| Abstrakt: |
Abstract: The history of organ transplantation spans 50 years and issues regarding what is ethically acceptable in clinical practice have arisen. In the early days, many pioneers were criticized for offering the hope of prolonging the life of very ill patients when effective clinical transplantation was not established. Barnard (Cape Town, South Africa) did the first heart transplant in 1967 and was acclaimed a hero. The next year, hundreds of similar attempts were made worldwide with disastrous consequences and many recipient deaths, and there was a popular outcry to ban the perceived inhumane practice. Questions regarding the definition of death often arise e.g. who should be eligible for a transplant? How should organs be allocated? What quality of life can be achieved with a transplant? Should organs for transplantation be removed from healthy living donors related or unrelated to the patient? Boundaries of what is acceptable change with time, particularly as clinical outcomes improve. There is an overwhelming demand for transplantation, but the supply of donated organs is insufficient. How can surgeons introduce new and successful procedures for transplantation in an era of high expectations and clinical governance? The authors invite the reader to consider what decision they would make in the following short case reviews. [Copyright &y& Elsevier] |
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