MICHAEL F.A. WOODRUFF Emeritus Professor of Surgery, University of Edinburgh This book grew out of a very successful conference on Organ Transplantation held in Kuwait in December 1982. The material presented at the conference has been expanded and brought up to date, and the result is a well written and authoritative account of many aspects of organ transplantation by a distinguished team of contributors drawn from many countries. A unique feature of the book is the account it contains of the development of organ transplantation in the Middle East. Although, as yet, it has been virtually impossible in Islamic countries to take organs after death for use as transplants, it is beginning to look as if this situation may change. Meanwhile, using living volunteer donors and a small number of cadaveric organs sent from other countries, transplant teams in Kuwait and Turkey are obtaining results with kidney transplants which are as good, in terms of both transplant survival and patient survival, as those reported from acknowledged centres of excellence in the United States, Europe and other countries where organ transplantation has been established for many years.

One of the most interesting and at the same time most challenging fields of medicine and surgery has been that of organ donation and transplantation. It is a field that has made tremendous strides during the last few decades through the combined input and efforts of scientists from various specialties. What started as a dream of pioneers has become a reality for the thousands of our patients whose lives can now be saved and improved. However, at the same time, the challenges remain significant and so do the expectations. This book will be a collection of chapters describing these same challenges involved including the ethical, legal, and medical issues in organ donation and the technical and immunological problems the experts are facing involved in the care of these patients.The authors of this book represent a team of true global experts on the topic. In addition to the knowledge shared, the authors provide their personal clinical experience on a variety of different aspects of organ donation and transplantation.

This title provides a comprehensive and state-of-the-art summary of current and future immunosuppressive strategies in transplantation, with emphasis on the basic science mechanisms and clinical applicability of these strategies. The uniqueness of this book is the inclusion of up-to-date information on the basic mechanisms of actions of the immunosuppressive drugs as well as a summary of the clinical trials data and the potential use of these drugs in clinical organ transplantation. In addition to describing the various immunosuppressive strategies, the book has three special features, including immunosuppression in xenotransplantation, gene therapy approaches, and transplantation tolerance. A group of outstanding investigators have been assembled to write the chapters. The book is intended for the transplant professional and the specialist who wants to stay abreast of the current status of immunosuppression in organ transplantation. The book is also useful for basic scientists who work in the field of transplantation immunology.

Leading clinicians and scientists in solid organ transplantation review the current status of the field and describe cutting-edge techniques for detecting the immune response to the allografted organ. The authors present the latest techniques for HLA typing, detecting HLA antibodies, and monitoring T-cell response, and examine more specialized methods utilizing proteomics, laser dissection microscopy, and real-time polymerase chain reaction. The area of tolerance induction and reprogramming of the immune system is also covered, along with a discussion of up-to-date methods of organ preservation, of today's optimal immunosuppressive drug regimens, as well as the difficulty of mimicking chronic rejection in experimental models. Introductory chapters provide a theoretical update on current practices in renal, liver, islet, and lung transplantation and on the pathways of antigen presentation and chronic rejection.

In response to persistent donor organ shortages, organs from marginal donors, such as expanded criteria donors (ECD) and donation after cardiac death (DCD) donors, are now accepted and have been successfully transplanted, reducing the waiting times for transplantation. Especially in Japan, transplantation of DCD kidneys has a relatively long history because of the difficulty or lack of national consensus in accepting brain death, which has made it possible to accumulate considerable clinical experience. Thus, the current organ shortage has stimulated interest in the use of marginal donors for transplantation. On the other hand, however, it is known that these organs have a high rate of delayed graft function and a more complicated postoperative course. These drawbacks have created the greatest clinical challenge in transplantation to date because of the current shortage and limitations of donors using ECD and DCD. This book, prepared by distinguished authorities in their fields, is intended for clinicians and researchers. It highlights the use of marginal donors as a comparatively novel source of transplantation organs and provides a thorough overview of marginal donors from their historical origins to recent clinical applications, including the state-of-the-art science of organ/donor management, procurement, and preservation. Also provided is valuable information on ABO-incompatible donors which extend the availability of donor sources. Each chapter offers an individual analysis of the optimal requirements for the safe management and preservation of organs, including the heart, lung, liver, kidney, pancreas, and pancreatic islets.

This second edition of the introduction to the field of organ transplantation provides an excellent overview of the tremendous progress made in recent decades, and gives a clear description of the current status of transplant surgery for students and trainees with an interest in this field. It opens with introductory chapters on the history of transplantation and the basic science of immunobiology, and then examines through an organ-based structure the practice of transplantation in each major system, from skin to intestine. There is a 13-year gap between the first and second edition, and this is highlighted in the new collection of chapters of this updated version. This is a timely publication produced in line with the rapidly advancing field of transplantation. The editor, Nadey S Hakim, is a consultant transplant and general surgeon at Imperial College Healthcare NHS Trust, London, England, and has put together this second volume that will serve as an invaluable guide for transplant surgeons as well as trainees.

Preclinical experimental transplantation research that is based on microsurgical models in rats fulfills two indispensable conditions for modern organ transplanta tion research: Almost all organ grafts can be performed on the rat with an amount of technical effort that is still justifiable. Thus transplantation models that are analogous to human organ transplantation can be developed, tested, and evaluated. This fulfills a necessary condition from the standpoint of surgery. With the species rat, we have a great variety of genetically different inbred strains. From the immunological point of view this is an indispensable prerequisite for the investigation of preclinical transplantation models that can be expected to produce controllable, reproducible results. In vivo experimental results can be supplemented by and correlated to in vitro tests. Lately these experimental results are being greatly expanded and more precisely defined by the application of immunohistological methods that have been established recently in Kiel. In this book we hope to present a cross section of the microsurgical models in use today and of current immunological and immunohistological models. Furthermore, we wish to record the present state of microsurgical organ transplantation research and to show its relationship to the current state and development of clinical organ transplantation. A special aspect of our Kiel research group is the long-term, well-functioning, interdisciplinary cooperation between surgery, immunology, and pathology. Through this cooperation we attempt to provide an atmosphere in which theoretical and practical viewpoints can mutually influence each other.