Organ Transplantation and Artificial Organs

Transplantation of tissue is playing an increasing role in modern therapeutics. Survival of recipients and transplanted organs is excellent, making transplantation of many major organs a very successful therapeutic option. Evidence shows that a multidisciplinary approach to managing the brain-dead donor offers a better opportunity for successful organ survival after transplantation. Organ procurement procedures are most commonly performed in community hospitals and rural settings.

Immunotherapy is the treatment of disease by inducing, enhancing, or suppressing an immune response. Immunotherapies designed to elicit or amplify an immune response are classified as activation immunotherapies, while immunotherapies that reduce or suppress are classified as suppression immunotherapies. In recent years, immunotherapy has become of great interest to researchers, clinicians and pharmaceutical companies, particularly in its promise to treat various forms of cancer.

Xenotransplantation, is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenografts or xenotransplants. It is contrasted with allotransplantation, syngeneic transplantation or isotransplantation  and autotransplantation. Xenotransplantation of human tumor cells into immunocompromised mice is a research technique frequently used in pre-clinical oncology research. Human xenotransplantation offers a potential treatment for end-stage organ failure, a significant health problem in parts of the industrialized world.

Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person. Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver cells obtained from an animal were used instead of developing a piece of equipment for each function of the liver.

Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage renal disease. Kidney transplantation is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor renal transplants are further characterized as genetically related or non-related transplants, depending on whether a biological relationship exists between the donor and recipient. Hemodialysis is a method for removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in kidney failure. The mechanical device used to clean the patients’ blood is called a dialyzer, also known as an artificial kidney

Presumed consent legislation produces more donors and in particular more organs per donor. In cadaveric donation, the number of elderly donors is increasing, so the quality of organs available is getting poorer. There will be no substantial rise in transplantation unless there is a major breakthrough in the current programs. There will be an increase in the proportion of living related donors and debate about ethics of transplantation. Adverse publicity and debate may affect cadaveric donation and refusal rates The number of kidneys, livers and other body parts surgeons are harvesting through a controversial approach to organ donation has started to rise rapidly, a trend that is saving the lives of more waiting patients but, some say, risks sacrificing the interests of the donors.

Tissue engineering is the use of a combination of cells, engineering and materials methods, and suitable biochemical and physicochemical factors to improve or replace biological tissues. Tissue engineering involves the use of a scaffold for the formation of new viable tissue for a medical purpose. While it was once categorized as a sub-field of biomaterials, having grown in scope and importance it can be considered as a field in its own. While most definitions of tissue engineering cover a broad range of applications, the tissues involved require certain mechanical and structural properties for proper functioning.

Pediatric organ donation and organ transplantation can have a significant life-extending benefit to the young recipients of these organs and a high emotional impact on donor and recipient families. Pediatricians, pediatric medical specialists, and pediatric transplant surgeons need to be better acquainted with evolving national strategies that involve organ procurement and organ transplantation to help acquaint families with the benefits and risks of organ donation and transplantation. Efforts of pediatric professionals are needed to shape public policies to provide a system in which procurement, distribution, and cost are fair and equitable to children and adults.

Robotic surgery, computer-assisted surgery, and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in surgical procedures. Robotically-assisted surgery was developed to overcome the limitations of pre-existing minimally-invasive surgical procedures and to enhance the capabilities of surgeons performing open surgery. In the case of robotically-assisted minimally-invasive surgery, instead of directly moving the instruments, the surgeon uses one of two methods to control the instruments either a direct telemanipulator or through computer control.

Diabetes can be a new problem or a problem that is exacerbated after the transplant High cholesterol doesn't have any symptoms itself, but it's still dangerous. It can clog up your blood vessels, possibly damage your donor organ, and eventually lead to heart disease. High blood pressure Again, the medicines you need can aggravate or cause high blood pressure gastrointestinal problems this is a fairly common side effect of steroids. Your health care professional may prescribe medication to help Gout A buildup of uric acid in the blood can result in gout, a painful inflammation of some joints Anxiety and depression People who have received a transplant have usually been through a lot of frightening and nerve-racking experiences Sexual problems Some people who have a transplant develop some sexual problems, such as a decreased sex drive or loss of function.

The field of transplant ethics is a specialty within the practice of clinical ethics.  The goals of transplant ethics are to promote the integrity of transplant medicine, and the welfare of living donors and organ recipients.  Because organs are very scarce and a precious gift, transplant ethics aims for organ allocation to those with the capacity to benefit from it. There are many ethical dilemmas and complex situations that can arise during transplant and organ donation, Ethics assessment of fulminant patients, Transplantation for those who are uninsured or underinsured, Assessment of patients expressing ambivalence about pursuing transplant, Assessment of patients with compliance problems.

Immune system usually protects you from substances that may be harmful, such as germs, poisons, and sometimes, cancer cells. These harmful substances have proteins called antigens coating their surfaces. As soon as these antigens enter the body, the immune system recognizes that they are not from that person's body and that they are foreign, and attacks them. When a person receives an organ from someone else during transplant surgery, that person's immune system may recognize that it is foreign. This is because the person's immune system detects that the antigens on the cells of the organ are different or not matched. Mismatched organs, or organs that are not matched closely enough, can trigger a blood transfusion reaction or transplant rejection.

Allotransplant is the transplantation of cells, tissues, or organs, to a recipient from a genetically non-identical donor of the same species. The transplant is called an allograft, allogeneic transplant, or homograft. Most human tissue and organ transplants are allografts. It is contrasted with autotransplantation, syngeneic transplantation  and xenotransplantation. Allografts can be referred to as homostatic if they are biologically inert when transplanted, such as bone and cartilage. An immune response against an allograft or xenograft is termed rejection. An allogenic bone marrow transplant can result in an immune attack, called graft-versus-host disease.