Transplantation of the liver for metastatic endocrine tumors of the intestine and pancreas

In the Pittsburgh series of 1,000 orthotopic liver transplants (OLTx), from January 1981 to July 1987, the indication for transplantation in five patients consisted of unresectable hepatic metastases arising from endocrine tumors of gastrointestinal origin: glucagonoma, two patients; carcinoid, two, and gastrinoma, one patient. Three patients underwent resection of the primary tumor (two distal pancreatectomies and one ileal resection) at the time of the hepatic transplantation. All patients underwent extensive nodal dissection. Three of the five patients are alive with no evidence of residual disease after a median follow-up study of 12 months. Hepatic transplantation broadens the concept of radical excision of tumor and may be considered as a potential therapeutic approach for some highly selected instances of unresectable hepatic metastases arising from endocrine tumors of the intestine and pancreas

Donors vastly underestimate differences in charities’ effectiveness

This is the final version. Available on open access from the Society for Judgment and Decision Making via the link in this recordSome charities are much more cost-effective than other charities, which means that they can save many more lives with the same amount of money. Yet most donations do not go to the most effective charities. Why is that? We hypothesized that part of the reason is that people underestimate how much more effective the most effective charities are compared with the average charity. Thus, they do not know how much more good they could do if they donated to the most effective charities. We studied this hypothesis using samples of the general population, students, experts, and effective altruists in six studies. We found that lay people estimated that among charities helping the global poor, the most effective charities are 1.5 times more effective than the average charity (Studies 1 and 2). Effective altruists, in contrast, estimated the difference to be factor 30 (Study 3) and experts estimated the factor to be 100 (Study 4). We found that participants donated more to the most effective charity, and less to an average charity, when informed about the large difference in cost-effectiveness (Study 5). In conclusion, misconceptions about the difference in effectiveness between charities is thus likely one reason, among many, why people donate ineffectively

Effect of race upon organ donation and recipient survival in liver transplantation

The effect of the race of the donor on organ donation and on the outcome of clinical liver transplantation has not been addressed previously. The aims of this study were to determine: (1) the number of organs donated by each of the major racial groups of the United States, (2) the outcome of transplantation of these organs across racial groups, and (3) the pattern of liver disease that required transplantation in each of these racial groups. A significantly higher proportion of organs were donated by white non-Hispanic Americans than either black or Hispanic Americans. There was no significant difference in survival when an organ was transplanted between black and white Americans and vice versa. Postnecrotic cirrhosis from a variety of causes was the most common indicator affecting black and white recipients, while primary biliary cirrhosis and primary sclerosing cholangitis were uncommon in the black population. While the number of organs donated by blacks was low, it was, however, proportional to the number of black recipients in this study. Reasons for the low rate of donation by the black and white Hispanic population are discussed. It is concluded that race is not a criteria to be used in selection of donors for liver transplantation. Educational programs addressing issues of organ donation and transplantation directed towards the black and Hispanic populations are recommended. © 1990 Plenum Publishing Corporation