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David Goldfarb

A wide array of ethical issues comes into play regarding renal transplantation after prior solid organ transplantation. They include concerns about prevention and access. One must first understand the scope of the problem. The prevalence of chronic kidney disease (CKD) among prior non–renal organ transplant (NRTx) recipients is between 80 percent and 100 percent for those who survive three years. The more advanced stages of CKD, types IV and V, occur in 5–20 percent of patients by five years after NRTx, and they vary according to the type of transplant. CKD is lowest in heart–lung recipients and highest in intestine

David S. Goldfarb

One might think that rare diseases are rare. But if one were to combine all the rare diseases that affect Americans, the overall prevalence is not rare at all. In fact, 30 million Americans, or roughly 10 percent of the population, are affected by a rare disease. Many of these disorders are severe and lead to a significant effect on people’s lives and life expectancy. To bring new and concentrated attention to these often poorly studied disorders, 19 collaborative consortia were funded in 2009 by the Rare Disease Clinical Research Network, a project jointly sponsored by the National Institutes of