Transplantation E-Book

John L. R. Forsythe

Description

Transplantation meets the needs of surgeons in higher training and practising consultants for a contemporary and evidence-based account of this sub-specialty that is relevant to their general surgical practice. It is a practical reference source incorporating the most current information on recent developments, management issues and operative procedures. The text is thoroughly referenced and supported by evidence-based recommendations wherever possible, distinguishing between strong evidence to support a conclusion, and evidence suggesting that a recommendation can be reached on the balance of probabilities.

This is a title in the Companion to Specialist Surgical Practice series whose eight volumes are an established and highly regarded source of information for the specialist general surgeon.

• The Companion to Specialist Surgical Practice series provides a current and concise summary of the key topics within each major surgical sub-specialty.
• Each volume highlights evidence-based practice both in the text and within the extensive list of references at the end of every chapter.

• An expanded authorship team across the series includes additional European and World experts with an increased emphasis on global practice.
• The contents of the series have been extensively revised in line with recently published evidence.

• Modern techniques in transplantation and new forms of immunosuppression are emphasised throughout this volume.
• The substantial interest in new organ perfusion and in the preservation techniques in organ donation and transplantation are reflected in a new chapter written by an international expert.
• All the chapters reflect transplant care as a multi-disciplinary team of clinicians working in a collaborative fashion.

Sujets

• Medical
• Médecine
• Surgery

Informations

• Publié par: Saunders Ltd.
• Date de parution: 24 juin 2013
• Nombre de lectures: 0
• EAN13: 9780702049682
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Transplantation
A Companion to Specialist Surgical Practice
Fifth Edition

John L.R. Forsythe, MBBS MD FRCS(Ed) FRCS(Eng) FEBS
Honorary Professor and Consultant Transplant, Surgeon, Transplant Unit, Royal Infi rmary of Edinburgh, UK
Table of Contents
Cover image
Title page
Copyright
Contributors
Series Editors' preface
Editor's preface
Evidence-based practice in surgery
Chapter 1: Controversies in the ethics of organ transplantation
Introduction
Key terminology
Death, organ donation, patient autonomy and the choice to donate
Allocation of organs
Living donation
Altruistic donation
Implications of the living donor work-up
Human organs as a commodity: incentivisation and payment for organ donation
Chapter 2: Organ donation in the UK: recent progress and future challenges
Introduction
Recent progress
Progress
Future challenges
Other issues
Managing expectations
Summary/conclusions
Acknowledgements
Chapter 3: Immunology of graft rejection
Introduction
Basic concepts and nomenclature of immunology
Early inflammatory response
The alloimmune response
The effector arm of the immune response
Rejection of the allograft
Future developments
Acknowledgements
Chapter 4: Testing for histocompatibility
Introduction
HLA: history of clinical application and technical development
HLA genes and proteins: structure and genetics relevant to transplantation
HLA reactive antibodies, causes of sensitisation and antibody epitopes
Establishing antibody reactivity
Crossmatching
Clinical relevance of HLA reactive antibodies
Organ allocation and histocompatibility
Conclusion
Chapter 5: Immunosuppression with the kidney as paradigm
Introduction
Calcineurin inhibitors
Antimetabolites
mTOR inhibitors
Biological agents
Depleting antibodies
Non-depleting antibodies and biologicals
Strategies to lower toxicity
Looking ahead
Chapter 6: Preservation and perfusion of abdominal organs for transplantation
Introduction
Development of preservation techniques
Kidney
Liver
Pancreas
Intestine
Evidence in the field of organ preservation and perfusion
Conclusion
Chapter 7: Recent trends in kidney transplantation
Introduction
Demand inflation or supply recession?
Innovations in living donation
Incompatible transplantation
Trends in deceased kidney donation
Optimising donor organ quality
Kidney allocation – new principles, same old challenges?
Trends in surgical technique
Current practice and challenges in immunosuppression
Conclusion
Chapter 8: Liver transplantation
Introduction
Indications for liver transplantation
Liver transplant immunology
Technical considerations
Immunosuppressive agents
Post-transplant complications
Conclusion
Chapter 9: Pancreas transplantation
Introduction
Indications for pancreas transplantation
Patient selection for pancreas transplantation
Pancreas transplantation activity worldwide
The pancreas donor and the organ retrieval procedure
The pancreas transplant operation
Immunosuppression in pancreas transplantation
Acute rejection following pancreas transplantation
Complications of pancreas transplantation
Outcome following pancreas transplantation
Long-term outlook following pancreas transplantation
Chapter 10: Islet transplantation
Introduction
Patient selection and assessment
Islet isolation
The islet transplant
Immunosuppression and outcomes
Barriers to long-term function
Islets as a cell therapy
Chapter 11: Cardiothoracic transplantation
Introduction
Indications for heart transplantation
Aetiology of heart disease
Recipient evaluation and selection
Donor selection and matching
Donor heart procurement
Heart transplantation (Figs 11.1 and 11.2)
Special situations
Perioperative management
Survival
Cause of death after heart transplantation
Heart and lung transplantation (HLT)
Future direction in heart transplantation
Lung transplantation
Choice of lung transplant procedure
Lung recipient assessment and selection
Lung donor criteria and selection
Ex vivo lung perfusion
Lung recipient–donor matching
Lung retrieval and preservation
Single lung implantation
Bilateral sequential lung implantation
Peri- and postoperative care for lung transplants
Outcomes and complications of lung transplantation
Recent advances and controversies
Chapter 12: Transplant infectious disease
Introduction and general concepts
Viruses: epidemiology, prophylaxis, diagnosis and treatment
Bacteria: epidemiology, prophylaxis, diagnosis and treatment
Fungi: epidemiology, prophylaxis, diagnosis and treatment
Parasites: epidemiology, prophylaxis, diagnosis, and treatment
Pre-transplant infectious disease evaluation
Donor-derived infections
Lifestyle and infection: food, pets, travel and sexuality
Chapter 13: Chronic transplant dysfunction
Introduction
Organ-specific findings
The aetiology of chronic graft injury
Pathophysiology
The management of chronic graft injury in the kidney
Index
Copyright

Fifth edition © 2014 Elsevier Limited. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher's permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions .
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
First edition 1997
Second edition 2001
Third edition 2005
Fourth edition 2009
Fifth edition 2014
ISBN 978-0-7020-4960-6
e-ISBN 978-0-7020-4968-2
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress

Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.



Printed in China
Commissioning Editor: Laurence Hunter
Development Editor: Lynn Watt
Project Manager: Vinod Kumar Iyyappan
Designer/Design Direction: Miles Hitchen
Illustration Manager: Jennifer Rose
Illustrator: Antbits Ltd
Contributors

Murat Akyol, MD, FRCS , Consultant Transplant Surgeon, Royal Infirmary of Edinburgh ; Honorary Clinical Senior Lecturer, University of Edinburgh, Edinburgh, UK

John J. Casey, MBChB, PhD, FRCS(Glasg), FRCS(Ed), FRCS(Gen Surg) , Consultant Transplant Surgeon and Honorary Clinical Senior Lecturer, Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK

Marc J. Clancy, MA, MBChB, FRCS(Eng), PhD, FRCS(Gen Surg) , Consultant Transplant and General Surgeon, Clinical Lead for Transplantation, Honorary Associate Clinical Professor ; Transplant Unit, Western Infirmary, Glasgow, UK

John H. Dark, FRCS, FRCP , Professor of Cardiothoracic Surgery, Newcastle University ; The Freeman Hospital, Newcastle upon Tyne, UK

Philip A. Dyer, PhD, FRCPath , Consultant Clinical Scientist and Professor in Transplantation Science, Scottish National Blood Transfusion Service, Royal Infirmary of Edinburgh, Edinburgh, UK

Peter Friend, MD, FRCS , Professor of Transplanta