PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Directed Tissue Donation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed1998

Attitudes and beliefs concerning organ donation among Native Americans in the upper Midwest.

Because of increasing access to renal replacement therapy and the high incidence of renal disease among Native Americans largely due to type 2 diabetes mellitus, it is important to determine attitudes and beliefs in this population toward organ donation. In a study conducted on reservations in the upper Midwest during traditional powwows and health fairs, it was discovered that willingness to donate was more likely to occur if Native Americans were approached by a healthcare worker from their culture, if they had already signed a donor card, or if they knew someone with diabetes. Willingness to be a living donor (81%) was greater than willingness to donate after death (i.e., as a cadaveric donor) (54%). These findings indicate that cultural-specific information about organ failure rates and organ donation, when presented by knowledgeable individuals within the culture, could increase donation in the Native American population.

Attitude to Death↗
PubMed2003

Benefit of child-to-parent kidney donation.

Use of child-to-parent (CTP) kidney donation may be limited because of ethical concerns as well as doubts about its effectiveness. We used the United Network for Organ Sharing database to examine the effectiveness of CTP kidney donation compared with other types of living-related (LD) kidney donation and to cadaveric kidney donation. Data from 56 873 kidney transplants performed between 1988 and 1998 showed significantly greater transplant and patient survival for CTP kidney transplants compared with cadaveric kidney transplants. The average gain in kidney transplant half-life is 3.6 years for a CTP compared with a cadaveric kidney transplant, and it is estimated that this gain for the recipient far outweighs the 1 in 3000 risk of death to the donor associated with kidney donation. We conclude that CTP kidney donation should not be discouraged, and represents a useful source of transplantable kidneys.

Adult↗
PubMed1998

Egalitarian and maximin theories of justice: directed donation of organs for transplant.

It is common to interpret Rawls's maximin theory of justice as egalitarian. Compared to utilitarian theories, this may be true. However, in special cases practices that distribute resources so as to benefit the worst off actually increase the inequality between the worst off and some who are better off. In these cases the Rawlsian maximin parts company with what is here called true egalitarianism. A policy question requiring a distinction between maximin and "true egalitarian" allocations has arisen in the arena of organ transplantation. This case is examined here as a venue for differentiating maximin and true egalitarian theories. Directed donation is the name given to donations of organs restricted to a particular social group. For example, the family of a member of the Ku Klux Klan donated his organs on the provision that they go only to members of the Caucasian race. While such donations appear to be discriminatory, if certain plausible assumptions are made, they satisfy the maximin criterion. They selectively advantage the recipient of the organs without harming anyone (assuming the organs would otherwise go unused). Moreover, everyone who is lower on the waiting list (who, thereby, could be considered worse off) is advantaged by moving up on the waiting list. This paper examines how maximin and more truly egalitarian theories handle this case arguing that, to the extent that directed donation is unethical, the best account of that conclusion is that an egalitarian principle of justice is to be preferred to the maximin.

Beneficence↗
PubMedDate not supplied

Directed donation. The relevance of race.

The difficulty in finding well-matched kidneys for transplantation into black Americans is compounded by the disproportionately low rate of black donation. A program of directed donation that privileged black-to-black transplant could ease the chronic shortage of organs.

Black or African American↗
PubMed2000

The modern National Kidney Foundation: broad scope, clear vision, better lives.

The mission of the National Kidney Foundation is very broad, going well beyond what its name implies. The Foundation works for, cares about, and represents millions of Americans, from the child who wets the bed to the diabetic with hypertension to the grandfather on dialysis. It is dedicated to making lives better through a variety of educational programs for patients and their families as well as physicians, social workers, nurses, dietitians, technicians, administrators, and clinical and transplant coordinators. It supports research, promotes organ and tissue donation, provides direct services to patients, and advocates for patients through public policy and legislative initiatives. Its programs aid people at risk of kidney and urinary tract disease, individuals affected by these diseases, living organ donors and families of donors, and recipients of all types of lifesaving organ and tissue transplants.

Adult↗
PubMed1998

Factors influencing decisions about donation of the brain for research purposes.

OBJECTIVES: to find out the attitudes to brain donation for research purposes and factors involved in decision-making in elderly people. DESIGN: questionnaire administered after the decision had been made. SETTING AND SUBJECTS: 200 of the 640 people in Nottingham aged 67-100 who were assessed as part of the Medical Research Council multicentre Cognitive Function and Ageing Study of 2,518 people over 65 and were approached to consider brain donation for the neuropathology component of the study of dementia incidence. RESULTS: Most people completing the questionnaire had positive or neutral feelings about being approached. Positive influences included: personal approach, awareness of need for research and of suffering caused by dementia and a desire to help others. Many had fears about not being really dead, about post mortem examinations and feeling pain after death. Most preferred cremation and these were much more likely to donate. Two-thirds thought death was not talked about enough: 65% of those visited found talking helpful. Relatives had an important influence, usually dissuading the person from donating. CONCLUSIONS: some families who agreed to a relative's decision to donate only did so after discussing it together well in advance of death would have been unlikely to have agreed had they been approached for the first timeonly after death. There is a need to: (i) talk more about death, addressing people's fears, (ii) increase awareness of the need for autopsies and donation for research and (iii) provide more training in talking about death andautopsies.

Aged↗
PubMed2006

The allocation of organs donated by altruistic strangers.

In many transplant centers, organ retrieval from altruistic strangers is accepted practice; patients use Internet Web sites and other public media to locate strangers willing to give them an organ. It is argued that altruistic strangers should be permitted to select the recipients of their organs because 1) personal relationships are morally important; 2) it increases the number of available organs; and 3) no one is hurt by the process. Nonetheless, using public media to obtain organs may undermine equity in organ allocation. Organs donated by altruistic strangers do not go necessarily to patients who have the best immunologic match or the most urgent need or who have waited the longest. A publicly chartered organization should be established to coordinate live organ donation, including donation by altruistic strangers. Altruistic strangers should be educated to allocate their donated organs according to a prudent balance of equity and utility rather than their emotional response to a particular patient's plight, identity, or circumstances.

Adult↗
PubMed1991

Ethics, public policy, and human fetal tissue transplantation research.

This article focuses on the deliberations of the National Institutes of Health Human Fetal Tissue Transplantation Research Panel in 1988. It explores various arguments for and against the use of fetal tissue for transplantation research, following elective abortion, and for and against the use of federal funds for such research. After examining the relevance of various positions on the moral status of the fetus and the morality of abortion, the article critically examines charges that such research, especially with federal funds, would involve complicity in the moral evil of abortion, would legitimate abortion practices, and would provide incentives for abortions. Finally, it considers whether the donation model is appropriate for the transfer of human fetal tissue and whether the woman who chooses to have an abortion is the apppropriate donor of the tissue.

Aborted Fetus↗
PubMed2005

Directed altruistic living organ donation: partial but not unfair.

Arguments against directed altruistic living organ donations are too weak to justify a ban. Potential donors who want to specify the non-related person or group of persons to receive their donated kidney should be accepted. The arguments against, based on considerations of motivation, fairness and (non-)anonymity (e.g. those recently cited by an advisory report of the Dutch Health Council), are presented and discussed, as well as the Dutch Government's response. Whereas the Government argues that individuals have authority with regard to the allocation of their organs, partial considerations have not been sufficiently explored. In addition, it is argued that partial relationships govern human life, are significant and should be valued highly. These relationships are at the core of accepted living kidney donation between relatives (family members, partners, friends). Respecting the particular act of living donation goes beyond respect for autonomy; it touches upon our personal and social identity. Donation, e.g. of a kidney, is not undertaken strictly for the benefit of the recipient, but also to meet the moral standards we wish to set for ourselves. This consideration, rooted in a view of moral identity, provides the basis for many forms of directed donation that are both partial and justified. If the importance of this is not recognized, social policies can be neither adequate nor effective.

Advisory Committees↗
PubMed2005

Umbilical cord stem cells.

Until recently, blood that remained in the umbilical cord and placenta after delivery was routinely discarded. Now that this blood is known to contain both hematopoietic stem cells and pluripotent mesenchymal cells, there has been a substantial increase in the clinical use and research investigation of umbilical cord blood in hematopoietic transplantation and regenerative medicine. Until now, standards for collection and processing were not well established. The debate continues regarding the private banking of autologous blood for "biologic insurance" versus public banking for access by the general population. Obstetricians should support the acquisition of cord units for public banking in their geographic location where cord blood banks have established collection procedures. Issues related to cost, quality control, and the need for ethnic diversity in public banks preclude the universal collection of units from all obstetric deliveries. Directed donation of cord blood should be considered when there is a specific diagnosis of a disease within a family known to be amenable to stem cell transplantation.

Blood Banks↗
PubMed1996

Organ donors and nondonors. An American dilemma.

The principal motive for organ donation in the United States remains altruism. Surveys suggest that if the life-threatening and critical shortage of cadaveric donor organs were appropriately understood by the public, an altruistic response would lead to increased donation. However, despite intense educational efforts appealing to altruism, cadaveric organ donation has not increased substantially while the number of patients in need of a life-saving organ has grown markedly. To understand why organ donation has not increased, a telephone survey and focus group sessions of volunteers who were either for or against donation (donors and nondonors, respectively) were reviewed. The focus group nondonors demonstrated a remarkable lack of trust in the fairness of organ allocation and in the success of transplantation; indeed, this mistrust extended to the entire medical profession. The donors in the focus groups, on the other hand, believed that the system worked equitably, although their knowledge about organ donation and transplantation was equivalent to that of nondonors. For organ donation to increase, efforts must be directed toward those who are not convinced that donation is for the common welfare. One way to increase organ donation is for physicians to educate their patients better regarding the equity and success of transplantation.

Comprehension↗
PubMedDate not supplied

Motivation, attitudes and experience of donation: a follow-up of women donating eggs in assisted conception treatment.

This paper reports a follow-up of 39 women who had donated eggs to an assisted conception unit. Their experience of donation and their motivation and attitudes were assessed. Comparisons were made with a group of semen donors who were attending a second unit. Female and male donors donated for altruistic reasons and neither group wished to have contact with recipients or donor offspring or have their identity revealed. Female donors were more involved in the donation process and more interested in the outcome of donation. They also appeared to be more motivated by 'helping' than male donors. The sample of female donors contained a small group of women who were donating to sisters and friends. In comparison with anonymous donors, these women reported more effects upon the family and issues of secrecy and openness were more apparent. The results are discussed in the light of previous studies and the legal framework for donation in the UK. Attention is drawn to the lack of social psychological analyses in this controversial medical area.

Adult↗
PubMed2006

[Questionnaire on crossover renal transplantations in Germany].

Due to increasingly better long-term survival rates with dialysis the number of patients with renal failure constantly increases by 4% annually worldwide. Despite great progress in operative and perioperative management as well as improved immunosuppressive drugs, kidney transplantation still faces two major problems. First of all there is a huge deficit of donor organs and secondly the long-term results of the kidney grafts must be improved. One way to relieve this tense situation may be live kidney donation. In many countries not participating in Eurotransplant, especially the United States and Scandinavia, live kidney donation is performed more often than kidney transplantation from deceased donors. Germany implemented a transplantation law in December 1997. This law also regulates living donation, with exclusion of crossover transplantations. Cross-over transplantation is a special variation of live donation for couples who cannot donate/receive in their respective couple constellation. Therefore, the donor of the one couple donates his/her kidney to the recipient of the other couple and vice versa. According to German legislation this is illegal. We performed a study in order to evaluate the opinions of the German kidney transplant centers on crossover kidney transplantations. The majority of the German transplantation centers believe that crossover transplantation is acceptable with regard to ethical and medical concerns. To enable this kind of kidney transplantation the transplantation law would have to be changed. Nevertheless, nationwide polls show that live kidney donation represents only a very small portion of all transplantations taking place. Live kidney donation should be granted higher priority as dialysis triggers psychological and physical damage, especially in children. For many patients live kidney donation is the only chance for early transplantation with an excellent long-lasting kidney graft function.

Attitude of Health Personnel↗
PubMed1993

Religion, medical ethics, and transplants.

This article describes the exclusion of public expressions of religion from the history of bioethics during recent decades. It offers a proposal to include the public church for the purpose of gaining donations of vital organs for transplantation. I also include a brief discussion of theological support and practical suggestions for such a program.

Black or African American↗
PubMed2003

Pre-donated autologous blood transfusion in scoliosis surgery.

We studied the use of autologous pre-donatedblood transfusion in surgery for scoliosis in 45 patients who were divided into two groups; 27 who pre-donated autologous blood (group 1) and 18 who were planned recipients of allogenic blood (group 2). Normovolaemic haemodilution and intra-operative blood salvage was used in six patients in group 1 and three patients in group 2. The two groups did not differ significantly with respect to age, American Society of Anaesthesiologists score, mean operative time, number of vertebral segments fused, total blood loss, length of stay in intensive care and length of stay in hospital. The risk of requiring allogenic blood transfusion was found to be significantly less in group 1 (7.4% v 88.9%, p < 0.001). Only 5.21% of autologous units were wasted. Although intra-operative blood salvage reduced the total blood loss in both groups, it did not affect the need for subsequent allogenic transfusion or reduce the number of pre-donated autologous units which were given (p < 0.67). Autologous blood transfusion requiredextra time, personnel, resources and cost pounds sterling 28.88 per patient more than allogenic transfusion, however, the projected costs at May 2002 make this programme cost-effective by pounds sterling 51.54 per patient. Pre-donated autologous blood transfusion is acceptable and safe in scoliosis surgery. It significantly reduces the subsequent requirement of allogenic transfusion. Although the cost is currently more than allogenic transfusion, with the increase in the costs of the latter and the decrease in potential donors which is anticipated, pre-donation of autologous blood will become comparatively cost-effective.

Adolescent↗