Geographic inequity in transplant access.

Geographic inequity in transplant access. Curr Opin Organ Transplant. 2019 Jun;24(3):337-342 Authors: Lynch RJ, Patzer RE Abstract PURPOSE OF REVIEW: Scarcity is a defining feature of the modern transplant landscape, and in light of chronic shortages in donor organs, there is cause for concern about geographic inequities in patients' access to lifesaving resources. Recent policy changes designed to ameliorate unequal donor supply and demand have brought new interest to measuring and addressing disparities at all stages of transplant care. The purpose of this review is to describe an overview of recent literature on geographic inequities in transplant access, focusing on kidney, liver, and lung transplantation and the impact of policy changes on organ allocation. RECENT FINDINGS: Despite a major change to the kidney allocation policy in 2014, geographic inequity in kidney transplant access remains. In liver transplantation, the debate has centered on the median acuity score at transplantation; however, a more thorough examination of disparities in access and survival has emerged. SUMMARY: Geographic differences in access and quality of transplant care are undeniable, but existing disparity metrics reflect disparities only among candidates who are waitlisted. Future research should address major gaps in our understanding of geographic inequity in transplant access, including patients who may be transplant-eligible but experience a wide variety of...
Source: Current Opinion in Organ Transplantation - Category: Transplant Surgery Authors: Tags: Curr Opin Organ Transplant Source Type: research

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Organ transplantation as an option to overcome end-stage diseases is common in countries with advanced healthcare systems and is increasingly provided in emerging and developing countries. A review of the literature points to sex- and gender-based inequity in the field with differences reported at each step of the transplant process, including access to a transplantation waiting list, access to transplantation once waitlisted, as well as outcome after transplantation. In this review, we summarize the data regarding sex- and gender-based disparity in adult and pediatric kidney, liver, lung, heart, and hematopoietic stem cel...
Source: Transplantation - Category: Transplant Surgery Tags: Reviews Source Type: research
436Aim: Currently, there are no available tool able to non-invasively define the presence of transplanted pancreas graft rejection; therefore, graft biopsy is nowadays the only available diagnostic tool for pancreas graft rejection. The aim of the present study is to assess the role of 18F-FDG PET-CT in detecting and monitoring pancreas graft rejection. Materials and Methods: Retrospective study including 12 patients (6M and 6F; mean age at transplant: 45±12 yrs; mean duration of diabetes 24±11yrs) who underwent pancreas transplantation alone (PTA) or simultaneous pancreas-kidney transplant (SPK) in the past....
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: NETs, BAT and All That Source Type: research
AbstractIntroductionIdiopathic pulmonary fibrosis (IPF) is a fatal interstitial lung disease characterized by variable progression. The prealbumin (PA) is a parameter in a routine blood biochemistry examination. We sought to investigate the prognostic value in IPF patients.ObjectivesTo evaluate the prognosis value in patients with IPF.MethodsBlood biochemistry examination, demographics, pulmonary function data from patients with IPF consulted in Beijing Chao ‐Yang Hospital and China‐Japan Friendship Hospital between July 2012 and December 2016 were collected. Infection, liver and kidney dysfunction and lung transplanta...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research
Abstract PURPOSE OF REVIEW: Owing to long waitlist times and high waitlist morbidity and mortality, strategies to increase utilization of hepatitis C viremic-deceased donor organs are under investigation in kidney, liver, heart, and lung transplantation. RECENT FINDINGS: Direct-acting antiviral medications for hepatitis C virus infection have high cure rates and are well tolerated. Small, single-center trials in kidney and heart transplant recipients have demonstrated that with early posttransplant direct-acting antiviral therapy, 100% of uninfected recipients of hepatitis C viremic organs have been cured of ...
Source: Current Opinion in Organ Transplantation - Category: Transplant Surgery Authors: Tags: Curr Opin Organ Transplant Source Type: research
Purpose of review Scarcity is a defining feature of the modern transplant landscape, and in light of chronic shortages in donor organs, there is cause for concern about geographic inequities in patients’ access to lifesaving resources. Recent policy changes designed to ameliorate unequal donor supply and demand have brought new interest to measuring and addressing disparities at all stages of transplant care. The purpose of this review is to describe an overview of recent literature on geographic inequities in transplant access, focusing on kidney, liver, and lung transplantation and the impact of policy changes on...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: ETHICAL CONSIDERATIONS OF ALLOCATION: Edited by David A. Axelrod Source Type: research
Purpose of review Owing to long waitlist times and high waitlist morbidity and mortality, strategies to increase utilization of hepatitis C viremic-deceased donor organs are under investigation in kidney, liver, heart, and lung transplantation. Recent findings Direct-acting antiviral medications for hepatitis C virus infection have high cure rates and are well tolerated. Small, single-center trials in kidney and heart transplant recipients have demonstrated that with early posttransplant direct-acting antiviral therapy, 100% of uninfected recipients of hepatitis C viremic organs have been cured of infection after tran...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: ETHICAL CONSIDERATIONS OF ALLOCATION: Edited by David A. Axelrod Source Type: research
udy Abstract In solid organ transplant recipients (sOTRs), 5 years after transplantation cancer is a relevant cause of death. We aimed to report cancer incidence in the Swiss Transplant Cohort Study (STCS) between 2008 and 2014 and conducted a prospective cohort study of kidney, heart, lung, pancreas and liver transplant recipients enrolled into the STCS by retrospective analysis of collected data. The STCS provided data on 2758 solid organ transplants. In total, 134 cases of cancer were observed (30 liver, 21 prostate, 18 lung, 13 kidney, 52 other cancers). Standardised incidence ratios (SIRs) were highest for li...
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
Discussion MDSCs violently emerge in pathological conditions in an attempt to limit potentially harmful immune and inflammatory responses. Mechanisms supporting their expansion and survival are deeply investigated in cancer, in the perspective to reactivate specific antitumor responses and prevent their contribution to disease evolution. These findings will likely contribute to improve the targeting of MDSCs in anticancer immunotherapies, either alone or in combination with immune checkpoint inhibitors. New evidence indicates that the expansion of myeloid cell differentiation in pathology is subject to fine-tuning, as its...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusion: Overall, this study provides a high accurate approach to predict HILI and an in silico perspective into understanding the hepatotoxicity mechanism of TCM, which might facilitate the discovery and development of new drugs. Introduction Liver injury induced by drug, novel foods or phytotherapy, also known as hepatotoxicity, is still a major clinical and pharmaceutical concern (Amadi and Orisakwe, 2018; Hammann et al., 2018; Kyawzaw et al., 2018; Real et al., 2018). According to the data from United States National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), hepatotoxicity accounts for...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions. donors are a demographically and clinically diverse group. Understanding this diversity and future trends in VCA donor characteristics is critical in supporting this life-changing field of transplantation.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research
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