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Books : Health, Mind & Body : Disorders & Diseases : Organ Transplants
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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’s 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 “puzzle people,” 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’s organ - and Starzl remembers each one - is a puzzle. “It was not just the acquisition of a new part,” he writes. “The 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.” The surgeons and physicians who pioneered transplantation were also changed: they too became puzzle people. “Some were corroded or destroyed by the experience, some were sublimated, and none remained the same.”
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Now in its updated Fourth Edition, this popular handbook is a practical guide for physicians and surgeons who manage kidney transplant patients and for nurses and other professionals on the transplant team. In concise, readable, well-illustrated chapters, the book outlines the major concerns surrounding renal transplantation and the most successful approaches to problems arising in short-term and long-term patient care. This edition's chapters on immunobiology and immunosuppression have been completely rewritten to reflect recent advances. Chapters on surgery, histocompatibility, and the first three months post-transplant have also been thoroughly updated.
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Tales about organ transplants appear in mythology and folk stories, and surface in documents from medieval times, but only during the past twenty years has medical knowledge and technology been sufficiently advanced for surgeons to perform thousands of transplants each year. In the majority of cases individuals diagnosed as "brain dead" are the source of the organs without which transplants could not take place. In this compelling and provocative examination, Margaret Lock traces the discourse over the past thirty years that contributed to the locating of a new criterion of death in the brain, and its routinization in clinical practice in North America. She compares this situation with that in Japan where, despite the availability of the necessary technology and expertise, brain death was legally recognized only in 1997, and then under limited and contested circumstances. Twice Dead explores the cultural, historical, political, and clinical reasons for the ready acceptance of the new criterion of death in North America and its rejection, until recently, in Japan, with the result that organ transplantation has been severely restricted in that country. This incisive and timely discussion demonstrates that death is not self-evident, that the space between life and death is historically and culturally constructed, fluid, multiple, and open to dispute.
In addition to an analysThree decades after the first heart transplant surgery stunned the world, organs including eyes, lungs, livers, kidneys, and hearts are transplanted every day. But despite its routine nature -- or perhaps because of it -- transplantation offers enormous ethical challenges. A medical ethicist who has been involved in the organ transplant debate for many years, Robert M. Veatch offers the first complete and systematic account of the ethical and policy controversies surrounding organ transplants.Veatch structures his discussion around three major topics: the definition of death, the procurement of organs, and the allocation of organs. He addresses both fundamental questions and recently emerging issues, offering his own solutions in many instances.
Rich with case studies and written in an accessible style, this comprehensive reference is intended for a broad cross section of people interested in the ethics of transplantation from either the medical or public policy perspective: patients and their relatives, transplantation professionals, other health care professionals and administrators, members of organ procurement organizations, and government officials involved in the regulation of transplants.
This "how-to" atlas reveals the art of liver transplantation as practiced at the Baylor University Medical Center. It focuses on the techniques of Goran B. Klintmalm, who spent years studying with Thomas E. Starzl, "founding father" of liver transplantation. Readers will find detailed descriptions and drawings of today's full range of surgical procedures, along with extensive guidance on the radiologic and pathologic diagnosis of liver disease.- Superb line drawings clearly explain every procedure step by step.
- A wealth of outstanding radiographic images facilitate liver disease differentiation.
- Color pathology slides depict the various manifestations of liver disease.
- A section on "Post-Operative Evaluation" provides invaluable guidance on avoiding the many potential post-transplantation complications and ensuring the most favorable outcomes.
One of the most spectacular medical advances of the 20th century, organ transplantation has become a generally effective and routine treatment for patients with organ failure. In this book, a well-known expert in the fields of clinical transplantation and transplantation research traces the evolution of organ transplantation from its initial stirrings in the imaginations of the ancients to its status as accepted treatment for nearly 40,000 patients each year. Drawing often on his own first-hand experience, Dr Nicholas Tilney tells the story of the advances in organ transplantation, discusses how societal forces have driven its development, and reveals how its current success is marred by commercialism and exploitation of the less fortunate. Dr Tilney describes early transplantation attempts, the first successful kidney transplant in 1954 between identical twins, the scientific advances for suppressing the immune system, the introduction of the concept of host tolerance, research on donor matching, and the issue of donor brain death. He explores innovations in heart, lung, liver and other abdominal transplants and reflects on the attempts to make transplants between species. Finally he explains how organ transplantation has become a vast business, creating ethical and logistical conflicts about organ donations.No one argues the need for transplants. The debate centres on how to satisfy the great need for healthy organs. Advances in medical technology and science have made organ procurement, or the search and transfer of organs and tissue from one body to another, a very important issue. Since the demand for healthy organs far exceeds the supply, many questions enter this debate, blending medicine with politics, ethics, research, religion, and other concerns. How are we to meet the need? Can we do so and still respect personal ethics and religious convictions? Can organs be obtained without turning medical emergencies into free-market enterprise? Should people be permitted to sell their organs? Should animals be sacrificed to save the lives of humans? Could cloning be considered as a future source of organs? With over thirty of the most important, influential, and up-to-date articles from leaders in ethics, medicine, philosophy, law, and politics, this book examines the numerous and tangled issues that surround organ procurement and distribution.In transplantation, the living parts of a person are offered in life or death to others, known or unknown, who are in the end stages of grave illness. Donated organs are implanted not only in the bodies of recipients, but in their beings. This thought-provoking book, a collaboration among an exceptional group of scholars and physicians, ponders the far-reaching connections of transplantation to human experiences and raises questions that are at once elemental and transcendent. It explores matters of life and death, body and mind, psyche and soul, self and other. Sponsored by the Chicago-based Park Ridge Center for the Study of Health, Faith, and Ethics, the volume is the result of extended discussions among a group encompassing many religious and cultural traditions and many fields of expertise: philosophy, art, religion, folklore, psychiatry, anthropology, literature, history, social psychology, and surgery. Whether considering scientific advances in organ transplantation and their implications for medical morality, ambiguous images of organ transplantation in centuries of art and literature, the practices of organ procurement, or the complex bonds that are forged between donors, recipients, and their families, these essays carry our understanding beyond the typical scientific and pragmatic issues raised in discussions of bioethics and public polTransplant Infections is designed to be a practical reference covering the common and more unusual infections following bone marrow/stem cell and solid organ transplant. It provides a comprehensive review of epidemiology, diagnosis, and management of opportunistic infections and focuses on the clinical concerns of the practitioner. New to the Second Edition: expanded coverage in all sections, algorithms on work-up of infection for each setting, increased focus on the interaction of the infectious diseases specialist with transplanters, new information on increased infectious risk with stem cell and blood transplants, and progress in treatment and diagnosis of viral infections.Although organ transplantation is the preeminent medical miracle of the last quarter of a century, Many Sleepless Nights is the first book to go beyond the headlines and describe the patients who have embraced this last chance to hold on to life, the intricate medical procedures that can save them, the surgeons and nurses who work in this emotionally charged world, and the ethics which complicate this “miracle” high-tech therapy.
Lee Gutkind was granted unconditional access to the world’s largest transplant center - the University of Pittsburgh’s Presbyterian-University and Children’s hospitals, where there is an organ transplant every eight hours, 365 days per year. For four years he immersed himself in the frantic night-and-day world of transplantation, living side by side with transplant candidates and recipients, jetting though the night with organ procurement teams, monitoring patients with surgeons and nurses, observing in the operating room, participating in the ethical and psychosocial evaluations of prospective patients which help to determine who will receive scarce organs.
During his four years at Presbyterian and Children’s Hospitals, Gutkind established close relationships with many patients, and his portrayal of them, living and sometimes dying under unbelievable stress, is a moving and dramatic statement about the capacity of human beings to endure.
Many Sleepless Nights also outlines the history of organ transplantation and tells the story of the large and complex medical teams behind the operation. It captures the tension of the search for viable organs; the pressure decisions about which patients, among many, will receive them; and the surgery itself. Its vivid portrayal of the transplant pioneer Thomas Starzl - a man obsessed with saving lives - shows how a major innovator in American medicine functions during days and nights of extreme pressure.
Over 64,000 people in the US are living in limbo, awaiting an organ transplant.
The good news about organ transplants is that they are becoming fairly routine surgical procedures. The even better news is that they do work miracles. People who have been in ill health for years often describe a feeling of being reborn after a transplant.
However, those families who have been told that a loved one needs a transplant to live are thrust into a strange land. Patients and families worry that no organ will be available to them. They may fear the surgery or what living with someone else's organ will feel like. They may have only a foggy idea of what staying with an immunosuppressive therapy regime after the operation will entail.
Organ Transplants: Making the Most of Your Gift of Life describes:
- Deciding whether to have a transplant and choosing a transplant team
- The importance of the screening interview
- What factors go into determining a match, and what to do while waiting
- Detailed information on heart and lung, liver, kidney and pancreas, and other transplants
- Anti-rejection drugs and living with a transplant
- Emotional responses and support
- Specific situations such as living donors, transplants i
Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them -- in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand-wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded?
Kidney for Sale by Owner contends that the market is indeed a legitimate -- and humane -- way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. He carefully examines arguments against a market for body parts, including assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic.
Rather than focusing on purported human exploitation and the irratio
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 doctoCutting-Edge Medicine: What Psychiatrists Need to Know offers a comprehensive overview of recent developments in cardiovascular illness, gastrointestinal disorders, transplant medicine, and premenstrual mood disorders. With todayAs rapid and continuous advances in medicine, this book will help psychiatrists become familiar with the new technologies and knowledgeable about how these state-of-the-art medical treatmentsAhigh-technology cardiac care, organ transplantation, and new psychotropic, immunosuppressant, and antiretroviral drugsAaffect and interact with other disorders and medications. -Chapter 1: Mind and Heart: The Interplay Between Psychiatric and Cardiac IllnessAreviews intriguing findings on the links between psychiatric disorders (depression, anxiety) and cardiovascular disease. For example, depression appears to be an independent risk factor for the development and progression of coronary artery diseaseAeven in patients without preexisting heart disease. Also addressed are the neuropsychiatric effects of and psychosocial crises related to high-technology cardiac care and the cardiovascular side effects of psychotropic medications. -Chapter 2: Psychiatric Aspects of GastroenterologyAdiscusses the evidence for a relationship between psychiatric/behavioral disorders and the organs of the gastrointestinal system. Examples include the documented comorbidity between psychiatric diFeaturing more than 400 full-color digital intraoperative photographs, this atlas is a comprehensive “how-to” guide to heart, lung, liver, kidney, and pancreas transplantation. It presents photographs and succinct descriptions of every step of each operation—including patient positioning, dissection and exposure, retraction, anatomic details, anatomoses, completion, and drain placement. Photographs have been taken from multiple angles, including directly overhead wherever possible. Anatomic and technical variations are illustrated by drawings.
Coverage includes procurement and transplantation of cadaver organs, operations to obtain organs from living donors, and transplantation of living donor organs. The liver and kidney sections include pediatric transplantation.
Co-authored by a liver transplant survivor and transplant nurse coordinator, Coping with an Organ Transplant is designed to answer the critical questions about organ transplantation. It carries the reader through every step of the transplant process, from organ candidacy to long-term transplantation recovery, and includes explanations of pertinent medical terms, the effect of possible medications, as well as techniques and strategies for coping and healing.The book is divided into three parts. The first discusses what is in store for the organ transplant candidate, as he or she waits for an organ that meets the necessary specifications. The second part addresses the surgery itself, so that the candidate and his family have a clear idea of what occurs in the operating room. The last section introduces the reader to life after the transplant, with further suggestions for taking care of the new organ and for coping with this new lifestyle.
Coping with an Organ Transplant will help ease the worries of the growing number of organ transplant candidates and their families by preparing them mentally and emotionally for every hurdle that they may encounter on this often long and complicated process.
Achieving good clinical outcomes with implanted biomaterials depends upon achieving optimal function, both mechanical and biological, which in turn depends upon integrating advances realized in biological science, material science, and tissue engineering. As these advances push back the frontiers of biomaterial medicine , the control and patterning of bio-implant interface reactions will have a tremendous impact on future design and prospects of implant treatments.
Bio-Implant Interface: Improving Biomaterials and Tissue Reactions brings together a remarkable panel of scientists to present the state-of-the-art in our understanding of interactions at the interface between biomaterials and living tissue. Much of the focus is on the importance of the implant surface's topography and chemistry to its interaction with the biological environment. Biomineralization along with the biological content of the interface and its role in directing cellular response along desired pathways also receive particular attention.
The pursuit of new and better designs for improved biocompatibility and patient response to implants continues to challenge clinicians and scientists alike. This book offers a unique opportunity to bring yourself up-to-date on recent advances in the field and new strategies for controlling the bio-implant interface.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 occassional 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 l -Integrated Biomaterials Science provides an intriguing insight into the world of biomaterials. It explores the materials and technology which have brought advances in new biomaterials, highlighting the way in which modern biology and medicine are synergistically linked to other key scientific disciplines-physics, chemistry, and engineering. In doing so, Integrated Biomaterials Science contains chapters on tissue engineering and gene therapy, standards and parameters of biomaterials, applications and interactions within the industrial world, as well as potential aspects of patent regulations. Integrated Biomaterials Science serves as a comprehensive guide to understanding this dynamic field, yet is designed so that chapters may be read and understood independently, depending on the needs of the reader. Integrated Biomaterials Science is attractive to a broad audience interested in a deeper understanding of this evolving field, and serves as a key resource for researchers and students of biomaterials courses, providing all with an opportunity to probe further.





















