Transplantationskirurgi

Given the tensions and demands of medicine, highly successful physicians and surgeons rarely achieve equal success as prose writers. It is truly extraordinary that a major, international pioneer in the controversial field of transplant surgery should have written a spellbinding, and heart-wrenching, autobiography.Thomas Starzl grew up in LeMars, Iowa, the son of a newspaper publisher and a nurse. His father also wrote science fiction and was acquainted with the writer Ray Bradbury. Starzl left the family business to enter Northwestern University Medical School where he earned both and M.D. and a PhD. While he was a student, and later during his surgical internship at the Johns Hopkins Hospital, he began the series of animal experiments that led eventually to the world\u2019s first transplantation of the human liver in 1963.Throughout his career, first at the University of Colorado and then at the University of Pittsburgh, he has aroused both worldwide admiration and controversy. His technical innovations and medical genius have revolutionized the field, but Starzl has not hesitated to address the moral and ethical issues raised by transplantation. In this book he clearly states his position on many hotly debated issues including brain death, randomized trials for experimental drugs, the costs of transplant operations, and the system for selecting organ recipients from among scores of desperately ill patients.There are many heroes in the story of transplantation, and many \u201cpuzzle people,\u201d the patients who, as one journalist suggested, might one day be made entirely of various transplanted parts. They are old and young, obscure and world famous. Some have been taken into the hearts of America, like Stormie Jones, the brave and beautiful child from Texas. Every patient who receives someone else\u2019s organ - and Starzl remembers each one - is a puzzle. \u201cIt was not just the acquisition of a new part,\u201d he writes. \u201cThe rest of the body had to change in many ways before the gift could be accepted. It was necessary for the mind to see the world in a different way.\u201d The surgeons and physicians who pioneered transplantation were also changed: they too became puzzle people. \u201cSome were corroded or destroyed by the experience, some were sublimated, and none remained the same.\u201d

‘Gripping … so powerfully emotional that at times I had to put it down to wipe my eyes’Mail on Sunday‘How do you say thank you to someone for giving you their heart? It is the greatest gift a person can ever give.’Marc is a promising young footballers of 15, growing up in Scotland. A few hundred miles away in England, Martin is a fun-loving 16-year-old. Both are enjoying their summers when they are suddenly struck down by debilitating illnesses. Within days, the boys are close to death.Although their paths have never crossed, their fortunes are about to be bound in the most extraordinary, intimate way. One of them will die and in doing so, he will save the other’s life.This is a deeply powerful and dramatic story. It is extremely rare for the family of a donor to have any personal contact with the recipient of their loved one’s organ. Yet remarkably, the mothers of these two boys meet and become friends, enabling the extraordinary, bittersweet moment in which a mother who has lost her son meets the boy he saved. Reaching out and placing her palm flat against his chest, she feels the heart of her son beating away inside another. Her boy, the boy who gave his heart away.

The author of the New York Times bestseller Broken Open returns with a visceral and profound memoir of two sisters who, in the face of a bone marrow transplant-one the donor and one the recipient-begin a quest for acceptance, authenticity, and most of all, love. A mesmerizing and courageous memoir: the story of two sisters uncovering the depth of their love through the life-and-death experience of a bone marrow transplant. Throughout her life, Elizabeth Lesser has sought understanding about what it means to be true to oneself and, at the same time, truly connected to the ones we love. But when her sister Maggie needs a bone marrow transplant to save her life, and Lesser learns that she is the perfect match, she faces a far more immediate and complex question about what it really means to love-honestly, generously, and authentically. Hoping to give Maggie the best chance possible for a successful transplant, the sisters dig deep into the marrow of their relationship to clear a path to unconditional acceptance.They leave the bone marrow transplant up to the doctors, but take on what Lesser calls a "soul marrow transplant," examining their family history, having difficult conversations, examining old assumptions, and offering forgiveness until all that is left is love for each other's true selves. Their process-before, during, and after the transplant-encourages them to take risks of authenticity in other aspects their lives. But life does not follow the storylines we plan for it. Maggie's body is ultimately too weak to fight the relentless illness. As she and Lesser prepare for the inevitable, they grow ever closer as their shared blood cells become a symbol of the enduring bond they share. Told with suspense and humor, Marrow is joyous and heartbreaking, incandescent and profound. The story reveals how even our most difficult experiences can offer unexpected spiritual growth. Reflecting on the multifaceted nature of love-love of other, love of self, love of the world-Marrow is an unflinching and beautiful memoir about getting to the very center of ourselves.

Over the past decade, there has been rapid growth in bioengineering applications in the field of spine implants. Spine Technology Handbook explains the technical foundation for understanding and expanding the field of spine implants, reviews the major established technologies related to spine implants, and provides reference material for developing and commercializing new spine implants. The editors, who have a track record of collaboration and editing technical books, provide a unified approach to this topic in the most comprehensive and useful book to date. Related website provides the latest information on spine technology including articles and research papers on the latest technology and development Major technologies reviewed include devices used for fusion (screws, plates, rods, and cages), disc repair and augmentation, total disc replacement, and vertebral body repair and augmentation Technology landscape, review of published/public domain data currently available, and safety and efficacy of technology discussed in detail

There have been tremendous strides in cellular transplantation in recent years, leading to accepted practice for the treatment of certain diseases, and use for many others in trial phases. The long history of cellular transplantation, or the transfer of cells from one organism or region of the body to another, has been revolutionized by advances in stem cell research, as well as developments in gene therapy.

Cellular Transplants: From Lab to Clinic provides a thorough foundation of the basic science underpinning this exciting field, expert overviews of the state-of-the-art, and detailed description of clinical success stories to date, as well as insights into the road ahead. As highlighted by this timely and authoritative survey, scale-up technologies and whole organ transplantation are among the hurdles representing the next frontier.

The contents are organized into four main sections, with the first covering basic biology, including transplant immunology, the use of immunosuppressive drugs, stem cell biology, and the development of donor animals for transplantation. The next part looks at peripheral and reconstructive applications, followed by a section devoted to transplantation for diseases of the central nervous system. The last part presents efforts to address the key challenges ahead, such as identifying novel transplantable cells and integrating biomaterials and nanotechnology with cell matrices.

Provides detailed description of clinical trials in cell transplantation Review of current therapeutic approaches Coverage of the broad range of diseases addressed by cell therapeutics Discussion of stem cell biology and its role in transplantation

Regenerative Medicine Applications in Organ Transplantation illustrates exactly how these two fields are coming together and can benefit one another. It discusses technologies being developed, methods being implemented, and which of these are the most promising. The text encompasses tissue engineering, biomaterial sciences, stem cell biology, and developmental biology, all from a transplant perspective. Organ systems considered include liver, renal, intestinal, pancreatic, and more. Leaders from both fields have contributed chapters, clearly illustrating that regenerative medicine and solid organ transplantation speak the same language and that both aim for similar medical outcomes. The overall theme of the book is to provide insight into the synergy between organ transplantation and regenerative medicine.

Recent groundbreaking achievements in regenerative medicine have received unprecedented coverage by the media, fueling interest and enthusiasm in transplant clinicians and researchers. Regenerative medicine is changing the premise of solid organ transplantation, requiring transplantation investigators to become familiar with regenerative medicine investigations that can be extremely relevant to their work. Similarly, regenerative medicine investigators need to be aware of the needs of the transplant field to bring these two fields together for greater results.

Bridges the gap between regenerative medicine and solid organ transplantation and highlights reasons for collaboration Explains the importance and future potential of regenerative medicine to the transplant community Illustrates to regenerative medicine investigators the needs of the transplant discipline to drive and guide investigations in the most promising directions

Personalized Immunosuppression in Transplantation: Role of Biomarker Monitoring and Therapeutic Drug Monitoring provides coverage of the various approaches to monitoring immunosuppressants in transplant patients, including the most recently developed biomarker monitoring methods, pharmacogenomics approaches, and traditional therapeutic drug monitoring.

The book is written for pathologists, toxicologists, and transplant surgeons who are involved in the management of transplant patients, offering them in-depth coverage of the management of immunosuppressant therapy in transplant patients with the goal of maximum benefit from drug therapy and minimal risk of drug toxicity.

This book also provides practical guidelines for managing immunosuppressant therapy, including the therapeutic ranges of various immunosuppressants, the pitfalls of methodologies used for determination of these immunosuppressants in whole blood or plasma, appropriate pharmacogenomics testing for organ transplant recipients, and when biomarker monitoring could be helpful.

Focuses on the personalized management of immunosuppression therapy in individual transplant patients Presents information that applies to many areas, including gmass spectrometry, assay design, assay validation, clinical chemistry, and clinical pathology Provides practical guidelines for the initial selection and subsequent modifications of immunosuppression therapy in individual transplant patients Reviews the latest research in biomarker monitoring in personalizing immunosuppressant therapy, including potential new markers not currently used, but with great potential for future use Explains how monitoring graft-derived, circulating, cell free DNA has shown promise in the early detection of transplant injury in liquid biopsy

Mathematical Approaches to Liver Transplantation provides mathematical approaches to the optimization of liver graft distribution. Through mathematical and computational methods, several aspects related to organ allocation are tackled, with possible solutions presented. The book discusses topics such as patient selection for liver transplantation, transplantation procedures, dynamics of organs waiting list, improvement on grafts allocation, live donors and MELD scale. The content focuses on liver transplantation, however the mathematical approaches presented can be successfully replicated to different organs. This book is a valuable source for mathematical biologists, bioinformaticians, and several members of biomedical field who are involved in decision-making related to organs transplantation.

Provides a mathematical approach to the optimization of liver grafts distribution Presents mathematical and computational methods for several aspects relating to organ allocations and discusses possible solutions Encompasses optimization models for the best organ distribution strategy to support decision-makers that are responsible for liver and other organ transplantation policies

Regenerative Hepatology and Liver Transplantation is the second volume in the Regenerative and Transplant Medicine series. This volume is essential as no field in the biomedical sciences has more interest than organ transplantation regarding regenerative medicine, primarily because of the urgent need to improve transplant outcomes and increase transplantation rates is critical to treat the many patients suffering from liver disease.The goal of this book is to bridge regenerative hepatology and transplant medicine, by illustrating the state of the art of clinical liver transplantation, as well as of the progress of regenerative medicine (RM) investigations aiming at the bioengineering, regeneration, and repair of the liver.This volume is necessary and would be placed well in the current global trend toward increasing organ donation utilizing such cutting-edge technologies. Written by the world’s experts in the field of liver diseases, it is a perfect reference for transplant operators, researchers, regenerative medicine operators, tissue engineering operators, biotech operators, and those in academia, industry, and regulatory agencies working to advance the field.Second volume in the Regenerative and Transplant Medicine series, focusing on the liverCovers the liver and diseases, transplantation, cell transplantation, liver preservation and machine perfusion, and liver bioengineeringBuilds on previous works and demonstrates how regenerative and transplant medicine work together to provide an increased ability to improve health care outcomes for individuals

Biomarkers in Kidney Transplantation: Clinical Aspects and Laboratory Determination provides a focused study on traditional and emerging biomarkers to predict early rejection of kidney transplants supporting appropriate therapeutic interventions. Coverage includes predictive and diagnostic biomarkers for different types of rejections, including biomarkers of acute, chronic/sub chronic rejection or clinical rejection, T-cell mediated rejection, antibody mediated rejection and mixed rejection. Comparisons are provided for broad classification of pharmacokinetic versus pharmacodynamic biomarkers, and differentiation is shown between the susceptibility, diagnostic, predictive, prognostic and monitoring biomarkers.Coverage of the analytical aspects of biomarker measurement, the process of biomarker discovery and their clinical validation addresses both the clinical features of biomarkers as well as the pitfalls of determining such biomarkers in clinical laboratories. By combining all current markers known for kidney transplant in one collection, this easy-to-use reference is perfect for pathologists, clinical pharmacologists, clinical laboratory scientists and all physicians involved in organ transplantation, including immunologists and transplant surgeons.

Includes comprehensive coverage on all available biomarkers to predict organ rejectionProvides guidance on how to interpret test results of all available biomarkersCovers possible sources of errors in measuring biomarkers to eliminate issues of interference

This book analyses the impact of organ transplantation. It also presents new, original analyses of data, and assesses medical practices, social and economic observations, and other information on: access to transplantation services for low-income populations and racial and ethnic minority groups; organ donation rates; waiting times for transplantation; patient survival rates and organ failure rates leading to retransplantation; and cost of organ transplantation services. It includes chapters on the possibilities of expanding the pool of available cadaver organs. It also analyzes the results of transplantation of cadaver organs from older donors and marginal, non-heart beating donors. Transplantation policies based on the offering of organs by living donors are also described, as is the impact of delayed graft function on organ allocation.

This book provides a comprehensive review of ethical issues in clinical nephrology. With the advent of dialysis and kidney transplantation midway through the 20 Century, clinical nephrology was one of the first areas of medicine to deal with complex ethical issues such as rationing of health care and discontinuation of life-sustaining therapy. In the first section of the book this historical perspective is reviewed, followed by a consideration of legal issues. Specific ethical issues in nephrology are discussed in detail in the next section. These include problems in the allocation of chronic dialysis and in termination of that treatment. Also reviewed are issues in kidney transplantation, such as proposals for enhanced acquisition of kidneys, including a number of controversial proposals such as payment to donors and xenotransplantation; and equity in allocation of the supply of kidneys. Other chapters consider ethical issues in genetics; special problems in the care of children with kidney disease; and broad societal issues such as allocation of national resources for expensive therapies and economic issues in clinical practice. In the final part of the book ethical issues in the care of patients with kidney disease are discussed from an Asian and African perspective.

Spare Parts centres on the developments that have occurred in the field of organ transplantation during the 1980s and early 1990s, and on the rise and fall of the Jarvik-7 artificial heart in that period. It is vividly written in a narrative ethnographic style. The interconnected stories of organ transplantation and the artificial heart are recounted in an interpretive framework that attributes their most enduring significance to the triple themes of uncertainty, gift exchange, and the allocation of scarce material and non-material resources, and to the way that they open questions of life and death, identity and solidarity.

The majority of patients in need of organ transplants do not survive long enough for a suitable human organ to become available. Xenotransplantation, the transplant of animal organs into humans, has attracted substantial media attention. If, as appears likely, it proves possible to "humanize" animal organs and evade the problems of rejection, in the coming few years there will be a tremendous increase in this procedure, mostly using organs from animals specifically for their harvestable organs. This book will lay out the potential and promise of the technique, the history of organ transplantation, the technical problems and breakthroughs in overcoming immune rejection, and typing and humanizing donor organs for transplantation. The ethical question of growing animals specifically for organ harvest, and the substantial public health concern from the certainty that animal viruses will pass into humans with the donated organs, will be fully discussed. The authors are among the leaders in the field of Xenotransplantation.

Perhaps no medical breakthrough in the twentieth century is more spectacular, more hope-giving, or more fraught with ethical questions than organ transplantation. Each year some 25,000 Americans are pulled back from the brink of death by receiving vital new organs. Another 5,000 die while waiting for them. And what distinguishes these two groups has become the source of one of our thorniest ethical questions.In Raising the Dead, Ronald Munson offers a vivid, often wrenchingly dramatic account of how transplants are performed, how we decide who receives them, and how we engage the entire range of tough issues that arise because of them. Each chapter begins with a detailed account of a specific case--Mickey Mantle's controversial liver transplant, for example--followed by careful analysis of its surrounding ethical questions (the charges that Mantle received special treatment because he was a celebrity, the larger problems involving how organs are allocated, and whether alcoholics should have an equal claim on donor livers). In approaching transplant ethics through specific cases, Munson reminds us of the complex personal and emotional dimension that underlies such issues. The book also ranges beyond our present capabilities to explore the future possibilities in xenotransplantation (transplanting animal organs into humans) and stem cell technology that would allow doctors to grow new organs from the patient's own cells.Based on extensive scientific research, but written with a novelist's eye for the human condition, Raising the Dead shows readers the reality of organ transplantation now, the possibility of what it may become, and how we might respond to the ethical challenges it forces us to confront.

Organ transplantation is one of the most dramatic interventions in modern medicine. Since the 1950s thousands of people have lived with 'new' hearts, kidneys, lungs, corneas, and other organs and tissues transplanted into their bodies. From the beginning, though, there was simply a problem: surgeons often encountered shortages of people willing and able to give their organs and tissues. To overcome this problem, they often brokered financial arrangements. Yet an ethic of gift exchange coexisted with the 'commodification of the body'. The same duality characterized the field of blood transfusion, which was essential to the development of modern surgery. This book is the first to bring together the histories of blood transfusion and organ transplantation. It shows how these two fields redrew the lines between self and non-self, the living and the dead, and humans and animals. Drawing on newspapers, magazines, legal cases, films and the papers and correspondence of physicians and surgeons, Lederer challenges the assumptions of some bioethicists and policymakers that popular fears about organ transplantation necessarily reflect timeless human concerns and preoccupations with the body. She shows how notions of the body- intact, in parts, living and dead- are shaped by the particular culture in which they are embedded.

The use of human tissue for transplantation is becoming a billion-dollar business. This book is the first comprehensive exploration of the American tissue transplantation industry. It traces the chain of distribution of musculoskeletal tissue (e.g. bones and ligaments) and skin from the generous donation of grieving families to its transplantation into hundreds of thousands of persons each year. Commodification, commercialization, and the occasional use of tissue for "cosmetic" surgery have raised ethical questions about the acceptability of "markets" in human body parts that have been altruistically donated by families. Inevitably, questions about the informed consent and the need for responsible stewardship by the industry have been raised, often in the Press.The book provides a comprehensive background to these ethical problems by explaining the historical development, breadth, and organization of the tissue industry, including the technical developments that have made it simultaneously clinically relevant and an attractive market for investment capital. It explores the similarities and differences in how government regulates other tissues and solid organs (such as hearts and kidneys). Contributions to the book come from an interdisciplinary group of scholars, industry representatives, government regulators, and, not least, families who have donated tissue from their dead loved ones.

Ronald Munson plunges us into the tense and tangled world of organ transplantation. Using vivid, often gut-wrenching cases as points of departure, Munson shows us how transplants are performed, decisions are made, and ethical and social issues arise. Fast-paced and readable, the science and medicine lucidly explained, this book forces us to confront the human and moral dimensions of using donor organs to save lives.Munson uses case examples to explore, explain, and try to resolve a handful of crucial problems arising from acquiring and allocating donor organs. Should "social worth" count in allotting organs? Should we ignore the "dead-donor rule" and take organs from infants born lacking a brain? Should we permit people to sell one of their kidneys? Should organs be removed from people who aren't yet brain dead? Can children become living donors? He also explores the promises and perils of transplanting animal organs into people, and the promise that stem-cell engineering will permit physicians to repair damaged organs or replace them with new copies.

When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, we are no closer to the goal of adequate organ supply without living donors--if anything, the supply-demand ratio is worse. While most research on the ethics of organ transplantation focuses on how to allocate organs as a scarce medical resource, the ethical treatment of organ donors themselves has been relatively neglected. In The Living Organ Donor as Patient: Theory and Practice, Lainie Friedman Ross and J. Richard Thistlethwaite, Jr. argue that living donor organ transplantation can be ethical provided that we treat living solid organ donors as patients in their own right. Ross and Thistlethwaite develop a five-principle framework to examine some of the attempts to increase living donation. It uses the three principles of the Belmont Report: respect for persons, beneficence, and justice modified to organ transplantation, as well as the principles of vulnerability and special relationships creating special obligations. Their approach requires that the transplant community fully embrace current and prospective living organ donors as patients to whom we have special obligations. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral limits of living solid organ donation be realized and living donors be given the full respect and care they deserve.

Biomedical scientists are the foundation of modern healthcare, from cancer screening to diagnosing HIV, from blood transfusion for surgery to food poisoning and infection control. Without biomedical scientists, the diagnosis of disease, the evaluation of the effectiveness of treatment, and research into the causes and cures of disease would not be possible.The Fundamentals of Biomedical Science series has been written to reflect the challenges of practicing biomedical science today. It draws together essential basic science with insights into laboratory practice to show how an understanding of the biology of disease is coupled to the analytical approaches that lead to diagnosis. Assuming only a minimum of prior knowledge, the series reviews the full range of disciplines to which a Biomedical Scientist may be exposed—from microbiology to cytopathology to transfusion science.The science of transfusion and transplantation demands a multifaceted understanding of immunology, haematology, and genetics from the biomedical scientist. Transfusion and Transplantation Science synthesizes the essential concepts of these subjects and presents them within the practical framework of the hospital banking and transplantation centre, providing you with the knowledge and skills to specialize in this discipline.

Organ Preserving Approaches in the Treatment of Rectal Cancer brings together the medical and surgical management of patients, by exploring organ preservation's history and evolution, the diagnostic techniques involved in identifying patients that have a good response to therapy, and the various techniques for enhancing complete responses to neoadjuvant therapies. The book examines different methods for treating patients using an organ preservation approach, including "watch and wait" and local excision techniques, alongside discussions on quality of life, future developments, and methods for stratifying patients into this approach.Leading experts from across the world offer insights into the management of rectal cancer beyond the standard surgical framework. They advocate for avoiding surgery when practical, including employing patient observation and monitoring when no cancer is detected following chemotherapy and radiotherapy. Oncologists, surgeons, and academics in the field will gain practical guidance on how to identify these patients, manage follow-up care, and what to do if this approach is unsuccessful.

With the success of organ transplantation and the declining number of heart beating cadaver donors, 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 adopted 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.

Pancreas transplantation has rapidly moved from an experimental procedure associated with high rates of morbidity and mortality to a mainstream technique with excellent patient and graft survival. Over 30,000 pancreas transplants have already been performed. The value of pancreas transplantation however must be balanced against the risk of the operative procedure and the innovative long-term immunosuppressive therapy. The indications for this procedure and the selection of the patients are critical to ensure low mortality and any improvements in quality of life. This second edition reflects recent advances in the field, especially the increasing number of islet transplantations and the growing interest in stem cell research applicable to this condition. It provides an authoritative account on the current status of the whole organ pancreas transplantation and islet and pancreatic stem cell transplantation.

If you die through mistakes in moral reasoning, then you are as dead as if you die through mistakes made in medicine.Organ transplantation saves lives yet thousands die every year on waiting lists through lack of organs. We are exhorted to donate; but is our individual reluctance the essence of the problem, or is it caused by deeper issues in the way public policy is discussed and formulated? Janet Radcliffe Richards casts a sharp critical eye on the moral arguments, forcing us to confront the logic and implications of our own position. A book for everyone who is up for intellectual challenge and is serious about moral reasoning in any context.

Transplantation is a medically successful and cost-effective way to treat people whose organs have failed--but not enough organs are available to meet demand. Ethics and the Acquisition of Organs is concerned with the major ethical problems raised by policies for acquiring organs. The main topics are the rights of the dead, the role of the family, opt in and opt out systems, the conscription of organs, living organ donation from adults and children, directed donation and priority for donors, and the sale of organs. In this ground-breaking work, T. M. Wilkinson uses concepts from moral and political theory such as autonomy, rights, posthumous interests, justice, and well-being, in a context informed by the clinical, legal, and policy aspects of transplantation. The result is a rigorous philosophical exploration of real problems and options. He argues that the ethics of acquiring organs for transplantation is not only of great intellectual interest, but also of practical importance. As such, this book will be of profit not only to students and academics who work in applied ethics and bioethics, but also to the lawyers, policy-makers, clinicians, and lobby groups interested in transplantation.

Saving lives through organ transplantation has become increasingly possible thanks to advances in research and care. Today, the complex field of transplantation continues to develop rapidly, fuelled by demographic change and further evolutions in scientific understanding. The Oxford Textbook of Transplant Anaesthesia and Critical Care has been written and edited by pioneers in the field of organ transplantation with an international team of authors, in order to equip anaesthetists and intensivists with the knowledge and training necessary to provide high quality and evidence-based care. The text addresses fundamentals aspects of scientific knowledge, care of the donor patient, transplant ethics and special considerations. Dedicated sections address each of the major organs; kidney, pancreas, liver, heart and lung, intestinal and multivisceral. Within each organ-based section, expert authors explore underlying disease, planning for transplantation, specialized procedures, perioperative and critical care management as well as post-transplant considerations. Focus points for future developments in transplant immunology are also set out, inspiring current practitioners to engage with current clinical research and help participate in the further advancement of the science of transplantation. The print edition of the Oxford Textbook of Transplant Anaesthesia and Critical Care comes with a year's access to the online version on Oxford Medicine Online. By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables.

In Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, Miller and Truog challenge fundamental doctrines of established medical ethics. They argue that the routine practice of stopping life support technology in hospitals causes the death of patients and that donors of vital organs (hearts, lungs, liver, and both kidneys) are not really dead at the time that their organs are removed for life-saving transplantation. These practices are ethically legitimate but are not compatible with traditional rules of medical ethics that doctors must not intentionally cause the death of their patients and that vital organs can be obtained for transplantation only from dead donors. In this book Miller and Truog undertake an ethical examination that aims to honestly face the reality of medical practices at the end of life. They expose the misconception that stopping life support merely allows patients to die from their medical conditions, and they dispute the accuracy of determining death of hospitalized patients on the basis of a diagnosis of "brain death" prior to vital organ donation. After detailing the factual and conceptual errors surrounding current practices of determining death for the purpose of organ donation, the authors develop a novel ethical account of procuring vital organs. In the context of reasonable plans to withdraw life support, still-living patients are not harmed or wronged by organ donation prior to their death, provided that valid consent has been obtained for stopping treatment and for organ donation. Recognizing practical difficulties in facing the truth regarding organ donation, the authors also develop a pragmatic alternative account based on the concept of transparent legal fictions. In sum, Miller and Truog argue that in order to preserve the legitimacy of end-of-life practices, we need to reconstruct medical ethics.

Pre- and post-operative care of transplant patients is an aspect of Critical Care Medicine in which most ICU physicians and nurses have received little or no formal training and are left to cope with this complex population with only incomplete 'on-the-job experience' as a guide. In response to this clinical knowledge gap, ICU Care of Abdominal Organ Transplant Patients provides a concise bedside resource fo intensivists, surgeons, and nurses caring for abdominal organ transplant patients before and after surgery.In a concise, practical style, the authors offer concrete solutions to questions and situations confronted by ICU clinicians. Chapters address general principles of immunosuppression, infectious complications, management, and nursing considerations, plus indications, approach to anesthesia, transplant procedure, and post-operative care for liver, kidney, pancreas, islet cell, and small bowel and multivisceral transplantation.