Organ and Tissue

Transplantation
Science Perspectives 10: Chapter 3.7

Video: https://youtu.be/6rKUBBjaa0g
 Organ Transplantation
Organ transplant is the moving of an organ from one body to
another, for the purpose of replacing the recipients damaged
or failing organ with a working one from the donor site.

Organ donors can be living or deceased.

Face
 History of Organ Transplantation - Kidneys
1902 - The first successful experimental kidney transplants were performed
at the Vienna Medical School in Austria with animals.
1909 - The first kidney transplant experiments were performed in humans
in France using animal kidneys. A surgeon inserted slices of rabbit kidney
into a child suffering from kidney failure. Although the immediate results
were excellent the child died about 2 weeks later.
1933 - The first human-to-human kidney transplant was performed.
Unknown to doctors at the time, there were mismatches in donor and
recipient blood groups and the donor kidney never functioned.
1954 - Joseph E. Murray and his colleagues at Peter Bent Brigham Hospital
in Boston performed the first truly successful kidney transplant from one
twin to another. This was done without any immunosuppressive
medication. Why?
 History of Organ Transplantation
1818 First successful human to human blood transfusion by British
obstetrician Dr. James Blundell, to a patient for the treatment of
postpartum hemorrhage.
1967 First successful human to human heart transplant by Dr. Christiaan
Barnard, in South Africa.
1983 First successful single lung transplant, by Dr. Joel Cooper, Toronto,
Canada
1986 First successful double lung transplant, by Dr. Joel Cooper, Toronto,
Canada
2005 First successful partial face transplant, by Dr. Bernard Devauchelle,
Dr. Benoit Lengele and Dr. Jean-Michel Dubernard, France.
 Types of Organ Donors
Persons after death; most common type.
Living persons related to recipients; best because it increases the
chances that the organ will be an appropriate genetic match,
therefore decreasing the risk of rejection. Also means reduced
waiting time for the recipient.
Living persons unrelated to recipients.
Brain-dead persons; their breathing and heartbeat has stopped, but
are kept alive by a machine (called cadaveric donors).
 Living Donors
The donor remains alive and donates a renewable tissue, cell, fluid, or
donates an organ or part of an organ in which the remaining organ
can regenerate or take on the workload of the rest of the organ.
Examples: Blood (regenerates), skin, lobe of lung, liver (regenerates),
kidney
 Risks associated with Organ Transplants
Due to the genetic difference between most organs and the recipient,
the recipients immune system will identify the organ as foreign and
attempt to destroy it, causing transplant rejection.
To prevent rejection, recipients need to take medication to prevent
their immune systems from rejecting the new tissue or organ.
With the immune system suppressed, the bodys ability to fight off
infections is reduced and the patient can die from illnesses that would
otherwise not be fatal.
Wait time is the second risk factor. The longer the wait time, the
higher the chance of death before getting the organ needed.
 Ethical Ways
There is a shortfall in human donors
The reason that most people waiting for an organ transplant never receive
one is simply that there are not enough human organs to go around.
What can we do?
Could be addressed by increasing the number of willing donors.
Use stem cells to replace cells that are lost or damaged from disease or injury.
For example, transplants of stem cells from (matched) bone marrow were first
done in the early 1970s and are now regularly used to treat leukaemia.
Store stem cells extracted from umbilical cord blood to replace bone marrow
in the future, if needed.
 Controversial Ways
Xenotransplantation
A transplant of organs or tissue from one species to another.
Most common: Heart valve transplants from pigs to humans.
Pigs are the current preferred donor species because their organs are a
similar size to human organs, they have large litters and they are easy to rear.
Human-Pig Chimeras
Injecting human stem cells inside pig embryos. Result = pigs with human
organs
Video: https://youtu.be/Avpcno5fx-M
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