Transplantation Reviews最新文献

{"title":"Research progress on anatomy reconstruction of rat orthotopic liver transplantation","authors":"Weikang Wu ,&nbsp;Juzheng Yuan ,&nbsp;Fuyuan Liu ,&nbsp;Lu Liu ,&nbsp;Xudan Wang ,&nbsp;Xiao Li ,&nbsp;Kaishan Tao","doi":"10.1016/j.trre.2024.100841","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100841","url":null,"abstract":"<div><p>Rat orthotopic liver transplantation (ROLT) serves as an ideal animal model and has gained popularity in addressing complications and perioperative treatments related to clinical liver transplantation. Through extensive research on ROLT model construction, the conventional “two-cuff” method has gradually become established. However, traditional methods still present challenges including limited visual field during vascular suturing, vascular torsion, biliary tract injuries, and prolonged anhepatic periods. Consequently, this paper aims to review the latest advancements and various techniques in this field, providing a valuable reference for individuals interested in constructing ROLT models.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100841"},"PeriodicalIF":4.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Was antiviral prophylaxis necessary after kidney transplantation utilizing HBcAb+ donors? A systematic review and meta-analysis","authors":"Saifu Yin ,&nbsp;Xiaoting Chen ,&nbsp;Xingxing Li ,&nbsp;Fan Zhang ,&nbsp;Jiapei Wu ,&nbsp;Tao Lin","doi":"10.1016/j.trre.2024.100840","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100840","url":null,"abstract":"<div><h3>Background</h3><p>Current guidelines lack consensus on whether antiviral prophylaxes should be administered after kidney transplantation from HBcAb+ donors. This systematic review and meta-analysis aimed to evaluate the incidence and risk factors of de novo HBV (DNH) infection, as well as graft and patient survival.</p></div><div><h3>Methods</h3><p>We searched PubMed, Embase, and the Cochrane Library up to December 31, 2023. We included relevant studies that assessed clinical outcomes following transplantation utilizing HBcAb+ kidneys. Summary measures of effect and 95% confidence intervals (CI) for prevalence, risk factors, as well as graft and patient survival were estimated using random-effects meta-analysis.</p></div><div><h3>Results</h3><p>Thirteen studies were included for the final analysis. The DNH incidence was at 0.36% (9/2516) with low heterogeneity (I² = 6%). HBsAb+ recipients (OR: 0.78, 95%CI: 0.25–2.38), HBcAb+ recipients (OR: 3.11, 95%CI: 0.91–10.66, <em>P</em> = 0.071), and recipients not receiving any antiviral prophylaxis (OR: 1.26, 95%CI: 0.15–10.58) were not associated with higher DNH risk. Specifically, HBsAb-/HBcAb+ recipients had the highest DNH incidence (4.65%), followed by HBsAb-/HBcAb- (0.49%), HBsAb+/HBcAb- recipients (0.45%), and HBsAb+/HBcAb+ (0%). Furthermore, recipients receiving HBcAb+ kidneys had comparable graft survival (HR: 1.06, 95%CI: 0.94–1.19, <em>P</em> = 0.55) and patient survival (HR:1.16, 95%CI: 0.98–1.38, <em>P</em> = 0.090) compared with recipients receiving HBcAb- kidneys.</p></div><div><h3>Conclusion</h3><p>Kidney transplantation utilizing HBcAb+ kidneys contributed to comparable graft and patient survival with an extremely low risk of HBV transmission. Antiviral prophylaxes may only be administered in HBsAb-/HBcAb+ recipients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100840"},"PeriodicalIF":4.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140135130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of echocardiographic assessment for the risk of adverse events in liver transplant recipients: A systematic review and meta-analysis","authors":"Quirino Lai ,&nbsp;Miriam Caimano ,&nbsp;Francesca Canale ,&nbsp;Lucia Ilaria Birtolo ,&nbsp;Flaminia Ferri ,&nbsp;Stefano Ginanni Corradini ,&nbsp;Massimo Mancone ,&nbsp;Giuseppe Marrone ,&nbsp;Daniela Pedicino ,&nbsp;Massimo Rossi ,&nbsp;Elisabetta Vernole ,&nbsp;Maurizio Pompili ,&nbsp;Marco Biolato","doi":"10.1016/j.trre.2024.100838","DOIUrl":"10.1016/j.trre.2024.100838","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>Echocardiographic findings may provide valuable information about the cardiac conditions in cirrhotic patients waiting for liver transplantation (LT). However, data on the ability of the different echocardiographic parameters to predict post-transplant risk of mortality are scarce and heterogeneous. This systematic review evaluates the role of different echocardiographic features as predictors of post-LT mortality. A meta-analysis was also performed according to the observed results.</p></div><div><h3>Methods</h3><p>A systematic review was conducted according to PRISMA guidelines. Medline (PubMed) database was searched through February 2023 for relevant published original articles reporting the prognostic value of echocardiographic findings associated with outcomes of adult LT recipients. The risk of bias in included articles was assessed using ROBINS-E tool. Methodological quality varied from low to high across the risk of bias domains.</p></div><div><h3>Results</h3><p>Twenty-three studies were identified after the selection process; ten were enrollable for the meta-analyses. According to the results observed, the E/A ratio fashioned as a continuous value (HR = 0.43, 95%CI = 0.25–0.76; <em>P</em> = 0.003), and tricuspid regurgitation (HR = 2.36, 95%CI = 1.05–5.31; <em>P</em> = 0.04) were relevant predicting variables for post-LT death. Other echocardiographic findings failed to merge with statistical relevance.</p></div><div><h3>Conclusion</h3><p>Tricuspid regurgitation and left ventricular diastolic dysfunction play a role in the prediction of post-LT death. More studies are needed to clarify further the impact of these echocardiographic features in the transplantation setting.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100838"},"PeriodicalIF":4.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139945401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-transplant lymphoproliferative disorders following kidney transplantation: A literature review with updates on risk factors, prognostic indices, screening strategies, treatment and analysis of donor type","authors":"Mehmet Ergisi ,&nbsp;Bryan Ooi ,&nbsp;Omar Salim ,&nbsp;Vassilios Papalois","doi":"10.1016/j.trre.2024.100837","DOIUrl":"10.1016/j.trre.2024.100837","url":null,"abstract":"<div><p>Post-transplant lymphoproliferative disorders (PTLD) is a devastating complication of kidney transplantation with an insidious presentation and potential to disseminate aggressively. This review delineates the risk factors, prognostic indexes, screening, current management algorithm and promising treatment strategies for PTLD. Kidneys from both extended criteria donors (ECD) and living donors (LD) are being increasingly used to expand the donor pool. This review also delineates whether PTLD outcomes vary based on these donor sources.</p><p>While Epstein-Barr virus (EBV) is a well-known risk factor for PTLD development, the use of T-cell depleting induction agents has been increasingly implicated in aggressive, monomorphic forms of PTLD. Research regarding maintenance therapy is sparse. The international prognostic index seems to be the most validate prognostic tool. Screening for PTLD is controversial, as annual PET-CT is most sensitive but costly, while targeted monitoring of EBV-seronegative patients was more economically feasible, is recommended by the American Society of Transplantation, but is limited to a subset of the population. Other screening strategies such as using Immunoglobulin/T-cell receptor require further validation.</p><p>A risk-stratified approach is taken in the treatment of PTLD. The first step is the reduction of immunosuppressants, after which rituximab and chemotherapy may be introduced if unsuccessful. Some novel treatments have also shown potential benefit in studies: brentuximab vedotin, chimeric antigen receptor T-cell therapy and EBV-specific cytotoxic T lymphocytes.</p><p>Analysis of LD v DD recipients show no significant difference in incidence and mortality of PTLD but did reveal a shortened time to development of PTLD from transplant. Analysis of SCD vs ECD recipients show a higher incidence of PTLD in the ECD group, which might be attributed to longer time on dialysis for these patients, age, and the pro-inflammatory nature of these organs. However, incidence of PTLD overall is still extremely low. Efforts should be focused on optimising recipients instead. Minimising the use of T-cell depleting therapy while encouraging research on the effect of new immunosuppressants on PTLD, screening for EBV status are essential, while enabling shared decision-making during counselling when choosing kidney donor types and individualised risk tailoring are strongly advocated.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100837"},"PeriodicalIF":4.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X2400020X/pdfft?md5=8ba2c60effdfcf12b67a9e3de18779ca&pid=1-s2.0-S0955470X2400020X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139945445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent C3 glomerulopathy after kidney transplantation","authors":"Shota Obata ,&nbsp;Pedro A.S. Vaz de Castro ,&nbsp;Leonardo V. Riella ,&nbsp;Paolo Cravedi","doi":"10.1016/j.trre.2024.100839","DOIUrl":"10.1016/j.trre.2024.100839","url":null,"abstract":"<div><p>The complement system is part of innate immunity and is pivotal in protecting the body against pathogens and maintaining host homeostasis. Activation of the complement system is triggered through multiple pathways, including antibody deposition, a mannan-binding lectin, or activated complement deposition. C3 glomerulopathy (C3G) is a rare glomerular disease driven by complement dysregulation with high post-transplantation recurrence rates. Its treatment is mainly based on immunosuppressive therapies, specifically mycophenolate mofetil and glucocorticoids. Recent years have seen significant progress in understanding complement biology and its role in C3G pathophysiology. New complement-tergeting treatments have been developed and initial trials have shown promising results. However, challenges persist in C3G, with recurrent post-transplantation cases leading to suboptimal outcomes. This review discusses the pathophysiology and management of C3G, with a focus on its recurrence after kidney transplantation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100839"},"PeriodicalIF":4.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139924443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehabilitation in patients awaiting liver transplantation","authors":"Amine Benmassaoud ,&nbsp;Myriam Martel ,&nbsp;Franco Carli ,&nbsp;Olivia Geraci ,&nbsp;Stella S. Daskalopoulou ,&nbsp;Giada Sebastiani ,&nbsp;Amal Bessissow","doi":"10.1016/j.trre.2024.100835","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100835","url":null,"abstract":"<div><h3>Background</h3><p>Frailty, malnutrition and sarcopenia lead to a significant increase in morbidity and mortality before and after liver transplantation (LT). Prehabilitation attempts to optimize physical fitness of individuals before major surgeries. To date, little is known about its impact on patients awaiting LT.</p></div><div><h3>Aims</h3><p>The aim of our scoping review was to describe whether prehabilitation in patients awaiting LT is feasible and safe, and whether it leads to a change in clinical parameters before or after transplantation.</p></div><div><h3>Methods</h3><p>We performed a systematic review of the literature from 1946 to November 2023 to identify prospective studies and randomized controlled trials of adult LT candidates who participated in an exercise training program.</p></div><div><h3>Results</h3><p>Out of 3262 citations initially identified, six studies were included. Studies were heterogeneous in design, patient selection, intervention, duration, and outcomes assessed. All studies were self-described as pilot or feasibility studies and had a sample size ranging from 13 to 33. Two studies were randomized controlled trials. Two study restricted to patients with cirrhosis who were eligible for liver transplantation or on the transplant list. Exercise programs lasted between 6 and 12 weeks. In terms of feasibility, proportion of eligible patients that were recruited was between 54 and 100%. Program completion ranged between 38 and 90%. Interventions appeared safe with 9 (9.2%) adverse events noted. In the intervention group, improvements were generally noted in peak oxygen consumption and workload, 6-min walking distance, and muscle strength. One study suggested a decrease in post-transplant hospital length of stay.</p></div><div><h3>Conclusions</h3><p>Overall, it appears that prehabilitation with exercise training is feasible, and safe in patients awaiting LT. Higher quality and larger studies are needed to confirm its impact on pre- and post-transplantation-related outcomes.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100835"},"PeriodicalIF":4.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139748773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing quality of life in solid organ transplant recipients: A systematic review of the development, content, and quality of available condition- and transplant-specific patient-reported outcome measures","authors":"Ben Rimmer ,&nbsp;Rebeka Jenkins ,&nbsp;Siân Russell ,&nbsp;Dawn Craig ,&nbsp;Linda Sharp ,&nbsp;Catherine Exley","doi":"10.1016/j.trre.2024.100836","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100836","url":null,"abstract":"<div><h3>Purpose</h3><p>We aimed to identify the condition- and transplant-specific patient-reported outcome measures (PROMs) available to measure quality of life (QoL) in solid organ transplant (SOT) recipients, examine their development and content, and critically appraise the quality of their measurement properties, to inform recommendations for clinical and research use.</p></div><div><h3>Methods</h3><p>We systematically searched MEDLINE, Embase, CINAHL, PsycINFO, Cochrane CENTRAL, and Scopus from inception to 27th January 2023. Search hits were screened for eligibility by two independent reviewers; papers reporting the development and/or validation of condition- and transplant-specific PROMs measuring QoL in adult SOT recipients were considered eligible. We abstracted and synthesised data on PROM characteristics, development (item generation and/or reduction), and content (QoL dimensions). Quality appraisal and synthesis were informed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, and included methodological and quality assessment of measurement properties, GRADE levels of evidence, feasibility and interpretability.</p></div><div><h3>Results</h3><p>We identified 33 papers reporting 26 QoL PROMs validated in SOT recipients (kidney <em>n</em> = 10 PROMs; liver <em>n</em> = 6; lung <em>n</em> = 3; heart <em>n</em> = 2; pancreas n = 1; multiple organs <em>n</em> = 4). Patient discussions (<em>n</em> = 17 PROMs) and factor analysis (<em>n</em> = 11) were the most common item generation and reduction techniques used, respectively. All PROMs measured ≥3 of nine QoL dimensions (all measured emotional functioning); KDQoL-SF and NIDDK-QA measured all nine. Methodological quality was variable; no PROM had low evidence or better for all measurement properties. All PROMs were COSMIN recommendation category ‘B', primarily because none had sufficient content validity.</p></div><div><h3>Conclusions</h3><p>There are many condition- and transplant-specific QoL PROMs validated in SOT recipients, particularly kidney. These findings can help inform PROM selection for clinicians and researchers. However, caution is required when adopting measures, due to the substantial heterogeneity in development, content, and quality. Each PROM has potential but requires further research to be recommendable. Greater consideration of patient and professional involvement in PROM development in this setting is needed to ensure sufficient content validity.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100836"},"PeriodicalIF":4.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000193/pdfft?md5=df47eb91c5cd1108c5f4a4fc2517357d&pid=1-s2.0-S0955470X24000193-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139738112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of goal-directed fluid therapy on delayed graft function in kidney transplant recipients: A systematic review and meta-analysis","authors":"Michael P. Klonarakis ,&nbsp;Mannat Dhillon ,&nbsp;Emir Sevinc ,&nbsp;Meghan J. Elliott ,&nbsp;Matthew T. James ,&nbsp;Ngan N. Lam ,&nbsp;Kevin J. McLaughlin ,&nbsp;Paul E. Ronksley ,&nbsp;Shannon M. Ruzycki ,&nbsp;Tyrone G. Harrison","doi":"10.1016/j.trre.2024.100834","DOIUrl":"10.1016/j.trre.2024.100834","url":null,"abstract":"<div><p>Delayed graft function (DGF) is a common post-operative complication with potential long-term sequelae for many kidney transplant recipients, and hemodynamic factors and fluid status play a role. Fixed perioperative fluid infusions are the standard of care, but more recent evidence in the non-transplant population has suggested benefit with goal-directed fluid strategies based on hemodynamic targets. We searched MEDLINE, EMBASE, Cochrane Controlled Trials Registry and Google Scholar through December 2022 for randomized controlled trials comparing risk of DGF between goal-directed and conventional fluid therapy in adults receiving a living or deceased donor kidney transplant. Effect estimates were reported with odds ratios (OR) and pooled using random effects meta-analysis. We identified 4 studies (205 participants) that met the inclusion criteria. The use of goal-directed fluid therapy had no significant effect on DGF (OR 1.37 95% CI, 0.34–5.6; <em>p</em> = 0.52; I² = 0.11). Subgroup analysis examining effects among deceased and living kidney donation did not reveal significant differences in the effects of fluid strategy on DGF between subgroups. Overall, the strength of the evidence for goal-directed versus conventional fluid therapy to reduce DGF was of low certainty. Our findings highlight the need for larger trials to determine the effect of goal-directed fluid therapy on this patient-centered outcome.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100834"},"PeriodicalIF":4.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X2400017X/pdfft?md5=1d194adabec20ab884a91886e2d974d8&pid=1-s2.0-S0955470X2400017X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latest advances in frailty in kidney transplantation: A narrative review","authors":"Ruth Fergie ,&nbsp;Alexander P. Maxwell ,&nbsp;Emma L. Cunningham","doi":"10.1016/j.trre.2024.100833","DOIUrl":"10.1016/j.trre.2024.100833","url":null,"abstract":"<div><p>Frailty is a clinical syndrome that is characterised by decline in multiple systems with associated decreased physiological reserve and ability to respond to stressor events. It is associated with greater healthcare burden. It is common in patients with end-stage renal disease (ESRD). Kidney transplantation is considered the optimal form of renal replacement therapy for suitable patients with ESRD. However, surgery and immunosuppression are physiological stresses that can disproportionately affect frail individuals. Frailty is emerging as a potentially important risk factor in patients waitlisted for kidney transplantation. Most of the published research to date in this area comes from a single transplant centre in the USA. Frailty, as measured using the Physical Frailty Phenotype (FP), is prevalent in waitlisted patients and has been associated with early hospital re-admission, prolonged length of stay, delayed graft function and increased mortality after kidney transplantation. However, although kidney transplantation is a substantial physiological stress to a patient's reserve, by restoring kidney function, kidney transplantation has also been shown to improve a patient's frailty status. The FP is the most studied tool in patients waitlisted for transplantation, but it has not been able to distinguish those whose frailty is improved by kidney transplantation.</p><p>In summary, there remain significant gaps in knowledge and uncertainties as to how to effectively use existing frailty measures to inform decision-making around kidney transplantation. Further research is needed to address these important gaps in the literature.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100833"},"PeriodicalIF":4.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000168/pdfft?md5=d87f31ad7793c75e8420bf137961e746&pid=1-s2.0-S0955470X24000168-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139578131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The psychology, legality, ethics and medical aspects of organ donation by minors","authors":"A. Ashwin ,&nbsp;S.D. Cherukuri ,&nbsp;A. Rammohan","doi":"10.1016/j.trre.2024.100832","DOIUrl":"10.1016/j.trre.2024.100832","url":null,"abstract":"<div><p>Any individual who has not attained the chronological age of legal majority as per national law is termed a minor. The concept of living donation (LD) has always been a subject of ethical debate and further compounding the controversy is the question of LD by minors. The decision for a minor to donate poses a special challenge as it involves a close family unit of parent-child relationship. Such an emotionally loaded situation wherein questions of attachment, perceived duties, moral obligation are likely to cloud a truly informed consent on the part of the minor to donation, who may find themselves in a vulnerable position. Furthermore, a minor's cognitive ability to comprehend the gravity of LD and when required defy parental coercion need to be elucidates before a minor is accepted for LD. Experts have set out stringent conditions which need to be met prior to the exceptional circumstance that a minor is considered for organ donation. Such donations should require parental permission, child's assent and the involvement of a paediatric-trained donor advocacy team. This article debates the question of minors acting as live donors from ethical, medical, psychosocial and legal viewpoints with an aim to present internationally defined circumstances when a minor may morally participate as a LD, thereby laying the foundation for future deliberations in this regard using traditional metrics to juxtapose divergent courses of action.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100832"},"PeriodicalIF":4.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139496884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}