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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Tissue Transplantation01:24

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Kidney Transplant III: Nursing Management01:16

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Bone Marrow Sampling and Transplants01:22

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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Updated: Mar 2, 2026

Investigating the Immunological Mechanisms Underlying Organ Transplant Rejection
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The Organ Transplant Imperative.

Wil L Santivasi1, Jacob J Strand2, Paul S Mueller3

  • 1Department of Medicine, Mayo Clinic, Rochester, MN.

Mayo Clinic Proceedings
|May 14, 2017
PubMed
Summary
This summary is machine-generated.

Many patients awaiting organ transplants may die without discussing end-of-life care preferences. The "transplant imperative" can hinder advance care planning, even when patient outcomes are poor.

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Area of Science:

  • Medical Ethics
  • Transplant Medicine
  • Palliative Care

Background:

  • Over 120,000 patients were listed for solid organ transplants in the US in 2016.
  • Limited data exist on goals-of-care discussions during the transplant process.
  • Existing research on goals of care often focuses on malignancy, ESRD, and heart failure, not the dynamic transplant journey.

Purpose of the Study:

  • To introduce and define the "organ transplant imperative."
  • To explore how this imperative may impede advance care planning and goals-of-care discussions in transplant candidates.
  • To highlight the need for better communication and integration of palliative care in solid organ transplantation.

Main Methods:

  • Conceptual analysis of the "organ transplant imperative."
  • Situating the concept within clinical inertia and treatment imperatives.
  • Illustrative case study of a patient with end-stage liver disease (ESLD).

Main Results:

  • The "organ transplant imperative" describes a perceived obligation to pursue transplantation, potentially overriding advance care planning.
  • This imperative can lead to patients dying without goals-of-care discussions, even with poor prognoses.
  • A case study demonstrated conflicting physician perspectives and a patient's death without advance care planning benefits.

Conclusions:

  • Increased awareness of the "transplant imperative" is crucial for patients, specialists, and generalists.
  • Formalized involvement of palliative medicine experts is needed in solid organ transplant care.
  • Addressing the "transplant imperative" can improve end-of-life care for transplant candidates.