Abstract:
:In German legislation and in Eurotransplant's practice of liver allocation, urgency of need is considered as the primary distribution criterion. However, at a certain stage, the "sickest-first" principle is regarded as counterproductive as the performance status of these patients receiving an organ is on average critical and mortality and morbidity after liver transplantation increase. Within the medical transplant community, the criterion of prospect for success is highly accepted. As clinicians having a certain scope in decision-making as "gatekeepers" in regard to which patient gets on the waiting list and at which stage a patient is defined as "not transplantable" and as transplantation centers aspire good success rates, the goal of high prospect for success might become more weighty than intended by legislation and professional guidelines. From an ethical point of view, it is submitted a so-called mediatory approach in between the two extremes "sickest-first" and "fittest-first." Beyond that, it is argued for further development of a prognostic score for post-operative outcome after liver transplantation - as long as questions of social justice are borne in mind - to support "objective" decision-making.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Bobbert M,Ganten TMdoi
10.1111/ctr.12154subject
Has Abstractpub_date
2013-07-01 00:00:00pages
34-9eissn
0902-0063issn
1399-0012journal_volume
27 Suppl 25pub_type
杂志文章abstract:BACKGROUND:Multidrug-resistant (MDR) gram-negative bacteria are a growing threat to solid organ transplantation (SOT) patients in the intensive care unit (ICU). We aimed to examine the mortality rates of gram-negative MDR bacterial infection in SOT patients compared with patient population undergoing other cardiothorac...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12575
更新日期:2015-09-01 00:00:00
abstract::Cytomegalovirus (CMV) infection complicates the post-operative course of patients receiving solid organ transplants. While ganciclovir has significantly reduced the direct effects of CMV infection, some patients cannot tolerate the optimal therapeutic exposure required for CMV prevention and treatment. Few reports dir...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2008.00942.x
更新日期:2009-06-01 00:00:00
abstract::Accurate prognostic indicators are lacking for livers with early marginal graft function, making the decision to re-transplant a difficult one. Therefore, we studied 99mTc-labeled DISIDA scanning as a predictor of recovery of marginal grafts. Records of 28 liver transplant recipients with prolonged periods of marginal...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract::Acute renal failure (ARF) is a common and severe complication after liver transplantation (LT). The aim of this study was to ascertain the impact of ARF requiring dialysis in the outcome of LT and to analyze the risk factors leading to this event in the early post-operative period. From October 1988 to December 1994, ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the hypothesis that intraoperative infusion of dexmedetomidine can exert a protective effect against hepatic ischemia-reperfusion injury (IRI) in adult living donor liver transplantation (LDLiver transplantation). PATIENTS AND METHODS:Forty recipients were allocated i...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/ctr.12713
更新日期:2016-04-01 00:00:00
abstract::In France, liver grafts which have been refused by at least five centers are proposed as rescue allocation (RA). The aim of this study is to clarify the feasibility and safety of RA grafts in liver transplantation (LT). Short- and long-term outcomes of patients who received RA grafts (RA group) were compared with thos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14046
更新日期:2020-07-19 00:00:00
abstract:AIMS:To evaluate the effect of donor liver resident mesenchymal cells, M2 macrophages on liver graft outcome after living donor liver transplantation. MATERIALS AND METHODS:Seventy donor biopsies were included in the study. Outcomes at day 3, 7, 30, and 180 postliver transplantation were assessed. Mesenchymal stem cel...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13197
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Angiotensin converting enzyme (ACE) inhibitors have been successfully used for treatment of proteinuria after renal transplantation (RTx). Factors possibly responsible for the great inter-patient variance of the antiproteinuric effect (APE) have not yet been investigated in renal-transplanted patients. METH...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Arterial stiffness and left ventricular hypertrophy (LVH) are major independent risk factors for cardiovascular disease in healthy and renal population. In this study, we aimed to investigate comparative long-term effects of renal transplantation (RTx) and of hemodialysis (HD) on both arterial stiffness and ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00794.x
更新日期:2008-05-01 00:00:00
abstract::There is no recommendation regarding the type of induction therapy to use in ABO-incompatible (ABOi) kidney transplantation. The aim of this retrospective study was to compare the outcome of ABOi living donor kidney transplant (LDKT) recipients who received either polyclonal antibodies or anti-interleukin-2 receptor (...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13681
更新日期:2019-10-01 00:00:00
abstract::Tuberculosis remains one of the most serious infections after organ transplantation. Isoniazid prophylaxis for liver transplant recipients with a history of tuberculosis is generally recommended. However, its benefit is controversial because of potential hepatotoxicity of isoniazid. It is crucial to determine appropri...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00630.x
更新日期:2007-03-01 00:00:00
abstract::Xenotransplantation is a potential strategy to overcome the shortage of human donor organs. As this technique has a major medical and psychological impact on patients and their family and friends, the attitude of patients currently waiting for organ transplantation is important. Therefore, we conducted a survey on the...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01296.x
更新日期:2011-05-01 00:00:00
abstract::Of 1463 liver allograft recipients receiving the combination of FK506 and steroids as their primary immunosuppressive regimen, 2 patients developed Kaposi's sarcoma. Although previously described as a complication of organ transplantation, this is the first case report of Kaposi's sarcoma occurring in association with...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Severe systemic hypertension (HTN) is a risk factor for perioperative cardiovascular complications; however, its impact at the time of kidney transplantation (KTX) is not well defined. METHODS:A retrospective cohort study of adult kidney-only transplant recipients between October 2009 and December 2012 was ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12579
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Although liver transplantation may potentially cure hepatocellular carcinoma (HCC), the risk of HCC recurrence is 8%-20% at five years post-transplant. Pre-transplant alpha-fetoprotein (AFP) is a predictor of HCC recurrence, but it is unknown if pre-transplant AFP also predicts survival in patients with recu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13634
更新日期:2019-07-01 00:00:00
abstract::These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of tuberculosis in the pre- and post-transplant period. The challenges of screening for both latent and active TB in the setting of transplantation are...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13513
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Incisional hernias, that significantly affect the quality of life of patients, are common complications especially after major surgery, such as liver transplantation. The purpose of this meta-analysis is to outline the available evidence on the complications occurring after mesh implantation as a treatment o...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.14103
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:After pancreas transplantation (PTx) some patients report occasional symptoms of hypoglycaemia and at times, serious hypoglycaemia. Continuous blood glucose monitoring (CBGM) allows determination of the daily glucose profile and detection of unrecognized hypoglycaemia. The aims of our study were to determine...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1046/j.1399-0012.2003.00101.x
更新日期:2003-12-01 00:00:00
abstract::We investigated tolerability and efficacy of ezetimibe treatment (10 mg/d) in 25 heart allograft recipients already on stable statin therapy. Total cholesterol (TC), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C), triglycerides (TG), immunosuppressant drug levels, laboratory and clinical parameters ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2008.00838.x
更新日期:2008-09-01 00:00:00
abstract::An exploratory, post hoc analysis was performed using data from a prospective, multicenter, open-label, randomized, two-period (14 d per period), two-sequence, crossover, steady-state pharmacokinetic study comparing generic tacrolimus (Sandoz) vs. reference tacrolimus in stable renal transplant patients receiving thei...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/ctr.12256
更新日期:2013-11-01 00:00:00
abstract::Calcineurin inhibitors (CNI) are the mainstay of immunosuppression after liver transplantation (LT), but CNIs are associated with significant nephrotoxicity. Recently, mTOR inhibitors such as sirolimus and everolimus (EVR) have been used with or without CNIs in LT recipients for their renal-sparing effect. We conducte...
journal_title:Clinical transplantation
pub_type: 杂志文章,meta分析,评审
doi:10.1111/ctr.12872
更新日期:2017-02-01 00:00:00
abstract::Haploidentical stem cell transplantation (SCT) is increasingly used to treat pediatric patients with malignant or nonmalignant hematological disorders. The CD34+ dose of bone marrow or peripheral blood stem cells (PBSCs) has been shown to be an important determinant of the transplant outcome in adults under various pr...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12880
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Prior liver transplantation and immunosuppression potentially translate into significant morbidity and poor outcomes after any type of pancreatic surgery. Little is known about the outcomes of pancreatic surgery after liver transplantation. This study was designed to review our experience regarding the indic...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12317
更新日期:2014-03-01 00:00:00
abstract::Differentiating acute pyelonephritis (APN) from acute rejection (AR) in renal allograft biopsies can sometimes be difficult because of overlapping clinical and histologic features, lack of positive urine cultures,and variable response to antibiotics. We wanted to study differential gene expression between AR and APN u...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12795
更新日期:2016-09-01 00:00:00
abstract::An increasing number of patients and families are utilizing online crowdfunding to support their medical expenses related to organ transplantation. The factors influencing the success of crowdfunding campaigns are poorly understood. Crowdfunding campaigns were abstracted from a popular crowdfunding web site. Campaigns...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13267
更新日期:2018-06-01 00:00:00
abstract::The exact mechanism of acute and chronic allograft rejection still remains unclear. The chemokine SDF-1 as mediator of allograft rejection has been under intensive investigation in liver, cardiac and bone marrow transplantation, whereas in renal transplantation, there are no reports about SDF-1 to date. This study was...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00540.x
更新日期:2006-11-01 00:00:00
abstract::The combination of methotrexate and cyclosporine A (MTX-CSA) is the standard regimen for the prevention of graft vs. host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-SCT) from HLA-identical siblings. Mycophenolate mofetil and CSA (MMF-CSA) combination has been successfully used for GV...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00894.x
更新日期:2009-01-01 00:00:00
abstract::Evaluation of potential kidney transplant recipients is important to identify and treat conditions that may influence graft or patient survival after transplantation. We performed a single-center, observational cohort study to determine whether pretransplant midodrine use influences outcomes after kidney transplantati...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13366
更新日期:2018-09-01 00:00:00
abstract::Transplant-related aneurysms are an unusual complication following pancreas transplantation. We present a case of a pseudoaneurysm developing in a recipient 6 months after bladder-drained pancreas transplantation. The pseudoaneurysm was incidentally found during ultrasonographic evaluation in preparation for a pancrea...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-0012.2001.150113.x
更新日期:2001-02-01 00:00:00
abstract::Renal transplantation was performed in a 24-yr-old woman with type AA systemic amyloidosis. Renal biopsy at 11 yr post-transplantation showed no amyloid recurrence, but the presence of mesangial proliferative glomerulonephritis and focal segmental glomerular sclerosis. Renal function was satisfactory with the exceptio...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00