Editorial Board
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 1, 2023 Category: Surgery Source Type: research
Intestinal and multivisceral transplantation
can be a lifesaving treatment for patients with complications from the treatment of intestinal failure. However, the indications for this highly specialized treatment are broadening and include other such indications as patients with acute abdominal vascular catastrophes as well as patients with previously unresectable benign intra-abdominal tumours. Since the first successful multivisceral transplant in the late 1980s, the field has expanded and more than 4000 transplants have taken place worldwide and outcomes continue to improve. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - August 19, 2023 Category: Surgery Authors: Neil Russell Tags: Transplantation Source Type: research
Liver transplantation
Major advances have been made in the field of liver transplantation over the last 50 years. Survival rates are now approximately 90% thanks to improved immunosuppression regimens following the introduction of calcineurin inhibitors, the development of novel organ preservation strategies and enhanced perioperative care. The spectrum of disease now definitively treated with liver transplantation has also grown to encompass not only acute and chronic liver disease but also hepatic malignancies. Early referral to specialist centres affords better outcomes for potential recipients and has prompted the development of scoring s...
Source: Surgery (Medicine Publishing) - August 19, 2023 Category: Surgery Authors: S.G. Farid Tags: Transplantation Source Type: research
The immunology of organ transplantation
Transplantation is the gold standard treatment for many patients with end-stage organ failure. In addition to the medical and surgical challenges in organ transplantation, the major biological barrier is immunological. This barrier may lead to graft rejection and loss. An understanding of transplant immunology is essential in order to care for transplant recipients. The aims of this article are to describe commonly used immunological terms, the immunology of graft rejection, the different types of rejection, and how this process may be prevented with immunosuppressive therapy. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - August 18, 2023 Category: Surgery Authors: Benedict L. Phillips, Chris Callaghan Tags: Basic science Source Type: research
Contents
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - August 1, 2023 Category: Surgery Source Type: research
Editorial Board
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - August 1, 2023 Category: Surgery Source Type: research
Surgery for renal replacement therapy
This article discusses the assessment, surgical operations and management of complications in haemodialysis and peritoneal dialysis. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - July 29, 2023 Category: Surgery Authors: John Asher Tags: Transplantation Source Type: research
Heart transplantation
is the definitive treatment for selected patients with end-stage heart failure refractory to medical, interventional and surgical treatment. However, due to a limited number of donor organs, most patients wait a long time for heart transplantation and a significant proportion die or become unsuitable for transplantation while waiting. Although post-transplant survival outcomes continue improving, a fifth of recipients die within 1 year after transplantation. In addition, recipients face constant threats from infection, rejection, malignancy and chronic allograft vasculopathy. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Nick Chilvers, John H. Dark Tags: Transplantation Source Type: research
Kidney transplantation
Renal transplantation is well established as the treatment of choice for selected patients with end-stage renal failure. A renal transplant recipient can enjoy an improved quality of life whilst benefiting from a reduction in the mortality compared with long-term dialysis. However, the success of transplantation is limited by the disparity between an ever-growing demand and an insufficient supply of organs. Expansion of the organ donor pool has been achieved through increased utilization of living donor kidneys, transplantation across HLA and ABO boundaries as well as a greater acceptance and consideration of more marginal...
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Adam D. Barlow, Ahmed S. Ghoneima Tags: Transplantation Source Type: research
Pancreas transplantation
is now the standard of care for selected patients with diabetes and end-stage renal failure or life-threatening diabetic complications. The morbidity and mortality of pancreas transplantation is higher than other transplant types, and for this reason selection criteria for both donors and recipients are more stringent. Meticulous organ retrieval technique and back-table preparation, and a standard implantation technique using enteric drainage are central to good outcomes. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Simon Knight, Thomas Vogel, Peter Friend Tags: Transplantation Source Type: research
Organ retrieval and preservation
The success of organ transplantation can be attributed to many factors but ultimately depends upon retrieval and preservation techniques to maintain the quality of an organ. Thoracic and abdominal organs from deceased donors are retrieved during a multi-organ procedure. The organs are flushed and cooled in situ with preservation solution followed by dissection and removal. With high-risk donors, such as donation after circulatory death, rapid in-situ cooling is essential to minimize the injury. Live kidney donation is becoming increasingly popular and the disincentives have been significantly reduce d by the introduction...
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Michael L. Nicholson, Sarah A. Hosgood Tags: Transplantation Source Type: research
Ethical and legal issues associated with organ donation and transplantation
Organ donation and transplantation has transformed the lives of many around the world. Despite its place as a treatment option for numerous forms of end-stage organ disease, the need for careful ethical and legal consideration is paramount. In this article we discuss three rules: the Dead Donor Rule, which underpins the use of organs for donation from deceased individuals; the ‘Rule of Consent’ which includes consideration of both deceased and living donors and the recipients of organs; and finally the ‘Fair Transplant Rule’, which offers protection from the challenging issues of exploitation and organ allocation f...
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Jennifer Lewis, Dale Gardiner Tags: Transplantation Source Type: research
Lung transplantation: state of the art and current practice
Lung transplantation remains the standard of care for selected patients with progressive respiratory failure with advanced chronic lung disease. In the late 1980s, early surgical pioneers of lung transplantation developed programmes which included the surgical techniques and patient management principles that remain in use today. Since then, development of technology and advancements in clinical care to support patients on the lung transplant waiting list, along with advances in immunosuppression, have led to increased numbers of lung transplants and improved recipient outcomes. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Anders S.I. Andreasson, John H. Dark Tags: Transplantation Source Type: research
Test yourself: MCQ and single best answer
For questions 1 –4, select the statements which are true. The correct answers are given below. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Adrian Ben Cresswell Tags: Test yourself Source Type: research
Modern immunosuppression
Organ transplantation provides both life-saving and life-enhancing function for patients suffering from end-stage organ failure. Transplantation has only been possible due to the advances in immunosuppression. The viability of a transplanted organ depends on modulation of the human immune system to avoid rejection in response to foreign antigens. Modern immunosuppression consists of multi-modal therapy (chemical drugs and biological agents) acting on different parts of the immune response. Three phases of immunosuppression can be recognized: induction, maintenance and withdrawal. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - July 28, 2023 Category: Surgery Authors: Balaji Mahendran, Rodrigo S. Figueiredo, Colin Wilson Tags: Transplantation Source Type: research
