Ethical dilemmas related to living donor liver transplantation in Asia

AbstractLiving donor liver transplantation (LDLT) has evolved rapidly in Asia with good outcomes for both donor and recipient. Nonetheless, LDLT remains a highly demanding technique and complex surgery. The potential risks to the donors provide the basis for many of the ethical dilemmas associated with LDLT. The transplant team must have a good knowledge of the principles of bioethics in order to handle these matters. To look after the need, donor ’s safety and the chance for good recipient outcomes, the principles of respect for the donor’s autonomy, beneficence, and non-maleficence should be practiced. In accordance with the concept of equipoise, the risk to the donor must balance the benefit to the recipient. The transplant center shou ld have adequate experience and proven expertise in LDLT. There are concerns regarding the validity of informed consent given by the donor. While donations to non-relative patients may, at first sight, indicate radical altruism, it is important to apply careful scrutiny. Though organ trading is stri ctly prohibited by the law, there seems to be an inherent risk with directed donations to strangers. Transplant tourism has flourished in some countries in spite of the existence of strict laws. There are reservations regarding transplantation done by foreign visiting teams. Donor websites facilitat ing patients and donors and Facebook pages bear no responsibility for the outcomes of their matches and cannot ensure sufficient and accu...
Source: Irish Journal of Medical Science - Category: General Medicine Source Type: research

Related Links:

Publication date: Available online 15 June 2019Source: Journal of Pharmacological SciencesAuthor(s): Takanobu Nakazawa, Ryota Hashimoto, Kazuhiro Takuma, Hitoshi HashimotoAbstractSince induced pluripotent stem cells (iPSCs) were generated from mice and humans by Professor Shinya Yamanaka et al. in 2006 and 2007, respectively, a variety of human-derived cells have been generated, including myocardial, liver, retinal pigment epithelial, and neuronal cells. These iPSCs are now used not only in clinical research focusing on regeneration and transplantation in diverse medical fields, but also in molecular and cellular pathologi...
Source: Journal of Pharmacological Sciences - Category: Drugs & Pharmacology Source Type: research
Conclusions: Immigration increased the incidence of HCC and the need for active treatment such as LT. This fact raises the question of whether immigrants from regions with a high incidence of HCC ought to be subjected to mandatory hepatitis B and C virus (HBV and HCV) diagnosis and consequent liver ultrasounds for diagnosis of occult HCC. With such strategies, the morbidity and mortality of HCC could be reduced. PMID: 31190577 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
ConclusionsYoung donor age and small liver graft are risk factors for HAT in deceased donor pediatric liver transplantation.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
Authors: Na SY, Moon W Abstract New therapeutic strategies in inflammatory bowel disease (IBD) have shifted from symptom control towards treat-totarget algorithms in order to optimize treatment results. The treatment of IBD has evolved with the development of tumor necrosis factor-α inhibitors beyond the conventional therapies. In spite of their long-term effectiveness, many patients do not respond to or cannot sustain treatment with these drugs, which have various side effects. Therefore, the development of new drugs targeting specific pathways in the pathogenesis of IBD has become necessary. Some novel biol...
Source: Gut and Liver - Category: Gastroenterology Tags: Gut Liver Source Type: research
Conclusion: Although the sample size was small to some extent, this single-center study first reported that LT from DCD donors showed similar short- and long-term outcomes with DBD donors and justified the widespread implementation of voluntary citizen-based deceased organ donation in China. However, the results should be verified with a multicenter larger study. PMID: 31191649 [PubMed]
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
Conditions:   HCC;   Liver Transplantation Intervention:   Sponsor:   Zhejiang University Not yet recruiting
Source: - Category: Research Source Type: clinical trials
Authors: Madadi-Sanjani O, Kuebler JF, Dippel S, Gigina A, Falk CS, Vieten G, Petersen C, Klemann C Abstract Biliary atresia (BA) is characterized by progressive destruction of the biliary system leading to liver fibrosis and deterioration of liver function. Serum hepatocyte growth factor (HGF) has been shown to be increased in cirrhotic diseases including BA. The aim of this study was to investigate the prognostic value of HGF levels in sera and liver tissue for the further disease course. A total of 49 serum and liver samples from infants with BA were acquired during Kasai-portoenterostomy (KPE) and analyzed by m...
Source: Growth Factors - Category: Research Tags: Growth Factors Source Type: research
Conclusions: In HCV-negative recipients, allografts with>15% Sd-MaS have significantly reduced graft survival and show low ATP and higher AST peaks in the immediate posttransplant period. Donors with>15% Sd-MaS have significantly higher BMI, longer ICU stays, and lower PaO2. PMID: 31187028 [PubMed - in process]
Source: Canadian Journal of Gastroenterology - Category: Gastroenterology Tags: Can J Gastroenterol Hepatol Source Type: research
Conclusion: Our data indicate that the risk of microvascular invasion is highest in tumors localized to segment 8. The size and number of HCC tumors were not associated with an increased risk of microvascular invasion. PMID: 31186641 [PubMed]
Source: Journal of Cancer Epidemiology - Category: Epidemiology Tags: J Cancer Epidemiol Source Type: research
AbstractPatients being considered for a liver transplant undergo a rigorous evaluation process to identify the medical and psychosocial factors that may impact transplant success.  The American Association for the Study of Liver Disease outlines recommendations for medical factors, but guidelines for psychosocial factors, such as multiculturalism, are less clear. The aim of this unique case study was to highlight the importance of multicultural awareness in the context of l iver transplantation. More specifically, the report follows an American Indian man from initial diagnosis through psychological assessme...
Source: Journal of Clinical Psychology in Medical Settings - Category: Psychiatry & Psychology Source Type: research
More News: Biomedical Science | Eyes | General Medicine | Ireland Health | Legislation | Liver | Liver Transplant | Medical Ethics | Science | Transplant Surgery | Transplants | Urology & Nephrology | Websites