The procedure established to evaluate the health status and risk factors of the potential DONORS of biological materials. Donors are selected based on the principles that their health will not be compromised in the process, and the donated materials, such as TISSUES or organs, are safe for reuse in the recipients.
Individuals supplying living tissue, organs, cells, blood or blood components for transfer or transplantation to histocompatible recipients.
Non-cadaveric providers of organs for transplant to related or non-related recipients.
'Blood donors' are individuals who voluntarily and safely donate a specific amount of their own blood, which can be further separated into components, to be used for transfusion purposes or for manufacturing medical products, without receiving remuneration that is intended to reward them financially.
Identification of the major histocompatibility antigens of transplant DONORS and potential recipients, usually by serological tests. Donor and recipient pairs should be of identical ABO blood group, and in addition should be matched as closely as possible for HISTOCOMPATIBILITY ANTIGENS in order to minimize the likelihood of allograft rejection. (King, Dictionary of Genetics, 4th ed)
Differential and non-random reproduction of different genotypes, operating to alter the gene frequencies within a population.
The degree of antigenic similarity between the tissues of different individuals, which determines the acceptance or rejection of allografts.
The administrative procedures involved with acquiring TISSUES or organs for TRANSPLANTATION through various programs, systems, or organizations. These procedures include obtaining consent from TISSUE DONORS and arranging for transportation of donated tissues and organs, after TISSUE HARVESTING, to HOSPITALS for processing and transplantation.
The transference of a part of or an entire liver from one human or animal to another.
Antigens determined by leukocyte loci found on chromosome 6, the major histocompatibility loci in humans. They are polypeptides or glycoproteins found on most nucleated cells and platelets, determine tissue types for transplantation, and are associated with certain diseases.
The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host.
Transplantation between individuals of the same species. Usually refers to genetically disparate individuals in contradistinction to isogeneic transplantation for genetically identical individuals.
The transference of BONE MARROW from one human or animal to another for a variety of purposes including HEMATOPOIETIC STEM CELL TRANSPLANTATION or MESENCHYMAL STEM CELL TRANSPLANTATION.
Transfer of HEMATOPOIETIC STEM CELLS from BONE MARROW or BLOOD between individuals within the same species (TRANSPLANTATION, HOMOLOGOUS) or transfer within the same individual (TRANSPLANTATION, AUTOLOGOUS). Hematopoietic stem cell transplantation has been used as an alternative to BONE MARROW TRANSPLANTATION in the treatment of a variety of neoplasms.
The clinical entity characterized by anorexia, diarrhea, loss of hair, leukopenia, thrombocytopenia, growth retardation, and eventual death brought about by the GRAFT VS HOST REACTION.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.

Nonmyeloablative allogeneic stem cell transplantation using alternative donors. (1/223)

BACKGROUND: The reduced intensity of nonmyeloablative stem cell transplant (NMSCT) has enabled older patients to benefit from allogeneic therapy. Identification of suitable donors remains an obstacle. The use of alternative donors for stem cell therapy is essential to ensure broad applicability of allogeneic therapy. METHODS: Clinical results using alternative hematopoietic stem cell donors are reviewed, including matched unrelated donors, partially matched family member donors, and unrelated partially matched umbilical cord blood. RESULTS: The successful use of NMSCT in the treatment of hematologic and nonhematologic diseases has increased the number of patients capable of receiving allogeneic therapy. However, the stem cell donor pool remains limited due to the infrequent number of patients with matched siblings. CONCLUSIONS: The use of alternative donor stem cell sources can expand the number of patients able to receive allogeneic therapy. Preliminary studies indicate that the use of alternative donors can provide reliable engraftment, although graft-vs-host disease remains a concern.  (+info)

Should selecting saviour siblings be banned? (2/223)

By using tissue typing in conjunction with preimplantation genetic diagnosis doctors are able to pick a human embryo for implantation which, if all goes well, will become a "saviour sibling", a brother or sister capable of donating life-saving tissue to an existing child. This paper addresses the question of whether this form of selection should be banned and concludes that it should not. Three main prohibitionist arguments are considered and found wanting: (a) the claim that saviour siblings would be treated as commodities; (b) a slippery slope argument, which suggests that this practice will lead to the creation of so-called "designer babies"; and (c) a child welfare argument, according to which saviour siblings will be physically and/or psychologically harmed.  (+info)

New trends in umbilical cord blood transplantation. (3/223)

Since the first report of a successful umbilical cord blood transplantation in 1988, there has been great interest in the use of cord blood as an alternative stem cell source to treat cancer and genetic diseases. More than 4000 cord blood transplantations have been performed worldwide. In this review, the scientific rationale for this therapy, as well as related preclinical studies, cord blood banking issues, and ethical concerns, will be addressed. Results of studies in both pediatric and adult transplantation will be discussed. Finally, new indications for cord blood use and emerging technologies will be addressed.  (+info)

Anonymous or identity-registered sperm donors? A study of Dutch recipients' choices. (4/223)

BACKGROUND: The aim of the present study was to gain insight into parents' own donor preferences within a system offering the choice between an anonymous and identity-registered donor. A comparison was made between recipients choosing for an anonymous donor (AD choosers) and those choosing for an identifiable donor (ID choosers) with regard to their sexual orientation, demographic characteristics, disclosure issues and infertility distress. METHODS: Data from 105 couples (61% heterosexual, 39% lesbian) were registered on a standardized form during implication counselling sessions previous to treatment. RESULTS: Sixty-three per cent of the heterosexual couples and 98% of the lesbian couples had chosen an ID donor. Major differences between ID and AD choosers were identified. Among the ID choosers secrecy towards the child was no option, whereas 83% of the AD choosers did not intend to inform their child. Compared with heterosexual ID choosers, AD choosers were more distressed about their infertility and had a lower educational level. CONCLUSION: Legislation imposing ID donors appears to be acceptable for the majority of this study population. For a vulnerable group of heterosexual couples, who remained secretive about the use of a donor, adaptation to the new system is not self-evident.  (+info)

Designing deaf babies and the question of disability. (5/223)

This article explores the recent controversy surrounding a Deaf lesbian couple's deliberate attempt at finding a Deaf donor to increase their chances of having a d/Deaf baby. Many have criticized the Deaf couple for harming their child; Deaf advocates have responded that the couple's decision reflects a natural cultural desire. This article seeks to explore how the medical model of disability implicitly used on both sides of the debate has obscured important points. Once this controversy takes into consideration the social construction of disability, the ethical defense of seeking a deaf child gains further support. This leads to the ironic claim that seeking a deaf child could actually mitigate the conditions of disability within the family.  (+info)

Comparison of killer Ig-like receptor genotyping and phenotyping for selection of allogeneic blood stem cell donors. (6/223)

The repertoire of killer Ig-like receptors (KIRs) can be determined at the level of DNA, RNA, or surface protein expression for selection of blood stem cell donors. We compared genotyping and phenotyping of the four inhibitory KIRs that are important in transplantation for leukemia in 73 unrelated persons. In 5 (7%) of the 68 individuals in whom the KIR2DL1 gene was present and in 10 (15%) of the 67 in whom KIR3DL1 was present, the corresponding receptor was not expressed by NK cells, as determined by flow cytometry analysis. In contrast, one or both allelic forms of KIR2DL2/KIR2DL3 were expressed by a high proportion of NK cells in all 73 individuals. However if both KIR2DL2 and KIR2DL3 genes were present, KIR2DL3 was preferentially expressed, as transcripts of KIR2DL2 was not detectable by RT-PCR in 42% of these individuals. In total, repertoire assessment for the four KIRs by genotyping vs phenotyping was not in complete agreement in 18 (25%) of the 73 individuals. Furthermore, among the samples that tested positive for the expression of a certain KIR gene, the levels of transcripts and surface expression varied considerably as measured by both real-time quantitative PCR and flow cytometry analysis. Extension of this comparative analysis to include all 12 KIR family members showed that KIR2DL3 and KIR3DL2 were the only genes whose transcripts were consistently detectable. These results caution the use of genotyping alone for donor selection or leukemia-relapse prognostication because some KIRs may be expressed at a very low level.  (+info)

Human cells, tissues, and cellular and tissue-based products; donor screening and testing, and related labeling. Interim final rule; opportunity for public comment. (7/223)

The Food and Drug Administration (FDA) is issuing an interim final rule to amend certain regulations regarding the screening and testing of donors of human cells, tissues, and cellular and tissue-based products (HCT/Ps), and related labeling. FDA is taking this action in response to comments from affected interested persons regarding the impracticability of complying with certain regulations as they affect particular HCT/Ps.  (+info)

Is conceiving a child to benefit another against the interests of the new child? (8/223)

Conceiving a child by way of embryo selection and tissue matching to benefit a sick sibling is generally justified on the grounds that as well as the potential to save the sick child, there is a benefit for the new baby. The new baby is selected so he or she will not have the disease suffered by the first child. It is not possible, however, to select against conditions for which there is no test and Jamie Whitaker's birth is a case where the process of in vitro fertilisation with tissue matching is viewed as being of benefit only to a third party-the sick child. Some people object to using the technology for this purpose. There are also good reasons to argue that the technology should be used to save a sick child, and that it would be morally remiss for Jamie's parents not to consent to the use of his cord blood.  (+info)

Donor selection is the process of evaluating and choosing potential organ, tissue, or stem cell donors based on various medical and non-medical criteria to ensure the safety and efficacy of the transplantation. The goal of donor selection is to identify a compatible donor with minimal risk of rejection and transmission of infectious diseases while also considering ethical and legal considerations.

Medical criteria for donor selection may include:

1. Age: Donors are typically required to be within a certain age range, depending on the type of organ or tissue being donated.
2. Blood type and human leukocyte antigen (HLA) typing: Compatibility between the donor's and recipient's blood types and HLA markers is crucial to reduce the risk of rejection.
3. Medical history: Donors must undergo a thorough medical evaluation, including a review of their medical history, physical examination, and laboratory tests to assess their overall health and identify any potential risks or contraindications for donation.
4. Infectious disease screening: Donors are tested for various infectious diseases, such as HIV, hepatitis B and C, syphilis, and cytomegalovirus (CMV), among others, to ensure they do not transmit infections to the recipient.
5. Tissue typing: For organ transplants, tissue typing is performed to assess the compatibility of the donor's and recipient's major histocompatibility complex (MHC) antigens, which play a significant role in the immune response and rejection risk.

Non-medical criteria for donor selection may include:

1. Consent: Donors must provide informed consent for organ or tissue donation, and their next of kin or legal representative may be involved in the decision-making process for deceased donors.
2. Legal considerations: There are specific laws and regulations governing organ and tissue donation that must be followed, such as age restrictions, geographical proximity between the donor and recipient, and cultural or religious beliefs.
3. Ethical considerations: Donor selection should adhere to ethical principles, such as fairness, respect for autonomy, and non-maleficence, to ensure that the process is transparent, equitable, and free from coercion or exploitation.

A tissue donor is an individual who has agreed to allow organs and tissues to be removed from their body after death for the purpose of transplantation to restore the health or save the life of another person. The tissues that can be donated include corneas, heart valves, skin, bone, tendons, ligaments, veins, and cartilage. These tissues can enhance the quality of life for many recipients and are often used in reconstructive surgeries. It is important to note that tissue donation does not interfere with an open casket funeral or other cultural or religious practices related to death and grieving.

A living donor is a person who voluntarily donates an organ or part of an organ to another person while they are still alive. This can include donations such as a kidney, liver lobe, lung, or portion of the pancreas or intestines. The donor and recipient typically undergo medical evaluation and compatibility testing to ensure the best possible outcome for the transplantation procedure. Living donation is regulated by laws and ethical guidelines to ensure that donors are fully informed and making a voluntary decision.

A blood donor is a person who voluntarily gives their own blood or blood components to be used for the benefit of another person in need. The blood donation process involves collecting the donor's blood, testing it for infectious diseases, and then storing it until it is needed by a patient. There are several types of blood donations, including:

1. Whole blood donation: This is the most common type of blood donation, where a donor gives one unit (about 450-500 milliliters) of whole blood. The blood is then separated into its components (red cells, plasma, and platelets) for transfusion to patients with different needs.
2. Double red cell donation: In this type of donation, the donor's blood is collected using a special machine that separates two units of red cells from the whole blood. The remaining plasma and platelets are returned to the donor during the donation process. This type of donation can be done every 112 days.
3. Platelet donation: A donor's blood is collected using a special machine that separates platelets from the whole blood. The red cells and plasma are then returned to the donor during the donation process. This type of donation can be done every seven days, up to 24 times a year.
4. Plasma donation: A donor's blood is collected using a special machine that separates plasma from the whole blood. The red cells and platelets are then returned to the donor during the donation process. This type of donation can be done every 28 days, up to 13 times a year.

Blood donors must meet certain eligibility criteria, such as being in good health, aged between 18 and 65 (in some countries, the upper age limit may vary), and weighing over 50 kg (110 lbs). Donors are also required to answer medical questionnaires and undergo a mini-physical examination before each donation. The frequency of blood donations varies depending on the type of donation and the donor's health status.

Histocompatibility testing, also known as tissue typing, is a medical procedure that determines the compatibility of tissues between two individuals, usually a potential donor and a recipient for organ or bone marrow transplantation. The test identifies specific antigens, called human leukocyte antigens (HLAs), found on the surface of most cells in the body. These antigens help the immune system distinguish between "self" and "non-self" cells.

The goal of histocompatibility testing is to find a donor whose HLA markers closely match those of the recipient, reducing the risk of rejection of the transplanted organ or tissue. The test involves taking blood samples from both the donor and the recipient and analyzing them for the presence of specific HLA antigens using various laboratory techniques such as molecular typing or serological testing.

A high degree of histocompatibility between the donor and recipient is crucial to ensure the success of the transplantation procedure, minimize complications, and improve long-term outcomes.

Genetic selection, also known as natural selection, is a fundamental mechanism of evolution. It refers to the process by which certain heritable traits become more or less common in a population over successive generations due to differential reproduction of organisms with those traits.

In genetic selection, traits that increase an individual's fitness (its ability to survive and reproduce) are more likely to be passed on to the next generation, while traits that decrease fitness are less likely to be passed on. This results in a gradual change in the distribution of traits within a population over time, leading to adaptation to the environment and potentially speciation.

Genetic selection can occur through various mechanisms, including viability selection (differential survival), fecundity selection (differences in reproductive success), and sexual selection (choices made by individuals during mating). The process of genetic selection is driven by environmental pressures, such as predation, competition for resources, and changes in the availability of food or habitat.

Histocompatibility is the compatibility between tissues or organs from different individuals in terms of their histological (tissue) structure and antigenic properties. The term is most often used in the context of transplantation, where it refers to the degree of match between the human leukocyte antigens (HLAs) and other proteins on the surface of donor and recipient cells.

A high level of histocompatibility reduces the risk of rejection of a transplanted organ or tissue by the recipient's immune system, as their immune cells are less likely to recognize the donated tissue as foreign and mount an attack against it. Conversely, a low level of histocompatibility increases the likelihood of rejection, as the recipient's immune system recognizes the donated tissue as foreign and attacks it.

Histocompatibility testing is therefore an essential part of organ and tissue transplantation, as it helps to identify the best possible match between donor and recipient and reduces the risk of rejection.

Tissue and organ procurement is the process of obtaining viable tissues and organs from deceased or living donors for the purpose of transplantation, research, or education. This procedure is performed by trained medical professionals in a sterile environment, adhering to strict medical standards and ethical guidelines. The tissues and organs that can be procured include hearts, lungs, livers, kidneys, pancreases, intestines, corneas, skin, bones, tendons, and heart valves. The process involves a thorough medical evaluation of the donor, as well as consent from the donor or their next of kin. After procurement, the tissues and organs are preserved and transported to recipients in need.

Liver transplantation is a surgical procedure in which a diseased or failing liver is replaced with a healthy one from a deceased donor or, less commonly, a portion of a liver from a living donor. The goal of the procedure is to restore normal liver function and improve the patient's overall health and quality of life.

Liver transplantation may be recommended for individuals with end-stage liver disease, acute liver failure, certain genetic liver disorders, or liver cancers that cannot be treated effectively with other therapies. The procedure involves complex surgery to remove the diseased liver and implant the new one, followed by a period of recovery and close medical monitoring to ensure proper function and minimize the risk of complications.

The success of liver transplantation has improved significantly in recent years due to advances in surgical techniques, immunosuppressive medications, and post-transplant care. However, it remains a major operation with significant risks and challenges, including the need for lifelong immunosuppression to prevent rejection of the new liver, as well as potential complications such as infection, bleeding, and organ failure.

HLA (Human Leukocyte Antigen) antigens are a group of proteins found on the surface of cells in our body. They play a crucial role in the immune system's ability to differentiate between "self" and "non-self." HLA antigens are encoded by a group of genes located on chromosome 6, known as the major histocompatibility complex (MHC).

There are three types of HLA antigens: HLA class I, HLA class II, and HLA class III. HLA class I antigens are found on the surface of almost all cells in the body and help the immune system recognize and destroy virus-infected or cancerous cells. They consist of three components: HLA-A, HLA-B, and HLA-C.

HLA class II antigens are primarily found on the surface of immune cells, such as macrophages, B cells, and dendritic cells. They assist in the presentation of foreign particles (like bacteria and viruses) to CD4+ T cells, which then activate other parts of the immune system. HLA class II antigens include HLA-DP, HLA-DQ, and HLA-DR.

HLA class III antigens consist of various molecules involved in immune responses, such as cytokines and complement components. They are not directly related to antigen presentation.

The genetic diversity of HLA antigens is extensive, with thousands of variations or alleles. This diversity allows for a better ability to recognize and respond to a wide range of pathogens. However, this variation can also lead to compatibility issues in organ transplantation, as the recipient's immune system may recognize the donor's HLA antigens as foreign and attack the transplanted organ.

Graft survival, in medical terms, refers to the success of a transplanted tissue or organ in continuing to function and integrate with the recipient's body over time. It is the opposite of graft rejection, which occurs when the recipient's immune system recognizes the transplanted tissue as foreign and attacks it, leading to its failure.

Graft survival depends on various factors, including the compatibility between the donor and recipient, the type and location of the graft, the use of immunosuppressive drugs to prevent rejection, and the overall health of the recipient. A successful graft survival implies that the transplanted tissue or organ has been accepted by the recipient's body and is functioning properly, providing the necessary physiological support for the recipient's survival and improved quality of life.

Homologous transplantation is a type of transplant surgery where organs or tissues are transferred between two genetically non-identical individuals of the same species. The term "homologous" refers to the similarity in structure and function of the donated organ or tissue to the recipient's own organ or tissue.

For example, a heart transplant from one human to another is an example of homologous transplantation because both organs are hearts and perform the same function. Similarly, a liver transplant, kidney transplant, lung transplant, and other types of organ transplants between individuals of the same species are also considered homologous transplantations.

Homologous transplantation is in contrast to heterologous or xenogeneic transplantation, where organs or tissues are transferred from one species to another, such as a pig heart transplanted into a human. Homologous transplantation is more commonly performed than heterologous transplantation due to the increased risk of rejection and other complications associated with xenogeneic transplants.

Bone marrow transplantation (BMT) is a medical procedure in which damaged or destroyed bone marrow is replaced with healthy bone marrow from a donor. Bone marrow is the spongy tissue inside bones that produces blood cells. The main types of BMT are autologous, allogeneic, and umbilical cord blood transplantation.

In autologous BMT, the patient's own bone marrow is used for the transplant. This type of BMT is often used in patients with lymphoma or multiple myeloma who have undergone high-dose chemotherapy or radiation therapy to destroy their cancerous bone marrow.

In allogeneic BMT, bone marrow from a genetically matched donor is used for the transplant. This type of BMT is often used in patients with leukemia, lymphoma, or other blood disorders who have failed other treatments.

Umbilical cord blood transplantation involves using stem cells from umbilical cord blood as a source of healthy bone marrow. This type of BMT is often used in children and adults who do not have a matched donor for allogeneic BMT.

The process of BMT typically involves several steps, including harvesting the bone marrow or stem cells from the donor, conditioning the patient's body to receive the new bone marrow or stem cells, transplanting the new bone marrow or stem cells into the patient's body, and monitoring the patient for signs of engraftment and complications.

BMT is a complex and potentially risky procedure that requires careful planning, preparation, and follow-up care. However, it can be a life-saving treatment for many patients with blood disorders or cancer.

Hematopoietic Stem Cell Transplantation (HSCT) is a medical procedure where hematopoietic stem cells (immature cells that give rise to all blood cell types) are transplanted into a patient. This procedure is often used to treat various malignant and non-malignant disorders affecting the hematopoietic system, such as leukemias, lymphomas, multiple myeloma, aplastic anemia, inherited immune deficiency diseases, and certain genetic metabolic disorders.

The transplantation can be autologous (using the patient's own stem cells), allogeneic (using stem cells from a genetically matched donor, usually a sibling or unrelated volunteer), or syngeneic (using stem cells from an identical twin).

The process involves collecting hematopoietic stem cells, most commonly from the peripheral blood or bone marrow. The collected cells are then infused into the patient after the recipient's own hematopoietic system has been ablated (or destroyed) using high-dose chemotherapy and/or radiation therapy. This allows the donor's stem cells to engraft, reconstitute, and restore the patient's hematopoietic system.

HSCT is a complex and potentially risky procedure with various complications, including graft-versus-host disease, infections, and organ damage. However, it offers the potential for cure or long-term remission in many patients with otherwise fatal diseases.

Graft-versus-host disease (GVHD) is a condition that can occur after an allogeneic hematopoietic stem cell transplantation (HSCT), where the donated immune cells (graft) recognize the recipient's tissues (host) as foreign and attack them. This results in inflammation and damage to various organs, particularly the skin, gastrointestinal tract, and liver.

Acute GVHD typically occurs within 100 days of transplantation and is characterized by symptoms such as rash, diarrhea, and liver dysfunction. Chronic GVHD, on the other hand, can occur after 100 days or even years post-transplant and may present with a wider range of symptoms, including dry eyes and mouth, skin changes, lung involvement, and issues with mobility and flexibility in joints.

GVHD is a significant complication following allogeneic HSCT and can have a substantial impact on the patient's quality of life and overall prognosis. Preventative measures, such as immunosuppressive therapy, are often taken to reduce the risk of GVHD, but its management remains a challenge in transplant medicine.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

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