a result, there were no waiting lists and no apparent shortage. Moreover, under the living related donor system, there was no obvious need for any payment to encourage donor cooperation. The affection associated with the kinship between the donor and recipient was generally thought to be sufficient to motivate the requisite organ supply. And, where it was not, any necessary payment (or coercion) between family members could easily be arranged without resorting to the sort of middlemen generally required for market exchange. Such intrafamily cajoling by emotional pressure or outright payment also remained out of sight of the transplant centers and attending physicians. Therefore, a system of "altruistic" supply seemed to make sense in this setting, and reliance upon such a system did not seriously impede the use of this emerging medical technology. Indeed, it seemed to work quite well. That situation gradually changed, however, as new drugs began to allow the use of cadaveric donor organs and transplant success rates improved. Apparently, sometime during the 1970s, organ waiting lists began to arise as transplant candidates formed queues for needed cadaveric organs. The existing organ procurement system, however, was never altered to meet the needs of the greatly expanded pool of potential recipients created by the new technological opportunities. While some minor modifications have been implemented and considerable sums spent to educate the public regarding the virtues of organ donation, the basic system of complete reliance upon altruism to motivate supply has not changed. As a result, we have come to the current tragic situation in which thousands of patients die each year for lack of a suitable donor organ. These deaths have sparked considerable debate about how best to reform the U.S. organ procurement system to increase cadaveric donations. That debate, in turn, is reflected in a large and growing literature in which a variety of alternative policy proposals have been advanced. These proposals are surveyed in Chapter 3 of this monograph. While some authors have argued for continued reliance upon the current system with, perhaps, an appeal for increased educational expenditures, most now recognize that more fundamental policy change is required. The five most common proposals that have appeared in the literature are: (1) presumed consent, (2) conscription, (3) required request, (4) compensation, and (5) cadaveric organ markets. The first three of these proposals have, to varying degrees, been implemented either in the United States or abroad. In Chapter 3, we describe how each of these policies operates. We then demonstrate that, under reasonable assumptions regarding cadaveric organ supply and demand curves, the proposal to allow cadaveric organ markets to form clearly dominates all other policy options on social welfare grounds. Indeed, the organ market proposal appears to be the only alternative likely to eliminate the organ shortage entirely. Moreover, we estimate that, relative to the current system, creation of a market for procurement of cadaveric kidneys alone would, conservatively estimated, increase social welfare by over USD 300 million per year. Expanding the market system of procurement to other solid organs, then, would be likely to expand these welfare gains to well over USD 1 billion per year. And these welfare gains would be accompanied by several thousand lives saved annually. Despite the likelihood of such superior performance, however, the organ market proposal is not ubiquitously supported by those writing in this area. Both ethical and economic objections have been raised against the use of this most promising policy option. Upon inspection, however, these objections are found to be attributable, to a large degree, to: (1) some rather dubious ethical positions that have, in fact, been shown to be either logically weak or outright specious; (2) some fundamental misconceptions about how markets in general and organ markets in particular might operate in practice; and (3) several implicit (and empirically unlikely) assumptions regarding underlying structural parameters of cadaveric organ supply and demand curves. Chapter 4 addresses the first two sources of opposition, while Chapter 6 attempts to shed some light on the third. Importantly, we demonstrate in these chapters that none of the objections that have been raised in the literature to date is supported by either straightforward economic theory or empirical evidence. A dispassionate, objective analysis of the relevant arguments reveals no sound basis for rejecting the cadaveric organ market proposal. That is not to say, however, that sound economic reasons do not exist for particular interest groups to oppose this policy option. As with any policy change, there are parties likely to win and parties likely to lose from the formation of organ markets and resolution of the shortage. Chapter 5 focuses on the possibility that suppliers of transplant-related services - including, among other things, UNOS (an organization that maintains the nation's organ transplant waiting lists), organ procurement organizations, and transplant centers - could, in theory, suffer a decline in profits or a reduction in (or elimination of) the demand for their services if the organ market proposal were adopted. In addition, other parties providing substitutable services, such as dialysis clinics, could experience financial losses as well. While the economic stakes that a group holds in the outcome of this policy debate are not necessarily determinative of the positions adopted, they at least tend to temper each party's receptiveness to the options presented and the arguments used to support them. Consequently, while the case for adoption of the cadaveric organ market proposed is compelling, one should not expect to observe ubiquitous support for that proposal, particularly among suppliers of transplant services and organizations responsible for managing the shortage. The Case for Change The economic analysis and empirical evidence presented in this monograph support the following significant conclusions: 1. The shortage of cadaveric organs for transplantation has persisted for more than three decades. It is large, growing, and responsible for at least several thousand deaths each year. 2. The organ shortage is not caused by an insufficient number of potentially transplantable cadaveric organs. Rather, it is the direct result of a public policy that proscribes organ purchases and sales. 3. Economic theory strongly suggests that this shortage can be resolved by changing that policy to allow cadaveric organs markets to form. Such markets would permit cadaveric organ prices to rise and fall as necessary to equilibrate supply and demand, thereby eliminating the shortage. The social welfare gains achievable through implementation of the organ market proposal appear to be quite substantial, probably exceeding USD 1 billion per year. 4. Ethical objections to cadaveric organ markets appear to be either logically specious or generally unconvincing. Indeed, the alleged moral superiority of any policy that leads to unnecessary deaths along with higher expenditures must be viewed as inherently suspect. It seems, to us, indefensible to argue that one group of people should be denied lifesaving transplants simply because another group (who neither supplies nor demands cadaveric organs) prefers altruistic supply over market exchange. 5. Initial empirical evidence (though limited) suggests that adoption of organ markets would completely resolve the shortage at surprisingly low equilibrium prices. Our data suggest that payments on the order of USD 1,000 per donor would encourage an increase in the number of donors that would be sufficient to clear the market. These data also suggest that the alleged public opposition to such markets has been grossly exaggerated. It appears that it is the medical community, not the public, that is opposed to organ markets. We believe that these findings conclusively demonstrate the desirability, on social welfare grounds, of repealing the ban on cadaveric organ purchases contained in the National Organ Transplant Act of 1984. That ban has caused the unnecessary deaths of tens of thousands of patients and prolonged the suffering of many thousands more. And, ironically, it has done this while actually increasing federal and state expenditures on the affected programs. Thus, our current cadaveric organ procurement policy simultaneously causes unnecessary deaths and increased costs. And all of this is done for the high moral purpose of preventing the families of recently deceased accident and stroke victims from receiving any payment for their agreement to allow removal of their loved ones' organs.

Sarah had been dying of cystic fibrosis since the day she was born. The disease quickly ravaged her lungs and little body bit-by-bit. Fragile and frail, she had only weeks to live, when her mum realised the reality of Sarah's situation: transplant laws, restricting access to lungs based on arbitrary age restrictions, meant Sarah's options were limited. The injustice of her daughter's fate spurred Janet to start a public battle against outdated health care regulations and a battle to save Sarah's life. Janet transformed her pain and desperation into a voice for Sarah and other kids using social media as her megaphone with friends and family as Sarah's warriors. How does a family navigate catastrophic illness and life in a hospital, while still maintaining a sense of normalcy? Saving Sarah is a story of hope and courage, and a mother's determination to never give up. It's also the story of how a family - Janet and her husband Fran have three other children, one adopted from Ghana - reacts and adjusts when one of its members is in ongoing crisis.