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Ethical Implications of Multi-Organ Transplants OPTN/UNOS Ethics Committee
Public Comment Proposal Ethical Implications of Multi-Organ Transplants OPTN/UNOS Ethics Committee Prepared by: Abigail Fox, MPA UNOS Policy & Community Relations Department Contents Executive Summary 1 Is the sponsoring Committee requesting specific feedback or input about the resource? 1 What problem will this resource address? 1 Why should you support this resource? 1 How was this resource developed? 1 How well does this resource address the problem statement? 3 Which populations are impacted by this resource? 3 How does this resource impact the OPTN Strategic Plan? 4 How will the OPTN implement this resource? 5 How will members implement this resource? 5 Will this resource require members to submit additional data? 5 How will members be evaluated for compliance with this resource? 5 White Paper 6 OPTN/UNOS Public Comment Proposal Ethical Implications of Multi-Organ Transplants Affected Policies: N/A Sponsoring Committee: Ethics Committee Public Comment Period: January 22, 2019 – March 22, 2019 Executive Summary The allocation policies for multi-organ transplant (MOT) have the potential to create inequity in the organ distribution process, either in the rate of transplantation or in the time to transplantation. Such potential inconsistencies may affect the patients who are awaiting MOT as well as those who are awaiting single organ transplantation (SOT) because both groups depend upon available organs from the same limited donor pool. Prioritization of MOT candidates and the allocation rules for each combination have not been standardized across the different organs. As a result, the current allocation system has generated confusion in the transplant community about the rationale for differences in MOT allocation plans between different organ combinations. -
State Operations Manual Appendix X – Guidance to Surveyors: Organ Transplant Programs
State Operations Manual Appendix X – Guidance to Surveyors: Organ Transplant Programs Table of Contents (Rev. 200, Issued: 02-21-20) Transmittals for Appendix X Part I – The Standard Organ Transplant Program Survey Protocol I. Introduction II. Survey Protocol Tasks Task 1 - Pre-survey: off-site Preparation Task 2 - Entrance Activities Task 3 - Sample Selection Task 4 - Tracer for Selected Patients and Living Donors including Observations of Care, Interviews and Medical Record Review Task 5 – Administrative Review Task 6 – Personnel Record Review (If Indicated) Task 7 – Pre-exit Task 8 – Exit Conference Task 9 - Post Survey Activities III. Alternate Survey Protocol: Pediatric Heart Program Task 1 - Pre-survey: off-site Preparation Task 2 - Entrance Activities Task 3 - Sample Selection Task 4 – Review of Transplant Patient Medical Records Task 5 – Staff Interview Task 6 – Personnel Record Review Task 7 – Administrative Review Task 8 – Pre-exit Task 9 – Exit Conference Task 10 - Post Survey Activities Part II – Interpretive Guidelines for Organ Transplant Surveys 42 C.F.R. 482.72 OPTN Membership 42 C.F.R. 482.74 Notification to CMS 42 C.F.R. 482.76 Pediatric Transplants 42 C.F.R. 482.78 Emergency preparedness for Transplant Programs 42 C.F.R. 482.80 Data Submission, Clinical Experience and Outcome Requirements for Initial Approval 42 C.F.R. 482.82 Data Submission, Clinical Experience and Outcome Requirements Re-approval 42 C.F.R. 482.90 Patient and Living Donor Selection 42 C.F.R. 482.92 Organ Recovery and Receipt 42 C.F.R. 482.94 Patient and Living Donor Management 42 C.F.R. -
History of Lung Transplantation Akciğer Transplantasyonu Tarihçesi
REVIEW History of Lung Transplantation Akciğer Transplantasyonu Tarihçesi Gül Dabak Unit of Pulmonology, Kartal Kosuyolu Yüksek Ihtisas Teaching Hospital for Cardiovascular Diseases and Surgery, İstanbul ABSTRACT ÖZET History of lung transplantation in the world dates back to the early 20 Dünyada akciğer transplantasyonu tarihçesi, deneysel çalışmala- th century, continues to the first clinical transplantation performed rın yapılmaya başlandığı 20. yüzyılın ilk yıllarından itibaren Ja- by James Hardy in the United States of America in 1963 and comes mes Hardy’ nin Amerika Birleşik Devletleri’nde 1963’te yaptığı to the present with increased frequency. Over 40.000 heart-lung ilk klinik transplantasyona uzanır ve hızlanarak günümüze gelir. and lung transplantations were carried out in the world up to 2011 yılına kadar dünyada 40,000’in üzerinde kalp-akciğer ve 2011. The number of transplant centers and patients is flourishing akciğer transplantasyonu yapılmıştır. Transplantasyon alanındaki in accordance with the increasing demand and success rate in that artan ihtiyaca ve başarılara paralel olarak transplant merkezleri arena. Lung transplantations that started in Turkey at Sureyyapasa ve hasta sayıları da giderek artmaktadır. Türkiye’de 2009 yılında Teaching Hospital for Pulmonary Diseases and Thoracic Surgery Süreyyapaşa Göğüs Hastalıkları ve Cerrahisi Eğitim ve Araştırma in 2009 are being performed at two centers actively to date. This Hastanesi’ nde başlayan akciğer transplantasyonları günümüzde review covers a general outlook on lung transplantations both in iki merkezde aktif olarak yapılmaktadır. Bu derlemede, ülkemiz- the world and in Turkey with details of the first successful lung deki ilk başarılı akciğer transplantasyonu detaylandırılarak dün- transplantation in our country. yada ve ülkemizdeki akciğer transplantasyonu tarihçesi gözden Keywords: Lung transplantation, heart-lung transplantation, his- geçirilmektedir. -
Partnering with Your Transplant Team the Patient’S Guide to Transplantation
Partnering With Your Transplant Team The Patient’s Guide to Transplantation U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration This booklet was prepared for the Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation by the United Network for Organ Sharing (UNOS). PARTNERING WITH YOUR TRANSPLANT TEAM THE PATIENT’S GUIDE TO TRANSPLANTATION U.S. Department of Health and Human Services Health Resources and Services Administration Public Domain Notice All material appearing in this document, with the exception of AHA’s The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities, is in the public domain and may be reproduced without permission from HRSA. Citation of the source is appreciated. Recommended Citation U.S. Department of Health and Human Services (2008). Partnering With Your Transplant Team: The Patient’s Guide to Transplantation. Rockville, MD: Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation. DEDICATION This book is dedicated to organ donors and their families. Their decision to donate has given hundreds of thousands of patients a second chance at life. CONTENTS Page INTRODUCTION.........................................................................................................................1 THE TRANSPLANT EXPERIENCE .........................................................................................3 The Transplant Team .......................................................................................................................4 -
Intestine Transplant Manual
Intestine Transplant Manual Toronto Intestine Transplant Program TRANSPLANT MANUAL E INTESTIN This manual is dedicated to our donors, our patients and their families Acknowledgements Dr. Mark Cattral, MD, (FRCSC) Dr. Yaron Avitzur, MD Andrea Norgate, RN, BScN Sonali Pendharkar, BA (Hons), BSW, MSW, RSW Anna Richardson, RD We acknowledge the contribution of previous members of the team and to Cheryl Beriault (RN, BScN) for creating this manual. 2 TABLE OF CONTENTS Dedications and Acknowledgements 2 Welcome 5 Our Values and Philosophy of Care Our Expectations of You Your Transplant Team 6 The Function of the Liver and Intestines 9 Where are the abdominal organs located and what do they look like? What does your Stomach do? What does your Intestine do? What does your Liver do? What does your Pancreas do? When Does a Patient Need an Intestine Transplant? 12 Classification of Intestine Failure Am I Eligible for an Intestine Transplant? Advantages and Disadvantages of Intestine Transplant The Transplant Assessment 14 Investigations Consultations Active Listing for Intestine Transplantation (Placement on the List) 15 Preparing for the Intestine Transplant Trillium Drug Program Other Sources of Funding for Drug Coverage Financial Planning Insurance Issues Other Financial Considerations Related to the Hospital Stay Legal Considerations for Transplant Patients Advance Care Planning Waiting for the Intestine Transplant 25 Your Place on the Waiting List Maintaining Contact with the Transplant Team Coping with Stress Maintaining your Health While -
Performance Changes Following the Revision of Organ Allocation System of Lung Transplant
J Korean Med Sci. 2021 Mar 29;36(12):e79 https://doi.org/10.3346/jkms.2021.36.e79 eISSN 1598-6357·pISSN 1011-8934 Original Article Performance Changes Following the Cell Therapy & Organ Transplantation Revision of Organ Allocation System of Lung Transplant: Analysis of Korean Network for Organ Sharing Data Hye Ju Yeo ,1,2 Do Hyung Kim ,3 Yun Seong Kim ,1 Doosoo Jeon ,1 and Woo Hyun Cho 1,2 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea Received: Aug 4, 2020 2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Accepted: Jan 13, 2021 Yangsan Hospital, Yangsan, Korea 3Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Address for Correspondence: Korea Woo Hyun Cho, MD Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine and Research Institute for ABSTRACT Convergence of Biomedical Science and Technology, Pusan National University Background: There is currently a lack of data on the impact of the recent revision of the Yangsan Hospital, 20 Geumo-ro, Mulgeum- eup, Yangsan 50612, Republic of Korea. domestic lung allocation system on transplant performance. E-mail: [email protected] Methods: We conducted a retrospective analysis of transplant candidates and transplant patients registered in Korean Network for Organ Sharing between July 2015 and July 2019. Study © 2021 The Korean Academy of Medical periods were classified according to the introduction of the revised lung allocation system as Sciences. This is an Open Access article distributed follows: period 1 from July 2015 to June 2017 and period 2 from August 2017 to July 2019. -
Chicago Police and the Labor and Urban Crises of the Late Twentieth Century
The Patrolmen’s Revolt: Chicago Police and the Labor and Urban Crises of the Late Twentieth Century By Megan Marie Adams A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Philosophy in History in the Graduate Division of the University of California, Berkeley Committee in charge: Professor Robin Einhorn, Chair Professor Richard Candida-Smith Professor Kim Voss Fall 2012 1 Abstract The Patrolmen’s Revolt: Chicago Police and the Labor and Urban Crises of the Late Twentieth Century by Megan Marie Adams Doctor of Philosophy in History University of California, Berkeley Professor Robin Einhorn, Chair My dissertation uncovers a history of labor insurgency and civil rights activism organized by the lowest-ranking members of the Chicago police. From 1950 to 1984, dissenting police throughout the city reinvented themselves as protesters, workers, and politicians. Part of an emerging police labor movement, Chicago’s police embodied a larger story where, in an era of “law and order” politics, cities and police departments lost control of their police officers. My research shows how the collective action and political agendas of the Chicago police undermined the city’s Democratic machine and unionized an unlikely group of workers during labor’s steep decline. On the other hand, they both perpetuated and protested against racial inequalities in the city. To reconstruct the political realities and working lives of the Chicago police, the dissertation draws extensively from new and unprocessed archival sources, including aldermanic papers, records of the Afro-American Patrolman’s League, and previously unused collections documenting police rituals and subcultures. -
Vascularized Composite Allografts (Lc Cendales, Section Editor)
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector Curr Transpl Rep (2014) 1:173–182 DOI 10.1007/s40472-014-0025-6 VASCULARIZED COMPOSITE ALLOGRAFTS (LC CENDALES, SECTION EDITOR) Vascularized Composite Allografts: Procurement, Allocation, and Implementation Axel Rahmel Published online: 3 July 2014 # The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Vascularized composite allotransplantation is a allotransplantation. In 2005, the first face transplantation was continuously evolving area of modern transplant medicine. performed in Lyon [5]; since then the number of face trans- Recently, vascularized composite allografts (VCAs) have plants has increased [6]. This special category of transplants is been formally classified as ‘organs’.Inthisreview,keyas- localized at the border between tissue and organ transplanta- pects of VCA procurement are discussed, with a special focus tion. The term composite tissue allotransplantation (CTA) on interaction with the procurement of classical solid organs. used in the past reflects that it was often considered as a In addition, options for a matching and allocation system that special type of tissue transplantation [7]. Several reports ensures VCA donor organs are allocated to the best-suited looking in-depth at limb and face transplantation made it clear recipients are looked at. Finally, the different steps needed to that vascularized composite allotransplantation is in central promote VCA transplantation in society in general and in the aspects more similar to organ than to tissue transplantation medical community in particular are highlighted. [7–12]. After careful evaluation involving the transplant com- munity and the general public, the United States Department of Health and Human Services recently published its decision Keywords Transplantation . -
Pulmonary Transplantation Council
INTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION (ISHLT) LUNG TRANSPLANTATION CORE COMPETENCY CURRICULUM (ISHLT LTX CCC) SECOND EDITION June 2017 THE EDUCATIONAL WORKFORCE OF THE ISHLT PULMONARY TRANSPLANTATION COUNCIL L. LEARD, G. DELLEGREN, and D. DILLING Acknowledgements to First Edition Authors: T. ASTOR, G. BERRY, K. CHAN, D. MASON, D. LEVINE, C. WIGFIELD CONTACT: EMAIL: [email protected] TEL: 708-327-2488 FAX: 708-327-2382 1 (V 2.0 June 15, 2017) ISHLT PULMONARY TRANSPLANTATION COUNCIL EDUCATION WORKFORCE CHAIR LORRIANA LEARD, MD UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER SAN FRANCISCO, CALIFORNIA, USA [email protected] CO-CHAIRS GORAN DELLEGREN, MD, PHD SAHLGRENSKA UNIVERSITY HOSPITAL GOTEBORG, SWEDEN [email protected] DANIEL DILLING, MD LOYOLA UNIVERSITY MEDICAL CENTER MAYWOOD, ILLINOIS, USA [email protected] ACKNOWLEDGEMENT OF PRIOR CURRICULTUM CONTENT AUTHORS: KEVIN M. CHAN, MD UNIVERSITY OF MICHIGAN HEALTH SYSTEM 1500 EAST MEDICAL CENTER 3916 TAUBMAN CENTER, BOX 0360 ANN ARBOR, MI 48109 734-936-5047 734-936-7048 (FAX) [email protected] DEBORAH J. LEVINE, MD UT HEALTH CENTER @ SAN ANTONIO 7703 FLOYD CURL DR. DEPT. OF SURGERY, MC 7841 SAN ANTONIO, TX 78229 210-567-5616 210-567-2877 (FAX) [email protected] DAVID P. MASON, MD CLEVELAND CLINIC FOUNDATION THORACIC & CV SURGERY, J4-1 9500 EUCLID AVE. CLEVELAND, OH 44195 216-444-4053 216-445-6876 (FAX) 2 [email protected] GERRY J. BERRY MD STANFORD UNIVERSITY MEDICAL CENTER DEPT. ANATOMIC PATHOLOGY 300 PASTEUR DRIVE SUIT H 2110 STANFORD, CA 94305 650- 723- 7211 650-725-7409 (FAX) [email protected] TODD L. ASTOR, MD PULMONARY AND CRITICAL CARE UNIT MASSACHUSETTS GENERAL HOSPITAL 55 FRUIT STREET, BULFINCH 148 BOSTON, MA 02114 617-623-9704 [email protected] 3 ISHLT LTX CCC: LIST OF CONTENTS I. -
Historical Perspectives of Lung Transplantation: Connecting the Dots
4531 Review Article Historical perspectives of lung transplantation: connecting the dots Tanmay S. Panchabhai1, Udit Chaddha2, Kenneth R. McCurry3, Ross M. Bremner1, Atul C. Mehta4 1Norton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA; 2Department of Pulmonary and Critical Care Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; 3Department of Cardiothoracic Surgery, Sydell and Arnold Miller Family Heart and Vascular Institute; 4Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA Contributions: (I) Conception and design: TS Panchabhai, AC Mehta; (II) Administrative support: TS Panchabhai, RM Bremner, AC Mehta; (III) Provision of study materials or patients: TS Panchabhai, U Chaddha; (IV) Collection and assembly of data: TS Panchabhai, U Chaddha, AC Mehta; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Atul C. Mehta, MD, FCCP. Professor of Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; Staff Physician, Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA. Email: [email protected]. Abstract: Lung transplantation is now a treatment option for many patients with end-stage lung disease. Now 55 years since the first human lung transplant, this is a good time to reflect upon the history of lung transplantation, to recognize major milestones in the field, and to learn from others’ unsuccessful transplant experiences. James Hardy was instrumental in developing experimental thoracic transplantation, performing the first human lung transplant in 1963. George Magovern and Adolph Yates carried out the second human lung transplant a few days later. -
Our Mission: to Advance the Art and Science of Transplant Surgery Through Leadership, Advocacy, Education, and Training
Published for Members of the American Society of Transplant Surgeons Summer 2014 7th Annual Surgical Fellows Symposium: Elevating the Educational Experience Snowbird, Utah Our Mission: To advance the art and science of transplant surgery through leadership, advocacy, education, and training. ASTS.org Chimera Summer 2014 1 ASTS Council July 2014 – May 2015 Vol. XXIV, No. 3 Summer 2014 President Lloyd E. Ratner, MD, MPH (2015) Peter G. Stock, MD, PhD (2015) Columbia University University of California-San Francisco Department of Surgery Department of Surgery, 622 West 168th Street, New York, NY 10032 Division of Transplant 212-342-3539 [email protected] 505 Parnassus Avenue, Box 0780 San Francisco, CA 94143-0780 Douglas G. Farmer, MD (2016) 415-353-1551 [email protected] Ronald Reagan UCLA Medical Center Surgery-Liver & Pancreas Transplant President-Elect MC7054 Charles M. Miller, MD (2015) 757 Westwood Plaza, Suite 8501 Cleveland Clinic Foundation Los Angeles, CA 90095-9574 9500 Euclid Avenue, Mail Code A-110 310-267-9612 [email protected] Cleveland, OH 44195 216-445-2381 [email protected] James F. Markmann, MD, PhD (2016) Division of Transplantation 20 Immediate Past President 55 Fruit Street Alan N. Langnas, DO (2014) 503 White Building Editor’s Letter 3 University of Nebraska Medical Center Boston, MA 02114 PO Box 983280, 600 South 42nd Street 617-643-4533 [email protected] President’s Letter 4 Omaha, NE 68198 402-559-8390 [email protected] Mark D. Stegall, MD (2016) ASTS News 5 Mayo Clinic Past President 200 First Street, SW ASTS Fellowship Training 8 Kim M. -
An Overview of Anesthesia Practices for Heart Transplant in India
Acta Scientific Pharmaceutical Sciences (ISSN: 2581-5423) Volume 3 Issue 12 December 2019 Review Article An Overview of Anesthesia Practices for Heart Transplant in India Sandeep Kumar Kar* and Pallav Mishra Assistant Professor, Cardiac Anesthesiology, IPGMER, Kolkata, India *Corresponding Author: Sandeep Kumar Kar, Assistant Professor, Cardiac Anesthesiology, IPGMER, Kolkata, India. Received: November 20, 2019 DOI: 10.31080/ASPS.2019.03.0449 Abstract is growing. Immunosuppressive agents have dramatically improved success of heart transplantation. Non-ischemic cardiomyopathy Heart transplant has seen a significant progress the number of patients with heart failure qualifying for cardiac transplantation has surpassed ischemic cardiomyopathy as need for transplantation. The use of bridge therapy with mechanical circulatory support has improved both short-term and long-term survival of heart transplant recipients has gradually improved over time Keywords: Heart Transplant; Non-Ischemic Cardiomyopathy; Mechanical Circulatory Assist Introduction st Organ Transplantation in India under aegis of National Organi- Dr. Christiaan 1 successful adult heart transplant on Mr. Louis Neethling Washkansky 3 December 1967 at Groote Schuur zation Tissue Transplantation Organization (NOTTO) setup under Barnard hospital Cape town, South Africa Directorate General of Health Services established to oversee all Caves and Transvenous endomyocardial biopsy for diagnosis donation and transplantation activities. In this regard, the entire Colleagues of immune rejection of heart transplant in 1970. country is having the following setup at National, Regional and Jean Francois Immunosuppressive effects of cyclosporin A as State Level. Borel preventive strategy to cardiac rejection in 1976. Bruce Reitz National and Norman 1st successful combined heart lung transplant [4]. (NOTTO) Level Shumway Regional KEM Guwahati Table 2 PGIMER IPGME and RGGGH Level Hospital Medical Chandigarh R Kolkata Chennai (ROTTO) Mumbai College ents.