Giving and Getting Gifts of Life by Adela T
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The Economics and Ethics of Alternative Cadaveric Organ Procurement Policies
The Economics and Ethics of Alternative Cadaveric Organ Procurement Policies Roger D. Blairt David L. Kasermantt Under the National Organ TransplantAct of 1984, organsuppliers-usually the famillies of critically injured accident victims-are not allowed to receive compensation in exchange for granting permission to remove the organs of their deceased relatives. This organ procurement regime is therefore driven solely by potential donors' altruism. Due to the growing nationwide shortage of transplantableorgans, the altruisticsystem has begun to draw considerable criticism. Focussing on the transplantationof kidneys, this Article challenges the theoreticaland economic underpinningsof the altruisticsystem by compar- ing it to two alternative policies: a market system that allows demand and supply to equilibrate at a positive price, and a system which transfers property rights in cadavericorgans from potential donors to recipients.Blair and Kaser- man subject these alternative policies to economic and ethical scrutiny, and conclude that the market system would not only generate the largest number of transplantablekidneys, but would also provide the greatest gain in overall social welfare. Introduction ......................................... 404 1. The Kidney Shortage - Magnitude, Causes, and Consequences .... 407 A. Size of the Shortage ............................... 408 B. Causes of the IncreasingShortage .................... 408 C. Consequences of the Shortage ........................ 410 II. The Current System: Altruism ......................... -
Transplant Immunology.Pdf
POLICY BRIEFING Transplant Immunology September 2017 The British Society of Immunology is the largest Introduction immunology society in Europe. Our mission is to promote excellence in immunological research, scholarship and Transplantation is the process of moving cells, tissues, or clinical practice in order to improve human and animal organs, from one site to another, either within the same health. We represent the interests of more than 3,000 person or between a donor and a recipient. If an organ immunologists working in academia, clinical medicine, system fails, or becomes damaged as a consequence of and industry. We have strong international links and disease or injury, it can be replaced with a healthy organ collaborate with our European, American and Asian or tissue from a donor. partner societies in order to achieve our aims. Organ transplantation is a major operation and is only Key points: offered when all other treatment options have failed. Consequently, it is often a life-saving intervention. In • Transplantation is the process of moving cells, 2015/16, 4,601 patient lives were saved or improved in i tissues or organs from one site to another for the the UK by an organ transplant. Kidney transplants are purpose of replacing or repairing damaged or the most common organ transplanted on the NHS in diseased organs and tissues. It saves thousands the UK (3,265 in 2015/16), followed by the liver (925), and i of lives each year. However, the immune system pancreas (230). In addition, a total of 383 combined heart poses a significant barrier to successful organ and lung transplants were performed, while in 2015/16. -
Organ Procurement in Israel: Lessons for South Africa
RESEARCH Organ procurement in Israel: Lessons for South Africa M Slabbert,1 BA (Hons) HED, B Proc, LLB, LLD; B Venter,2 LLB, LLM 1 Department of Jurisprudence, University of South Africa, Pretoria, South Africa 2 Faculty of Law, Midrand Graduate Institute, Midrand, South Africa Corresponding author: B Venter ([email protected]) Modern medicine makes it possible to transplant not only kidneys but any solid organs from one human body to another. Although it is the ideal to harvest organs from a brain-dead person, a kidney or a part of the liver or lung can be transplanted from a living donor to a patient. The majority of countries where organ transplants are performed have a dire need for transplantable organs as the current systems of organ procurement are not obtaining a sufficient amount of transplantable organs. Today’s cruel reality is that many patients are dying while waiting for a transplant. Few nations are able to meet the organ demand through their domestic transplant systems and there is a constant debate about ethical ways of procuring organs for transplantation purposes. This article will scrutinise the Israeli system of organ procurement and it will be compared with the current system of organ donation in South Africa (SA) in order to indicate whether SA could possibly, or should, follow the example of Israel to improve its acute donor organ shortage. S Afr J BL 2015;8(2):44-47. DOI:10.7196/SAJBL.444 Since the first kidney transplant a new chance of life Declaration does not provide explicit support for donor incentives. -
Organ Transplant Discrimination Against People with Disabilities Part of the Bioethics and Disability Series
Organ Transplant Discrimination Against People with Disabilities Part of the Bioethics and Disability Series National Council on Disability September 25, 2019 National Council on Disability (NCD) 1331 F Street NW, Suite 850 Washington, DC 20004 Organ Transplant Discrimination Against People with Disabilities: Part of the Bioethics and Disability Series National Council on Disability, September 25, 2019 This report is also available in alternative formats. Please visit the National Council on Disability (NCD) website (www.ncd.gov) or contact NCD to request an alternative format using the following information: [email protected] Email 202-272-2004 Voice 202-272-2022 Fax The views contained in this report do not necessarily represent those of the Administration, as this and all NCD documents are not subject to the A-19 Executive Branch review process. National Council on Disability An independent federal agency making recommendations to the President and Congress to enhance the quality of life for all Americans with disabilities and their families. Letter of Transmittal September 25, 2019 The President The White House Washington, DC 20500 Dear Mr. President, On behalf of the National Council on Disability (NCD), I am pleased to submit Organ Transplants and Discrimination Against People with Disabilities, part of a five-report series on the intersection of disability and bioethics. This report, and the others in the series, focuses on how the historical and continued devaluation of the lives of people with disabilities by the medical community, legislators, researchers, and even health economists, perpetuates unequal access to medical care, including life- saving care. Organ transplants save lives. But for far too long, people with disabilities have been denied organ transplants as a result of unfounded assumptions about their quality of life and misconceptions about their ability to comply with post-operative care. -
International Trial of the Edmonton Protocol for Islet Transplantation
The new england journal of medicine original article International Trial of the Edmonton Protocol for Islet Transplantation A.M. James Shapiro, M.D., Ph.D., Camillo Ricordi, M.D., Bernhard J. Hering, M.D., Hugh Auchincloss, M.D., Robert Lindblad, M.D., R. Paul Robertson, M.D., Antonio Secchi, M.D., Mathias D. Brendel, M.D., Thierry Berney, M.D., Daniel C. Brennan, M.D., Enrico Cagliero, M.D., Rodolfo Alejandro, M.D., Edmond A. Ryan, M.D., Barbara DiMercurio, R.N., Philippe Morel, M.D., Kenneth S. Polonsky, M.D., Jo-Anna Reems, Ph.D., Reinhard G. Bretzel, M.D., Federico Bertuzzi, M.D., Tatiana Froud, M.D., Raja Kandaswamy, M.D., David E.R. Sutherland, M.D., Ph.D., George Eisenbarth, M.D., Ph.D., Miriam Segal, Ph.D., Jutta Preiksaitis, M.D., Gregory S. Korbutt, Ph.D., Franca B. Barton, M.S., Lisa Viviano, R.N., Vicki Seyfert-Margolis, Ph.D., Jeffrey Bluestone, Ph.D., and Jonathan R.T. Lakey, Ph.D. ABSTRACT Background From the University of Alberta, Edmon- Islet transplantation offers the potential to improve glycemic control in a subgroup ton, AB, Canada (A.M.J.S., E.A.R., J.P., G.S.K., of patients with type 1 diabetes mellitus who are disabled by refractory hypoglyce- J.R.T.L.); the University of Miami, Miami (C.R., R.A., T.F.); the University of Minne- mia. We conducted an international, multicenter trial to explore the feasibility and sota, Minneapolis (B.J.H., R.K., D.E.R.S., reproducibility of islet transplantation with the use of a single common protocol M.S.); Harvard Medical School, Boston (the Edmonton protocol). -
Incentivizing Organ Donor Registrations with Organ Allocation Priority
HEALTH ECONOMICS Health Econ. (2016) Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/hec.3328 INCENTIVIZING ORGAN DONOR REGISTRATIONS WITH ORGAN ALLOCATION PRIORITY AVRAHAM STOLERa,*, JUDD B. KESSLERb, TAMAR ASHKENAZIc, ALVIN E. ROTHd and JACOB LAVEEe aDepartment of Economics, DePaul University and Coherent Economics, Highland Park, IL, USA bThe Wharton School, University of Pennsylvania, Philadelphia, PA, USA cIsraeli National Transplant Center, Tel Aviv, Israel dDepartment of Economics, Stanford University, Stanford, CA, USA eTel Aviv University Faculty of Medicine and the Heart Transplantation Unit, Sheba Medical Center, Ramat Gan, Israel ABSTRACT How donor organs are allocated for transplant can affect their scarcity. In 2008, Israel’s Parliament passed an Organ Transplantation Law granting priority on organ donor waiting lists to individuals who had previously registered as organ donors. Beginning in No- vember 2010, public awareness campaigns advertised the priority policy to the public. Since April 2012, priority has been added to the routine medical criteria in organ allocation decisions. We evaluate the introduction of priority for registered organ donors using Israeli data on organ donor registration from 1992 to 2013. We find that registrations increased when information about the priority law was made widely available. We find an even larger increase in registration rates in the 2 months leading up to a program dead- line, after which priority would only be granted with a 3-year delay. We also find that the registration rate responds positively to public awareness campaigns, to the ease of registration (i.e. allowing for registering online and by phone) and to an election drive that included placing registration opportunities in central voting locations. -
Pancreas Islet Transplantation for Patients with Type 1 Diabetes Mellitus: a Clinical Evidence Review
Pancreas Islet Transplantation for Patients With Type 1 Diabetes Mellitus: A Clinical Evidence Review HEALTH QUALITY ONTARIO SEPTEMBER 2015 Ontario Health Technology Assessment Series; Vol. 15: No. 16, pp. 1–84, September 2015 HEALTH TECHNOLOGY ASSESSMENT AT HEALTH QUALITY ONTARIO This report was developed by a multi-disciplinary team from Health Quality Ontario. The lead clinical epidemiologist was Myra Wang, the medical librarian was Caroline Higgins, and the medical editor was Susan Harrison. Others involved in the development and production of this report were Irfan Dhalla, Nancy Sikich, Stefan Palimaka, Andree Mitchell, Farhad Samsami, Christopher Pagano, and Jessica Verhey. We are grateful to Drs. Mark Cattral, Atul Humar, Scott McIntaggart, and Jeffrey Schiff at University Health Network for their clinical expertise and review of the report; and to Ms. Marnie Weber at University Health Network and Ms. Julie Trpkovski at Trillium Gift of Life for the information they provided in helping us contextualize pancreas islet transplantation in Ontario. Ontario Health Technology Assessment Series; Vol. 15: No. 16, pp. 1–84, September 2015 2 Suggested Citation This report should be cited as follows: Health Quality Ontario. Pancreas islet transplantation for patients with type 1 diabetes mellitus: a clinical evidence review. Ont Health Technol Assess Ser [Internet]. 2015 Sep;15(16):1–84. Available from: http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ontario-health-technology- assessment-series/eba-pancreas-islet-transplantation Indexing The Ontario Health Technology Assessment Series is currently indexed in MEDLINE/PubMed, Excerpta Medica/Embase, and the Centre for Reviews and Dissemination database. Permission Requests All inquiries regarding permission to reproduce any content in the Ontario Health Technology Assessment Series should be directed to [email protected]. -
Organ Donation Opportunites for Action
http://www.nap.edu/catalog/11643.html We ship printed books within 1 business day; personal PDFs are available immediately. Organ Donation: Opportunities for Action Committee on Increasing Rates of Organ Donation, James F. Childress and Catharyn T. Liverman, Editors ISBN: 0-309-65733-4, 358 pages, 6 x 9, (2006) This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/11643.html Visit the National Academies Press online, the authoritative source for all books from the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council: • Download hundreds of free books in PDF • Read thousands of books online for free • Explore our innovative research tools – try the “Research Dashboard” now! • Sign up to be notified when new books are published • Purchase printed books and selected PDF files Thank you for downloading this PDF. If you have comments, questions or just want more information about the books published by the National Academies Press, you may contact our customer service department toll- free at 888-624-8373, visit us online, or send an email to [email protected]. This book plus thousands more are available at http://www.nap.edu. Copyright © National Academy of Sciences. All rights reserved. Unless otherwise indicated, all materials in this PDF File are copyrighted by the National Academy of Sciences. Distribution, posting, or copying is strictly prohibited without written permission of the National Academies Press. Request reprint permission for this book. Organ Donation: Opportunities for Action http://www.nap.edu/catalog/11643.html ORGAN DONATION OPPORTUNITIES FOR ACTION Committee on Increasing Rates of Organ Donation Board on Health Sciences Policy James F. -
S. 518 [Report No
II Calendar No. 773 108TH CONGRESS 2D SESSION S. 518 [Report No. 108–387] To increase the supply of pancreatic islet cells for research, to provide better coordination of Federal efforts and information on islet cell transplan- tation, and to collect the data necessary to move islet cell transplantation from an experimental procedure to a standard therapy. IN THE SENATE OF THE UNITED STATES MARCH 5, 2003 Ms. COLLINS (for herself, Mrs. MURRAY, Mr. BREAUX, Mr. MILLER, Mr. BUNNING, Mr. LOTT, Mr. DAYTON, Mr. ALLEN, Mr. INHOFE, Mrs. LIN- COLN, Mr. DASCHLE, Mr. CHAMBLISS, Mr. SMITH, Mr. DORGAN, Mr. BINGAMAN, Mr. REED, Mr. MCCAIN, Mr. BIDEN, Mr. HARKIN, Mr. CHAFEE, Mr. CRAIG, Mr. HAGEL, Mr. FITZGERALD, Mr. COCHRAN, Mr. DOMENICI, Mr. BOND, Mr. DURBIN, Mr. SESSIONS, Mr. ENSIGN, Mr. ALEXANDER, Mr. WARNER, Mr. KERRY, Mr. GRAHAM of South Carolina, Mr. CORZINE, Mr. DODD, Mrs. CLINTON, Mr. SCHUMER, Mr. NELSON of Nebraska, Ms. MIKULSKI, Mr. LIEBERMAN, Mr. COLEMAN, Mr. FEIN- GOLD, Mrs. BOXER, Mr. BURNS, Mr. LAUTENBERG, Ms. LANDRIEU, Mr. TALENT, Ms. STABENOW, Mr. DEWINE, Ms. MURKOWSKI, Mr. GRAHAM of Florida, Mr. NELSON of Florida, and Mr. SARBANES) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions OCTOBER 7, 2004 Reported by Mr. GREGG, with an amendment [Strike out all after the enacting clause and insert the part printed in italic] A BILL To increase the supply of pancreatic islet cells for research, 2 to provide better coordination of Federal efforts and infomation on islet cell transplantation, and to collect the data necessary to move islet cell transplantation from an experimental procedure to a standard therapy. -
Kidney Function After Islet Transplant Alone in Type 1 Diabetes Impact of Immunosuppressive Therapy on Progression of Diabetic Nephropathy
Pathophysiology/Complications ORIGINAL ARTICLE Kidney Function After Islet Transplant Alone in Type 1 Diabetes Impact of immunosuppressive therapy on progression of diabetic nephropathy 1 2 PAOLA MAFFI, MD, PHD ANDREA CAUMO, PHD he Diabetes Control and Complica- 1 1 FEDERICO BERTUZZI, MD PAOLO POZZI, MD tions Trial has shown that in pa- 1 3 FRANCESCA DE TADDEO, MD CARLO SOCCI, MD 1 4 tients with type 1 diabetes, intensive AOLA AGISTRETTI PHD ASSIMO ENTURINI MD T P M , M V , 1 4 diabetes treatment reduces incidence and RITA NANO, MD ALESSANDRO DEL MASCHIO, MD 1 1 delays progression of long-term compli- PAOLO FIORINA, MD, PHD ANTONIO SECCHI, MD cations (1). The Epidemiology of Diabetes Intervention and Complications (EDIC) study, a follow-up of the original Diabetes OBJECTIVE — Islet transplantation alone is an alternative for the replacement of pancreatic Control and Complications Trial cohort, endocrine function in patients with type 1 diabetes. The aim of our study was to assess the impact of the Edmonton immunosuppressive protocol (tacrolimus-sirolimus association) on kidney function. has shown a sustained effect of intensive diabetes treatment on the development RESEARCH DESIGN AND METHODS — Nineteen patients with type 1 diabetes and and progression of nephropathy and ma- metabolic instability received islet transplantation alone and immunosuppressive therapy ac- crovascular disease (2). Furthermore, the cording to the Edmonton protocol. Serum creatinine (sCr), creatinine clearance (CrCl), and 24-h EDIC study has shown that patients with urinary protein excretion (UPE) were assessed at baseline and during a follow-up of 339 patient- type 1 diabetes with some endogenous C- months. -
Organ and Tissue Donation
ORGAN AND TISSUE DONATION www.kidney.org If I needed a kidney or some other vital organ to live… would I be able to get one? Maybe. Some people who need organ transplants cannot get them because of a shortage of donations. The national waiting list for organ transplants grows longer every day. Thousands die each year while waiting for a transplant of a vital organ, such as a kidney, heart, or liver. How are organs and tissues for transplantation obtained? Organs can be donated by people at the time of death (deceased donors) or by living donors. A living donor may be a relative, friend, or possibly someone who does not know the recipient but wishes to be a donor for someone in need. This brochure provides information about organ and tissue donation at the time of death. For more information about living donation, visit www.kidney.org/livingdonors How are donated organs and tissues distributed? The federal government contracts with an independent organization, called 2 NATIONAL KIDNEY FOUNDATION the United Network for Organ Sharing (UNOS), to manage the distribution of organs donated by individuals at the time of death (deceased donors). Because of the shortage of donations, transplant candidates’ names are placed on a waiting list. Guidelines have been established to ensure that all patients on the waiting list have a fair chance at receiving the organ they need regardless of age, sex, race, lifestyle, or social status. Organs are also distributed based on needs and medical criteria. Donated tissues are distributed through a separate process, which is coordinated by various tissue banks. -
Organ Procurement Processes in the Operating Room
Volume 33 Issue 2 Article 2 4-30-2020 Organ Procurement Processes in the Operating Room: The Effects of an Educational Session on Levels of Confidence and Understanding in Operating Room Registered Nurses and Surgical Technologists Ann Ross University of Wisconsin-Green Bay, [email protected] Janet Reilly University of Wisconsin-Green Bay, [email protected] Emily Halla Hospital Sisters Health System (HSHS) St Vincent's Hospital, Clinical Educator–Surgical Services, Green Bay, Wisconsin, [email protected] Follow this and additional works at: https://www.journal.acorn.org.au/jpn Kathryn Anderson Univ Persityart of of the Wisconsin–Or Perioperative,gan Oper andating Tissue Room and and Donation, Surgical Hospital Nursing De Commonsvelopment,, and Madison, the Sur gerWisconsiny Commons, [email protected] This work is licensed under a Creative Commons Attribution 4.0 License. Recommended Citation Ross, Ann; Reilly, Janet; Halla, Emily; and Anderson, Kathryn (2020) "Organ Procurement Processes in the Operating Room: The Effects of an Educational Session on Levels of Confidence and Understanding in Operating Room Registered Nurses and Surgical Technologists," Journal of Perioperative Nursing: Vol. 33 : Iss. 2 , Article 2. Available at: https://doi.org/10.26550/2209-1092.1072 https://www.journal.acorn.org.au/jpn/vol33/iss2/2 This Article is brought to you for free and open access by Journal of Perioperative Nursing. It has been accepted for inclusion in Journal of Perioperative Nursing by an authorized editor of Journal of Perioperative