Restarting the clock...again: ethical considerations in retransplantation.
Cardiac and pulmonary transplantation has revolutionized end-stage heart and lung therapy. With the advent of cyclosporine and other immunosuppressive therapies, many patients lead productive lives. Unfortunately, other patients who have undergone cardiac and/or pulmonary transplantation do not have favorable results. In fact, some require retransplantation to live. Because of organ scarcity, healthcare professionals and patients must examine not only retransplantation survival rates but also the ethical considerations when dealing with resource-limited organs. Given that retransplantation survival rates are not as favorable as those for primary transplantation and that no studies involving quality of life and morbidity could be located, considerable thought should be given to this controversial practice.
Andrews
Tracy D
TD
Aortic Surgery and Cardiac Surgical Outcomes at the Columbia University/New York Presbyterian Hospital, New York, NY 10032, USA. tda2110@columbia.edu
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000235:genetics / Q000601:surgery; D003422:Critical Care; D006084:Graft Rejection / Q000209:etiology / Q000628:therapy; D006085:Graft Survival; D015276:Health Care Rationing / Q000941:ethics / Q000458:organization & administration; D016027:Heart Transplantation / Q000009:adverse effects / Q000941:ethics* / Q000451:nursing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D024802:Nurse's Role; D018579:Patient Selection / Q000941:ethics*; D028662:Principle-Based Ethics; D012086:Reoperation / Q000941:ethics*; D009927:Tissue and Organ Procurement / Q000941:ethics / Q000458:organization & administration