RESUMO
Organ transplantation is the optimal treatment for patients with end stage liver disease and end stage renal disease. However, due to the imbalance in the demand and supply of deceased organs, most transplant centers worldwide have consciously pursued a strategy for living donation. Paired exchanges were introduced as a means to bypass various biologic incompatibilities (blood- and tissue-typing), while expanding the living donor pool. This shift in paradigm has introduced new ethical concerns that have hitherto been unaddressed, especially with nondirected, altruistic living donors. So far, transplant communities have focused efforts on separate liver- and kidney-paired exchanges, whereas the concept of a transorgan paired exchange has been theorized and could potentially facilitate a greater number of transplants. We describe the performance of the first successful liver-kidney swap.
Assuntos
Doença Hepática Terminal/cirurgia , Falência Renal Crônica/cirurgia , Transplante de Rim/ética , Transplante de Fígado/ética , Obtenção de Tecidos e Órgãos/ética , Adulto , Altruísmo , Beneficência , Doação Dirigida de Tecido , Seleção do Doador , Feminino , Glomerulonefrite/cirurgia , Teste de Histocompatibilidade , Humanos , Transplante de Rim/métodos , Transplante de Fígado/métodos , Doadores Vivos/ética , Pessoa de Meia-Idade , Síndrome Nefrótica/cirurgia , Risco , Obtenção de Tecidos e Órgãos/métodos , Doadores não Relacionados/ética , Adulto JovemRESUMO
A major United States Food and Drug Administration effort is devoted to process analytical technology (PAT), which is emerging as the likely "surprise" of the second half of the decade. PAT is an approach to monitoring, manufacturing, and other processes on a continuous rather than discrete basis. It carries the future promise of new methods of production. Building PAT into a chromatography system provides a significant cost and quality advantage to high volume multitest laboratories and provides a significant marketing advantage to the first suppliers able to implement such an approach.
Assuntos
Cromatografia/normas , Controle de Qualidade , Laboratórios/normas , Gestão da Qualidade Total/normas , Estados Unidos , United States Food and Drug Administration/legislação & jurisprudênciaRESUMO
A successful biodefense strategy relies upon any combination of four approaches. A nation can protect its troops and citizenry first by advanced mass vaccination, second, by responsive ring vaccination, and third, by post-exposure therapeutic treatment (including vaccine therapies). Finally, protection can be achieved by rapid detection followed by exposure limitation (suites and air filters) or immediate treatment (e.g., antibiotics, rapid vaccines and iodine pills). All of these strategies rely upon or are enhanced by microarray technologies. Microarrays can be used to screen, engineer and test vaccines. They are also used to construct early detection tools. While effective biodefense utilizes a variety of tactical tools, microarray technology is a valuable arrow in that quiver.
