Abstract:
PURPOSE OF REVIEW:Geographic variation in liver transplantation has been the subject of extensive scrutiny, reflecting concerns that location is unfairly determinative for people needing organ transplantation. Drawing upon a number of established ethical approaches, we examine whether geographic differences in access to livers are inherently unethical. RECENT FINDINGS:We posit that the ethical imperative for redistribution largely hinges upon the belief that access to organs systematically disadvantages certain identifiable groups of patients over others. Yet, our data suggest that regions likely to be net-contributors may suffer from less access to transplantation and other health services, fewer social protections and greater burden of liver disease. Drawing upon a number of ethical approaches, including strict egalitarianism, utilitarianism, Maximin, Reciprocity, Sen's Impartial Spectator and a health equity framework, we demonstrate that the current proposal has significant weaknesses, and may not achieve its goals of improving equity and efficiency. SUMMARY:Formulating effective policies and programs to ameliorate health inequalities requires an understanding of the interrelated causes of mortality disparities and specific interventions to mitigate these causes. Although our analysis does not indicate how ethically distribute livers, but it suggests that this be done with consideration for population-based health measures.
journal_name
Curr Opin Organ Transplantjournal_title
Current opinion in organ transplantationauthors
Ladin K,Hanto DWdoi
10.1097/MOT.0000000000000400subject
Has Abstractpub_date
2017-04-01 00:00:00pages
174-178issue
2eissn
1087-2418issn
1531-7013journal_volume
22pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Transplantation of islets of Langerhans is an emerging treatment procedure for patients with severe type 1 diabetes, but despite recent progress the procedure is associated with massive tissue loss caused by an inflammatory reaction termed instant blood-mediated inflammatory reaction (IBMIR). This rea...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32834c2393
更新日期:2011-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Antibody-mediated rejection (ABMR) is the leading cause of allograft failure in kidney transplant recipients. This article provides a summary of the clinical research relating to donor-specific antibodies (DSA) and ABMR in kidney transplant recipients at the University of Wisconsin-Madison Transplant ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章
doi:10.1097/MOT.0000000000000814
更新日期:2020-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights current outcomes in intestinal transplantation and summarizes advances that have recently occurred in five interrelated areas: progress in intestinal rehabilitation, immunologic and technical modifications, awareness of opportunities for improved allograft monitoring, and better...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328330680d
更新日期:2009-10-01 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
abstract:PURPOSE OF REVIEW:Travel-related diseases may be seen in transplant recipients after travel, after transplant tourism, and via transmission from blood and organ donors, augmented by recent increases in travel, migration, and globalization. Such infections include tuberculosis, Plasmodium (malaria), Babesia, Trypanosoma...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328359266b
更新日期:2012-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize recent evidence in literature regarding incidence and risk factors for biliary complications in living donor liver transplantation (LDLT), and current concepts in evaluation of donor biliary anatomy and surgical techniques of biliary reconstruction, to reduce the incidence of biliary comp...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000693
更新日期:2019-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The number of sensitized heart transplant candidates is rising. Highly sensitized patients are disadvantaged because they encounter longer waiting times to heart transplant. Strategies to reduce their waiting times include waitlist prioritization and desensitization therapies. The purpose of this revi...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000635
更新日期:2019-06-01 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:Inducible pluripotent stem (iPS) cells derived from somatic cells represent a novel renewable source of tissue precursors. The potential of iPS cells is considered to be at least equivalent to that of human embryonic stem cells, facilitating the treatment or cure of diseases such as diabetes mellitus,...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283337196
更新日期:2010-02-01 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: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:Cellular human antipig immune responses are increasingly recognized as an important barrier to successful clinical xenotransplantation. This review addresses the role of monocytes/macrophages, natural killer (NK) cells, and T cells in xenograft rejection. We focus on the receptor-ligand interactions t...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328336b8e5
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Re-transplantation of the lung has come of age. Here, we wish to review the recent literature on the topic and discuss clinical implications. RECENT FINDINGS:Many large volume transplant centres routinely perform lung re-transplantation with satisfactory outcomes. The main indication is bronchiolitis...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328357d8ba
更新日期:2012-10-01 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:Although conceptually unchanged, the evaluation and selection of the liver transplant candidate has seen significant recent advances. Expanding criteria for transplant candidacy, improved diagnostics for risk stratification and advances in prognostic models have paralleled recent changes in allocation...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章
doi:10.1097/MOT.0000000000000829
更新日期:2021-02-01 00:00:00
abstract:PURPOSE OF REVIEW:High infectious risk donors (HRDs) fall into a behavioral category thought to increase risk of infectious transmission through transplantation; despite controversy surrounding their use, they comprise almost 9% of donors in which at least one organ is recovered. This review seeks to describe national ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283449dd3
更新日期:2011-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Extensive research in murine transplant models over the past two decades has convincingly demonstrated the ability of regulatory dendritic cells (DCregs) to promote long-term allograft survival. We review important considerations regarding the source of therapeutic DCregs (donor or recipient) and thei...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000097
更新日期:2014-08-01 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:In spite of impressive improvements in short-term outcomes for intestine transplant recipients, late allograft loss continues to plague the field. Attention has mostly been focused on T-cell-mediated cellular mechanisms of allograft rejection to explain these losses; however, as in other forms of soli...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283533847
更新日期:2012-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Memory T cells have emerged as a major threat to transplant survival; they are well equipped and well positioned to respond to antigens in an accelerated fashion. They participate in transplant rejection and resist interventions that usually contain naïve T cells. Thus, the means to prevent memory T c...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32834ee443
更新日期:2012-02-01 00:00:00
abstract:PURPOSE OF REVIEW:This review summarizes recent advances in the role of endogenous and exogenous Toll-like receptor ligands in the activation and inhibition of immune responses in transplantation. RECENT FINDINGS:During an alloresponse, Toll-like receptors can be engaged by both damage-induced endogenous ligands or mi...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283061149
更新日期:2008-08-01 00:00:00
abstract::World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost-effectiveness. Anything that is both cheaper and better, but ...
journal_title:Current opinion in organ transplantation
pub_type: 社论
doi:10.1097/MOT.0b013e328354c277
更新日期:2012-08-01 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: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: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 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:To review the current understanding of the ethical and societal difficulties of penile transplantation. RECENT FINDINGS:Penile transplantation, as with other forms of vascularized composite allotransplantation, has increasing acceptance in society but is still not entirely accepted. Guidelines aiming...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章
doi:10.1097/MOT.0000000000000820
更新日期:2020-12-01 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:Macrophages are members of the innate immune response. However, their role in the adaptive immune response is not known. The purpose of this review is to highlight our current understanding of macrophage structure and function and how they may participate in allograft injury. RECENT FINDINGS:Studies ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32834ee5b6
更新日期:2012-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Type 1 and type 2 diabetes mellitus represent a widespread metabolic disorder, related to autoimmune β-cell destruction and insulin resistance, leading to β-cell dysfunction, respectively, that are associated with severe chronic complications with irreversible multiorgan morphological and functional d...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000055
更新日期:2014-04-01 00:00:00