A pioneer in organ transplantation discusses the amazing advances in the field One of the most spectacular medical advances of the twentieth century, organ transplantation has become a generally effective and routine treatment for patients with organ failure. In this riveting book, a well-known expert in the fields of clinical transplantation and transplantation research traces the evolution of organ transplantation from its initial stirrings in the imaginations of the ancients to its current status as accepted treatment for nearly 40,000 patients each year. Drawing often on his own firsthand experience, Dr. Nicholas L. Tilney tells the story of the advances in organ transplantation, discusses how societal forces have driven its development, and reveals how its current success is marred by commercialism and exploitation of the less fortunate. Dr. Tilney describes early transplantation attempts, the first successful kidney transplant in 1954 between identical twins, the scientific advances for suppressing the immune system, the introduction of the concept of host tolerance, the new research on donor matching, and the issue of donor brain death. He explores innovations in heart, lung, liver, and other abdominal transplants and reflects on the attempts to make transplants between species. Finally he explains how organ transplantation has become a vast business, creating ethical and logistical conflicts about organ donations.

This book is the first to provide a thorough overview of the experience of pancreas transplantation in Asian countries, including in particular Korea, Taiwan, and Japan. Recent trends are identified and attention drawn to differences in comparison with the United States and Europe. Such differences relate, for example, to the history of pancreas transplantation, the operative procedure, and the organ-sharing system. In addition, the insulin-secreting ability of pancreatic islet cells is thought to vary depending on race. Beyond these aspects, the coverage also encompasses ABO-incompatible living donor pancreas transplantation, which is very rarely performed elsewhere in the world. By introducing the number, technique, and outcomes of pancreas transplantation in Asian countries, the book will hopefully further stimulate the pancreas transplantation program in this region and beyond. It will be of value for all medical professionals in the field and will be informative for diabetic patients receiving insulin treatment in Asia.

The field of transplantation has grown exponentially over the last few decades, and leaders in the field may argue that we have seen only the tip of the iceberg. Perhaps in no other discipline is there a need for multidisciplinary dialogue, debate, and approaches to patient care. In preparing this book, we have attempted to introduce readers to a few of the key clinical and ethical issues confronting the field of transplantation today. In so doing, we recognize that the face of transplantation may change dramatically in the years to come. Nevertheless, the issues raised throughout this book will serve as a useful introduction to important clinical issues and as a catalyst for clinicians and researchers to expand the horizons of transplantation. Health professionals involved in evaluating and treating transplant patients must be knowledgeable of the indications for transplantation and patient outcomes and the process of evaluation and management. Chapters 1 and 2, focusing on solid organ transplantation and blood/marrow transplantation, provide this important contextual information. The next two chapters address what is often considered the most significant issue facing the field of transplantation - organ donation. While the number of patients needing transplantation has risen dramatically in recent years, the rate of organ donation has remained relatively stable. Chapter 3 highlights the many ethical issues surrounding the more general concept of organ donation, while Chapter 4 focuses specifically on the burgeoning interest in living organ donation.

This volume features up-to-date protocols for the isolation, preservation, and validation of various cell sources comprising large and small animal models, examining the impact of cell transplantation on acute and chronic liver diseases. Hepatocyte Transplantation: Methods and Protocols guides readers through laboratory protocols for the generation of humanized livers for the assessment of biological actions in vivo and techniques to monitor cell engraftment after cell transplantation in vivo are described and procedures for computational analyses of hepatocyte transplantation. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Comprehensive and practical, Hepatocyte Transplantation: Methods and Protocols is an essential resource for researchers and clinicians to assess the biological as well as the therapeutic potential of hepatocyte transplantation.

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.

Xenotransplantation could have an impact on at least three aspects of medicine. The first is as a means of overcoming a severe shortage of human donor organs for the treatment of organ failure. The second aspect relates to the possibility that a xenogeneic organ would not be susceptible to infection by a "human" virus and thus the xenograft might resist injury caused by such viruses. The third and, as of yet, unexplored aspect relates to a means of delivering genes for therapeutic purposes thus overcoming some of the limitations of "conventional" gene therapy.     

This text for students and researchers, takes an interdisciplinary approach to describing the chemistry and physics of materials, their biocompatibility, and the consequences of implantation of devices made of these materials into the human body. The reader is introduced to the principles of polymer science and the study of metals, ceramics and composites, and also to the basic biology required to understand the nature of the host-transplant interface. Topics covered in this book include the macromolecular components of cells and tissues, self-assembly processes, biological cascade systems, microscopic structure of cells and tissues, immunology, transplantation biology, and the pathobiology of wound healing. Topics covered in the materials science chapters include the structures and properties of polymers, metals, ceramics and composites, and the processes for forming materials as well as the pathobiology of devices. The final two chapters deal with tissue engineering and the relations between the biology of cells and tissue transplantation, and the engineering of tissue replacements using passaged cells.

Addressing all aspects of brain death and thoroughly detailing how a potential organ donor should be maintained to ensure maximum use of the organs and cells, The Brain-Dead Organ Donor: Pathophysiology and Management is a landmark addition to the literature. This first-of-its-kind, multidisciplinary volume will be of interest to a large section of the medical community. The first section of the book reviews the historical, medical, legal, and ethical aspects of brain death. That is followed by two chapters on the pathophysiology of brain death as investigated in small and large animal models. This includes a review of the many hormonal changes, including the neuroendocrine- adrenergic 'storm', that takes place during and following the induction of brain death, and how they impact metabolism. The next section of the book reviews various effects of brain death, namely its impact on thyroid function, the inflammatory response that develops, and those relating to innate immunity. The chapters relating to assessment and management of potential organ donors will be of interest to a very large group of transplant surgeons and physicians as well as critical care and neurocritical care physicians and nurses. Neurologists, endocrinologists, neurosurgeons, and pathologists will also be interested, especially in the more basic science sections on various aspects of brain-death and hormonal therapy. Organ procurement organizations and transplant coordinators worldwide will also be interested in this title. Other chapters will be of interest to medical historians, medico-legal experts, and ethicists.

As the world's most comprehensive and deeply researched system of alternative and complementary medicine, Chinese medicine enjoys a large following in scientifically developed communities. Yet its concepts and principles have been shrouded in mystery and obscure language. This path-breaking book strips this ancient science of its mystique and metaphysical pretentions and interprets it to strike common ground with biomedical science. Concepts like qi and meridians are interpreted not as physical entities, but as constructs to facilitate diagnosis and therapy using heuristic models. Written for medical professionals, philosophers of medicine and discerning readers interested in holistic therapies, the book offers a unique perspective of Chinese medicine in an advanced biomedical world. It has practical chapters on cardiovascular disease, irritable bowel syndrome and cancer, and a compilation of Chinese herbs. This second edition of the acclaimed Theory of Chinese Medicine has new material on chronic diseases and the intriguing possible convergence of biomedicine and TCM.

This text serves as a convenient one-stop resource on the pathogenesis, diagnosis and treatment of kidney diseases in context of advanced heart failure and presence of ventricular assist devices. Advances in managing heart failure, evidence-based practices and therapies are covered, along with the management of this unique and complex subset of patients. The book also provides insights into combined heart and kidney transplantation. Authored by leaders in nephrology, cardiology and transplantation, this book fills a critical knowledge gap in understanding and treating patients with acute or chronic dysfunction of the heart and kidneys and how one induces dysfunction in the other organ.

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.

The skin is the largest human organ system. Loss of skin integrity due to injury or illness results in a substantial physiologic imbalance and ultimately in severe disability or death. The most common cause of significant skin loss is thermal injury, followed by trauma and chronic ulcerations.

Over the past decades extraordinary advances have been made in the understanding of cellular and molecular processes of wound healing and the pathobiology of chronic wounds. This knowledge has led to wound care innovations that facilitate more rapid closure of wounds with better functional and aesthetic outcome. A sensible and resource-saving utilization of these innovative technologies requires a broad knowledge of these processes and innovations.

This book intends to give an overview about today's wound care developments in tissue engineering and skin replacement. It presents a variety of indications and diversities of clinical applications to help the surgeon select a specific procedure for each clinical situation.

This book summarizes rapid progress and innovation in transplantation and regenerative medicine - the merger of reconstructive plastic surgery and transplantation - called Vascularized Composite Allotransplantation. This merger includes face, hand, uteri, larynx, tongue, penis and trachea translplantations as well as other body part transplants using grafts derived from organ donors. These sorts of transplants are now performed more commonly. Cell therapies for immunomodulation are surrogates for immune responses after transplantation to non-invasive imaging of neuroregeneration for improving functional outcomes after transplant.

This volume is a compendium of cutting-edge molecular methods for the successful transplantation of hematopoietic stem cells. The availability of genetic profiles for committed and uncommitted stem cells combined with the determination of molecular steps involved in hematopoietic stem cell activation and self-renewal hold tremendous promise for future success in the clinic. Currently, stem cells can be quantified and sorted successfully, but transduction, labeling, and in vivo tracking of stem cells are difficult techniques with traditionally low efficiency levels. The contributors to this volume describe promising tools for stem cell transplant research models, such as in vivo bioluminescence imaging.

Topics included in this volume are molecular profiling of hematopoietic stell cells, methods for imaging cell fates in hematopoiesis, PCR-SSP typing of HLA Class I and Class II alleles, sequence-based HLA typing, and typing minor HLA antigens. Also discussed in this volume are the roles of natural killer cells and killer inhibitor receptor polymorphisms, polymorphisms within epithelial receptors, molecular methods used for the detection of autologous graft contamination in lymphoid disorders, and the application of proteomics to posttransplantation follow-up. With the recent trend moving from gene expression to the protein expression profiles, the application of proteomics to the posttransplant follow-up of patients is becoming routine. As a result, this volume will become an invaluable source for biochemists, molecular biologists, and clinicians.

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.

When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, we are no closer to the goal of adequate organ supply without living donors-if anything, the supply-demand ratio is worse. While most research on the ethics of organ transplantation focuses on how to allocate organs as a scarce medical resource, the ethical treatment of organ donors themselves has been relatively neglected. In The Living Organ Donor as Patient: Theory and Practice, Lainie Friedman Ross and J. Richard Thistlethwaite, Jr. argue that living donor organ transplantation can be ethical provided that we treat living solid organ donors as patients in their own right. Ross and Thistlethwaite develop a five-principle framework to examine some of the attempts to increase living donation. It uses the three principles of the Belmont Report: respect for persons, beneficence, and justice modified to organ transplantation, as well as the principles of vulnerability and special relationships creating special obligations. Their approach requires that the transplant community fully embrace current and prospective living organ donors as patients to whom we have special obligations. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral limits of living solid organ donation be realized and living donors be given the full respect and care they deserve.

In consultation with Consulting Editor, Dr. Helen Boucher, Dr. Mossad has created an issue that provides a very current look at the prevention of infections in the solid organ transplant patient. Top authors in the field have contributed clinical reviews on the following topics: Is this organ donor safe; Immunization of solid organ transplant candidates & recipients; Safe living following solid organ transplantation; Strategies for Antimicrobial Stewardship in solid organ transplant recipients; Multi drug resistant bacterial infections in solid organ transplant candidates and recipients; Yeast infections in solid organ transplant recipients; Mold infections in solid organ transplant recipients; Endemic mycoses in solid organ transplant recipients; Prevention and treatment of cytomegalovirus infections in solid organ transplant recipients; Management of BK polyomavirus infection in kidney & pancreas transplant recipients; Prevention and treatment of clostridium difficile-associated diarrhea in solid organ transplant recipients; Management of viral hepatitis in solid organ transplant recipients; Prevention and management of tuberculosis in solid organ transplant recipients; Management of mycobacteria other than tuberculosis in solid organ transplant recipients; Management of strongyloidiasis in solid organ transplant recipients; and Transplantation in HIV infected patients. Readers will come away with the clinical information and evidence they need to improve outcomes of the organ transplant patient.

The use of human tissue for transplantation is becoming a billion-dollar business. This book is the first comprehensive exploration of the American tissue transplantation industry. It traces the chain of distribution of musculoskeletal tissue (e.g. bones and ligaments) and skin from the generous donation of grieving families to its transplantation into hundreds of thousands of persons each year. Commodification, commercialization, and the occasional use of tissue for "cosmetic" surgery have raised ethical questions about the acceptability of "markets" in human body parts that have been altruistically donated by families. Inevitably, questions about the informed consent and the need for responsible stewardship by the industry have been raised, often in the Press.

The book provides a comprehensive background to these ethical problems by explaining the historical development, breadth, and organization of the tissue industry, including the technical developments that have made it simultaneously clinically relevant and an attractive market for investment capital. It explores the similarities and differences in how government regulates other tissues and solid organs (such as hearts and kidneys). Contributions to the book come from an interdisciplinary group of scholars, industry representatives, government regulators, and, not least, families who have donated tissue from their dead loved ones.

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.

The sudden call, the race to the hospital, the high-stakes operation - the drama of transplant surgery is well known. But what happens before and after the surgery? In Transplanting Care, Laura L. Heinemann examines the daily lives of midwestern organ transplant patients and those who care for them, from pretransplant preparations through to the long posttransplant recovery. Heinemann points out that as efforts to control healthcare costs gain urgency - and as new surgical techniques, drug therapies, and home medical equipment advance - most of the transplant process now takes place at home, among kin. Indeed, the transplant system effectively depends on unpaid care labor, typically provided by spouses, parents, siblings, and others. Drawing on scores of interviews with patients, relatives, and healthcare professionals, Heinemann follows a variety of patients and loved ones as they undertake this uncertain and strenuous ""transplant journey."" She also shows how these home-based caregiving efforts take place within the larger economic and political context of a paucity of resources for patients and caregivers, who ultimately must surmount numerous obstacles. The author concludes that the many snags encountered by transplant patients and loved ones make a clear case for more comprehensive health and social policy that treats care as a necessarily shared public responsibility. An illuminating look at the long transplant journey, Transplanting Care also offers broader insight into how we handle infirmity in America - and how we might do a better job of doing so.

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!

This second edition of the introduction to the field of organ transplantation provides an excellent overview of the tremendous progress made in recent decades, and gives a clear description of the current status of transplant surgery for students and trainees with an interest in this field. It opens with introductory chapters on the history of transplantation and the basic science of immunobiology, and then examines through an organ-based structure the practice of transplantation in each major system, from skin to intestine. There is a 13-year gap between the first and second edition, and this is highlighted in the new collection of chapters of this updated version. This is a timely publication produced in line with the rapidly advancing field of transplantation.The editor, Nadey S Hakim, is a consultant transplant and general surgeon at Imperial College Healthcare NHS Trust, London, England, and has put together this second volume that will serve as an invaluable guide for transplant surgeons as well as trainees.

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."

Distinguished medical researchers from around the world review novel neural reconstructive techniques that appear to be beneficial for Parkinson's disease and hold promise for treating Huntington's disease, pain, demyelinating diseases, and stroke. The contributors focus on those diseases for which clinical trials are either ongoing or likely to occur in the near future. Among the topics reviewed are results and rationale for some of the leading transplant programs for the treatment of Parkinson's disease, the use of PET scanning for patient evaluation, autopsy studies of transplant recipients, transplant immunology, fetal tissue transplantation for Huntington's disease, cellular transplantation for the treatment of pain and stroke, and transplantation of myelinating cells. A full discussion of the important ethical issues surrounding the use of fetal tissue for transplantation purposes is also included.