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Ethics Committees at Work

  • Pavel Tichtchenko (a1), Jean C. Edmond (a2), Robert M. Nelson (a3), Ellen L. Blank (a4), Robyn S. Shapiro (a5) and Charles Mackay (a6)...

Extract

The Research Center for Surgery (RCS) in Moscow is recognized as one of the largest and most prestigious surgical institutions in Russia. In this 400-bed facility more than 3,000 surgical procedures are performed annually, including heart, liver, and pancreas interventions and the reimplantation of limbs. The main focus of the research program at the RCS is on the transplantation of organs and reconstructive surgery. All procedures are free of charge to the patient.

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Notes

1. Heffron, T, Emond, J. Living-related liver transplantation. In: Busuttil, RW, Klintmalm, G, eds. Transplantation vfthe Liver. Philadelphia: W. B. Saunders, 1994 (in press).

2. Raia, S, Nery, J, Mies, S. Liver transplantation from live donors. Lancet 1988;ii:497.

3. Strong, RW, Lynch, SV, Ong, TN et al. , Successful liver transplantation from a living donor to her son. New England Journal of Medicine 1990;322:1505–7.

4. Broelsch, CE, Whitington, PF, Emond, JC et al. , Liver transplantation in children from living related donors. Annals of Surgery 1992;214: 428–39.

5. Singer, PA, Siegler, M, Lantos, JD et al. , The ethical assessment of innovative therapies: liver transplantation using living donors. Theoretical Medicine 1990;11:8794.

6. Anonymous. Annual report of the U.S. Scientific Registry of Transplant Recipients and the Organ Procurement and Transplantation Network—transplant date: 1988–1991. Richmond, Virginia: UNOS; and Bethesda, Maryland: the Division of Organ Transplantation, Bureau of Health Resources Development, Health Resources and Services Administration, U.S. Department of Health and Human Services, 1993.

7. Belle, SH, Beringer, KC, Murphy, JB, Detre, KM. The Pitt-UNOS Liver Transplant Registry. In: Terasaki, PI, Cecka, JM, eds. Clinical Transplants 1992. Los Angeles; UCLA Tissue Typing Laboratory, 1993:18.

8. Emond, JC. Clinical application of living-related liver transplantation. Gastroenterology Clinics of North America 1993;22:301–15.

9. Cecka, JM, Terasaki, PI. The UNOS Scientific RenalTransplant Registry – 1990. Long term survival of kidney grafts. In: Terasaki, PI, ed. Clinical Transplants 1990. Los Angeles: UCLA Tissue Typing Laboratory, 1991:111.

10. Kingsford, RP, Heyman, MB, Mudge, CL et al. , Initiation of a program for living-related liver transplantation: donor selection and outcome. Hepatology 1993;18:335A.

11. Emond, JC, Heffron, TG, Kortz, EO et al. , Improved results of living-related liver transplantation with routine application in a pediatric program. Transplantation 1993;55:835–40.

12. Tanaka, K, Uemoto, S, Tokunaga, Y et al. , Surgical techniques and innovations in living related liver transplantation. Annals of Surgery 1993;217:8291.

13. Heffron, T, Antonson, D, Langnas, A et al. , Living related liver transplantation affords optimal donor utilization. Transplantation Proceedings 1993 (in press).

14. See note 1. Heffron, , Emond, . 1994.

15. See note 12. Tanaka, et al. 1993;217:8291.

16. Lloyd, DM, Pieper, F, Gundlach, M et al. , Developments in segmental and living related liver transplantation. Transplantation Proceedings 1992;24:1287–92.

17. Boillot, ODawahra, M, Porcheron, J et al. , Pediatric liver transplantation from living related donors. Transplantation Proceedings 1994;30:261–3.

18. See note 7. Belle, et al. 1993:18.

19. Medical Advisory Board for Organ Transplantation MediCaL Sacramento, CA.01. 1993. Unpublished minutes.

20. Emond, JC, Whitington, PF, Thistlethwaite, JR et al. , Reduced-size orthotopic liver transplantation: use in the management of children with chronic liver disease. Hepatology 1989;10:867–72.

21. See note 12. Tanaka, et al. 1993;217:8291.Kawasaki, S, Makuuchi, M, Ishizone, S et al. , Liver regeneration in recipients and donors after transplantation. Lancet 1992;7:580–1.

22. Ozaki, CF, Katz, SM, Monsour, HP Jr et al. Vascular reconstruction in living-related liver transplantation. Transplantation Proceedings 1994;30:167–9.

Notes

1. de Ville, de Goyet, J, Hausleithner, V, Reding, R et al. , Impact of innovative techniques on the waiting list and results in pediatric liver transplantation. Transplantation 1993;56:1130–6.

2. Tokunaga, Y, Tanaka, K, Fujita, S et al. , Living related liver transplantation across ABO blood groups with FK506 and OKT3. Transplantation International (Germany) 1993;6:313–8.Emond, JC, Heffron, TG, Kortz, EO et al. , Improved results of living-related liver transplantation with routine application in a pediatric program. Transplantation (United States) 1993;55:835–40.

3. Skeie, B, Ashkanazi, J, Khambatta, H. Nutrition fluid and electrolytes. In: Barash, P, Cullen, B, Stoelting, R, eds. Clinical Anesthesia. Philadelphia: J. B. Lippincott, 1989:735.

4. Lallier, M, St-Vil, O, Luks, FI et al. , Biliary tract complications in pediatric orthotopic liver transplantation. Journal of Pediatric Surgery 1993;28:1102–5.Tanaka, K, Uemoto, S, Tokunaga, Y et al. , Surgical techniques and innovations in living related liver transplantation. Annals of Surgery 1993;217:8291.

5. Russel, S, Jacob, RG. Living-related organ donation: the donor's dilemma. Patient Education & Counseling 1993;21:8999.Goldman, LS. Liver transplantation using living donors: preliminary donor psychiatric outcomes. Psychosomatics 1993;34:235–40.Patenaude, AF. Psychological impact of bone marrow transplantation: current perspectives. Yale Journal of Biology and Medicine 1990;63:515–9.

6. Kawasaki, S, Makuuchi, M, Matsunaimi, H et al. , Preoperative measurement of segmental liver volume of donor for living related liver transplantation. Hematology 1993;18:11151120.Shimara, Y, Awane, M, Yamaoka, Y et al. , Analysis of the risk and operative stress for donors in living related liver transplantation. Transplantation 1992;54:983–8.

7. See note 2. Emond, , Heffron, , Kortz, . 1993;55:835–40. See note 4. Tanaka, , Uemoto, , Tokunaga, et al. , 1993;217:8291.

8. See note 2. Emond, Heffron, , Kortz, . et al. 1993;55:835–40.

Notes

1. Levine, RJ. Ethics and Regulation of Clinical Research. Baltimore: Urban and Schwarzen-berg, 1981:24.

2. Light, DW. Life, death and the insurance companies. New England Journal of Medicine 1994;330:498–9.

3. Charlesworth, M. Bioethics in a Liberal Society. New York: Cambridge University Press, 1993:167.

4. Pellegrino, ED, Thomasma, D. For the Patient's Good. New York: Oxford University Press, 1988:7391.MacKay, CR. The physician as fortuneteller. The Journal of Clinical Ethics 1991;2:234–5.

5. See note 4. Pellegrino, Thomasma, . 1988:7391.MacKay, . 1991;2:234–5.

6. Siegler, M, Lantos, JD. Commentary: Ethical justification for living liver donation. Cambridge Quarterly of Healthcare Ethics 1992;1:320–6.

7. See note 6. Siegler, Lantos, . 1992;1:320–6.

8. The experiences in the case of Baby Fae and Barney Clark stand as examples of what awaits the unwary by way of reaction.

9. See note 4. Pellegrino, Thomasma, . 1988:7391.MacKay, . 1991;2:234–5.

10. See note 6. Siegler, Lantos, . 1992;1:320–6.

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