The emergence and pitfalls of international tissue banking.

The rapid growth of tissue banking and associated international organisations following the fall of the Berlin wall in 1991 is described. This surge in collaboration led to a world-wide constructive movement to use and to produce human tissues. As the years progressed industrialisation, led by the USA, improved the quality of tissue allografts but led higher costs and consolidation within the developing industry. The growth of litigation more than kept pace with the industrial progress. One landmark case is described, the outcome of which could revolutionise the current practices now applied to eliminate possible viral contamination of implanted tissue grafts.

Professor Glyn O. Phillip's legacy within the IAEA programme on radiation and tissue banking.

Professor Phillips began his involvement in the implementation of this important IAEA programme, insisting that there were advantages to be gained by using the ionizing radiation technique to sterilize human and animal tissues, based on the IAEA experience gained in the sterilization of medical products. The outcome of the implementation of the IAEA programme on radiation and tissue banking demonstrated that Professor Phillips was right in his opinion.

Honoring 50 Years of Clinical Heart Transplantation in Circulation: In-Depth State-of-the-Art Review.

Heart transplantation has become a standard therapy option for advanced heart failure. The translation of heart transplantation from innovative experiments to long-term clinical success has married prescient insights with discipline and organization in the domains of surgical techniques, organ preservation, immunosuppression, organ donation and transplantation logistics, infection control, and long-term graft surveillance. This review explores the key milestones of the past 50 years of heart transplantation and discusses current challenges and promising innovations on the clinical horizon.

Tissue banking, biovigilance and the notify library.

This issue is dedicated to the contributions of Professor Glyn O. Phillips to the field of tissue banking and the advancement of science in general. The use of ionizing radiation to sterilize medical products drew the interest of the International Atomic Energy Agency (IAEA). A meeting in 1976 in Athens Greece to present work on the effects of sterilizing radiation doses upon the antigenic properties of proteins and biologic tissues was my first introduction of Professor Phillips and the role that he was to play in Tissue Banking (Friedlaender, in Phillips GO, Tallentine AN (eds) Radiation sterilization. Irradiated tissues and their potential clinical use. The North E. Wales Institute, Clwyd, p 128, 1978). The IAEA sponsored subsequent meetings in the Republic of Korea, Czechoslovakia and Rangoon, the later including a visit to the tissue bank by Professor Phillips. His advocacy resulted in multiple workshops and teaching opportunities in a variety of countries, one of which led to the establishment of the Asia Pacific Surgical Tissue Banking Association in 1989 (Phillips and Strong, in Phillips GO, Strong DM, von Versen R, Nather A (eds) Advances in tissue banking, vol 3. World Scientific, Singapore, pp 403-417, 1999).

Nagweyaab Geebawug: A retrospective autoethnography of the lived experience of kidney donation.

"Get the camera!" I yelled. As my young son came running towards me with the camera, I pointed up to the sky. Therethey were, four magnificent gleaming rainbows. The cloudssurrounding were a moody bluish black and the sun swiftly andgracefully beamed through them. The shimmering and glistening rainbows in that brief moment of sunshine pierced throughmy own darkness. In the last few months in my First Nationscommunity, we had experienced many deaths. Some of thesedeaths were relatives and friends. Years later, I would gaze atthe picture taken through hot tears, Nagweyaab geebawug orrainbow spirits I thought--these are the ancestors, those whohave passed reminding us to never give up. This is a story and inthis story an autoethnographical narrative emerges that is richwith contextual cultural interpretations of myself as a kidneydonor to my son. Through this autoethnographical narrative,there is the potential to further illuminate the lived experienceof chronic kidney disease (CKD) and kidney transplantation. Inthis paper, the terms First Nations and Indigenous are utilizedinterchangeably.

History of brain death as death: 1968 to the present.

The concept of brain death was formulated in 1968 in the landmark report A Definition of Irreversible Coma. While brain death has been widely accepted as a determination of death throughout the world, many of the controversies that surround it have not been settled. Some may be rooted in a misconstruction about the history of brain death. The concept evolved as a result of the convergence of several parallel developments in the second half of the 20th century including advances in resuscitation and critical care, research into the underlying physiology of consciousness, and growing concerns about technology, medical futility, and the ethics of end of life care. Organ transplantation also developed in parallel, and though it clearly benefited from a new definition of death, it was not a principal driving force in its creation. Since 1968, the concept of brain death has been extensively analyzed, debated, and reworked. Still there remains much misunderstanding and confusion, especially in the general public. In this comprehensive review, I will trace the evolution of the definition of brain death as death from 1968 to the present, providing background, history and context.

El cuerpo muerto y sus partes vivas en la moral católica. Algunas claves históricas de la donación de órganos en España, 1903-1960 / The Dead Body and its Living Parts in The Catholic Ethic. Some Historical Traces for Understanding Organ Transplantation in Spain, 1903-1960

Los primeros antecedentes médico-quirúrgicos de donación y trasplante de partes del cuerpo, dieron lugar a una concepción y vivencia del cuerpo humano como conjunto territorializado y capitalizado de partes reemplazables y funcionales. En los artículos de prensa analizados en este trabajo se estudia cómo, en la primera mitad del siglo XX, los preceptos y normas del régimen franquista y de la doctrina católica, así como la alianza entre hegemonía política, eclesiástica y científica, generaron la construcción cultural de la donación como muestra de caridad y amor cristiano y la percepción del cuerpo como bien común al servicio del prójimo (AU)

The first medical and surgical experiences of donating and transplanting body parts generated a new concept and perception of the human body as a territorialized and capitalized unit, composed of replaceable and functional parts. The press articles analyzed in this research reveal how, during the first half of the XXth century, Franco’s government and the Catholic doctrine, as well as the coalition of political, clerical and scientific hegemony, led to the cultural construction of donation as a proof of charity and Christian love and to an interpretation of the human body as a common good, available to serve others (AU)

Ex vivo lung perfusion: a comprehensive review of the development and exploration of future trends.

There is a critical mismatch between the number of donor lungs available and the demand for lungs for transplantation. This has created unacceptably high waiting-list mortality for lung transplant recipients. Currently (2012) in the United Kingdom, there are 216 patients on the lung transplant waiting list and 17 on heart and lung transplant list. The waiting times for suitable lungs average 412 days, with an increasing mortality and morbidity among the patients on the lung transplant list. Ex vivo lung perfusion (EVLP) has emerged as a technique for the assessment, resuscitation, and potential repair of suboptimal donor lungs. This is a rapidly developing field with significant clinical implications. In this review article, we critically appraise the background developments that have led to our current clinical practice. In particular, we focus on the human and animal experience, the different perfusion-ventilation strategies, and the impact of different perfusates and leukocyte filters. Finally, we examine EVLP as a potential research tool. This will provide insight into EVLP and its future development in the field of clinical lung transplantation.

[Which place for physicians in blood supply?]. / Quelle place pour les médecins en collecte?

Historically, blood transfusion has been divised, enhanced and organized by physicians. The special status of blood led to ensure that collection of blood and its components were placed under the supervision of a physician. Throughout its history, blood transfusion organization in France has established an exclusive exercise of the collection of blood and its components entrusted to doctors, thus creating the concept of "medicine of donation". This view is changing, and programmed exercise of this activity by nurses led to question about this profession perimeter, its necessary evolution, and finally about the place of physicians in blood supply.

The continuing evolution of the Langendorff and ejecting murine heart: new advances in cardiac phenotyping.

The isolated retrograde-perfused Langendorff heart and the isolated ejecting heart have, over many decades, resulted in fundamental discoveries that form the underpinnings of our current understanding of the biology and physiology of the heart. These two experimental methodologies have proven invaluable in studying pharmacological effects on myocardial function, metabolism, and vascular reactivity and in the investigation of clinically relevant disease states such as ischemia-reperfusion injury, diabetes, obesity, and heart failure. With the advent of the genomics era, the isolated mouse heart preparation has gained prominence as an ex vivo research tool for investigators studying the impact of gene modification in the intact heart. This review summarizes the historical development of the isolated heart and provides a practical guide for the establishment of the Langendorff and ejecting heart preparations with a particular emphasis on the murine heart. In addition, current applications and novel methods of recording cardiovascular parameters in the isolated heart preparation will be discussed. With continued advances in methodological recordings, the isolated mouse heart preparation will remain physiologically relevant for the foreseeable future, serving as an integral bridge between in vitro assays and in vivo approaches.

Transplantation behind the Iron Curtain--a short historical note on the 20th anniversary.

This article is dedicated to the memory of the pioneers of solid organ transplantation 20 yr after the Iron Curtain was demolished and Eastern European countries joined the free world. Despite the special political and medical conditions that existed, the evolution of transplantation could proceed following Western trends. With the formation of Intertransplant, kidney transplantation was formalized, and a limited organ exchange could be realized. The transplantation of non-renal organs was rather sporadic until 1989. This paper summarizes the efforts in transplantation in Eastern Europe during this period of tension with the West.

Cord blood banking: a historical perspective.

Umbilical cord blood (UCB) contains stem and progenitor cells capable of restoring haematopoietic and immunological function in vivo. UCB is currently used as an alternative source of haematopoietic stem cells for transplantation in patients suffering from haematological malignancies, bone marrow failures and inherited metabolic disorders. In order to facilitate transplantation, large repositories of frozen cord blood units (CBUs) from altruistic donations have been established in many parts of the world and to date there are more than 300,000 units stored worldwide. These products have been banked under stringent quality conditions, in order to ensure their safety and efficacy. The development and evolution of the policies and procedures currently in use in cord blood banking have been largely influenced by the clinical results of cord blood transplantation. This review aims to provide a historical overview of the various developments in the field of cord blood banking from its inception, highlighting the relevant aspects in their collection, banking and release that are known to influence the clinical outcome of these transplants.

Adult-to-adult living donor liver transplantation: history, current practice, and implications for the future.

More than 1600 Americans have received adult-to-adult living donor liver transplants. As the number of patients with end-stage liver disease is expected to grow significantly in the next 20 years due to hepatitis C infection, living donor liver transplantation has become a promising solution to the shortage of donor organs. The use of living donors provides organs in an environment of scarcity, allows patients to receive transplants when medically optimized, and produces liver segments with minimal ischemic damage. The donor complications most frequently cited in the medical literature include bile leaks and strictures, biloma, hepatic encephalopathy, wound infection, and pressure sores. In the wake of 2 donor deaths in the United States and subsequent media publicity, there have been new efforts by the transplant community to describe the risks and outcomes for donors, and establish safeguards to protect them from excessive pressure to donate.