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Delmonico, Francis

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Delmonico

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Francis

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Delmonico, Francis

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2006 - 200912010 - 20153

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Author's Publications: search.filters.isAuthorOfPublication.188f0b97-ddb5-494b-bfe8-08e11c74d2a3

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Now showing 1 - 4 of 4
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    The Science and Social Necessity of Deceased Organ Donation
    (Rambam Health Care Campus, 2011) Delmonico, Francis
    Successful deceased organ donation requires a reproducible – consistent (scientific) system that evaluates the potential for organ donation and determines objectively whether the national system is achieving its goals. The science of organ donation also pertains to the determination of death. We are a common humanity that dies similarly – a humanity whose ultimate criterion of life resides in the function of the human brain. The recent brain death law of Israel encouragingly enables a determination of death by the loss of neurologic function, but it has become complicated by a practice that may perpetuate societal misperceptions. As a result opportunities for deceased organ donation – to provide for Israelis in need of organ transplants – are being lost. A statured task force of society could be assembled to convey its support for deceased donation to influence society and resolve these misperceptions. The World Health Organization is now calling for each member state to achieve a self-sufficiency in organ donation and transplantation “equitably meeting the transplantation needs of a given population using resources from within that population”. Patients should not be compelled to go to foreign countries for their organs. Israel has been a leader in the development of a model program intended to address transplant tourism. Insurance companies are no longer permitted to provide resources for Israelis to undergo illegal transplants in foreign destinations. The social necessity of a scientifically and medically applied system of deceased organ donation is now evident so that a sufficient number of organs can be available for patients from within the country where they reside.
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    International Principles of Deceased Donor Organ Allocation
    (Avicenna Organ Transplantation Institute, 2013) Delmonico, Francis
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    Improvement in kidney transplantation in the Balkans after the Istanbul Declaration: where do we stand today?
    (Oxford University Press, 2015) Spasovski, Goce; Busic, Mirela; Delmonico, Francis
    Due to the limited access to kidney transplantation (KTx) in developing countries, desperate patients have engaged in the purchase and sale of kidneys. In 2004, the World Health Assembly urged member states to protect the poor and vulnerable from being exploited through practices of illegal organ trafficking that had become widespread throughout the world. In 2008, the international transplant community convened a summit of transplant professionals, legal experts and ethicists to combat organ trafficking, transplant tourism and transplant commercialism that resulted in the Declaration of Istanbul (DOI). The South-Eastern Europe Health Network (SEEHN) represents a nine country multigovernmental collaboration on health systems. The Regional Health Development Centre on Organ Donation and Transplant Medicine (RHDC) was established in 2011 in Croatia to facilitate cooperation among south-eastern European countries to improve organ transplantation within the Balkan region. Since 2011, a collaboration between the RHDC, the Custodian Group of the DOI (DICG) and SEEHN professionals has enhanced strategic planning and definition of country-specific action plan priorities on organ donation and transplantation. Data of kidney transplantation provided in this report show a significant increase in transplantation activities in a 4-year period in Macedonia, Moldova, Bosnia and Hercegovina, Romania and Montenegro. The success of the donation and transplantation programmes was influenced by the engagement of key professionals and the establishment of organizational infrastructure with the implementation of an appropriate funding model. In conclusion, the DOI has provided an ethical framework for engagement of health professionals from south-eastern European countries. The newly established SEEHN RHDC as a technical coordinating body greatly contributed in building institutional capacity and strengthening regional collaboration between health authorities and professionals within these countries for improvement of transplant activities in the Balkans.
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    Publication
    Transmission of Lymphocytic Choriomeningitis Virus by Organ Transplantation
    (New England Journal of Medicine (NEJM/MMS), 2006) Fischer, Staci A.; Graham, Mary Beth; Kuehnert, Matthew J.; Kotton, Camille; Srinivasan, Arjun; Marty, Francisco; Comer, James A.; Guarner, Jeannette; Paddock, Christopher D.; Demeo, Dawn; Shieh, Wun-Ju; Erickson, Bobbie R.; Bandy, Utpala; DeMaria, Alfred; Davis, Jeffrey P.; Delmonico, Francis; Pavlin, Boris; Likos, Anna; Vincent, Martin J.; Sealy, Tara K.; Goldsmith, Cynthia S.; Jernigan, Daniel B.; Rollin, Pierre E.; Packard, Michelle M.; Patel, Mitesh; Rowland, Courtney; Helfand, Rita F.; Nichol, Stuart T.; Fishman, Jay; Ksiazek, Thomas; Zaki, Sherif R.
    Background In December 2003 and April 2005, signs and symptoms suggestive of infection devel- oped in two groups of recipients of solid-organ transplants. Each cluster was inves- tigated because diagnostic evaluations were unrevealing, and in each a common do- nor was recognized. Methods We examined clinical specimens from the two donors and eight recipients, using viral culture, electron microscopy, serologic testing, molecular analysis, and histo- pathological examination with immunohistochemical staining to identify a cause. Epidemiologic investigations, including interviews, environmental assessments, and medical-record reviews, were performed to characterize clinical courses and to determine the cause of the illnesses. Results Laboratory testing revealed lymphocytic choriomeningitis virus (LCMV) in all the recipients, with a single, unique strain of LCMV identified in each cluster. In both investigations, LCMV could not be detected in the organ donor. In the 2005 cluster, the donor had had contact in her home with a pet hamster infected with an LCMV strain identical to that detected in the organ recipients; no source of LCMV infection was found in the 2003 cluster. The transplant recipients had abdominal pain, altered mental status, thrombocytopenia, elevated aminotransferase levels, coagulopathy, graft dysfunction, and either fever or leukocytosis within three weeks after transplan- tation. Diarrhea, peri-incisional rash, renal failure, and seizures were variably present. Seven of the eight recipients died, 9 to 76 days after transplantation. One recipient, who received ribavirin and reduced levels of immunosuppressive therapy, survived. Conclusions We document two clusters of LCMV infection transmitted through organ trans- plantation.