PubMed · 9675415
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P Krug. 1998. Nurses in Washington Internship program.. https://doi.org/10.1016/s0001-2092(06)62729-4
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Liver transplantations using a part of the liver from a living donor are already being performed around the world. The main arguments for performing such transplantations are the shortage of brain-dead donors and the consequently high mortality rate of patients on the waiting list for a liver transplantation. The disadvantages of this option are the mortality and morbidity risk for the living donor. The shortage of brain-dead donors could also be resolved by the implementation of special techniques such as split-liver and domino-liver transplantations or by using compromised and non-heart-beating donors. Furthermore, measures should be taken to reduce the shortage of brain-dead donors in the Netherlands. If such actions do not lead to an increase in the number of brain-dead donors and a willingness to restrict the indications for transplantation is not forthcoming then donation for liver transplantation by living donors is inevitable. Such a program should satisfy certain conditions and have the requisite medical-ethical and public support.
For 3 decades, vaccination against poliomyelitis has rested mainly on the use of the oral attenuated vaccine (OPV). In countries where wild type poliomyelitis has been successfully controlled by OPV, the rare cases of poliomyelitis that can still be identified occur in vaccinees or their contacts and are caused by vaccine related strains. Over years, data indicating that the inactivated vaccine (IPV) also has the potential to control poliomyelitis and that there are no known risks associated with the use of this vaccine have accumulated. The reasons for changes in vaccine policy in industrialised countries and the situation of the global effort of poliomyelitis immunisation are described. Some of the issues and challenges for the future are reviewed.