Emerging Ethical Challenges Raised by the Evolution of Vascularized Composite Allotransplantation. Caplan, A. L., Parent, B., Kahn, J., Dean, W., Kimberly, L. L., Andrew Lee, W. P., & Rodriguez, E. D. Transplantation, Online First(6):1240–1246, October, 2018. ![Emerging Ethical Challenges Raised by the Evolution of Vascularized Composite Allotransplantation [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Background Despite early skepticism, the field of vascularized composite allotransplantation (VCA) has demonstrated feasibility. The ethics of VCA have moved past doubts about the morality of attempting such transplant to how to conduct them ethically. Methods Leaders of each program performing and/or evaluating VCA in the United States were invited to participate in a working group to assess the state and future of VCA ethics and policy. Four meetings were held over the course of 1 year to describe key challenges and potential solutions. Results Working group participants concluded that VCA holds great promise as treatment for patients with particular injuries or deficits, but the field faces unique challenges to adoption as standard of care, which can only be overcome by data sharing and standardization of evaluation and outcome metrics. Conclusions Adequate attention must be given to concerns including managing the uniquely intense physician-patient relationship, ethical patient selection, ensuring patients have adequate representation, informing and earning the trust of the public for donation, standardizing metrics for success, and fostering an environment of data sharing. These steps are critical to transitioning VCA from research to standard of care, and to its insurance coverage inclusion.
@article{caplan_emerging_2018,
title = {Emerging {Ethical} {Challenges} {Raised} by the {Evolution} of {Vascularized} {Composite} {Allotransplantation}},
volume = {Online First},
issn = {0041-1337},
url = {https://journals.lww.com/transplantjournal/Abstract/onlinefirst/Emerging_Ethical_Challenges_Raised_by_the.96348.aspx},
doi = {10.1097/TP.0000000000002478},
abstract = {Background Despite early skepticism, the field of vascularized composite allotransplantation (VCA) has demonstrated feasibility. The ethics of VCA have moved past doubts about the morality of attempting such transplant to how to conduct them ethically.
Methods Leaders of each program performing and/or evaluating VCA in the United States were invited to participate in a working group to assess the state and future of VCA ethics and policy. Four meetings were held over the course of 1 year to describe key challenges and potential solutions.
Results Working group participants concluded that VCA holds great promise as treatment for patients with particular injuries or deficits, but the field faces unique challenges to adoption as standard of care, which can only be overcome by data sharing and standardization of evaluation and outcome metrics.
Conclusions Adequate attention must be given to concerns including managing the uniquely intense physician-patient relationship, ethical patient selection, ensuring patients have adequate representation, informing and earning the trust of the public for donation, standardizing metrics for success, and fostering an environment of data sharing. These steps are critical to transitioning VCA from research to standard of care, and to its insurance coverage inclusion.},
language = {en-US},
number = {6},
urldate = {2018-10-15},
journal = {Transplantation},
author = {Caplan, Arthur L. and Parent, Brendan and Kahn, Jeffrey and Dean, Wendy and Kimberly, Laura L. and Andrew Lee, W. P. and Rodriguez, Eduardo D.},
month = oct,
year = {2018},
keywords = {Berman},
pages = {1240--1246}
}
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Methods Leaders of each program performing and/or evaluating VCA in the United States were invited to participate in a working group to assess the state and future of VCA ethics and policy. Four meetings were held over the course of 1 year to describe key challenges and potential solutions. Results Working group participants concluded that VCA holds great promise as treatment for patients with particular injuries or deficits, but the field faces unique challenges to adoption as standard of care, which can only be overcome by data sharing and standardization of evaluation and outcome metrics. Conclusions Adequate attention must be given to concerns including managing the uniquely intense physician-patient relationship, ethical patient selection, ensuring patients have adequate representation, informing and earning the trust of the public for donation, standardizing metrics for success, and fostering an environment of data sharing. 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The ethics of VCA have moved past doubts about the morality of attempting such transplant to how to conduct them ethically.\n Methods Leaders of each program performing and/or evaluating VCA in the United States were invited to participate in a working group to assess the state and future of VCA ethics and policy. Four meetings were held over the course of 1 year to describe key challenges and potential solutions.\n Results Working group participants concluded that VCA holds great promise as treatment for patients with particular injuries or deficits, but the field faces unique challenges to adoption as standard of care, which can only be overcome by data sharing and standardization of evaluation and outcome metrics.\n Conclusions Adequate attention must be given to concerns including managing the uniquely intense physician-patient relationship, ethical patient selection, ensuring patients have adequate representation, informing and earning the trust of the public for donation, standardizing metrics for success, and fostering an environment of data sharing. 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