Browsing by Subject "Tissue and Organ Procurement"
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Item Comparison of Pre-Transplant Criteria and Outcomes for Living Donor Kidney Transplant Programs in India and the United States(2015-01-26) Bansal, Sukriti; Raja, Hari; Rajora, Nilum; Kher, VijayBACKGROUND: One of the greatest obstacles to treatment of end stage renal disease globally is organ donor shortage. While some nations (i.e. the US), have primarily cadaveric organ donors, developing nations rely heavily on living donors. This project is a comparison of two kidney transplants programs -- one in the US & one in India -- looking at the pre-transplant criteria of each & assessing the patient outcomes. METHODS: This is a cohort study of living donor kidney transplant patients from St. Paul University Hospital in Dallas, TX & kidney transplant patients from Medanta the Medicity in Gurgaon, India. Data for India was collected from a database of all patients who underwent a kidney transplant at Medanta, selected for patients who fit the following criteria: one cohort of patients had been transplanted the previous month (N=29), one cohort had been transplanted one year prior the date of the study (N=29), & one cohort had been transplanted 3 years prior (N=13). Information from the database was used to calculate patient & graft survival rates for the relevant time periods. Data for St. Paul was obtained from the Scientific Registry of Transplant Recipients, which already had the calculated 1 month, 1 year, & 3 year patient and graft survival rates. Information on pre-transplant criteria was obtained from the transplant teams at each respective institution. RESULTS: The majority of medical pre-operative criteria between the two programs are identical. One significant difference is ABO-incompatible transplants are performed at Medanta, while at St. Paul ABO-incompatible donor/recipient pairs are referred for paired donation. Medanta requires all living donors to be related, while St. Paul will accept unrelated donors. The patient survival rates for St. Paul are 100% (1 mo, N=32), 95.23% (1 yr, N=32) and 85.71 % (3 yr, N=21). Graft survival rates are 100% (1 mo, N=32), 95.24% (1 yr, N=32), and 81.82% (3 yr, N=22). The patient survival rates for Medanta are 100% (1 mo., N=29), 100% (1 yr, N=29), and 100% (3 yr, N=13). Graft survival rates are 100% (1 mo. N=29), 100% (1 yr, N=29), and 100% (3 yr, N=13). For all patients transplanted at Medanta, the overall patient survival rate was 98.40% (N=874) and the overall graft survival rate was 98.51% (N=874). Corresponding data wasn't available for St. Paul. CONCLUSION: While it appears that the 3 year survival rates are better for Medanta than for St. Paul, there is a limitation on making conclusions because this data does not encompass the entire program at Medanta. Further study is needed to truly assess if there is a significant difference. The overall conclusion is that transplant programs in both settings have successful outcomes.Item Conceptual controversies in death determination(2017-04-11) Bernat, James L.There is an intractable disagreement over whether the organ donor after the circulatory determination of death (DCDD) is dead at the time death is ordinarily declared. A rigorous analysis of death determination illuminates the cause of the controversy. Death determination can be conceptualized in two distinct ways: the biological approach in which cessation of vital functions must be irreversible and the medical approach in which cessation of vital functions must be permanent. The two noncongruent standards lead to determining death at different times and explain the current controversy over death determination in the DCDD donor. By the biological standard, the organ donor is not dead but by the medical standard, the organ donor is dead.Item Donor issues in organ transplantation(2014-07-11) Wada, SuzanneItem Ethics and VCA transplants: same issues or new challenges?(2023-09-12) Kahn, Jeffrey P.Vascular composite allografts (VCAs) are transplants of hands, face, penis, or uterus from deceased and sometimes (in the case of uterus) living donors. The ethics of solid organ donation and transplant have been discussed for decades, with policies and practices long established and ethics approaches widely discussed. VCAs have many characteristics that make them similar to solid organ transplants, but they also raise novel issues including risk-benefit balance for non-lifesaving therapies, decisions about deceased donation, evaluation of recipients, alternative therapies, and others. This talk will assess the similar and novel ethical issues and propose a framework for assessing the ethics of VCAs.Item Heart transplant using hearts that have stopped: managing the emotional rescue(2023-02-10) Shah, Ashish S.Item [News](1988-05-03) Harrell, AnnItem [News](1982-09-09) Harrell, AnnItem [News](1976-04-01) Fenley, BobItem [Southwestern News](1996-04-19) Abila, ReyesItem [Southwestern News](1998-04-17) Abila, ReyesItem [UT News](1985-10-18) Harrell, AnnItem [UT Southwestern Medical Center News](2009-01-06) Rian, Russell