Organ transplantation is one of the most dramatic interventions in modern medicine. Since the 1950s thousands of people have lived with 'new' hearts, kidneys, lungs, corneas, and other organs and tissues transplanted into their bodies. From the beginning, though, there was simply a problem: surgeons often encountered shortages of people willing and able to give their organs and tissues. To overcome this problem, they often brokered financial arrangements. Yet an ethic of gift exchange coexisted with the 'commodification of the body'. The same duality characterized the field of blood transfusion, which was essential to the development of modern surgery.
This book will be the first to bring together the histories of blood transfusion and organ transplantation. It will show how these two fields redrew the lines between self and non-self, the living and the dead, and humans and animals. Drawing on newspapers, magazines, legal cases, films and the papers and correspondence of physicians and surgeons, Lederer will challenge the assumptions of some bioethicists and policymakers that popular fears about organ transplantation necessarily reflect timeless human concerns and preoccupations with the body. She will show how notions of the body- intact, in parts, living and dead- are shaped by the particular culture in which they are embedded.

This book is written as a comprehensive guide for all tissue bank operators to procure and process bone and soft tissue allografts of highest quality standards for safe tissue transplantation practice in patients who require musculoskeletal tissue allograft transplantation. This comprehensive guide includes donor selection criteria, aseptic procurement techniques, laboratory testing and processing of grafts by deep freezing or freeze drying. It also includes sterilization of tissue grafts using gamma irradiation. Quality controls of tissue grafts are discussed in depth. The clinical transplantation of bone and soft tissue allografts is also discussed, with special consideration given to potential complications. Principles of sterile technique in the operating theater are described. The book also incorporates the basic sciences of tissue banking including anatomy, biomechanics, microbiology and immunology. It also covers radiation science so that the reader can better understand radiation sterilization of tissue grafts. Included in the book is a guide for public awareness programmes, radiation code of practice and general standards for tissue banking as recommended by the International Atomic Energy Agency.

Modernize your approach to graft biopsies, diagnosis and pathogenesis in transplantation pathology, with the second edition of this specialized textbook. Reach the latest classification schemes, combining both anatomic and clinical pathology, and gain a comprehensive understanding of detailed pathological processes, affecting both host and graft. Following publication of the first edition in 2009, technological advances in understanding of transplant immunology and physiology have enhanced many aspects of pathological diagnoses. This edition bridges key knowledge gaps in pathophysiologic mechanisms and constantly evolving clinical protocols, facilitating strong support for the pathologist, clinician, and student. Authored by leading experts in transplantation medicine, this multimedia guide boasts richly illustrated images, underscoring vital diagnostic features for busy readers. Addressing topics such as the immunopathology of graft rejection, laboratory medicine and dermatological complications in transplantation, this textbook engages with a variety of underlying pathogeneses, taking into account current laboratory and clinical findings, worldwide.

The book is designed to highlight recent updates in living related transplants, with chapters by leaders in the different types of transplantation. There are very few texts that tackle living donor liver, lung, pancreas and intestinal transplantation as well as the connected ethical issues. With some color photographs illustrating procedures, this concise book will be a valuable resource for students or professionals interested in developing a global view of the ethics and practice of transplantation.

Written and edited by global leaders in the field, Pediatric Liver Transplantation: A Clinical Guide covers all aspects of treatment and management regarding this multifaceted procedure and unique patient population. This practical reference offers detailed, focused guidance in a highly templated, easy-to-consult format, covering everything from pre-transplantation preparation to surgical techniques to post-operative complications. Provides an in-depth understanding of all aspects of pediatric liver transplantation, ideal for pediatric hepatologists, pediatric transplant surgeons, and others on the pediatric transplant team. Covers all surgical techniques in detail, including split graft, living related, auxiliary, and domino. Discusses pediatric liver transplantation consideration for an increasing number of additional metabolic, hematologic and renal conditions; breakthroughs in grafting and stem cell therapy; and techniques and present role of hepatocyte transplantation. Uses a quick-reference templated format; each chapter includes an overview, pathophysiology, conventional management, controversies, and bulleted summary of key take-aways. Includes state-of-the-art mini-reviews based on updated references and author experience throughout the text. Features a full-color design with numerous algorithms, figures, and radiological and histopathological photos. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Governments throughout the industrialized world make decisions that fundamentally affect the quality and accessibility of medical care. In the United States, despite the absence of universal health insurance, these decisions have great influence on the practice of medicine.

In "Medical Governance," David Weimer explores an alternative regulatory approach to medical care based on the delegation of decisions about the allocation of scarce medical resources to private nonprofit organizations. He investigates the specific development of rules for the U.S. organ transplant system and details the conversion of a voluntary network of transplant centers to one private rulemaker: the Organ Procurement and Transplantation Network (OPTN).

As the case unfolds, Weimer demonstrates that the OPTN is more efficient, nimble, and better at making evidence-based decisions than a public agency; and the OPTN also protects accountability and the public interest more than private for-profit organizations. Weimer addresses similar governance arrangements as they could apply to other areas of medicine, including medical records and the control of Medicare expenditures, making this timely and useful case study a valuable resource for debates over restructuring the U.S. health care system.

Every day, newspapers and television news programs present stories on the latest controversies over healthcare and medical advances, but they do not have the space to provide detailed background on the issues. Websites and weblogs provide information from activists and partisans intent on presenting their side of a story. But where can students - or even ordinary citizens - go to obtain unbiased, detailed background on the medical issues affecting their daily lives? This volume in the Health and Medical Issues Today series provides readers and researchers a balanced, in-depth introduction to the medical, scientific, legal, and cultural issues surrounding organ tranplants and its import in today's world of healthcare. Organ Transplantation is organized to provide readers with easy access to the information they need: BLSection 1 provides overview chapters on the background information needed to intelligently understand the issues and controversies surrounding organ transplants, such as how organs are procured and who determines who gets an organ. BLSection 2 offers capsule examinations of the contemporary issues and debates that provoke the most heated disagreements and misunderstandings, such as controversies over who deserves to get an organ, and the concerns over xenotransplantation BLSection 3 includes reference material on organ transplantation, including primary source documents from important players in the debates, a timeline of important events, and an annotated bibliography of useful print and electronic resources. This volume in the Health and Medicine Today series provides everything a student requires to understand the issues involved in organ transplantation and provides aspringboard for further research into the issue

Heart transplantation remains one of the major scientific achievements of twentieth century medicine. During the past four decades, it has evolved from an unproven experimental surgical technique to the most effective form of therapy for refractory end-stage heart disease. It has captured the public's imagination and expanded our understanding of fundamental immunologic mechanisms that are responsible for cellular and humorally-mediated immunity. Despite its successes, many clinical and scientific problems remain. One or more bouts of acute cellular or humoral (vascular) rejection will occur in over 75% of transplant recipients despite current immunosuppressive strategies. Further, rejection directly results in approximately 20% of post-transplant deaths and is believed to play a major role in the development of late allograft dysfunction and coronary vasculopathy. This book by international experts in the fields of transplantation medicine, immunobiology and cardiac imaging provides the reader with an up-to-date, consise summary of the latest developments in the diagnosis and treatment of acute cardiac rejection. It is axiomatic that a more complete understanding of the pathogenic processes involved in rejection will ultimately lead to its prevention. This volume will be useful to transplant cardiologists, cardiovascular surgeons, cardiac pathologists and transplant scientists who seek to prolong the lifespan and improve the quality of life of their transplant recipients.

This new book, edited by internationally renowned specialists Jean-Michel Dubernard, Marwan Dawahra and Paul McMaster, also pools the experience of consultants from both Europe and the US. It is divided into three main sections: Organ Preservation, Organ Harvesting and Surgical Techniques. Many different organs are covered including heart, kidneys, lungs, pancreas, intestine and bowel. The various aspects of preservation are discussed including cooling, and preservation solutions, the composition of which are currently being actively explored. Longer term preservation of the heart is still an unsolved problem and this is considered, as well as the pros and cons of organ donation from live or cadaveric donors.

Fully referenced and illustrated with over 50 line drawings, Organ Preservation and Transplant Surgery will be of particular interest to those involved in the often complex surgery of organ harvesting or trainees in transplantation surgery. It gives clear accounts of the techniques involved and a detailed update in the underlying science that determines and currently limits organ storage. It will also prove invaluable to the younger researcher who needs a clearer understanding of the scientific basis of organ preservation and the clinical need for better organ preservation.

Three decades after the first heart transplant surgery stunned the world, organs including eyes, lungs, livers, kidneys, and hearts are transplanted every day. But despite its increasingly routine nature-or perhaps because of it-transplantation offers enormous ethical challenges. A medical ethicist who has been involved in the organ transplant debate for many years, Robert M. Veatch explores a variety of questions that continue to vex the transplantation community, offering his own solutions in many cases.

Ranging from the most fundamental questions to recently emerging issues, "Transplantation Ethics" is the first complete and systematic account of the ethical and policy controversies surrounding organ transplants. Veatch structures his discussion around three major topics: the definition of death, the procurement of organs, and the allocation of organs. He lobbies for an allocation system-administered by nonphysicians-that considers both efficiency and equity, that takes into consideration the patient's age and previous transplant history, and that operates on a national rather than a regional level.

Rich with case studies and written in an accessible style, this comprehensive reference is intended for a broad cross section of people interested in the ethics of transplantation from either the medical or public policy perspective: patients and their relatives, transplantation professionals, other health care professionals and administrators, social workers, members of organ procurement organizations, and government officials involved in the regulation of transplants.

The title of this profound work conveys the bold, uncertain, and often dangerous adventure in which medical professionals and their organ transplant and dialysis patients are engaged. Built around a series of case studies developed through years of first-hand ethnographic research, The Courage to Fail is the product of collaborative first-hand research concerned with various social phenomena generated by transplantation and dialysis and also by the development and deployment of an artificial heart. The authors examine the individuals involved and the workings and atmosphere of some of the medical centers in which these forms of therapy have been developed. They examine "gift-exchange" dimensions of transplantation: the transcendent and tyrannical aspects of the "gift of life" that transplants entail for donors and recipients -- and for medical professionals as well. They also analyze the dilemma of uncertainty inherent in medicine, which occurs with particular force in the development of such experimental techniques.

Since publication of the original edition, the authors have continued to follow social and medical developments surrounding organ transplants and dialysis. In their new introduction, they discuss transplantation as a gift of life, how death is defined and when it occurs, efforts to procure more organs, and organ allocation and issues of equity. This book will be of interest to physicians, medical students, medical sociologists, and anyone interested in the history of and issues surrounding organ replacement.

The developments that have occurred in the field of organ transplantation during the 1980s and early 1990s, and the simultaneous rise and fall of the Jarvik-7 artificial heart are the subject of this vividly written and absorbing new volume. In Spare Parts, fascinating, interconnected stories of organ transplantation and the artificial heart are recounted in an interpretive framework that explores the vision of the "replaceable body." Themes of uncertainty, gift exchange, and the allocation of scarce material and non-material resources underscore a discussion that openly examines the escalating ardor about the goodness of repairing and remaking people with transplanted organs. Likewise, the stories open questions of life and death, identity, and solidarity. This important book offers insights into the symbolic and anthropomorphic meanings associated with the human body and its organs, and into the ways that medical professionals come to terms with the concomitant aspects of transferring vital body parts. Both artificial and donor organs, as well as the process of transplantation, are the subject of a thoughtful discussion which touches on the medical myths and rituals that they generate. Chronologically, Spare Parts begins where the authors' previous book, The Courage to Fail, leaves off. More than a sequel, however, this work reflects their increasingly troubled and critical reactions to the expansion of organ replacement. Likely to be controversial, this book is must reading for bioethicists, medical sociologists and anthropologists, health-care lawyers, planners and administrators, nurses and physicians, medical journalists and science writers, and concerned lay readers.

No one argues the need for transplants. The debate centers on how to satisfy the great need for healthy organs. Advances in medical technology and science have made organ procurement, or the search and transfer of organs and tissue from one body to another, a very important issue. Since the demand for healthy organs far exceeds the supply, many questions enter this debate, blending medicine with politics, ethics, research, religion, and other concerns. How are we to meet the need? Can we do so and still respect personal ethics and religious convictions? Can organs be obtained without turning medical emergencies into free-market enterprise? Should people be permitted to sell their organs? Should animals be sacrificed to save the lives of humans? Could cloning be considered as a future source of organs?
With more than thirty of the most important, influential, and up-to-date articles from leaders in ethics, medicine, philosophy, law, and politics, The Ethics of Organ Transplants examines the numerous and tangled issues that surround organ procurement and distribution.
Co-edited by Dr. Arthur L. Caplan, a world recognized scholar in bioethics and health policy, this volume divides the issue into five related areas: (1) sources of organs for transplantation and various methods of transplants, including living donations, fetal tissue use, defining brain death, and nonhuman organ transfer; (2) policy, including presumed consent, required requests, and mandated choice to relieve the shortage problem; (3) the ethics of selling organs, the effect on supply and use of organs, making organ procurement a global effort; (4) case histories and questions on who should (not) receive transplants; and (5) the value

With the success of organ transplantation and the declining number of heart beating cadaver doctors, the number of patients awaiting a transplant continues to rise. This means that alternative sources of donors have been sought, including donors after cardiac death. Such donors sustain rapid damage to their organs due to ischaemia, and as a consequence, some organs do not work initially and some none at all. The proportion of such transplants has increased dramatically in recent years--25% of kidney transplants in the UK were from such donors in 2006, highlighting how much progress has been made.
Written by international experts, this book lays out the moral, legal, and ethical restraints to using such donors for organ transplant together with the techniques that have been adpoted to improve their outcome. The different approaches and results of renal transplant according to country are covered together with the procedures and outcomes adopted to use other organs, notably the liver and lungs.

Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them - in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded? Kidney for Sale by Owner contends that the market is indeed a legitimate - and humane - way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic. Rather than focusing on purported human exploitation and the irrational moral repugnance of selling organs, Cherry argues that we should focus on saving lives. Following on the thinking of the philosopher Robert Nozick, he demonstrates that, with regard to body parts, the important core humanitarian values of equality, liberty, altruism, social solidarity, human dignity, and, ultimately, improved health care are more successfully supported by a regulated market rather than by well meant but misguided, prohibitions.

Enter the world of organ transplantation and develop a new understanding of processes and techniques for working effectively with patients in this increasing medical population. This multidisciplinary overview of organ transplantation contains chapters by major figures in the medical arena, internationally known bioethics writers, and experienced chaplains from the clinical setting of transplantation, as well as respected pastoral theologians. The authors, who include Art Caplan, Donald Capps, and Jack Copeland, explain transplantation completely for the nonmedical person and delve into the myriad ethical and religious issues and controversies surrounding organ donation and transplantation. Enlightening chapters clarify issues and help readers better understand the transplantation process, making them more effective in their work with transplant patients. Organ Transplantation in Religious, Ethical and Social Context is divided into three sections. The first emphasizes transplantation as a team effort. Chapters focus on the various roles of chaplains and other team members.Section two addresses ethical questions which arise from transplantation and organ donation and includes interfaith perspectives. The third section is dedicated to theological and pastoral views concerning transplantation. Some specific topics discussed in this book include: a surgeon's perspective of the role of the chaplain influence of psychosocial factors in the heart transplantation decision process ministry to organ recipients and their families the special relationship between the transplant coordinator and the transplant patient Catholic and interfaith perspectives on organ donation using the Psalms as a pastoral resource with transplant patients Hospital chaplains, transplant social workers, transplant coordinators, and other professionals interested or involved in the process of organ transplantation will find this book to be full of interesting and thought-provoking insights and information.

The possibility of treating patients with organ replacement therapy has created a new frontier in medical care. Hospitals have to deal with such vital issues as selecting potential recipients of transplants, ensuring equity in allocating organs, pre- and peri-transplantation care of patients, and post-transplantation follow-up of organ recipients. The decisions pertaining to these issues often fall to social workers, who, with their bifocal concern for individuals and society, have significant contributions to make. Here, Dhooper reviews the contributions of the few social workers in this field and suggests ways of improving their work, consolidating their professional gains, and maximizing their impact. Dhooper discusses all aspects of organ transplantation, and explores and proposes new social work roles and appropriate skills for involvement at the individual, organizational, and community levels. He deals with the larger moral, societal, economic, and technical issues, as well as the here-and-now concerns of the social worker. Recommended for social workers trained for practice in the 1990s and beyond, and particularly those specializing in health and mental health social work.

Diagnosis of death by neurological criteria (DNC) is a construct which has been part of the British medico-legal landscape for nearly half a century. This book examines the factors behind its emergence, and discusses the various changes that took place in the last few decades that culminated in the current definition and clinical criteria for determining brain-based death. It highlights the continuities and discontinuities in practice, and the impact they have on the issue of withdrawal of mechanical ventilation in intensive care units and on the field of organ transplantation. The book also explores the law's response to the introduction and development of DNC in clinical practice. It demonstrates how the legitimacy of the definition and criteria used by the medical profession were forged in the courtroom rather than in Parliament. It documents why case law were introduced in court, and assesses whether organ donation was a consideration in the deliberations. It will be emphasised that courts have given insufficient consideration to requests made in recent cases to consider a broader range of methods to determine death. Those pleas were made on the grounds that the definition and criteria used in the UK are dissimilar to those used in other jurisdictions that also adopt DNC; and that faith communities have a different understanding of death. By taking a close look at those other approaches before highlighting the inherent limitations of the courtroom as the forum that confers DNC its legitimacy, the book puts forward the argument that the democratic process should be engaged.

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.

As a major transplantation center, the University of Pittsburgh has conducted more than 300 liver transplants. Because the problems faced by an institution contemplating the initiation of such an organ transplantation program are many, unique, and often unexpected, the university has been beseiged by requests from other physicians and hospitals for training and advice. This book represents much of the accumulated experience on hepatic transplantation to date.

Living donor kidney (LDK) transplantation has become the definitive approach to the treatment of end-stage renal failure, providing a better quality of life and the best opportunity for survival when compared with dialysis or transplantation from a deceased donor. A timely compendium of the modern day practice of LDK transplantation from a group of outstanding international experts, this text explores a number of controversial aspects of this innovative new technique. Discussing in detail the current situation, the authors also focus on the responsibility of the medical community to the live kidney donor as a patient, and the potential for complacency regarding donor risk. Emphasizing the ethical principles that must dictate medical practice in LDK transplantation for the foreseeable future - voluntarism, informed consent and medical follow-up - this book comprehensively records the best practices currently available.

Hematopoietic stem cell transplantation (HSCT) is currently utilized as a treatment option for a variety of life-threatening conditions affecting children and young adults including leukemia, lymphoma, neuroblastoma, brain tumors, inherited immune deficiency syndromes, blood disorders, and inherited metabolic diseases. This expertly written reference provides current information on methods and outcomes in a wide range of pediatric diseases, using a variety of HSCT approaches. It guides the pediatric professional in the proper execution and understanding of HSCT, and provides illustrative discussions of the hematopoietic and immune systems, clear outlines of current chemotherapy regimens, and expert guidance on each phase of stem cell transplantation and management, including patient evaluation and recovery.