Recently, however, NDDs have participated in kidney exchange (KE) procedures, including KE ‘chains’, which have received considerable media attention. This increasing application of KE chains with NDD participation has occurred with limited ethical analysis
and without ethical guidelines. This article aims to provide a rigorous ethical evaluation of NDDs and chain KEs. NDDs and bridge donors (BDs) (i.e. living donors who link KE procedures within KE chains) raise several ethical concerns including coercion, privacy, confidentiality, exploitation and commercialization. In addition, although NDD participation in KE procedures this website may increase transplant numbers, it may also reduce NDD kidney allocation to the DDWL, and disadvantage selleck chemicals llc vulnerable populations, particularly O blood group candidates. Open KE chains (also termed ‘never-ending’ chains) result in a permanent diversion of NDD kidneys from the DDWL. The concept of limited KE chains is discussed as an ethically preferable means for protecting NDDs and BDs from coercion and minimizing ‘backing out’, whereas ‘honor systems’ are rejected because they are coercive and override autonomy. Recent occurrences of BDs backing out argue for adoption of ethically based protective measures for NDD participation in KE.”
“Study Design. Retrospective clinical case study.
Objective. To evaluate whether spinal column
injury severity influences neurological outcome after cervical spine injury patterns of SB203580 concentration Allen’s classification.
Summary of Background Data. Allen’s classification is commonly used in cervical fracture/dislocation. Cervical spine injuries are classified into 6 common patterns by their mechanism. Each pattern is divided into stages according to spinal column damage severity, and these stages have been closely correlated with the neurological damage at injury. However, the validity of the relationship has not been adequately discussed. Moreover, only a few reports have assessed whether the injury pattern influences the neurological outcome.
Methods. We selected 155 patients with unstable subaxial
cervical spine injuries. Only 146 patients having more than 12-month postoperative follow-up were included. All were treated with posterior spinal arthrodesis. Supplemental anterior surgery was added in four patients. The injury patterns were graded using Allen’s classification. The neurological status at injury and final follow-up was evaluated using the American Spinal Injury Association (ASIA) impairment scale.
Results. Patients were categorized by using Allen’s classification as follows: distractive flexion, 82; compressive flexion, 29; compressive extension, 21; vertical compression, 8; and distractive extension, 6. In distractive flexion cases, the ratios of ASIA A cases at final follow-up increased with advancing stage (27%, 18%, 63%, and 100% in stages 1-4; P < 0.001).