Organ Donation and Transplantation after Cardiac Death

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With the success of organ transplantation and the declining number of heart beating cadaver doctors, the number of patients awaiting a transplant continues to rise. This means that alternative sources of donors have been sought, including donors after cardiac death. Such donors sustain rapid damage to their organs due to ischaemia, and as a consequence, some organs do not work initially and some none at all. The proportion of such transplants has increased dramatically in recent years—25% of kidney transplants in the UK were from such donors in 2006, highlighting how much progress has been made. Written by international experts, this book lays out the moral, legal, and ethical restraints to using such donors for organ transplant together with the techniques that have been adpoted to improve their outcome. The different approaches and results of renal transplant according to country are covered together with the procedures and outcomes adopted to use other organs, notably the liver and lungs.

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Editorial Reviews

Doody's Review Service
Reviewer: Truman M Earl, MD, MSCI (Washington University School of Medicine)
Description: This book provides a detailed description of the ethical, logistical, and methodological concerns involved in deceased donor organ utilization.
Purpose: It certainly achieves the worthy objective of describing the various techniques available to allow for successful transplantation from donors following cardiac death.
Audience: The authors have a great deal of experience with donation after cardiac death and appropriately target this book at transplant surgeons and physicians.
Features: The historical aspects of organ preservation and donation after cardiac death are covered well. Individual chapters detail utilization of various organs from non-heart beating donors. Highlighted are the various options in organ preservation pre-recovery and determination of organ suitability.
Assessment: This unique contribution provides a detailed description of several options available in the utilization and preservation of deceased donor organs.
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Product Details

  • ISBN-13: 9780199217335
  • Publisher: Oxford University Press, USA
  • Publication date: 5/20/2009
  • Pages: 360
  • Product dimensions: 6.30 (w) x 9.30 (h) x 0.80 (d)

Meet the Author

David Talbot has been a transplant surgeon in Newcastle since 1995 having trained in the north east of England and Birmingham. His early research interests were antibody detection using flow cytometry and later mainly non heart beating donation. His current clinical practice includes access surgery, renal and liver transplantation, live donor and paediatric renal transplantation. Dr. D'Alessandro received his BS from Gannon University in 1976 and his MD from Hahnemann University in 1981. He continued his education as a resident in surgery, research fellow, and transplant fellow at the University of Wisconsin. Dr. D'Alessandro is Professor of Surgery, Director of Multiorgan Transplantation, Director of Pediatric Liver Transplantation, and Executive Director of the Organ Procurement Organization at the University of Wisconsin. Dr. D'Alessandro is board certified in Surgery and Surgical Critical Care. His research in the field of transplantation has resulted in over 200 publications in such journals as Transplantation, Transplantation Proceedings, Transplantation Reviews, Surgery, and Annals of Surgery. Dr. D'Alessandro's research focuses on liver and small bowel preservation for transplantation.

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Table of Contents

Contributors xi

1 History of non-heart-beating donation Gauke Kootstra 1

2 Legal, moral, and ethical issues Sam D. Shemie Michael De Vita 7

3 History of organ perfusion in organ transplantation Diethard Monbaliu Qiang Liu Katrien Vekemans Jacques Pirenne 31

4 Viability testing of kidneys from non-heart-beating donors David Talbot 51

5 Perfusate development for the NHBD Colin Wilson 67

6 Thrombolysis in the non-heart-beating donor David Talbot Mohamed Gok Thomas Minor 103

7 Supplemental cryopreservation of the donor by peritoneal cooling John Asher Alex Navarro 117

8 Gaseous oxygen to improve viability of marginal or pre-damaged organ grafts during hypothermic storage Thomas Minor 131

9 Extracorporeal circulatory-assisted non-heart-beating organ donation Jeff Punch 153

10 Patient selection and management Julio Pascual John D. Pirsch 161

11 The renal biopsy in non-heart-beating organ transplantation M. Snoeijs R. Matthijsen M.H. Christiaans J.P. van Hooff E. van Heurn W. Buurman R.J. van Suylen C.J. Peutz-Kootstra 173

12 Early results for renal transplants from non-heart-beating donors Alex Navarro 203

13 Liver transplantation using non-heart-beating donors Paolo Muiesan 213

14 Lung transplantation from non-heart-beating donors-donation after cardiac death (DCD) Chris Wigfield Robert Love John Dark 231

15 Donors without a heart beat in the United States Anthony D'Alessandro 255

16 Non-heart-beating donation in Europe Ernest van Heurn David Talbot 271

17 Renal and islet transplantation from non-heart-beating donors in Japan Hirofumi Noguchi Nobuyo Hatanaka Shinichi Matsumoto 289

18 The current situation and further development David Talbot AnthonyD'Alessandro 307

Index 313

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