Organ transplantation

Organ transplant
Reenactment of the first heart transplant, performed in South Africa
MeSHD016377
Transplant surgeon
Occupation
Names
  • Physician
  • Surgeon
Occupation type
Specialty
Activity sectors
Medicine, Surgery
Description
Education required
Fields of
employment
Hospitals, Clinics

Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

Organs that have been successfully transplanted include the heart, kidneys, liver, lungs, pancreas, intestine, thymus and uterus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), corneae, skin, heart valves, nerves and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed by the liver and then the heart. [citation needed] Corneae and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than tenfold. [citation needed]

Organ donors may be living, brain dead, or dead via circulatory death.[1] Tissue may be recovered from donors who die of circulatory death,[2] as well as of brain death – up to 24 hours past the cessation of heartbeat. Unlike organs, most tissues (with the exception of corneas) can be preserved and stored for up to five years, meaning they can be "banked". Transplantation raises a number of bioethical issues, including the definition of death, when and how consent should be given for an organ to be transplanted, and payment for organs for transplantation.[3][4] Other ethical issues include transplantation tourism (medical tourism) and more broadly the socio-economic context in which organ procurement or transplantation may occur. A particular problem is organ trafficking.[5] There is also the ethical issue of not holding out false hope to patients.[6]

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs.[7]

  1. ^ Manara, A. R.; Murphy, P. G.; O'Callaghan, G. (2011). "Donation after circulatory death". British Journal of Anaesthesia. 108: i108–21. doi:10.1093/bja/aer357. PMID 22194426.
  2. ^ Bernat, James L.; Capron, Alexander M.; Bleck, Thomas P.; Blosser, Sandralee; Bratton, Susan L.; Childress, James F.; DeVita, Michael A.; Fulda, Gerard J.; Gries, Cynthia J.; Mathur, Mudit; Nakagawa, Thomas A.; Rushton, Cynda Hylton; Shemie, Sam D.; White, Douglas B. (March 2010). "The circulatory–respiratory determination of death in organ donation". Critical Care Medicine. 38 (3): 963–970. doi:10.1097/CCM.0b013e3181c58916. PMID 20124892.
  3. ^ See WHO Guiding Principles on human cell, tissue and organ transplantation, Annexed to World Health Organization, 2008. Archived 3 March 2016 at the Wayback Machine
  4. ^ Further sources in the Bibliography on Ethics of the WHO Archived 4 March 2016 at the Wayback Machine.
  5. ^ See Organ trafficking and transplantation pose new challenges Archived 15 February 2014 at the Wayback Machine.
  6. ^ Cite error: The named reference The-Guardian-Simon-Garfield-April-6-2008 was invoked but never defined (see the help page).
  7. ^ Frohn C, Fricke L, Puchta JC, Kirchner H (February 2001). "The effect of HLA-C matching on acute renal transplant rejection". Nephrol. Dial. Transplant. 16 (2): 355–60. doi:10.1093/ndt/16.2.355. PMID 11158412.