Cadaveric Transplantation (cadaveric + transplantation)

Distribution by Scientific Domains
Medical Sciences80%

Selected Abstracts

Is the Cost of Adult Living Donor Liver Transplantation Higher Than Deceased Donor Liver Transplantation?

LIVER TRANSPLANTATION, Issue 3 2004
Mark W. Russo MD
Background An important long-term consideration for living-donor liver transplantation (LDLT) is the expense compared with cadaveric-liver transplantation. LDLT is a more complex procedure than cadaveric transplantation and the cost of donor evaluation, donor surgery, and postoperative donor care must be included in a cost analysis for LDLT. In this study, we compare the comprehensive cost of LDLT with that of cadaveric-liver transplantation. Methods All costs for medical services provided at our institution were recorded for 24 LDLT and 43 cadaveric recipients with greater than 1 year follow-up transplanted between August 1997 and April 2000. The donor costs include donors evaluated and rejected, donors evaluated and accepted, donor right hepatectomy costs, and donor follow-up costs (365 days postdonation). LDLT and cadaveric recipient costs include medical care 90 days pre-LDLT, recipient transplant costs, and recipient follow-up costs (365 days posttransplant) including retransplantation. Cost is expressed as an arbitrary cost unit (CU) that is a value between $500 to $1,500. Results Total LDLT costs (evaluations of rejected donors + evaluations of accepted donors + donor hepatectomy + donor follow-up care for 1 year + pretransplant recipient care [90 days pretransplant] + recipient transplantation + recipient 1-year posttransplant care)= 162.7 CU. Total mean cadaveric transplant costs (pretransplant recipient care [90 days pretransplant] + recipient transplantation [including organ acquisition cost] + recipient 1-year posttransplant care)=134.5 CU, (P = ns) Conclusions The total comprehensive cost of LDLT is 21% higher than cadaveric transplantation, although this difference is not significant. (Transplantation 2003;75:473,476.) [source]

Role of adult living liver donation in patients with hepatocellular cancer

LIVER TRANSPLANTATION, Issue 10C 2003
John Paul Roberts
Key points 1. Transplantation represents the best therapy for hepatocellular carcinoma (HCC) as compared with resection. 2. On an intention-to-treat basis, living donor transplantation (LDLT) represents a better alternative to cadaveric transplantation (CLT). 3. Current criteria for transplantation for patients with HCC using cadaveric organs may be appropriate for living donor transplantation. [source]

Role of adult living donor liver transplantation in patients with hepatitis C

LIVER TRANSPLANTATION, Issue 10C 2003
Gregory T. Everson
Key points 1. Living donor liver transplantation (LDLT) is an option for patients with end-stage liver disease or hepatoma caused by chronic hepatitis C. 2. Reports from some, but not all, transplant centers indicate that hepatitis C may recur earlier, recurrence may be more severe, and graft loss caused by recurrent hepatitis C may be more frequent in LDLT compared with cadaveric transplantation. 3. Several unique characteristics of LDLT (versus cadaveric transplantation) may favor severe recurrence of hepatitis C. These include an increase in genetic similarity between donor and recipient, higher degree of HLA matching, greater systemic bioavailability of immunosuppressive agent, and hepatic regeneration. 4. Hepatic regeneration may promote the acceleration and severity of recurrent hepatitis C by enhancement of hepatitis C viral uptake by hepatocytes through stimulation of the low-density lipoprotein receptor and increase in activity of the internal ribosomal entry site. [source]

Measurement of free radicals and NO by chemiluminescence to identify the reperfusion injury in renal transplantation

LUMINESCENCE: THE JOURNAL OF BIOLOGICAL AND CHEMICAL LUMINESCENCE, Issue 2 2002
S. Oehlschläger
Abstract Oxygen free radicals are generated during the reperfusion of ischaemic organs. Several experimental studies have demonstrated that the damage produced by reperfusion can be prevented by a scavenger of free radicals. Furthermore, a significantly improved 5 year graft survival rate after cadaveric renal transplantation has been reported in patients treated with scavengers of free radicals (Land et al., 1993). Therefore, a question remains to be answered: whether a routine monitoring of the radical-mediated reperfusion injury with renal transplantation is useful, and whether there is a necessity for a generalized protective treatment in transplant patients. In a prospective trial, we evaluated a group of eight patients during and after renal cadaveric transplantation (three men, five women), using the chemiluminometric measurement of serum free radicals and NO. The serum quantities of free radicals and NO were significantly increased after reperfusion of the transplant kidney (p,<,0.02). The mean time of noticeably increased levels of serum free radicals was 4.8,±,1.2,h after reperfusion. The results thus showed an increased liberation of free radicals in the peripheral blood of transplant recipients as possible evidence of free radicals-mediated reperfusion injury in renal transplantation. The generation of free radicals measured by chemiluminescence allow a controlled therapy to decrease the generation of free radicals with antioxidants during the early transplantation period e.g. in older recipients. Copyright © 2002 John Wiley & Sons, Ltd. [source]

History of and necessity for KPros

ACTA OPHTHALMOLOGICA, Issue 2009
C LIU
The history of keratoprostheses goes back over 200 years. There was a resurgence in interest in the second half of the twentieth century as it was recognised that keratoplasty could not solve all types of corneal blindness. Many devices have been described but few have survived. Corneal transplantation is complicated by graft rejection and astigmatism. There is also a problem with adequate supply, and there is a risk of transmission of infection. There is a desire for an artificial cornea which surpasses cadaveric transplantation. There is much ongoing work, but the majority of clinical work on keratoprostheses are for corneal blindness not amenable to cadaveric grafts. These can be separated into two main groups. The wet blinking eye which have had multiple graft failures, and the dry eye with a keratinised ocular surface which may also have a deficiency in lid cover. The approaches to these are quite different. [source]