Organs Transplantation

Organ transplant
by Alsafwa Medical Family
Why Organ transplant ??!!
organ transplant (an operation moving an organ from one
organism (the donor) to another (the recipient)) "he had a
kidney transplant"; "the long-term results of cardiac
transplantation are now excellent"; "a child had a multiple
organ transplant two months ago"
 Types of transplants
• Autograft
• Allograft
• Isograft
• Xenograft and Xenotransplantion
• Split transplants
• Domino transplants
 Autograft

• A transplant of tissue from one to oneself.

Sometimes this is done with surplus
tissue, or tissue that can regenerate, or
tissues more desperately needed
elsewhere (examples include skin grafts,
for CABG, etc.) Sometimes this is done to
remove the tissue and then treat it or the
person, before returning it (examples
include stem-cell autograft and storing
blood in advance of surgery).
 Allograft
• An allograft is a transplanted organ or
tissue from a genetically non-identical
member of the same species. Most human
tissue and organ transplants are allografts.
 Isograft
• A subset of allografts in which organs or
tissues are transplanted from a donor to a
genetically identical recipient (such as an
identical twin). Isografts are differentiated
from other types of transplants because
while they are anatomically identical to
allografts, they are closer to autografts in
terms of the recipient's immune response.
Xenograft and Xenotransplantion
• A transplant of organs or tissue from one
species to another. Xenotransplantion is often
an extremely dangerous type of transplant.
Examples include porcine heart valves, which
are quite common and successful, a baboon-to-
human heart (failed), and piscine-primate (fish to
non-human primate) islet (i.e. pancreatic or
insular tissue), the latter's research study
directed for potential human use if successful.
See: xenotransplantation.
 Split transplants
• Sometimes, a deceased-donor organ
(specifically the liver) may be divided
between two recipients, especially an adult
and a child.
 Domino transplants
• This operation is usually performed for cystic fibrosis as
both lungs need to be replaced and it is a technically
easier operation to replace the heart and lungs en bloc.
As the recipient's native heart is usually healthy, this can
then itself be transplanted into someone needing a heart
transplant. That term is also used for a special form of
liver transplant, in which the recipient suffers from
familial amyloidotic polyneuropathy in which the liver
(slowly) produces a protein that damages other organs;
their liver can be transplanted into an older patient who
is likely to die from other causes before a problem
arises.
 Major organs and tissues transplanted
• Thoracic organs
• Heart (Deceased-donor only)
• Lung(Deceased-donor and Living-Donor)
• En bloc Heart/Lung (Deceased-donor and Domino transplant)
• Other organs
• Kidney (Deceased-donor and Living-Donor)
• Liver (Deceased-donor and Living-Donor)
• Pancreas (Deceased-donor only)
• (Deceased-donor only)
• Tissues, cells, fluids
• Hand (Deceased-donor only
• Cornea (Deceased-donor onlySkin graft including Face transplant (almost always autograft)
• Penis (Deceased-donor only)
• Islets of Langerhans (Pancreas Islet Cells) (Deceased-donor and Living-Donor)
• Bone marrow/Adult stem cell (Living-Donor and Autograft)
• Blood transfusion/Blood Parts Transfusion (Living-Donor and Autograft)
• Blood vessels (Autograft and Deceased-Donor)
• Heart valve (Deceased-Donor, Living-Donor and Xenograft[Porcine/bovine])
• Bone (Deceased-Donor, Living-Donor, and Autograft)
• Skin(Deceased-Donor, Living-Donor, and Autograft)
History of Organ transplant
The Chinese physician Pien Chi'ao reportedly
exchanged hearts between a man of strong spirit but
weak will with one of a man of weak spirit but strong
will in an attempt to achieve balance in each man.
• Roman Catholic
accounts report the
third-century saints
Damian and Cosmas
as replacing the
gangrenous leg of the
Roman deacon
Justinian with the leg
of a recently deceased
Ethiopian.
• The first reasonable
account is of the
Indian surgeon
Sushruta in the
second century BC,
who used
autografted skin
transplantation in
nose reconstruction
rhinoplasty.
• Centuries later,
the Italian
surgeon
performed
successful skin
autografts; he
also failed
consistently with
allografts
• the first successful
human corneal
transplant, a
keratoplastic
operation, was
performed by Eduard
Zirm in Austria in
1905.
• Their skillful
anastomosisoperations,
the new suturing
techniques, laid the
groundwork for later
transplant surgery and
won Carrel the 1912
Nobel Prize for Medicine
or Physiology
 • Archibald McIndoe
carried on the work into World War II as reconstructive surgery
 • The first
attempted human
deceased-donor
transplant was
performed by the
Ukrainian
surgeon in the
1930s

Yu Yu Voronoy
• the late 1940s Peter
Medawar, working
for the National
Institute for Medica
Research, improved
the understanding of
rejection. Identifying
the immune
reactions in 1951
Medawar suggested
that
immunosuppressive
drugs
• On March 9th 1981 t
the first successful
heart-lung transplant
took place at Stanford
University Hospital.
The head surgeon,
Bruce Reitz, credited
the patient's recovery
to cyclosporine-A.
 Timeline of successful transpants
• 1905: First successful cornea transplant by Eduard Zirm
• 1954: First successful kidney transplant by Joseph Murray (Boston, U.S.A.)
• 1966: First successful pancreas transplant by Richard Lillehei and William Kelly
(Minnesota, U.S.A.)
• 1967: First successful liver transplant by Thomas Starzl (Denver, U.S.A.)
• 1967: First successful heart transplant by Christiaan Barnard (Cape Town, South
Africa)
• 1970: First successful monkey head transplant by Robert White (Cleveland, U.S.A.)
• 1981: First successful heart/lung transplant by Bruce Reitz (Stanford, U.S.A.)
• 1983: First successful lung lobe transplant by Joel Cooper (Toronto, Canada)
• 1986: First successful double-lung transplant (Ann Harrison) by Joel Cooper
(Toronto, Canada)
• 1987: First successful whole lung transplant by Joel Cooper (St. Louis, U.S.A.)
• 1995: First successful laparoscopic live-donor nephrectomy by Lloyd Ratner and
Louis Kavoussi (Baltimore, U.S.A.)
• 1998: First successful live-donor partial pancreas transplant by David Sutherland
(Minnesota, U.S.A.)
• 1998: First successful hand transplant (France)
• 2005: First successful partial face transplant (France)
• 2006: First successful penis transplant (China)
Reasons for donation
Living related donors
Paired-exchange
Good Samaritan
Compensated donation
Forced donation
Ethical concerns
Who will buy ... my beautiful
kidney?
 Ethical concerns
• The World Health Organization argues
that transplantations promote health, but
the notion of “transplantation tourism” has
the potential to violate human rights or
exploit the poor
There is also a powerful opposing view, that trade in organs, if
properly and effectively regulated to ensure that the seller is fully
informed of all the consequences of donation, is a mutually beneficial
transaction between two consenting adults, and that prohibiting it
would itself be a violation of Articles 3 and 29 of the Universal
Declaration of Human Rights.
Organ transplantation in different
countries
Organ transplant in Egypt
Which side are you ?!
Dialogue
In Egypt !
Thank You