Organ Transplantation – Donation, Surgery and Research

Moving an organ from a donor’s body to a patient’s body, or to create organs from the patient’s own stem cells (regenerative medicine as an emerging field) in order to replace the recipient’s damaged or absent organ, that is what the term Organ Transplantation refers to, including the following organs:

• Thymus
• Intestine
• Lungs
• Pancreas
• Liver
• Kidneys
• Heart

It also involves to transplantation of tissues such as,

• Bones
• Muscoloskeletal grafts
• Cornea
• Skin
• Heart valves
• Nerves
• Veins

It is one of the most complex and challenging areas of medicine, because of the ever-present risk that the recipient body rejects the transplant, making the removal necessary.

Benefits and Outcomes of Organ Transplant

Organ transplant is the last possibility to address a state of organ failure. Kidney for instance, is the most frequently carried out organ transplant worldwide, and it is considered the best treatment for its cost effectiveness and life quality prospects it restores. Organ transplantation requires long term health evaluation of the patient. Only academic communities and medical scientists have the right to monitor the outcomes of transplants and regulate donations.

Three Essential Processes

In modern times, doctors and patients face an enormous demand for transplants which has long surpassed the supply of organs. Patients must wait a long time, years in some cases, for a chance to get hold of a donated organ. That’s why scientists are working along with politicians to solve this problem. Organ distribution is therefore the first essential step, followed by the transplant surgery and the follow-up or post-surgery recovery.

Evaluation Process

The following are some components of the transplant evaluation process:

• Psychological evaluation – in which the medical team assesses significant psychological and social issues such as stress, financial situation and family support.
• Blood tests – essential in the selection process to joining the donor’s list. They are performed to determine donor match, priority in the list and to improve chances against organ rejection.
• Diagnosis – to assess health status. Includes X-rays, ultrasound, biopsy, dental examinations, among other diagnostic tests depending on the transplant surgery required.

Organ Distribution

When a particular organ fails, transplant can be the only chance for the patient. For procedures like kidney and liver transplant, a willing donor might be found among family members or friends. A very small number of transplants come from people donating as a result of a good, Samaritan gesture. Nevertheless, there is still the necessity of being appropriate for donor-recipient match, a process of selection achieved through serotyping. Then it is possible to proceed with the surgery state. Patients must find a transplant team or a group of organ surgeons and health professionals, who decide if the patient is a good candidate, based on the attitude, psychological state, medical history and other factors, to be included in the national waiting list for transplantation. When the organ becomes available, based on the criteria of all relevant information, a recipient, the best match for the organ is chosen. Then the hospital prepares for surgery.

Surgical Procedure

The fully anesthetized patient is injected with anticoagulant to keep the blood from clotting during the transplantation procedure. Doctors connect the hearth-lung machine, in the case of a heart transplant, or other life-support devices to enable the surgeon to remove the organ without disrupting body functions. After the organ exchange, the patient is stitched and taken to recovery room, where they are expected to regain consciousness within a few hours. They might leave the hospital in less than a week.

Three types of rejection

Following a transplant surgery, the following three types of rejection might occur:

• Chronic rejection – might last months or years.
• Acute rejection – a few days after transplant and it is the immune response to foreign matter.
• Hyperacute rejection – as soon as the organ is connected to the new body.

Types of Transplant

• Autograft – transplant of tissue from one area of the body to another, using surplus tissue which is regenerative.
• Allograft – transplant of tissue or organ between non-identical members of a species. This transplant might cause rejection due to genetic difference.
• Xenograft or xenotransplant – a transplant from one species to another. Very risky due to rejection.
• Split transplants – when an organ is divided between two recipients (liver transplant usually, liver being regenerative).
• Domino – when both livers are to be replaced from patients suffering from cystic fibrosis.