Alloantibody can be a major barrier to successful organ transplantation; however, therapy to control antibody production or to alter its impact on the allograft remains limited. The goal of this review is to examine the regulatory steps that are involved in the generation of alloreactive B cells, with a specific emphasis on how known mechanisms relate to clinical situations in transplant recipients. Thus, we will examine the process of activation of mature, naÔve B cells and how this relates to de novo antibody production.
Research has shown that most patients with end-stage kidney failure prefer treatment by transplantation. This entails taking immunosuppressant drugs daily throughout the life of the kidney. Failure to do so causes transplant rejection and a return to dialysis, or sometimes even death. Up to 50% of transplanted patients report failing to take their medication as prescribed. This qualitative study used focus groups to explore patients' lived experience in relation to medication adherence. Data were analysed using thematic analysis.
AIM: To investigate the experiences of everyday life after lung transplantation of patients with previous chronic obstructive pulmonary disease (COPD). BACKGROUND: Compared with patients being transplanted due to other indications, those with COPD prior to lung transplantation report more problems in the form of shortness of breath, fatigue, sexual problems, insomnia and increased appetite. In addition, they are often faced with problems returning to normal working life. How these problems influence the patient's everyday life is unknown. DESIGN: An exploratory qualitative study.
American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation
BACKGROUND: Kidney transplantation offers better outcomes compared to dialysis, but requires patients to adhere to an ongoing and complex self-management regimen. Medication nonadherence remains a leading cause of transplant loss, and inadequate self-management undermines transplantation and other health outcomes. We aimed to describe kidney transplant recipients' motivations, challenges, and attitudes toward self-management. STUDY DESIGN: Systematic review and thematic synthesis of qualitative studies. SETTING & POPULATION: Kidney transplant recipients.
Transplantation surgeries contribute to conceptions of the body as a collection of replaceable parts and of the self as distinct from all but its neural locus. There remains substantial cultural resistance to these conceptions, which leads the medical community to attempt to link the surgeries to social values that are sufficiently powerful to minimize the sense of a disjuncture between traditional concepts of personhood and those consistent with transplantation.
Living donor kidney transplantation comprises approximately 30% of kidney transplantations in the United States and is an effective form of renal replacement therapy, with low risk to the donor. Twenty percent of living donors do not have a genetic relationship with their recipients. In the selection of living donors, guiding ethical principles include altruism, the absence of coercion or monetary reward, patient autonomy, beneficence, and nonmaleficence.
International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics
The clinically detailed report of a successful uterus transplantation and live birth in Sweden, in which a family friend donated her uterus, provides a basis for expanded practice. Family members and friends can serve as living donors without offending legal or ethical prohibitions of paid organ donation, even though family members and friends often engage in reciprocal gift exchanges. Donations from living unrelated sources are more problematic, and there is a need to monitor donors' genuine altruism and motivation. Donation by deceased women-i.e.
Dialysis patients experience considerable psychologic stress, but practical issues impede delivery of psychiatric care. The authors describe five cases in which the use of hypnosis for symptom reduction provided the basis for beneficial psychiatric intervention.
The immunobiological activity was investigated of certain medicinal plants widely used in the Ayurvedic and Unani systems of medicine for treatment of chronic infections and immunological disorders. The effect of an ethanolic extract of each drug was studied on delayed type hypersensitivity, humoral responses to sheep red blood cells, skin allograft rejection, and phagocytic activity of the reticuloendothelial system in mice. Picrorhiza kurroa was found to be a potent immunostimulant, stimulating both cell-mediated and humoral immunity.