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Biomedical subjects

F A M Shaheen

Publications and source records attributed to F A M Shaheen.

11 recordsLinked to original sources
PubMed2005

A proposed Saudi approach to the ethical utilization of living unrelated kidney donation.

We outline a proposal for the use of living unrelated kidney donors for transplantation. This proposal, although recommended by the Saudi National Committee on Renal Transplantation, is still under discussion and has not been implemented yet. We feel that this proposal is ethical with airtight safeguards against commercialization and for the protection of the well-being of the donor with assurance that he or she has not been coerced into donation.

Fees and Charges↗
PubMed2005

Improving transplantation programs and patient care.

Organ transplantation is the preferred mode of replacement therapy. Currently acceptable 5-year posttransplantation survival rates are 85% for renal grafts, 70% for liver, and 65% for heart. Organ donation, however, remains a significant factor in organ transplantation, as humans are the only possible donors and the numbers of patients on waiting lists remain high. Several factors affect organ transplantation in countries in the Middle East Society for Organ Transplantation (MESOT) region, including inadequate preventive medicine, differing health infrastructures, poor awareness within the medical community and lay public regarding the importance of organ donation and transplantation, a high level of ethnicity, and poor government support of organ transplantation. Moreover, there is lack of team spirit among transplant physicians, a lack of coordination between groups that manage organ procurement and the transplant centers, and a lack of effective health insurance coverage for many persons. Three models of organ donation and transplantation exist in the MESOT region-the Saudi, Iranian, and Pakistani models. Living-organ donation, the most widely practiced form of donation in countries in the MESOT region, includes kidney and partial liver. Cadaveric organ donation has significant potential in the MESOT region. However, numerous obstacles must be overcome in MESOT countries. Resolution of these obstacles will require continuous work on many fronts. Experiences from all sources must be incorporated into new and improved models that can overcome current inadequacies. Solutions will require continued focus within the medical community, steady support from the lay public and religious institutions, as well as governmental assistance.

Humans↗
PubMed2004

A survey on the prevalence and management of hepatitis B after renal transplantation in Asian-Pacific countries.

The carrier rate for hepatitis B virus (HBV) varies from 1% to 2% to 10% in Asian-Pacific countries. A survey involving 12 transplant centers from 11 countries in this region showed that 1% to 25% of kidney transplant recipients were infected with HBV, and up to 60% of these subjects showed abnormal liver biochemistry. While nearly all centers tested anti-HBs in potential kidney transplant recipients, HBV vaccination of nonimmune subjects was routine in only 66.7%. One-third of the surveyed units rejected HBsAg-positive subjects as kidney donors, while the others demonstrated differing policies in choosing the respective recipients. Two units (16.7%) excluded HBsAg-positive patients from kidney transplantation, whereas the others only excluded those with severe liver disease. Heterogeneity also applies to the immunosuppressive regimens, the use of HBV DNA in serial monitoring, and the timing of antiviral therapy in HBsAg-positive kidney transplant recipients. The data showed that despite HBV infection being a significant problem in kidney transplantation, there is a lack of uniform management policy, attributable to the clinical complexity and deficiency of research data. Although improvement in clinical outcome is likely with the advent of nucleoside analogue therapy and better monitoring, the financial implications in the adoption of these recent advances remain realistic concerns.

Asia↗
PubMed2004

Increasing organ donation rates from Muslim donors: lessons from a successful model.

As the great majority of the population in Saudi Arabia is Muslim, the Islamic views about organ donation and transplantation have been the focus of interest to the transplant community in this and other Muslim countries. The first resolution of the Islamic council in Saudi Arabia (Senior Ulama Commission) about organ donation and transplantation was issued in 1982. It permitted tissue and organ transplantation from both living and cadaveric donors. This resolution marked a new era in organ transplantation in Saudi Arabia, leading to the formation of the Saudi Center of organ transplantation (SCOT), which organizes the process of organ donation and transplantation in Saudi Arabia. There were major strategies to reach the goals of the organ procurement centers adopted by SCOT: improving the awareness of the medical community to the importance of organ donation and transplantation, improving the awareness of the public at large to the importance of organ donation and transplantation, and developing an efficient coordinated system with both the donating hospitals and the transplant centers. Various organs had been transplanted in Saudi Arabia through the end of 2002: 3759 kidney transplants (1267 cadaver, 2492 living); 279 liver transplants(225 cadaver, 54 living); 92 heart transplants; 421 cornea transplants; 8 lungs; and 5 combined kidneys and pancreas. In addition, there have been many tissue donations of bone marrow, heart valves (264 hearts), skin, and bone. Despite the success of the Saudi program, there have been public and medical obstacles that have obviated the full benefit of cadaver donors. We suggest increasing the awareness of the medical community and the public at large to the importance of organ donation and transplantation.

Humans↗
PubMed2003

important social factors that affect organ transplantation in Islamic countries.

Social attitudes and beliefs have direct and strong impact on people's acceptance of organ donation and brain death, and therefore affect the entire practice of organ transplantation. The views differ from one society to another, and they at least partially explain regional variations in the world with respect to success of organ transplantation. Social attitudes and ethics in Islamic countries are closely intertwined with Islamic tradition, teachings and heritage. These positions are strongly adhered to in many Islamic countries, and by Moslems who live in countries that are not predominantly Islamic. We feel that transplant physicians and transplant coordinators should be aware of these factors when dealing with potential donors and recipients. Decision-making can be facilitated if these issues are considered prior to consulting with a donor's family and if an appropriate compassionate explanation of need for transplantation and basis of brain death diagnosis is provided based on a knowledge of underlying social constraints. Such steps can make the donation process smoother for both health care workers and the family.

Attitude↗
PubMedDate not supplied

Current status of renal transplantation in the Kingdom of Saudi Arabia.

The reported annual incidence of end-stage renal disease in Saudi Arabia is 100 to 120 patients per million population. The first dialysis unit in Saudi Arabia was established in 1971; thereafter, rapid advances have been made in the field of renal replacement therapy. At the end of 2002, there were 144 centers offering dialysis to about 7390 patients. A National Kidney Foundation was established in 1985 to implement the cadaveric organ transplant program and to coordinate the renal care facilities. This center was renamed Saudi Center for Organ Transplantation (SCOT) in 1993 to encompass transplantation of organs other than the kidney. An impetus was achieved in 1982 with the approval by Islamic scholars of the concept of brain-death and organ transplantation. From 1979, when the first renal transplant was performed, until the end of 2002, more than 3810 renal transplants have been performed in 13 transplant centers in Saudi Arabia, in addition to 260 liver, 95 heart, 280 heart valve, 510 cornea, 4 pancreas, 8 lung, and 1000 bone marrow transplants. The survival of patients and (grafts) in those who received living related renal transplants was 98.4(96.9), 96.7(96.7), and 96.7(92.2) at 1, 3, and 5 years, respectively. Moreover, the survival of patients and grafts among those who received cadaveric donor organs was 96.2(96.2), 93(92.1), and 93(87.2), at 1, 3, and 5 years, respectively. In conclusion, there has been increased renal transplantation in Saudi Arabia and there is even more room to increase the frequency of these transplants to decrease the expanding gap between supply and demand through increasing the efforts for organ donation from living and cadaveric donors.

Humans↗