Journal articles on the topic 'Organ transplantation'
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Tumin, Makmor, Khaled Tafran, Wan Ahmad Hafiz Wan Md Adnan, and Ahmad Farid Osman. "Assessing Countries’ Deceased Organ Donation and Transplantation Performance." MARCH 2023 19, no. 2 (March 13, 2023): 170–74. http://dx.doi.org/10.47836/mjmhs.19.2.25.
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Introduction: Donors per million population and transplantations per million population are standardized, widely used indicators to assess and compare countries’ performance in organ donation and transplantation. This study aims to investigate these two particular metrics of organ donation and transplantation performance, and to introduce a new index, namely, ‘transplantations per patients on the waiting list’. Methods: Secondary analyses of data on 23 countries in 2016 were used to construct the transplantations per patients on the waiting list indicator for kidney, liver, pancreas, heart, and lung transplantation, as well as for the transplantation of any of the five aforementioned organs. Results: According to the transplantations per patients on the waiting list, the best-performing countries in terms of organ donation and transplantation are Belarus for kidney transplantation, Finland for liver and pancreas transplantation, Australia for heart transplantation, and France for lung transplantation. Considering all five organs together, Sweden, Australia, Finland, Austria, and Poland were the top five best-performing countries, followed by Spain in the sixth position. Conclusion: The deceased transplantations per patients on the waiting list can be an alternative indicator to assess performance, along with the widely-used donors and transplantations per million population, but still has its limitations in certain scenarios.
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Vukovic, Milivoje, Nebojsa Moljevic, Zoran Milosevic, Nenad Katanic, and Dragan Krivokuca. "Multiple organ procurement." Medical review 60, no. 7-8 (2007): 339–42. http://dx.doi.org/10.2298/mpns0708339v.
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Introduction. Liver transplantation is the most demanding of all solid organ transplantations. It requires perfect organization and motivation of health care professionals, patients and their families. This article deals with the procedure for multiple organ procurement, reviews criteria for organ donation and describes the surgical technique for multiple organ procurement. Discussion. Adequate selection and evaluation of cadaveric donors and of organs for transplantation should include early identification of potential donors, and early diagnosis of brain death. The procurement of the highest number of viable organs for transplantation requires excellence in each of the phases. Early and aggressive physiologic support in the maintenance of potential donors can reduce organ donor loss due to irreversible asystole or multiorgan failure (it is almost always possible to maintain organ perfusion pressure) and increase the number of organs without increasing post-transplant morbidity or mortality. The ideal donor is a young, previously healthy, brain dead, victim of an accident. Conclusion. The surgical procedure for multiple organ procurement from brain death donors must be performed without intraopertive organ damage. .
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Milijić, Svetlana, and Aleksandar Nikolić. "Ethics in Organ Transplantation." Acta Facultatis Medicae Naissensis 35, no. 2 (June 1, 2018): 87–93. http://dx.doi.org/10.2478/afmnai-2018-0010.
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Abstract Organ transplantation is specific medical procedure which is used as a way of treatment. Transplantation is often the only way of curing a patient. Today, hundreds of people in the world live successfully with donor organs, and transplantations as medical interventions are performed routinely. In Europe, about 10,000 patients are saved annually by transplantation, but there are far larger numbers of those waiting for their so-called rescue organ. In all countries, transplant medicine is regulated by special laws, regulations and conventions that provide medical, legal, and ethical regulations. Organ donation is an act of charity and giving, and not a contract on movement. Righteousness and fairness are emphasized in transplantation medicine. The question of organ transplanting affects the most intimate issues of human integrity, human dignity, health and illness. That is why certain instructions, rules of conduct and treatment are required from ethics. Today, in ethical dilemmas regarding organ transplantation, less emphasis is placed on imperative ethics, which emphasizes the idea of obligation, and more emphasis is placed on the so-called indicative ethics in which the idea of general accountability and solidarity is in the foreground. In cases of transplanting organs from a living patient, it is a doctor`s duty to provide complete information to the donor and the recipient about the purpose and nature of the procedure itself, success probability, consequences, possible risks and noted adverse reactions. In cases of transplanting from a cadaver, the basic ethical question is defining brain death and respect for the deceased. The main reason of a small number of donors is lack of information, fear of organ donating and ethical questions related to transplantation.
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Opoku, John Kwaku. "ORGAN TRANSPLANTATION MEDICINE: RELIGIOUS AND ETHICAL CONSIDERATIONS." Volume-1: Issue-9 (November, 2019) 1, no. 9 (December 7, 2019): 13–21. http://dx.doi.org/10.36099/ajahss.1.9.2.
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There are not enough solid organs available to meet the needs of patients with organ failure. Thousands of patients every year die on the waiting lists for transplantation. Yet there is currently available, underutilized, potential source of organs. Many patients die in intensive care following withdrawal of life-sustaining treatment whose organs could be used to save the lives of others. At present the majority of these organs go to waste. In this paper, I consider and evaluate a range of religious and ethical responses to improve the quality of organ transplantations available today. The responses of four world religions (Christianity, Islam, Buddhism and Hinduism) towards organ transplantation are considered. We argue that religious involvement in medical technologies like transplantation medicine gives to individuals the greatest chance of being able to help others with their organs after death under well-guided means. It is believed that attempts to increase patient autonomy will be realised in the light of religion and ethics.
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N.V. Kuznetsova, N. V. x., and A. I. Merzlyakova. "COMPARATIVE ANALYSIS OF THE LEGAL REGULATION OF ORGAN DONATION IN THE RUSSIAN FEDERATION, SWITZERLAND AND THE UNITED STATES OF AMERICA." Bulletin of Udmurt University. Series Economics and Law 32, no. 6 (November 24, 2022): 1088–93. http://dx.doi.org/10.35634/2412-9593-2022-32-6-1088-1093.
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For a long time, the transplantation of organs and tissues from one person to another has remained an unsolvable medical problem. Nowadays, donor organ transplantation is a common and successful way to treat patients with terminal organ failure, which undoubtedly makes it more in demand. The largest percentage of all organ transplants involves transplants from people who have already died. In this regard, an important issue is the possibility for a person to express his or her will regarding the posthumous removal of organs for transplantation, and the mechanisms and possibilities of this expression of will as such. The article deals with the provisions of Russian, US and Swiss legislation regulating the organization and functioning of the organ transplantation system in each country; legal relations in the field of organ and tissue transplantation as well as the mechanisms of citizens' will regarding the posthumous removal of organs and tissues for transplantation purposes. Legal problems of realization of such will in the Russian Federation are covered. The ways of solving the arising problems are offered. The role of legislation, including the presumption on the removal of organs, and other factors influencing the increase in the number of transplantations carried out in the country are considered.
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Gautier, S. V., and S. M. Khomyakov. "Organ donation and transplantation in the Russian Federation in 2016 9th report of the National Registry." Russian Journal of Transplantology and Artificial Organs 19, no. 2 (June 23, 2017): 6–26. http://dx.doi.org/10.15825/1995-1191-2017-2-6-26.
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Aim. To carry out monitoring of the organization and tendencies in the development of organ donation and transplantation in the Russian Federation in 2016. Materials and methods. Questioning of the heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics of the years, between certain regions of the Russian Federation and transplantation centers is done. Results. According to the register 35 centers of kidney transplantation, 22 centers of liver transplantation and 11 centers of heart transplantation were functioning in the Russian Federation in 2016. The waiting list of kidney transplantation in 2016 included 4818 potential recipients that make 14% of total number of the patients (35 000) receiving dialysis. The rate of donor activity in 2016 made 3.3 p. m. p. Efficiency of donor programs in 2016 continued to increase: the share of multiorgan retrieval made 64.1%, average number of organs received from one effective donor made 2.7. In 2016 the rate of kidney transplantation made 7.4 p. m. p., the rate of liver transplantation made 2.6 p. m. p.; the rate of heart transplantation made 1.5 p. m. p. In 2016 the number of transplantations in the Russian Federation increased by 14.8% in comparison with 2015 having overcome the level of 1700 organs transplantation. The Moscow region still remains to be the core of stability and development of the organ donation and transplantation in the country where 10 centers of transplantation function and half of all kidney transplantations and more than 70% of all liver and heart transplantations are carried out. Conclusion. The results of 2016 were positively affected by the introduction of targeted financial support of medical activity, related to organ donation, from federal budget resources. Among unresolved problems which constrain the development there are collision of legal regulation of licensing of medical activities for organ donation and transplantation, lack of the state order for the organization of transplantological medical care in each region, lack of responsibility of the heads of the regions and medical organizations for the organization of organ donation. Positive tendencies of the development of organ donation and transplantation in Russia call for further monitoring, strengthening and building.
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Kovtun, G. I., B. M. Todurov, and O. A. Kanyura. "History and actual problems of organ donation." Cardiac surgery and interventional cardiology, no. 1-2 (September 19, 2023): 5–14. http://dx.doi.org/10.31928/2305-3127-2023.1-2.514.
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The review is devoted to the history of the development of organ transplantation and the analysis of models of organ transplantation in countries that are leaders in the field of transplantation. Organs transplantation abroad has become an effective method of treatment that saves lives, but it is also an indicator of the success of the country’s development as a whole, an important element of national pride and prestige. However, performing transplantations is associated with problems of an organizational, as well as legal, moral and ethical nature. The main problem is a shortage of donor organs. The review analyzes measures aimed at increasing the level of donation in the world and promoting the development of transplantology.
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Glyantsev, S. P. "Phenomenon of Demikhov. In the Sklifosovsky Institute (1960–1986). Fighting "windmills" or lack of conditions (1961)." Transplantologiya. The Russian Journal of Transplantation 10, no. 4 (December 21, 2018): 336–46. http://dx.doi.org/10.23873/2074-0506-2018-10-4-336-346.
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The article describes the results of V.P. Demikhov's working at N.V. Sklifosovsky Institute for Emergency Medicine in 1961. We have presented a brief report of his laboratory activities and a prospective working plan that included preparing for vital organ transplantations in clinic, conducting immunological and morphological studies, resolving resuscitation issues, all aimed at: 1) revitalizing dead people and their organs for transplantatio, and 2) preserving the vitality of the isolated organs before transplantation. For the first time in the history of national surgery, the question of "brain death" was raised as a criterion for the possibility of organ harvesting. However, the documents we have reviewed demonstrated that such a plan was impossible to be realized with the efforts of a single institution. V.P. Demikhov was advised to revise the plan, abridge it, and bring it into line with the modest potential of the Institute to organ transplantations.
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Tokalak, Ibrahim, Hamdi Karakayali, Gökhan Moray, Nevzat Bilgin, and Mehmet Haberal. "Coordinating Organ Transplantation in Turkey: Effects of the National Coordination Center." Progress in Transplantation 15, no. 3 (September 2005): 283–85. http://dx.doi.org/10.1177/152692480501500313.
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In January 2001, the National Coordination Center, which brought tissue and organ procurement and transplantation under the Turkish Health Ministry, was established in Turkey. The main aims of this organization are to expand cadaveric donation and increase the number of transplantable organs supplied by cadaveric donors. We compared the proportions of cadaveric organ transplantations that were performed in Turkey before and after the national coordination system was established. Of all the cadaveric transplantations completed to date, 91.6% of kidney and 71.5% of liver procedures were done before implementation of the new system, and 8.4% and 28.5%, respectively, were performed after the system was established. The data show that the frequency of cadaveric donation has increased, as well as the number of cadaveric organ transplantations performed annually. The new national transplantation coordination system is making a good start at increasing cadaveric transplantation in Turkey. This system will hopefully lead to a larger organ pool and shorter waiting lists in future.
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Rodrigues-Filho, Edison Moraes, Cristiano Augusto Franke, and José Roque Junges. "Lung transplantation and organ allocation in Brazil." Revista de Saúde Pública 53 (March 7, 2019): 23. http://dx.doi.org/10.11606/s1518-8787.2019053000445.
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The philosophy of organ allocation is the result of two seemingly irreconcilable principles: utilitarianism and distributive justice. The process of organ donation and transplantation in Brazil reveals large inequalities between regions and units of the Federation, from the harvesting of organs to their implantation. In this context, lung transplantation is performed in only a few centers in the country and is still a treatment with limited long-term results. The allocation of the few organs harvested for the few procedures performed is defined mainly by chronology, a criterion that is not linked to necessity, which is a criterion of distributive justice, and neither to utility, a criterion of utilitarianism. This article reviews the organ allocation philosophy focusing on the case of lung transplantations in Brazil.
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HAN, Sung-Suk, Hyun-Ja HONG, and Hee-Ok CHUN. "A Study of the Improvements to the Human Organ Transplantation Law." Korean Journal of Medical Ethics 7, no. 1 (June 2004): 15–34. http://dx.doi.org/10.35301/ksme.2004.7.1.15.
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Purpose: On 18 March 2003, The Korean Ministry of Health and Welfare revised the Human Organ Transplantation Law, which was enacted to save lives and improve the quality of life of organ recipients. The present study was conducted to examine those revisions and make suggestions for further changes to the law. Methods : First, the problematic aspects of the law, such as the determination of brain death, the obtaining of informed consent, the allocation of the organs, and the practice of living organ donations, were first identified. Secondly, these aspects of the law were then examined and criticized in light of the organ transplantation laws in foreign countries. Thirdly, efforts to improve the law were described. Results: 1) The law should make it clear that when consent from the organ donor is impossible, consent should be obtained from the donor's guardian or the person living with the donnor. 2) In order to avoid delays in decisions concerning organ transplantation, the current organization and role of the Brain Death Determination Committee should be re-considered. 3) In the allocation of human organs and selection of organ recipients, giving priorities to the HOPO (Hospital-based Organ Procurement Organization) is not the best way to increase the number of human organ transplantations. A method is needed to increase the objectivity and justice in human organ allocation. 4) The law should be more specific in defining "living organ donations" and the role of the Hospital Ethics Committee. The law should also clearly prohibit the sale of human organs and the donation of organs from minors. Conclusion: This study provides four recommendations for improvements to the current Human Organ Transplantation Law. First, autonomous consent must be respected in donation. Second, brain death should be determinated clearly and precisely by means of a simple process. Third, organs should be allocated fairly. Fourth, living donations should be encouraged.
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Rathor, Mohammad Yousuf, Azarisman SM Shah, Nur Raziana Bt Rozi, Che Rosle Draman, and Wan Ahmad Syahril. "Ethical issues in Kidney Transplantation and “An” Islamic perspective." Bangladesh Journal of Medical Science 20, no. 2 (February 1, 2021): 241–49. http://dx.doi.org/10.3329/bjms.v20i2.51530.
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Kidney transplantation (KT) is currently the most realistic treatment option for patients with end-stage renal disease (ESRD) as it enables them to live longer and provides better quality of life post-transplantation. Before the 1960s, all these patients would die as there was no treatment available. It is the commonest solid organ transplantation carried out in the world at the moment. Organs are harvested from living or cadaveric donors, with living kidney donor organs generally functioning better and for longer periods of time compared to the latter. Issues surrounding organ transplantation in general and kidney transplantation in particular, are fraught with ethical dilemmas due to the shortage of organs, the logistics behind the acquisition of organs, use of living donors including minors and the black market that has sprouted thereof. Entwined in this quagmire are the legal, social and psychological consequences for the individuals involved and the society at large. It is further compounded by religious concerns, which have a significant influence on the society’s acceptance of the practice of organ donation. The practice of organ transplantation is generally accepted by most Islamic scholars as it is concordant to the objectives of Islamic Law (maqasid al Sharī’ah) which prioritize the preservation of human life. However, resistances do arise from some jurists and even physicians of the same Islamic faith despite a fatwas decreeing that organ and tissue transplantations are permissible in Islam under certain conditions. The take-up of organ-donation is still largely poor especially among Muslims. This article therefore hopes to explore the various moral and ethical issues surrounding KT as well as the Islamic viewpoints emanating from it. We hope that this knowledge and understanding will benefit both health-care personnel and the public in general.
Bangladesh Journal of Medical Science Vol.20(2) 2021 p.241-249
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Kim, Kyoung Jin, Jeonghoon Ha, Sang Wan Kim, Jung-Eun Kim, Sihoon Lee, Han Seok Choi, Namki Hong, et al. "Bone Loss after Solid Organ Transplantation: A Review of Organ-Specific Considerations." Endocrinology and Metabolism 39, no. 2 (April 30, 2024): 267–82. http://dx.doi.org/10.3803/enm.2024.1939.
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This review article investigates solid organ transplantation-induced osteoporosis, a critical yet often overlooked issue, emphasizing its significance in post-transplant care. The initial sections provide a comprehensive understanding of the prevalence and multifactorial pathogenesis of transplantation osteoporosis, including factors such as deteriorating post-transplantation health, hormonal changes, and the impact of immunosuppressive medications. Furthermore, the review is dedicated to organ-specific considerations in transplantation osteoporosis, with separate analyses for kidney, liver, heart, and lung transplantations. Each section elucidates the unique challenges and management strategies pertinent to transplantation osteoporosis in relation to each organ type, highlighting the necessity of an organ-specific approach to fully understand the diverse manifestations and implications of transplantation osteoporosis. This review underscores the importance of this topic in transplant medicine, aiming to enhance awareness and knowledge among clinicians and researchers. By comprehensively examining transplantation osteoporosis, this study contributes to the development of improved management and care strategies, ultimately leading to improved patient outcomes in this vulnerable group. This detailed review serves as an essential resource for those involved in the complex multidisciplinary care of transplant recipients.
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Shafiee, Ashkan, Elham Ghadiri, Jareer Kassis, and Anthony Atala. "Nanosensors for therapeutic drug monitoring: implications for transplantation." Nanomedicine 14, no. 20 (October 2019): 2735–47. http://dx.doi.org/10.2217/nnm-2019-0150.
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The number of patients requiring organ transplantations is exponentially increasing. New organs are either provided by healthy or deceased donors, or are grown in laboratories by tissue engineers. Post-surgical follow-up is vital for preventing any complications that can cause organ rejection. Physiological monitoring of a patient who receives newly transplanted organs is crucial. Many efforts are being made to enhance follow-up technologies for monitoring organ recipients, and point-of-care devices are beginning to emerge. Here, we describe the role of biosensors and nanosensors in improving organ transplantation efficiency, managing post-surgical follow-up and reducing overall costs. We provide an overview of the state-of-the-art biosensing technologies and offer some perspectives related to their further development.
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Scherstén, Tore, Hans Brynger, Ingvar Karlberg, and Egon Jonsson. "Cost-Effectiveness Analysis of Organ Transplantation." International Journal of Technology Assessment in Health Care 2, no. 3 (July 1986): 545–52. http://dx.doi.org/10.1017/s0266462300002622.
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In 1958 Joseph Murray and associates reported the first successful kidney transplantation between two identical twins at Peter Bent Brigham Hospital in Boston (14). Since then organ transplantation has advanced rapidly. Renal transplantation is now a standard treatment for irreversible renal failure, and liver transplantation is an accepted method for treating end-stage liver disease. A number of patients have survived more than 20 years after renal transplantation and more than 10 years after liver transplantation (20). Very few liver transplantations have been performed in Sweden but this method is expected to become more common in the near future.
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Gautier, S. V., and S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN RUSSIAN FEDERATION IN 2015. 8th report of National Register." Russian Journal of Transplantology and Artificial Organs 18, no. 2 (June 25, 2016): 6–26. http://dx.doi.org/10.15825/1995-1191-2016-2-6-26.
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Aim. To carry out monitoring of the organization and development of the organ donation and transplantation in theRussian Federationaccording to 2015.Materials and methods. Questioning of heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics by years, between certain regions of theRussian Federation, the transplantation centers is done.Results. According to the register in2015 inthe Russian Federation 36 centers of renal transplantation, 17 centers of liver transplantation and 10 centers of heart transplantation were functioning. The waiting list of kidney transplantation in 2015 included 4167 potential recipients that make 13% of the total number of the patients (31 500) receiving a dialysis. The rate of donor activity in 2015 made 3.0 pmp. Efficiency of donor programs in 2015 continues to increase: the share of multiorgan retrievals made 57.8%, average number of organs, received from one effective donor, made 2.7. In 2015 the rate of kidney transplantation made 6.5 pmp; the rate of liver transplantation made 2.2 pmp; the rate of heart transplantation made 1.2 pmp. The number of transplantations of liver and heart in theRussian Federationcontinues to increase. The number of transplantations of kidney remains approximately at one level in the range of 950–1050.Moscowcapital region continues to be the center of stability and development of the organ donation and transplantation in the country, in which 10 centers of transplantation are functioning and nearly a half from all kidney transplantations and more than 65% of all liver and heart transplantations are carried out.Conclusion. The potential for further development of the transplantation care in theRussian Federationcontinues to persist. In particular, at the expense of increasing efficiency of regional donation programs, expanding practices of multiorgan recuperation and transplantations of extrarenal organs, through interregional transplant coordination. It is critical to keep the volumes of the state order to deliver transplantological medical care to the population and to implement federal funding to conduct donation programs.
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Morrell, Matthew R., Sarah C. Kiel, and Joseph M. Pilewski. "Organ Transplantation for Cystic Fibrosis." Seminars in Respiratory and Critical Care Medicine 40, no. 06 (December 2019): 842–56. http://dx.doi.org/10.1055/s-0039-3399554.
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AbstractCystic fibrosis (CF) remains the most common indication for lung transplantation in children and the third most common in adults and has the highest median survival posttransplant for all pretransplant diagnoses. Criteria for transplant in patients with CF vary widely among transplant centers and early referral to multiple centers may be needed to maximize opportunities for lung transplantation. Comorbidities unique to CF such as resistant and atypical pathogens like Burkholderia and Mycobacterium abscessus, and cirrhosis require special consideration for lung transplantation but should not be considered as absolute contraindications. For those patients who are listed for lung transplantation, mechanical support with extracorporeal membrane oxygenation and mechanical ventilation can be efficacious as bridges to lung transplantation in experienced centers with adequate resources. Liver and pancreas transplantations are also acceptable options for end-organ disease related to CF and can provide improvements in both quantity and quality of life.
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Ratkovic, Marina, Nikolina Basic Jukic, Danilo Radunovic, Vladimir Prelevic, and Branka Gledovic. "Kidney Transplantation Program in Montenegro." BANTAO Journal 13, no. 2 (December 1, 2015): 68–72. http://dx.doi.org/10.1515/bj-2015-0015.
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AbstractIntroduction.There was no transplantation program in Montenegro until 2012. On the other hand, there were 93 patients with transplanted kidney. These transplantations were performed abroad; 15% in areas of black organ markets (India, Pakistan, Russian Federation). Beside the ethical problems, these transplantations carried a high risk of complications.Methods.Our health system had to ensure solution for patients with terminal organ failure. Preparation of all neccessary conditions for the beginning of transplantation program in Montenegro started in 2006 with different activities including public, legal, medical, educational and international cooperation aspects.Results.The first kidney transplantation from living donor in Montenegro was preformed on September 25th, 2012. In the period from 2012 until now 23 kidney transplantations from living related donor were performed and one kidney transplantation from deceased donor in the Clinical Center of Montenegro. In the a two year-follow-up period, all patients to whom kidney transplantation was performed are in a good condition and without serious complications in posttransplant period.Conclusion.Development of the transplantation program allowed controlled transplantation and safety of patients. Our next steps are development of deceased organ donor transplantation and achievement of higher rate of deceased donor organ transplantation and individualization of immunosuppressive therapy.
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POPESCU, Leontin. "ORGAN TRANSPLANTATION IN THE CHRISTIAN MORAL EVALUATION." Icoana Credintei 9, no. 17 (January 24, 2023): 58–80. http://dx.doi.org/10.26520/icoana.2023.17.9.58-80.
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Organ transplant medicine faces not only technical problems but also moral and cultural ones. Future medical science must seriously consider the possibility of creating a true culture of solidarity and of the gift that can be expressed through organ transplantation. The free and conscious act of donation and organ transplantation must continue to be of high moral value in the future: it is a heroic service in the service of life, but it is also a precious opportunity to exercise and use Christian love and compassion for one's brothers and sisters to the end, i.e. to the point of self-donation.
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Ayer, Shreyas. "BRIDGING DIVIDES: SWAP AND DOMINO ORGAN TRANSPLANTATION ACROSS SOCIOCULTURAL AND POLITICAL FRONTIERS." American Journal of Interdisciplinary Innovations and Research 06, no. 04 (April 21, 2024): 18–24. http://dx.doi.org/10.37547/tajiir/volume06issue04-04.
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Swap and domino organ transplantation represents a groundbreaking approach to address organ shortages by facilitating organ exchanges among incompatible donor-recipient pairs or utilizing organs from deceased donors to trigger multiple transplant chains. This paper explores the socio-cultural and political implications of swap and domino organ transplantation, transcending traditional boundaries and challenging existing norms in the field of organ donation and transplantation. Through a multidisciplinary lens, it examines the ethical considerations, legal frameworks, and societal attitudes surrounding swap and domino transplantation, highlighting both the opportunities and challenges inherent in this innovative approach. By fostering collaboration and cooperation across sociocultural and political divides, swap and domino transplantation offers a promising pathway to expand access to life-saving organ transplants and promote global health equity.
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Golsteyn, Bart H. H., and Annelore M. C. Verhagen. "Deceased by default: Consent systems and organ-patient mortality." PLOS ONE 16, no. 3 (March 17, 2021): e0247719. http://dx.doi.org/10.1371/journal.pone.0247719.
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Previous research shows that countries with opt-out consent systems for organ donation conduct significantly more deceased-donor organ transplantations than those with opt-in systems. This paper investigates whether the higher transplantation rates in opt-out systems translate into equally lower death rates among organ patients registered on a waiting list (i.e., organ-patient mortality rates). We show that the difference between consent systems regarding kidney- and liver-patient mortality rates is significantly smaller than the difference in deceased-donor transplantation rates. This is likely due to different incentives between the consent systems. We find empirical evidence that opt-out systems reduce incentives for living donations, which explains our findings for kidneys. The results imply that focusing on deceased-donor transplantation rates alone paints an incomplete picture of opt-out systems’ benefits, and that there are important differences between organs in this respect.
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能勢, 之彦, 秀雄 河原崎, 康裕 福井, and 亮. 折井. "Organ Transplantation." JAPANES JOURNAL OF MEDICAL INSTRUMENTATION 68, no. 1 (January 1, 1998): 2–27. http://dx.doi.org/10.4286/ikakikaigaku.68.1_2.
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Quinlan, Joseph J. "Organ Transplantation." Anesthesia & Analgesia 81, no. 3 (September 1995): 663–64. http://dx.doi.org/10.1097/00000539-199509000-00069.
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Gaedeke Norris, M. K. "Organ Transplantation." Dimensions Of Critical Care Nursing 9, no. 5 (September 1990): 251. http://dx.doi.org/10.1097/00003465-199009000-00001.
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Skaro, Anton I., Gordon Hazen, Daniela Ladner, and Bruce Kaplan. "Organ Transplantation." Transplantation 99, no. 7 (July 2015): 1316–20. http://dx.doi.org/10.1097/tp.0000000000000817.
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Collins, Bradley H. "Organ Transplantation." Annals of Surgery 238, Supplement (December 2003): S72—S89. http://dx.doi.org/10.1097/01.sla.0000097792.84274.9e.
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CURTIN, LEAH L. "Organ Transplantation." Nursing Management (Springhouse) 24, no. 7 (July 1993): 33???37. http://dx.doi.org/10.1097/00006247-199307000-00006.
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Quinlan, Joseph J. "Organ Transplantation." Anesthesia & Analgesia 81, no. 3 (September 1995): 663–64. http://dx.doi.org/10.1213/00000539-199509000-00069.
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DiMartini, Andrea F., Mary Amanda Dew, and Paula T. Trzepacz. "Organ Transplantation." FOCUS 3, no. 2 (April 2005): 280–303. http://dx.doi.org/10.1176/foc.3.2.280.
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Nyber, Denise Bauer. "Organ Transplantation." AORN Journal 58, no. 5 (November 1993): 880. http://dx.doi.org/10.1016/s0001-2092(07)65618-x.
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Linderer, Robin J. "Organ Transplantation." AORN Journal 58, no. 5 (November 1993): 880. http://dx.doi.org/10.1016/s0001-2092(07)65619-1.
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Coytle, Beth Ann. "Organ Transplantation." AORN Journal 58, no. 5 (November 1993): 880–82. http://dx.doi.org/10.1016/s0001-2092(07)65620-8.
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Calne, Roy. "Organ transplantation." Lancet 348, no. 9040 (November 1996): 1501–2. http://dx.doi.org/10.1016/s0140-6736(05)65894-1.
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Editor, JNMA. "Organ Transplantation." Journal of Nepal Medical Association 6, no. 2 (January 1, 2003): 88–89. http://dx.doi.org/10.31729/jnma.1118.
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Sharma, B. P. "ORGAN TRANSPLANTATION." Journal of Nepal Medical Association 6, no. 2 (January 1, 2003): 88–90. http://dx.doi.org/10.31729/jnma.1803.
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Gautier, S. V., Ya G. Moysyuk, and S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN THE RUSSIAN FEDERATION IN 2014 7th REPORT OF NATIONAL REGISTER." Russian Journal of Transplantology and Artificial Organs 17, no. 2 (May 26, 2015): 7–22. http://dx.doi.org/10.15825/1995-1191-2015-2-7-22.
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Aim. To carry out monitoring of the organization and development of organ donation and transplantation in the Russian Federation according to 2014. Materials and methods. Questioning of heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics of years, between certain regions of the Russian Federation, the transplantation centers, and also with data of the international registers is made. Results. According to the Register in 2014 in the Russian Federation functioned 36 centers of kidney transplantation, 14 centers of liver transplantation and 9 centers of heart transplantation. The waiting list of kidney transplantation in 2014 included 4636 potential recipients that makes 16% of total number of the patients 29 000 receiving dialysis. The rate of donor activity in 2014 made 3.2 per million population (pmp). Efficiency of donor programs in 2014 continued to increase: the share of effective donors after brain death in 2014 increased to 77.2%, the share of multiorgan explantation made 50.5%, average number of organs received from one effective donor made 2.6. In 2014 the rate of kidney transplantation made 7.0 pmp, the rate of liver transplantation made 2.1 pmp and the rate of heart transplantation made 1.1 pmp. In the Russian Federation the number of transplantations of liver and heart continues to increase. The significant contribution to development of the organ donation and transplantation brings the Moscow region in which 11 centers of transplantation function and nearly a half from all kidney transplantations and more than 65% of all liver and heart transplantations are carried out. Conclusion. In theRussian Federation the potential for further development of the transplantology remains. In particular, at the expense of increase in the efficiency of regional donation programs, introduction of technologies, expansion of the practices of multiorgan donation and transplantations of extrarenal organs, interregional transplant coordination. Preservation of volumes of public funding for transplantological medical care and federal financing of donation programs in regions are of great importance.
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Mealer, Corey, Haley Konsek, Zachary Travis, Rebecca N. Suk, and Taufiek Konrad Rajab. "Mechanisms of Cold Preservation and Reperfusion Injury for Solid Organ Transplantation: Implications for Partial Heart Transplantations." Transplantology 4, no. 3 (July 18, 2023): 124–38. http://dx.doi.org/10.3390/transplantology4030013.
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Cold preservation is a key component to organ procurement and transplantation. Cold preservation functions by slowing metabolic activity of procured organs and begins the period known as cold ischemic time (CIT). Reducing CIT and warm ischemic time (WIT) are paramount to minimizing donor organ damage from ischemia and the build-up of waste products and signals that drive reperfusion injury prior to transplantation into a matching recipient. Preventing damage from CIT and WIT and extending the amount of time that organs can tolerate has been a major goal of organ transplantation since donors and recipients are frequently not located within the same hospital, region, or state. Meanwhile, the amount of CIT that a transplant center is willing to accept differs based on the organ, the institution receiving the organ offer, and the doctor receiving the offer for that institution. With the introduction of a partial heart transplantation conducted last year at Duke University, it is important to discuss how much CIT transplant centers conducting a partial heart transplantation (pHT) are willing to accept. This article will review the physiology of WIT and CIT, associated organ damage, CIT variation among transplant centers and organ types, and provide a brief discussion of the future of pHT-accepted CIT and the need for research in this field.
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Mohammed, Alqahtani Ibtesam. "Organ Donation in the Context of Brain Death in Muslim Countries: Bioethical Positions." International Journal of Innovative Research in Medical Science 5, no. 07 (July 3, 2020): 222–24. http://dx.doi.org/10.23958/ijirms/vol05-i07/905.
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One of the miracles of modern medicine for patients with end stage organ failure is organ transplantation. The Organ Procurement and Transplantation Network (OPTN) defines organ donation as giving an organ, tissue, cells, or part of an organ from a living or deceased person (i.e., the donor) to a living person in need (i.e., the recipient). In the last two decades, the number of organ transplants has gradually increased; however, the demand for organ transplantation exceeds the number of available donors. Organs from brain dead donors have been suggested as an alternative option for increasing donation rates when living donors are not available. This article explores the debate surrounding brain death organ donation in Muslim countries. Because organ transplantation is based on Ijtihad, Muslim jurists have no clear-cut text in the Holy Quran or Sunna to use as a foundation for judgment. This has made organ transplants an issue among Muslim scholars and researchers, splitting them into two opinion groups, with one side seeing organ transplantation as legal and the other believing it to be illegal. However, all individuals have the right to choose whether they want to help others by sacrificing parts of themselves and donating their organs. Autonomy, justice, and beneficence must be employed in organ transplantation decision-making.
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Gautier, S. V., and S. M. Khomyakov. "Organ donation and transplantation in the Russian Federation in 2019. 12th report from the Registry of the Russian Transplant Society." Russian Journal of Transplantology and Artificial Organs 22, no. 2 (July 12, 2020): 8–34. http://dx.doi.org/10.15825/1995-1191-2020-2-8-34.
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Objective: to monitor current trends and developments in organ donation and transplantation in the Russian Federation based on the 2019 data. Materials and methods. Heads of organ transplant centers were surveyed. Data obtained over years from federal subjects of the Russian Federation and from organ transplant centers in the country were analyzed and compared. Results. Based on data retrieved from the 2019 Registry, only 46 kidney, 31 liver and 17 heart transplant centers were functioning in Russia. In 2019, there were 6,878 potential recipients in the kidney transplant waitlist. This represents 13.7% of the 50,000 dialysis patients in the country. Donation activity in 2019 reached 5.0 per million population; multi-organ procurement rate was 71.6%; 2.9 organs on average were procured from one effective donor. In 2019, there were 10.0 kidney transplants per million population, 4.0 liver transplants per million population and 2.3 heart transplants per million people. Same year, the number of transplant surgeries performed in Russia rose 10.7% from the previous year. Moscow and Moscow Oblast alone have 13 functioning organ transplantation centers. They account for half of all kidney transplant surgeries and 70% of all liver and heart transplants performed in the country. Organ recipients in the Russian Federation have exceeded 16,000 in number. Conclusion. Organ transplantations in Russia keep on increasing – 10–15% per year. Donor and transplant programs are also becoming more effective and efficient. However, the demand for organ transplants far exceeds the current supply of available organs in the Russian Federation. Peculiarities of the development of organ donation and organ transplantation in Russia in 2019 were associated with some factors, such as structure and geographical location of transplant centers, waitlisting of patients, funding sources and amount, and management of donor and transplant programs. The national transplantation registry will be developed taking into account new monitoring and analysis challenges.
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Langer, Róbert. "Milestone in Hungarian organ transplantation: joining Eurotransplant." Orvosi Hetilap 154, no. 22 (June 2013): 844–45. http://dx.doi.org/10.1556/oh.2013.29621.
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Hungarian organ transplantation reached a new milestone after half-a-century history, when becoming a full member of the 135-million Eurotransplant community this year. The transplantation of the five organs: kidney, liver, pancreas, heart and lung became a routine procedure. A handful of specialists performed nearly 7000 transplantations and doing so supported the evolution of a special branch of the Hungarian health care system. The author reports the latest results of the preliminary membership year, looking forward with great optimism by seeing new horizons with the advantages of the full membership. Orv. Hetil., 2013, 154, 844–845.
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Gautier, S. V., and S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN RUSSIAN FEDERATION IN 2017 10TH REPORT OF THE NATIONAL REGISTRY." Russian Journal of Transplantology and Artificial Organs 20, no. 2 (June 27, 2018): 6–28. http://dx.doi.org/10.15825/1995-1191-2018-2-6-28.
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Aim. To analyse the status and trends in the development of organ donation and organ transplantation in the Russian Federation according to 2017 data.Materials and methods. The survey of heads of transplantation centers was conducted. A comparative analysis of the data obtained in the dynamics of years, between individual subjects of the Russian Federation, the centers of transplantation is performed.Results. According to the register in 2017 in Russia there were only 41 centers for kidney transplantation, 24 liver and 16 hearts. The waiting list for kidney transplantation in 2017 included 5,531 potential recipients, which is approximately 13.8% of the total number of 40,000 patients receiving dialysis. The level of donor activity in 2017 was 3.8 per million of the population, while the share of multiorgan seizures was 66.5%, the average number of organs received from one effective donor was 2.8. In 2017, the level of kidney transplantation was 8.0 per million of the population, the liver transplantation index was 3.0 per million of the population; the rate of heart transplantation is 1.7 per million of the population. In 2017 the number of transplants in Russia increased by 11.3% compared to 2016. There are 11 transplantation centers on the territory of Moscow and the Moscow Region, and half of all kidney transplants and 70% of all liver and heart transplantations are performed. The number of patients with transplanted organs in the Russian Federation is approaching 13,000.Conclusion. In the Russian Federation there is a strong tendency to increase the number of effective donors and to increase the number of organ transplants, and the number of transplant centers is also increasing. In recent years, the country has created prerequisites for the development of organ donation and transplantation: the regulatory and legal framework, public donation funding, material and technical base, etc. In the coming years, positive experience and organizational patterns of organ donation and transplantation from successful regions in Other subjects of the Russian Federation for building effective programs. The leading role in this process should be played by the Academician V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs.
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Ahmad, Mahmood, Muhammad Shahbaz Manj, and Naheed Arain. "E-1 Human Organs Donation and Transplantation in the light of Hinduism." Al-Aijaz Research Journal of Islamic Studies & Humanities 4, no. 2 (December 6, 2020): 1–9. http://dx.doi.org/10.53575/e1.v4.02(20).1-9.
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Organ transplantation and organ donation is an important issue today. It was implemented in different ways. The medical field offers new methods of treatment, including organ transplantation and human services. This is one of the most difficult and complex aspects of modern medicine. It is a surgical replacement of diseased organ by another healthy human organ. It was implemented in different ways. Donation and organ transplantation are important issue of today. The medical field offers new methods of treatment, including organ transplantation and human services. Researchers have been trying to expand stem cells to other organs and are experimenting with alternatives to human blood. Organ Transplantation and donations are performed under the supervision of a competent transplant team.
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Joo, Ho No. "The Organ Transplantation Act and Recent Trends in Korea." Asia Pacific Journal of Public Health 25, no. 2 (March 2013): 209–13. http://dx.doi.org/10.1177/1010539513476935.
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The Organ Transplantation Act, including transplantation of organs from brain-dead donors, entered into force in Korea on February 9, 2000. This article introduces the Organ Transplantation Act, focusing on scope of the Act, determination of brain death, removal of organs from brain-dead or deceased donors, removal from living donors, organ allocation, and prohibition of trade in human organs. Especially, some primary ethical dilemmas surrounding organ allocation arise from the shortage of available organs. The primary ethical problems surrounding organ allocation are as follows. A key purpose of the organ donation incentive system is to increase the number of organ transplants from brain-dead donors. In particular, the priority for kidney patient was allowed in consideration of doctor’s strong desire to increase the brain-dead donors. Also, the organ allocation criteria based on the organ donation incentive system appear unfair, especially for the kidney patient, because the criteria do not fit the principles of distributive justice. In the future, the organ donation incentive system itself may need to be reexamined.
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Babini, Patrizia, Marco Lombardi, Vito Sparacino, and Giuseppe Vanacore. "Renal transplant patients: Review of Italian legislation." Giornale di Clinica Nefrologica e Dialisi 35 (May 8, 2023): 22–25. http://dx.doi.org/10.33393/gcnd.2023.2589.
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Organ transplantation is a life-saving procedure that can significantly improve the quality of life for patients suffering from organ failure. However, the procurement and transplantation of organs involves complex legal and ethical issues. Italy is not an exception, as the country has faced several challenges related to organ transplantation. The article provides an overview of the regulatory framework governing organ transplantation in Italy, focusing on patients’ needs.
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Yu, Andy S., Aijaz Ahmed, and Emmet B. Keeffe. "Liver Transplantation: Evolving Patient Selection Criteria." Canadian Journal of Gastroenterology 15, no. 11 (2001): 729–38. http://dx.doi.org/10.1155/2001/743019.
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The widespread recognition of the success of liver transplantation as a treatment for most types of acute and chronic liver failure has led to increased referrals for transplantation in the setting of a relatively fixed supply of cadaver donor organs. These events have led to a marked lengthening of the waiting time for liver transplantation, resulting in increased deaths of those on the waiting list and sicker patients undergoing transplantation. Nearly 5000 liver transplantations were performed in the United States in 2000, while the waiting list grew to over 17,000 patients. The mounting disparity between the number of liver transplant candidates and the limited supply of donor organs has led to reassessment of the selection and listing criteria for liver transplantation, as well as revision of organ allocation and distribution policies for cadaver livers. The development of minimal listing criteria for patients with chronic liver disease based on a specific definition for decompensation of cirrhosis has facilitated the more uniform listing of patients at individual centres across the United States. The United Network for Organ Sharing, under pressure from transplant professionals, patient advocacy groups and the federal government, has continuously revised allocation and distribution policies based on the ethical principles of justice for the individual patient versus optimal utility of the limited organ supply available annually. Beginning in 2002, it is likely that the Model for End-stage Liver Disease (MELD) score will be implemented to determine disease severity and direct donor organs to the sickest patients rather than to those with the longest waiting times.
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Ali, Jan A. "Islamic Perspectives on Organ Transplantation: A Continuous Debate." Religions 12, no. 8 (July 27, 2021): 576. http://dx.doi.org/10.3390/rel12080576.
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From a medical perspective, as well as an ordinary human perspective, organ transplantation is often understood as a process through which health is restored to sick humans and, consequently, their quality of life improved. Organ transplantation is a medical surgical procedure carried out by an expert or a team of experts who remove a failing or diseased organ or organs from the human body and replace it or them with a functioning organ or organs. With such positive portrayal of the process, organ transplantation is highly recommended and encouraged in modern medicine. However, in Islam, the Qur’an and hadiths—the two great texts of the religion—are silent on the subject. In other words, there is no discussion of the subject in the texts and, therefore, it is not clear whether organ transplantation is permissible or not in Islam. Thus, is organ transplantation an accepted modality of treatment that eliminates the patient’s agony from end-stage organ failure, remains an open-ended question. Whilst some Muslim scholars and jurists argue in favour of organ donation and transplantation, there are others who reject the practice as a breach of shari’ah. This paper posits that the subject of organ donation and transplantation in Islam is an unresolved matter without a ubiquitous consensus. The purpose of the paper is to educate the readers about the two key perspectives on the subject, and highlight that more research and a robust academic and sociological debate are needed to resolve the question of organ donation and transplantation in Islam.
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Monday Ikecukwu, Osebor. "The Moral Implications of Organ Farming." Mexican Bioethics Review ICSA 5, no. 9 (July 5, 2023): 1–5. http://dx.doi.org/10.29057/mbr.v5i9.10487.
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Organ transplantation is now widely considered the preferred mode of organ replacement therapy for patients suffering from organ failure. The success rate of organ transplantation goes with organ shortages. This has led to thousands of patients dying on the organ waiting list. Some have argued that human-to-human organ donation is an ethical response to the problem of organ shortages but human-to-human organ donation has not done enough to close the gap between the demand and supply of human organs. Steps need to be taken to improve the organ donation pool. The paper suggests organ farming. Organ farming is the genetic cultivation of human organs for clinical transplantation. The moral implications of organ farming include the question of human dignity, organ farming as playing God, and the destruction of embryos. From the Utilitarian standpoint, if organ farming promises to be good for the greatest number of persons it should be permitted, while the unethical practice of organ farming is regulated by law.
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Černiauskienė, Viktorija, Monika Čiplytė, and Saulius Vosylius. "Organų donoro priežiūra intensyviosios terapijos skyriuje." Lietuvos chirurgija 8, no. 1 (January 1, 2010): 0. http://dx.doi.org/10.15388/lietchirur.2010.1.2122.
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Viktorija Černiauskienė, Monika Čiplytė, Saulius VosyliusVilniaus universiteto Anesteziologijos ir reanimatologijos klinika, Vilniaus greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: saulius.vosylius@gmail.com Įvadas / tikslasDonorinių organų poreikis gerokai viršija atliktų organų transplantacijų skaičių. Dažniausios priežastys, dėl kurių potencialūs donorai netampa efektyviais donorais, yra donoro artimųjų prieštaravimas donorystei, medicininės kontraindikacijos, logistikos problemos, neadekvatus potencialių donorų gydymas iki eksplantacijos operacijos. Šio straipsnio tikslas yra apžvelgti naujausius medicinos mokslo laimėjimus atliekant potencialių organų donorų priežiūrą reanimacijos ir intensyviosios terapijos skyriuose. Metodai ir rezultataiIšliekant žymiam atotrūkiui tarp organų pasiūlos ir poreikio, būtina kuo efektyviau panaudoti esamus resursus, daugiau dėmesio skiriant tinkamai potencialaus organų donoro intensyviajai terapijai. Dėl smegenų mirties įvyksta sunkūs daugelio organizmui svarbių funkcijų sutrikimai: kraujotakos ir kvėpavimo sistemų, endokrininiai, elektrolitų balanso sutrikimai, hipotermija, koagulopatija ir intensyvus sisteminis uždegimo atsakas. IšvadosPasirinkta tinkama intensyviosios terapijos taktika galėtų padidinti transplantacijai tinkamų organų skaičių, išlaikyti geresnę jų funkciją po transplantacijos. Reikšminiai žodžiai: smegenų mirtis, intensyviosios terapijos skyriai, audinių ir organų donorystė, gairės Organ donor management in the intensive care unit Viktorija Černiauskienė, Monika Čiplytė, Saulius VosyliusClinic of Anaesthesiology and Intensive Care, Vilnius University,Šiltnamių Str. 29, LT-04130 Vilnius, LithuaniaE-mail: saulius.vosylius@gmail.com Background / objectiveThe demand for donor organs greatly exceeds the number of transplantations. Many reasons may determine this inadequacy, such as family refusal, medical contraindications, logistics problems and inadequate management of the organ donor. The aim of the study was to present the recent achievements of medical practice in the management of organ donors in intensive care units. Methods and resultsWhile the discrepancy between the number of organ donations and transplantations persists, it is essential to use available resources more effectively, paying more attention to the intensive care management of the organ donor. Many physiological changes follow after brain death, such as cardiovascular and pulmonary dysfunction, endocrine and homeostasis disturbances, hypothermia, coagulopathy and an enhanced inflammatory response. ConclusionsOptimal intensive care could increase the number of organs available for transplantation and improve their function after it. Keywords: brain death, intensive care units, tissue and organ procurement, guidelines as topic
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Ruutu, Tapani, Christian Koenecke, and Grzegorz W. Basak. "Allogeneic hematopoietic stem cell transplantation and solid organ transplantation in the same patient." Cellular Therapy and Transplantation 4, no. 1-2 (2015): 14–18. http://dx.doi.org/10.18620/1866-8836-2015-4-1-2-14-18.
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Copcă, Narcis, and Constanța Mihăescu-Pinţia. "Multi-organ Transplantation Center in Romania: a story of persuasion for a controverted issue." Proceedings of the International Conference on Business Excellence 13, no. 1 (May 1, 2019): 421–34. http://dx.doi.org/10.2478/picbe-2019-0037.
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Abstract Many countries built their own models of transplantation, collaborating to exchange knowledge and donor organs for effectively help their patients in need. Despite great clinical research on transplantation, literature regarding its management is scarce. Transplantation is quite a controverted issue in Romania, without a culture of donation, within a poor healthcare system. Yet, first attempts were in early 20th century, and modern transplantation started since 1995. There was always a shortage of organs, but after recent press scandals, people became more reluctant to donate, therefore transplantations went down, dramatically impacting patients.Our objective is to emphasize opportunity, need and sustainability for developing a multi-organ transplantation center in Romania, of regional importance, in order to better serve our patient needs in an effective and efficient manner. This research used descriptive analysis, secondary data compilation and review, legislative diagram, case study. Currently there are 68 transplantation centers accredited in Romania with 13,702 transplants accomplished (organs, tissues, cells), at a rate of 19.3/million, covering 19.4 millions of people living just 75.5 years in average (EU=80.2). But 5,400 Romanian patients wait for a transplant, while 550 died waiting... After modernization and building a great surgical center and team, Clinical Hospital St. Maria of 300 beds started complex surgery and successful liver transplantation in 2014, continued with lung transplant in 2018 – Romanian premiere, after many struggles. Next step is a modern multi-organ transplantation center. Vision, persuasion and effective leadership are crucial. Romanian potential for overspecialized surgery is greater than actual practice. Experience indicates that multi-organ transplantation centers are more effective and efficient than separated ones, by concentrating the best specialists, technology, knowledge and resources available for harvest, transplant and care, thus improving health outcomes (donors, successful transplants, lives saved, quality of life), prestige, retention of excellent professionals, and trust in healthcare system, at lower costs than in developed countries.