دورية أكاديمية
An ethical analysis of obesity as a contraindication to pediatric liver transplant candidacy.
| العنوان: | An ethical analysis of obesity as a contraindication to pediatric liver transplant candidacy. |
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| المؤلفون: | Berkman ER; Division of Pediatric Critical Care Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA; Division of Bioethics and Palliative Care Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA. Electronic address: emily.berkman@seattlechildrens.org., Hsu EK; Division of Pediatric Gastroenterology and Hepatology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA., Clark JD; Division of Pediatric Critical Care Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA; Division of Bioethics and Palliative Care Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA., Lewis-Newby M; Division of Bioethics and Palliative Care Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA; Division of Cardiac Critical Care, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA., Dick AAS; Division of Transplantation, Section of Pediatric Transplantation, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA., Diekema DS; Division of Bioethics and Palliative Care Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA; Division of Pediatric Emergency Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA., Wightman AG; Division of Bioethics and Palliative Care Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA; Division of Pediatric Nephrology, University of Washington School of Medicine, Seattle Children's Hospital Seattle, Washington, USA. |
| المصدر: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2023 Jun; Vol. 23 (6), pp. 736-743. Date of Electronic Publication: 2023 Mar 29. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 100968638 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-6143 (Electronic) Linking ISSN: 16006135 NLM ISO Abbreviation: Am J Transplant Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2023- : [New York] : Elsevier Original Publication: Copenhagen : Munksgaard International Publishers, 2001- |
| مواضيع طبية MeSH: | Liver Transplantation*/methods , Pediatric Obesity*/surgery , End Stage Liver Disease*/complications , End Stage Liver Disease*/surgery, Adult ; Child ; Humans ; United States/epidemiology ; Contraindications ; Ethical Analysis |
| مستخلص: | Childhood obesity is becoming more prevalent in the United States (US) and worldwide, including among children in need of a liver transplant. Unlike with heart and kidney failure, end-stage liver disease (ESLD) is unique in that no widely available medical technology can re-create the life-sustaining function of a failing liver. Therefore, delaying a life-saving liver transplant for weight loss, for example, is much harder, if not impossible for many pediatric patients, especially those with acute liver failure. For adults in the United States, guidelines consider obesity a contraindication to liver transplant. Although formal guidelines are lacking in children, many pediatric transplant centers also consider obesity a contraindication to a pediatric liver transplant. Variations in practice among pediatric institutions may result in biased and ad hoc decisions that worsen healthcare inequities. In this article, we define and report the prevalence of childhood obesity among children with ESLD, review existing guidelines for liver transplant in adults with obesity, examine pediatric liver transplant outcomes, and discuss the ethical considerations of using obesity as a contraindication to pediatric liver transplant informed by the principles of utility, justice, and respect for persons. (Copyright © 2023 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: bias; ethics; health disparities; obesity; pediatric liver transplant |
| تواريخ الأحداث: | Date Created: 20230330 Date Completed: 20230606 Latest Revision: 20230608 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.ajt.2023.03.017 |
| PMID: | 36997027 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1600-6143 |
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| DOI: | 10.1016/j.ajt.2023.03.017 |