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Addressing all aspects of brain death and thoroughly detailing how a potential organ donor should be maintained to ensure maximum use of the organs and cells, The Brain-Dead Organ Donor: Pathophysiology and Management is a landmark addition to the literature. This first-of-its-kind, multidisciplinary volume will be of interest to a large section of the medical community. The first section of the book reviews the historical, medical, legal, and ethical aspects of brain death. That is followed by two chapters on the pathophysiology of brain death as investigated in small and large animal models. This includes a review of the many hormonal changes, including the neuroendocrine- adrenergic ‘storm’, that takes place during and following the induction of brain death, and how they impact metabolism. The next section of the book reviews various effects of brain death, namely its impact on thyroid function, the inflammatory response that develops, and those relating to innate immunity. The chapters relating to assessment and management of potential organ donors will be of interest to a very large group of transplant surgeons and physicians as well as critical care and neurocritical care physicians and nurses. Neurologists, endocrinologists, neurosurgeons, and pathologists will also be interested, especially in the more basic science sections on various aspects of brain-death and hormonal therapy. Organ procurement organizations and transplant coordinators worldwide will also be interested in this title. Other chapters will be of interest to medical historians, medico-legal experts, and ethicists.
One of the most interesting and at the same time most challenging fields of medicine and surgery has been that of organ donation and transplantation. It is a field that has made tremendous strides during the last few decades through the combined input and efforts of scientists from various specialties. What started as a dream of pioneers has become a reality for the thousands of our patients whose lives can now be saved and improved. However, at the same time, the challenges remain significant and so do the expectations. This book will be a collection of chapters describing these same challenges involved including the ethical, legal, and medical issues in organ donation and the technical and immunological problems the experts are facing involved in the care of these patients.The authors of this book represent a team of true global experts on the topic. In addition to the knowledge shared, the authors provide their personal clinical experience on a variety of different aspects of organ donation and transplantation.
This updated and refined new edition is the only book to provide a comprehensive approach to the intensive care of neurologically injured patients from the emergency room and ICU through the operating room and post-surgical period. It reviews neuroanatomy, neuroradiology, and neurophysiology, examines the neurological problems most frequently seen in intensive care, and describes the various types of neurosurgery. General issues are discussed, such as cardiac care, fluids and electrolytes, nutrition, and monitoring as well as more specific conditions and complications including elevated intracranial pressure, seizures, and altered mental states.
In response to persistent donor organ shortages, organs from marginal donors, such as expanded criteria donors (ECD) and donation after cardiac death (DCD) donors, are now accepted and have been successfully transplanted, reducing the waiting times for transplantation. Especially in Japan, transplantation of DCD kidneys has a relatively long history because of the difficulty or lack of national consensus in accepting brain death, which has made it possible to accumulate considerable clinical experience. Thus, the current organ shortage has stimulated interest in the use of marginal donors for transplantation. On the other hand, however, it is known that these organs have a high rate of delayed graft function and a more complicated postoperative course. These drawbacks have created the greatest clinical challenge in transplantation to date because of the current shortage and limitations of donors using ECD and DCD. This book, prepared by distinguished authorities in their fields, is intended for clinicians and researchers. It highlights the use of marginal donors as a comparatively novel source of transplantation organs and provides a thorough overview of marginal donors from their historical origins to recent clinical applications, including the state-of-the-art science of organ/donor management, procurement, and preservation. Also provided is valuable information on ABO-incompatible donors which extend the availability of donor sources. Each chapter offers an individual analysis of the optimal requirements for the safe management and preservation of organs, including the heart, lung, liver, kidney, pancreas, and pancreatic islets.
Rates of organ donation lag far behind the increasing need. At the start of 2006, more than 90,000 people were waiting to receive a solid organ (kidney, liver, lung, pancreas, heart, or intestine). Organ Donation examines a wide range of proposals to increase organ donation, including policies that presume consent for donation as well as the use of financial incentives such as direct payments, coverage of funeral expenses, and charitable contributions. This book urges federal agencies, nonprofit groups, and others to boost opportunities for people to record their decisions to donate, strengthen efforts to educate the public about the benefits of organ donation, and continue to improve donation systems. Organ Donation also supports initiatives to increase donations from people whose deaths are the result of irreversible cardiac failure. This book emphasizes that all members of society have a stake in an adequate supply of organs for patients in need, because each individual is a potential recipient as well as a potential donor.
This collection features comprehensive overviews of the various ethical challenges in organ transplantation. International readings well-grounded in the latest developments in the life sciences are organized into systematic sections and engage with one another, offering complementary views. All core issues in the global ethical debate are covered: donating and procuring organs, allocating and receiving organs, as well as considering alternatives. Due to its systematic structure, the volume provides an excellent orientation for researchers, students, and practitioners alike to enable a deeper understanding of some of the most controversial issues in modern medicine.
New technologies and medical treatments have complicated questions such as how to determine the moment when someone has died. The result is a failure to establish consensus on the definition of death and the criteria by which the moment of death is determined. This creates confusion and disagreement not only among medical, legal, and insurance professionals but also within families faced with difficult decisions concerning their loved ones. Distinguished bioethicists Robert M. Veatch and Lainie F. Ross argue that the definition of death is not a scientific question but a social one rooted in religious, philosophical, and social beliefs. Drawing on history and recent court cases, the authors detail three potential definitions of death -- the whole-brain concept; the circulatory, or somatic, concept; and the higher-brain concept. Because no one definition of death commands majority support, it creates a major public policy problem. The authors cede that society needs a default definition to proceed in certain cases, like those involving organ transplantation. But they also argue the decision-making process must give individuals the space to choose among plausible definitions of death according to personal beliefs. Taken in part from the authors' latest edition of their groundbreaking work on transplantation ethics, Defining Death is an indispensable guide for professionals in medicine, law, insurance, public policy, theology, and philosophy as well as lay people trying to decide when they want to be treated as dead.
This book covers all aspects of modern techniques used in the rapidly developing field of adult critical care echocardiography, 3D transthoracic and transesophageal echocardiography, myocardial tissue velocity and deformation assessment, and contrast echocardiography. Featuring multiple color illustrations and echocardiographic images, it provides essential information on the technical aspects and current specifics of the equipment, anatomical imaging guidance, and physiological and pathological approaches with a focus on critically ill population. This book helps practitioners to not only understand the techniques and the applicability of these new technologies in various disease states, but also to apply them in a clinical setting. 3D echo, tissue deformation and contrast are opening tremendous new horizons for intensive care practitioners, offering them previously unimaginable insights into cardiac mechanics and anatomy and using non-invasive approaches for central hemodynamic diagnostic and monitoring management of intensive care patients. It also opens the way for completely new areas in clinical research. This book is useful for intensive care physicians, cardiologists, anesthesiologists, emergency physicians and sonographers involved in the provision of advanced echocardiographic services in intensive care units and in critical care environments. It is also suitable for students undertaking a Diploma of Diagnostic Ultrasound (Critical Care) with the Australasian Society of Ultrasound Medicine, adding to the existing literature used to prepare for the second and third parts examinations.
Part of the "What Do I Do Now?" series, Neurocritical Care provides insight into interventions in acute neurologic disorders. Using a case-based approach, this volume emphasizes how to handle comparatively common clinical problems emergently.