Abstract:
PURPOSE OF REVIEW:To summarize recent practices and views regarding children as living organ donors in the USA. RECENT FINDINGS:Living donors have become an increasingly important source of organs for transplantation. Concern for the rights of donors has resulted in reconsideration of the use of minors as living organ donors. Most commentators have voiced concerns that minors deserve extraordinary protection, but are unwilling to ban the practice of living donation by minors outright. Instead, factors to be considered in individual situations have been enumerated, and safeguards recommended. These same safeguards have also been recommended to be extended to adults, as attainment of legal age does not in itself confer immunity from exploitation. Developmental factors of importance include brain maturation affecting decision making, executive function and impulse control; the dependent status of minors, usually on the persons who may most want them to be donors; youthful idealism and sense of invulnerability; and incomplete identity formation. SUMMARY:Fewer children in the USA have become living donors in the past decade. Preadolescent children in particular should probably be considered as potential donors only in extraordinary circumstances. Safeguards protect not only children, but transplant physicians, programs and the image of the transplant endeavor.
journal_name
Curr Opin Organ Transplantjournal_title
Current opinion in organ transplantationauthors
Olbrisch ME,Levenson JL,Newman JDdoi
10.1097/MOT.0b013e328337352asubject
Has Abstractpub_date
2010-04-01 00:00:00pages
241-4issue
2eissn
1087-2418issn
1531-7013journal_volume
15pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Xenotransplantation may become clinically feasible once the mechanisms of graft loss and rejection are better understood. Inflammatory reactions to vasculature of grafted pig organs and pancreatic islets have been linked to procoagulant activation and consumption with resulting thrombosis that preclud...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283373ccc
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we summarize the current status of clinical trials using therapeutic cells produced from human embryonic stem cells (hESCs) and human induced pluripotent stem cells (hiPSCs). We also discuss combined cell and gene therapy via correction of defined mutations in human pluripotent stem ce...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000244
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Living donation has a tremendous impact in bridging the gap between the shortage of organs and the growing list of transplant candidates but remains underutilized as a percentage of total transplants performed. This review focuses on obesity and social determinants of health as potential barriers to t...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000779
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review summarizes current data on the induction of immunologic tolerance through mixed hematopoietic chimerism relevant to applying this approach to vascularized composite allotransplantation. RECENT FINDINGS:Clinical allograft tolerance has been achieved recently for kidney transplants, ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000248
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Cardiac allograft vasculopathy (CAV) is still one of the major causes of death following heart transplantation. Here, we review the recent advances in its prevention and treatment. RECENT FINDINGS:Preventive measures comprise control of classical risk factors, prophylaxis against cytomegalovirus, avo...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283577fd9
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Primary graft failure, which represents one of the most frequent causes of early mortality, is mostly caused by ischemia-reperfusion injury (IRI). IRI may also induce rejection, which is the principal cause of mortality after transplantation. It is essential to understand the mechanism of pulmonary IR...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000234
更新日期:2015-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The Notch signaling pathway is known to play a pivotal role in T- and B-cell development and fate, presenting it as an attractive therapeutic target in alloimmunity. This review provides an overview of the mechanisms of Notch signaling, focusing on new insights into its diverse functions in T-cell act...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000266
更新日期:2016-02-01 00:00:00
abstract:PURPOSE OF REVIEW:There have been several recent articles which have attempted to refine the appropriate timing of listing for lung transplantation and the identification of factors which increase the risk with particular emphasis on pretransplant microbiology in patients with cystic fibrosis. Moreover, there are sever...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32830fe6b8
更新日期:2008-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Pulmonary antibody-mediated rejection (AMR) while contributing to acute and chronic allograft dysfunction remains a diagnostic and therapeutic challenge. The diagnostic tenets upon which AMR is defined will be reviewed in the light of recent studies. RECENT FINDINGS:The introduction of solid phase as...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000235
更新日期:2015-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The epidemic of obesity is having a marked impact on liver transplant candidates and recipients, and optimal approach for the obese liver transplant patient is not yet defined. The current review summarizes the role of bariatric surgery in obese liver transplant patients. RECENT FINDINGS:NASH is now ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000513
更新日期:2018-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The use of everolimus has recently emerged for solid-organ transplantation in children. This review gives an overview of the relevant studies and clinical trials involving the immunosuppressive effects of everolimus in child organ transplant. RECENT FINDINGS:The use of everolimus in pediatric organ t...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328356b080
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To introduce the updated Banff schema for antibody-mediated renal allograft rejection and related revisions to definitions within this schema agreed upon during and immediately subsequent to the 2013 Banff Conference on Allograft Pathology. RECENT FINDINGS:The original Banff schema for diagnosis of a...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000072
更新日期:2014-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Adoptive cell therapy using CD4FOXP3 regulatory T cells (Treg) has emerged as a promising therapeutic strategy to treat autoimmunity and alloimmunity. Preclinical studies suggest that the efficacy of Treg therapy can be improved by modifying the antigen specificity, stability and function of therapeut...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000566
更新日期:2018-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Manipulating costimulatory signals has been shown to alter T cell responses and prolong graft survival in solid organ transplantation. Our understanding of and ability to target various costimulation pathways continues to evolve. RECENT FINDINGS:Since the approval of belatacept in kidney transplantat...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000656
更新日期:2019-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Renal dysfunction due to calcineurin inhibitor (CNI) toxicity is a major clinical problem in cardiac transplantation. The aim of the article is to review the efficacy and safety of various renal sparing strategies in cardiac transplantation. RECENT FINDINGS:Small studies have documented that late ini...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32832e6f7b
更新日期:2009-10-01 00:00:00
abstract:PURPOSE OF REVIEW:There continues to be an inadequate organ supply and lack of effective temporary support, for patients with liver failure. The purpose of this review is to discuss recent progress in the field of orthotopic pig-to-nonhuman primate (NHP) liver xenotransplantation (LXT). RECENT FINDINGS:From 1968 to 20...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000459
更新日期:2017-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The first generation of implantable pulsatile ventricular assist devices (VADs) has proven to be successful as bridge to transplantation. Adverse events such as mechanical failure and infections, however, limit their use for long-term support (>1 year) or as alternative for heart transplantation. Newe...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283303750
更新日期:2009-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The trend to extubate patients as soon as possible following large and complex surgery is supported by a large body of evidence showing early extubation is safe and saves money. However, the use of early extubation in liver transplant recipients is still debated. This review will explore the reasons w...
journal_title:Current opinion in organ transplantation
pub_type: 历史文章,杂志文章,评审
doi:10.1097/MOT.0b013e32832b2f6c
更新日期:2009-06-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an overview of currently available immunosuppressive strategies and novel therapeutic developments in pancreas transplantation. RECENT FINDINGS:From 1966 through 2012 more than 30 000 pancreas transplantations have been performed around the world with excellent patient and graft survival. ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32835c6eda
更新日期:2013-02-01 00:00:00
abstract:PURPOSE OF REVIEW:In the past few years, there has been an increasing interest in nonhuman histocompatibility antigens as targets of injury in organ-transplant recipients. This increased interest has been spurred by the fact that human-histocompatibility-antigen-identical kidney transplants also undergo immunological r...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328307ebd7
更新日期:2008-08-01 00:00:00
abstract:PURPOSE OF REVIEW:With improving survival rates following solid organ transplantation, assessment of its success has broadened with a focus on long-term outcomes, including nongraft-related medical outcomes and family and patient perceptions of quality of life. Posttransplant renal dysfunction contributes to long-term ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32833da439
更新日期:2010-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This article summarizes the complex interplay between the microbiota and host immune responses, and its impact on intestinal transplantation and allograft rejection. RECENT FINDINGS:Recent findings highlight the importance of Paneth cells as crucial producers of antimicrobial peptides that control th...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000278
更新日期:2016-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Immune monitoring is needed in small bowel transplantation (SBTx) because of a high incidence of rejection and graft loss, and life-threatening complications of high-dose prophylactic immunosuppression. RECENT FINDINGS:Clinical tests relevant to SBTx include methods to detect antidonor human leukocyt...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328339489c
更新日期:2010-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Pulmonary hypertension patients provide challenging issues to anesthesiology. The condition is more so when it is associated with liver transplant surgery. This situation is especially true when associated with portopulmonary hypertension (POPH), a subdivision of pulmonary hypertension. Understanding ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328346e138
更新日期:2011-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Exposure to noninherited maternal antigens (NIMAs) in fetal and neonatal life has life-long immunological consequences. Although there is a plethora of evidence of effects of mother on the immune responses of her offspring, there is very little knowledge available on how exposure to NIMA can result in...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32832d6683
更新日期:2009-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe the latest investigations into the role of frailty and assessment of other aging-related issues in the solid organ transplant candidate and recipient. This information is relevant for all involved in the care of transplant patients, but is especially relevant in infectious diseases, given ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000662
更新日期:2019-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Orthotopic liver transplant (OLT) is a major surgical procedure that can be both challenging and lengthy. One of the common findings in end-stage liver disease is renal failure, whether acute or chronic, which may complicate the intraoperative course. RECENT FINDINGS:The use of intraoperative hemodia...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328346c8a2
更新日期:2011-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Combined thoracic organ and liver transplantation has been shown to be a viable treatment option for patients with end-stage disease lung or heart and disease. There are increasing number of cases reported in the literature, as the number of institutions utilizing this strategy is growing. Herein, we ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000509
更新日期:2018-04-01 00:00:00
abstract:PURPOSE OF REVIEW:New immunosuppressive agents have decreased the incidence of acute rejection rates without improvement in long-term outcomes. Drug toxicity due to a narrow therapeutic index and individual variations in pharmacokinetics and pharmacodynamics significantly contributes to the inferior outcomes. This revi...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283193bc5
更新日期:2008-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Nonalcoholic steatohepatitis (NASH), obesity, and the metabolic syndrome are highly prevalent. NASH, a rare indication for liver transplantation in the early 1990s, is now the third most common indication. This review considers key aspects of the liver transplantation for NASH. RECENT FINDINGS:NASH i...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283615d30
更新日期:2013-06-01 00:00:00