Critical appraisals and cultural acceptance of the dead donor rule: A revisit of the contemporary transplantation era

Transplantation remains one of the most rapidly expanding surgical specialties. Harvesting organs plays a crucial step in this highly complex surgical and communication process, and the moment at which vital organs can be donated depends on the declaration of end-of-life. This declaration must be performed by medical practitioners on the basis of clear standardized criteria of death confirmation, within competent local and regional jurisdictions, and with the use of confirmatory tests as indicated to ascertain the irreversibility of end-of-life. The current medically and legally accepted definition of death in most societies challenges the traditional and societal understandings of the process of end-of-life. Significant criticisms and cultural oppositions to transplantation still exist, and there is an ongoing debate about the role and the status of transplantation as surgical and medical sciences continue to evolve. By discussing the social acceptance and common understanding of end-of-life determination, we aim to highlight the current knowledge on transplant ethics with respect to the balance between the need to protect the potential organ donor and the need to donate organs at their utmost viability. No report has been done on social acceptance of transplantation in Rwanda or other Low- and Middle-Income countries (LMIC); though, as emphasis on organ transplantation evolves, we also aim to highlight the need for clear directions towards new transplantation regulations. Technical and non-technical critical arguments and moral acceptance are juxtaposed with the elucidated ethical and deontological principles to support the contemporary concept of the dead donor rule

Analytical Retrospect of the First Successful Thoraco-laparoplasty for Congenital Diaphragmatic Hernia in a 1-day Old Newborn in Rwanda: A case review

Successful diaphragmatic surgeries with abdominal approaches have been reported nowadays in most developed and fully equipped surgical centers. Few reports exist in developing countries due to the rarity of the disease; and insufficiency of well-equipped centers for its accurate diagnosis and management. The following analytical retrospect describes a 1-day old newborn with congenital diaphragmatic hernia (CDH) received after 24hours of life and treated successfully at King Faisal Hospital Rwanda (KFH); with hernioplasty through a thoraco-abdominal approach. The newborn recovered perfectly well after surgery without complications. The discussion; herein; extends on the rationale and new practical concepts in the combination of both medical and surgical therapies; highlights some updated anticipatory preoperative and postoperative measures for a better overall outcome on such major and complex disease

Overview of Pre-Clinical Techniques for Predicting the Immunogenicity of Therapeutics in Drug Development

Immunogenicity testing is a vital component of drug development as it leads to drugs that are safer and more effective. This review provides an overview of the pre-clinical models that can be used to predict the immunogenic potential of novel protein therapeutics prior to administration in humans. Tools important for the prediction of the immunogenicity of protein therapeutics include animal models; in vitro cell assays; and in silico techniques. Animal models including rodents; transgenic mice; and non-human primates are reviewed. Among the immunoinformatics tools commonly used to predict immunogenicity include the Structural Epitope Database; Immune Epitope Database and Analysis Resource (IEDB); The MHCBN database; Dana-Farber Repository for Machine Learning in Immunology; and TEPITOPE. Identifiation and subsequent removal or inhibition of epitopes and MHC agretopes minimizes immunogenicity. Strategies for minimization of immunogenicity in biotherapeutics including epitope and MHC agretope removal; improvement of solubility; derivatization with polyethylene glycol (PEG); and use of chimeric antibodies are also discussed. Immunogenicity testing is an important part of the drug development process as it leads to drugs that are safer and more effective. Animal models including rodents; transgenic mice; and non-human primates; in vitro cell assays; and immunoinformatics tools are used to identify epitopes and MHC agretopes which are then eliminated or inhibited so as to minimize immunogenicity

Anti-trypanosomal Activity of Potential Inhibitors of Trypanosoma brucei Glycolytic Pathway Enzymes Selected by Docking Studies

Human African trypanosomiasis (HAT); a potentially fatal protozoan infection caused by tsetse-fl mediated transmission of Trypanosoma brucei (T. Brucei); is largely recognized as a neglected disease. The repertoire of drugs that is effective against the infection is limited and all drugs have several drawbacks including high level of toxicity; difficult administration regimens; and the resurgence of resistance. At present the biology of the parasite is well studied and a number of technologies are now available which can aid in the identifiation of potential drug targets. This review identifis putative inhibitors of trypanosomal glycolytic enzymes