Heart Transplantation after the Circulatory death; The Ethical Dilemma

Publication date: Available online 20 August 2018Source: Indian Heart JournalAuthor(s): Shayan Marsia, Ariba Khan, Maryam Khan, Saba Ahmed, Javeria Hayat, Abdul Mannan Khan Minhas, Samir Mirza, Nisar Asmi, Jonathon ConstantinAbstractDonors after brain dead (DBD) have been the major source of organ donation due to good perfusion of the organs. However, due to the mismatch in demand and supply of the organ donors and recipients, organ donation after circulatory death has increased recently all over the world. Kidneys, liver and lungs are being used for transplantation from Donors after circulatory death (DCDDs). Recently, heart transplantation from DCDDs has been started, which is under the firestorm of scrutiny by the ethicists. The ethical dilemma revolves around the question if the donors are actually dead when they are declared dead by cardio-circulatory death criteria for organ procurement. The subsequent literature review addresses all the perspectives by; differentiating between the donations methods known as DBDs and DCDDs, explaining the implications of the Dead Donor Rule on the organ donation pool and categorization of determinants of death leading to separation of the arguments under the two methods of donations.
Source: Indian Heart Journal - Category: Cardiology Source Type: research

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Authors: Khan MU, Mahmoud MI, Butt AA Abstract INTRODUCTION: Hepatitis C virus (HCV) infection is associated with an increased incidence and progression of chronic kidney disease (CKD), as well as higher mortality in CKD and renal transplant patients. Direct acting antiviral agents (DAAs) have revolutionized the treatment of HCV, with viral eradication attained in 90-100% of treated patients. DAAs have an excellent safety and tolerability profile in CKD and renal transplant patients. AREAS COVERED: In this review, we discuss the association of HCV with incidence and progression of CKD as well as its effect on o...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research
Publication date: 4–10 July 2020Source: The Lancet, Volume 396, Issue 10243Author(s): Jane Regan
Source: The Lancet - Category: General Medicine Source Type: research
Conclusion: Considering the high prevalence of UTI and antibiotic resistance rates in kidney transplant patients in our study, there is an urgent need for developing hospital based local antibiogram for appropriate management of UTI. Fosfomycin as an empirical therapy might be a useful choice for adequate coverage of potential pathogens at our centre. Further multi-centric studies on a larger sample size are recommended from India for formulating antibiotic policy. PMID: 32610862 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Conclusions: In this study, the conversion of maintenance immunosuppression from calcineurin inhibitors to mTOR inhibitors for clinical indications did appear to reduce the incidence of NMSC in kidney and liver transplant recipients. PMID: 32605413 [PubMed - in process]
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Conclusion: Our studies for the first time demonstrated that the acetate produced from gut microbiota mediated the dysregulation of cholesterol homeostasis through the activation of GPR43, thereby contributing to the tubulointerstitial injury of DN, suggesting that gut microbiota reprogramming might be a new strategy for DN prevention and therapy.
Source: Theranostics - Category: Molecular Biology Authors: Tags: Research Paper Source Type: research
Conclusion: We used publicly available datasets to create a gene signature of AR that identified AR irrespective of immunosuppression regimen or recipient age. This study highlights a novel model to screen and validate biomarkers across multiple treatment regimens.
Source: Theranostics - Category: Molecular Biology Authors: Tags: Research Paper Source Type: research
Conclusion: Post-transplantation treatment of chronic HCV is preferred in KTRs. The sofosbuvir/daclatasvir regimen as an interferon-free therapy is a safe, effective option for HCV infection in pediatric KTRs, who can tolerate sofosbuvir/daclatasvir well and respond favorably without significant adverse events. PMID: 32606888 [PubMed]
Source: International Journal of Nephrology and Renovascular Disease - Category: Urology & Nephrology Tags: Int J Nephrol Renovasc Dis Source Type: research
Primary hyperoxaluria (PH) is an inherited disease lacking of hepatic oxalic acid metabolic enzymes which could lead to irreverisible renal damage. Currently, liver –kidney transplantation is a curative but hig...
Source: BMC Gastroenterology - Category: Gastroenterology Authors: Tags: Research article Source Type: research
AbstractPurpose of ReviewOur aim is to review the experience with transplanting kidneys from decreased donors with acute kidney injury (AKI).Recent FindingsThe discard rate is higher for kidneys from AKI donors. Studies have uniformly shown that the risk of delayed graft function (DGF) is higher. However, the majority of studies have shown that other outcomes including short and long graft survival, eGFR, and risk of rejection are not inferior with transplanting AKI donor kidneys. To select AKI donor kidneys, we depend on preimplantation biopsy to exclude AKI kidneys with>  10% cortical necrosis or more than mild...
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research
Rabbit anti-thymocyte globulin (rATG) is currently the treatment of choice for glucocorticoid-resistant, recurrent, or severe acute allograft rejection (AR). However, rATG is associated with severe infusion-related side effects. Alemtuzumab is incidentally given to kidney transplant recipients as treatment for AR. In the current study, the outcomes of patients treated with alemtuzumab for AR were compared with that of patients treated with rATG for AR. The patient-, allograft-, and infection-free survival and adverse events of 116 alemtuzumab-treated patients were compared with those of 108 patients treated with rATG for A...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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