Faculty Bibliography

Because of a shortage of transplantable livers and hearts, the transplant community has had to decide--by who gets an organ--who lives or dies. Despite this shortage, whether one has previously received a transplant is not used as a criterion to distribute organs. The existing allocation system distributes 10% to 20% of available hearts and livers to retransplant patients. This article examines three differences between primary transplantation and retransplantation that may affect the priority that retransplant candidates should receive in vying for organs: (1) the special obligations that transplant teams have not to abandon patients on whom they have already performed a transplant, (2) the fairness of allowing individuals to get multiple transplants while some die awaiting their first, and (3) the difference in efficacy between primary transplantation and retransplantation. Only this last difference holds up to critical analysis. Our moral duty to direct scarce, lifesaving resources to those likely to benefit from them, suggests that, all other things equal, primary transplant candidates should receive priority because their mortality after transplantation is lower. Consistency also demands that previous transplant history be taken into account, as we already allocate organs according to ABO blood group matching, a factor that affects transplant outcome approximately the same amount as a previous transplantation. We therefore conclude that the system should be revised so that primary transplant candidates have a better chance of receiving organs than retransplant candidates.

Finding a vaccine to combat AIDS is no easy task. The virus that causes AIDS is small, hard to work with and capable of evolving into different strains. This means that vaccine research is slow and frustrating. It also means that vaccine development is expensive

If the good nurse were to suddenly be transported into the average U.S. hospital, clinic or group practice of today, she would be amazed to find that her 130-year-old lament still rings true. Medical record-keeping is still in the dark ages in the United States

If the good nurse were to suddenly be transported into the average U.S. hospital, clinic or group practice of today, she would be amazed to find that her 130-year-old lament still rings true. Medical record-keeping is still in the dark ages in the United States

When more than one sperm penetrates an egg the resulting embryo cannot become a baby. They took 17 of the abnormal embryos and put them in a specially prepared fluid. There the embryos were allowed to divide into two, four or eight-cell embryos. Then, they separated these into single cells. The cells began dividing again, meaning that 48 genetically identical embryos had been made from 17. And that meant that [Jerry Hall] and his colleagues had performed the first published experiment involving the cloning of human embryos

When more than one sperm penetrates an egg the resulting embryo cannot become a baby. They took 17 of the abnormal embryos and put them in a specially prepared fluid. There the embryos were allowed to divide into two, four or eight-cell embryos. Then, they separated these into single cells. The cells began dividing again, meaning that 48 genetically identical embryos had been made from 17

When more than one sperm penetrates an egg the resulting embryo cannot become a baby. They took 17 of the abnormal embryos and put them in a specially prepared fluid. There the embryos were allowed to divide into two, four or eight-cell embryos. Then, they separated these into single cells. The cells began dividing again, meaning that 48 genetically identical embryos had been made from 17

A retrospective study of all adults receiving BMT over a 13 year period at a large transplant center was performed to determine overall survival and prognostic indicators of poor outcome among patients receiving mechanical ventilation (MV). Of 653 adult BMT patients, 191 (29%) received MV after transplant. Of these 191, 161 (84%) died on the ventilator or within hours of extubation; 18 (10%) survived 1 week after extubation and 6 (3%) survived 6 months. Survival was not predicted by type of graft, use of total body irradiation (TBI) or reason for intubation. The patient's age and the timing of intubation were predictive of survival. Of patients > or = 40 years, 98% died within a week of extubation and all died within 30 days. Similarly, of those intubated within 90 days of transplant, 94% died within a week of extubation and all died by day 100. These results suggest that MV is rarely effective in achieving long-term survival in adult BMT recipients, especially older patients and those early in their transplant course. An argument, based on cost/benefit considerations and medical futility, can be developed to withhold MV in certain patient subsets apart from a clinical research trial.