The Good Samaritan or Non-Directed Donor

From the outset of kidney transplantation, some living donors were “Good Samaritan” donors—that is, individuals who donated a kidney without a specific recipient in mind. However, non-genetically related donors fell out of favor quickly because the results were no better than deceased donor grafts. As immunosuppression improved and graft outcomes from non-biologically related donors improved, attitudes changed (with greater and earlier support from the public than from transplant professionals and with greater support for spouses then friends then acquaintances, and then strangers). This chapter examines ethical controversies raised by Good Samaritan donors using a living donor ethics framework. It examines the moral justification for permitting living donation by strangers, the ethics of the donor and recipient selection and allocation processes, and whether Good Samaritan donors should be encouraged to catalyze a domino multi-donor-recipient pair chain rather than donate to a single candidate on the waitlist.

Implementation of the Fuzzy Topsis Algorithm in the Scholarship Recommendation System

The scholarships given to the University of Muhammadiyah Sidoarjo include outstanding scholarships (PPA) and underprivileged scholarships (BBP). During the selection made by the university which has 9 faculties throughout the university by manual method. Although there are requirements and files that must be submitted during registration as a potential recipient, this still supports the objectivity of the selection being carried out. For this reason, it is necessary to have an innovation digitally in the selection process for this scholarship recipient. Selection system that was built practically, quickly, and accurately. For this reason, it is necessary to support the support of a client-server application and also the Fuzzy TOPSIS algorithm to determine the results of calculations and rankings based on the calculation value of each student who has been registered as a scholarship recipient. In this study, an application that is a client server has been made, where students can enter prospective scholarship recipients online. The application made has implemented the TOPSIS Fuzzy Algorithm for sorting or ranking. So that this selection work is considered faster, easier and has objective results based on the system. From the applications that have been made, 1,000 students have been tested with the composition of quotas on PPA scholarships as many as 370 and 875 for BBP scholarships. Of the 1000 data on registered students, 239 met the top ranking requirements which were declared PPA scholarship recipients. As well as the top 793 students as BBP scholarship recipients, a letter of recommendation will be printed automatically based on the information the student has received as a scholarship candidate. This trial application recommendation is for ± 3 minutes. With an average value of 77.60% satisfactory..

2021 ISFM Consensus Guidelines on the Collection and Administration of Blood and Blood Products in Cats

Practical relevance: Blood and blood products are increasingly available for practitioners to use in the management of haematological conditions, and can be lifesaving and therapeutically useful for patients with anaemia and/or coagulopathies. It is important for feline healthcare that donors are selected appropriately, and transfusions of blood or blood products are given to recipients that will benefit from them. Complications can occur, but can be largely avoided with careful donor management and recipient selection, understanding of blood type compatibility, and transfusion monitoring. Clinical challenges: Feline blood transfusion, while potentially a lifesaving procedure, can also be detrimental to donor and recipient without precautions. Cats have naturally occurring alloantibodies to red cell antigens and severe reactions can occur with type-mismatched transfusions. Blood transfusions can also transmit infectious agents to the recipient, so donor testing is essential. Finally, donors must be in good health, and sedated as appropriate, with blood collected in a safe and sterile fashion to optimise the benefit to recipients. Transfusion reactions are possible and can be mild to severe in nature. Autologous blood transfusions and xenotransfusions may be considered in certain situations. Evidence base: These Guidelines have been created by a panel of authors convened by the International Society of Feline Medicine (ISFM), based on available literature. They are aimed at general practitioners to provide a practical guide to blood typing, cross-matching, and blood collection and administration.

Fair allocation of cryopreserved donor oocytes: towards an accountable process

ABSTRACT A growing number of people desire ART with cryopreserved donor oocytes. The allocation of these oocytes to couples and mothers to be is a 2-fold process. The first step is to select a pool of recipients. The second step is to decide who should be treated first. Prioritizing recipients is critical in settings where demand outstrips supply. So far, the issue of how to fairly allocate cryopreserved donor oocytes has been poorly addressed. Our ethical analysis aims to support clinics involved in allocation decisions by formulating criteria for recipient selection irrespective of supply (Part I) and recipient prioritization in case supply is limited (Part II). Relevant criteria for recipient selection are: a need for treatment to experience parenthood; a reasonable chance for successful treatment; the ability to safely undergo an oocyte donation pregnancy; and the ability to establish a stable and loving relationship with the child. Recipients eligible for priority include those who: have limited time left for treatment; have not yet experienced parenthood; did not undergo previous treatment with cryopreserved donor oocytes; and contributed to the supply of donor oocytes by bringing a donor to the bank. While selection criteria function as a threshold principle, we argue that the different prioritization criteria should be carefully balanced. Since specifying and balancing the allocation criteria undoubtedly raises a moral dispute, a fair and legitimate allocation process is warranted (Part III). We argue that allocation decisions should be made by a multidisciplinary committee, staffed by relevant experts with a variety of perspectives. Furthermore, the committees’ reasoning behind decisions should be transparent and accessible to those affected: clinicians, donors, recipients and children born from treatment. Insight into the reasons that underpin allocation decisions allows these stakeholders to understand, review and challenge decisions, which is also known as accountability for reasonableness.

Truthful Mechanisms for Medical Surplus Product Allocation

Problem definition: We analyze a resource allocation problem faced by medical surplus recovery organizations (MSROs) that recover medical surplus products to fulfill the needs of underserved healthcare facilities in developing countries. The objective of this study is to identify implementable strategies to support recipient selection decisions to improve MSROs’ value provision capability. Academic/practical relevance: MSRO supply chains face several challenges that differ from those in traditional for-profit settings, and there is a lack of both academic and practical understanding of how to better match supply with demand in this setting where recipient needs are typically private information. Methodology: We propose a mechanism design approach to determine which recipient to serve at each shipping opportunity based on recipients’ reported preference rankings of different products. Results: We find that when MSRO inventory information is shared with recipients, the only truthful mechanism is random selection among recipients, which defeats the purpose of eliciting information. Subsequently, we show that (1) eliminating inventory information provision enlarges the set of truthful mechanisms, thereby increasing the total value provision; and (2) further withholding information regarding other recipients leads to an additional increase in total value provision. Finally, we show that under a class of implementable mechanisms, eliciting recipient valuations has no value added beyond eliciting preference rankings. Managerial implications: (1) MSROs with large recipient bases and low inventory levels can significantly improve their value provision by appropriately determining the recipients to serve through a simple scoring mechanism; (2) to truthfully elicit recipient needs information to support the recipient selection decisions, MSROs should withhold inventory and recipient-base information; and (3) under a set of easy-to-implement scoring mechanisms, it is sufficient for MSROs to elicit recipients’ preference ranking information. Our findings have already led to a change in the practice of an award-winning MSRO.