Organ Transplantation
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Transcript of Organ Transplantation
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Definition of “organ transplantation”Medical point of view including:
(a) Types of organ donation(b) kinds of organs that can be transplanted
(c) Types of transplant including advantages and disadvantages
Organ transplantation in different countries and their statistics
Brief description of transplantation processBioethical and religious issues
Main problems by which people don’t will to donate their organs
Various ways of promotion about donation of organs to the people who are in need.
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A national “shortage”
Every 13 minutes… Every hour… Everyday…
A person is added to the list
4 more are added 17 lose the fight
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Organ transplant is a surgical operation in which a falling or damaged organ in the human body is removed and replaced with a functioning one.
Process of taking cells,tissues or organs called a “graft” from one individual and placing them into a different individual
Types of organ donation
Cadaveric organ donation: Involves in removing organs from a recently deceased (dead) donor.
Living organ donation: involves in the donation of one of a paired organ (such as kidneys) in which the donor’s organ system is still able to function after the donation
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Individual who provides the graft
“ DONOR”
Individual who receives the graft
“RECEIPIENT”
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Eligible donors
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THORACIC ORGANS
Heart Heart/lung lung
INTESTINE
KIDNEY STOMACH
PANCREAS
LIVER
ABDOMINALORGANS
TISSUE CELLSAND FLUIDS
corneaBlood
transfusion
Kinds of organs which could transplant
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Autograft: is self tissue transferred from one body site to another in the same
individual
Isograft: is tissue transferred between genetically identical individuals
Allograft: is tissue between genetically different members of the same species.
Xenograft: is tissue transferred between different species
TYPES OF TRANSPLANT
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It satisfies the humans needs when other alternatives therapeutic modalities failIt has a religious tone, all major religions do not forbid but encourage it on the
ground of saving human lifeIt presents the highest moral human values “love,sharity, cooperation and compassion”
Expensive, increase risk of infection due to immunosuppressive drugs.
Also organ could have some genetics charactersThe donor organ could not match the recipient body
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Organ transplantation in different countries
Despite efforts of international transplantation societies, it is not possible to access an accurate source on the number,rates and outcomes of all forms of transplantation globallythe best that we can achieve is estimations. This is not a sound basis for the future and thus one of the crucial strategies for the Global Alliance in Transplantation is to foster the collection and analysis of global data.
KidneyKidney(pmp*)(pmp*)
LiverLiver(pmp)(pmp)
HeartHeart(pmp(pmp))
USAUSA 5252 1919 88
EuropeEurope 2727 1010 44
AfricaAfrica 1111 3.53.5 11
AsiaAsia 33 0.30.3 0.030.03
Latin AmericaLatin America 1313 1.61.6 0.50.5
Transplantation of organs in different continents/regions year/ 2000
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In addition to the citizens waiting for organ transplants in the US and other developed nations, there are long waiting lists in the rest of the world. More than 2 million people need organ transplants in China. Donor bases vary in developing nations.
Traditionally, Muslims believe body desecration in life or death to be forbidden, and thus many reject organ transplant.
In Latin America the donor rate is 40–100 per million per year, similar to that of developed countries. However, in Uruguay, Cuba, and Chile, 90% of organ transplants came from cadaveric donors.
Cadaveric donors represent 35% of donors in Saudi Arabia. There is continuous effort to increase the utilization of cadaveric donors in Asia, however the popularity of living, single kidney donors in India yields India a cadaveric donor prevalence of less than 1 pmp.
Transplantation rates also differ based on race, sex, and income. A study done with patients beginning long term dialysis showed that the sociodemographic barriers to renal transplantation present themselves even before patients are on the transplant list.example, different groups express definite interest and complete pretransplant workup at different rates.
Previous efforts to create fair transplantation policies had focused on patients currently on the transplantation waiting list
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In 1994, the Government of India passed the Transplantation of Human Organs Act that legalized the concept of brain death and, for the first time, facilitated organ procurement from heart beating, brain dead donors. However, this concept has not caught on well in India for want of public education and awareness. This in turn is perpetuating the commercial sale of human organs due to the widening gap between the demand and supply. Thousands oflives are lost in India annually from heart and liver failure since transplantation of unpaired organs like heart, liver and pancreas is either difficult or impossiblefrom living donors.This is only possible on a large scale if these organs are available from cadaver donors
ORGAN DONATION IN INDIA.
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Within the European Union, organ donation is regulated by member states. Individuals who wish to donate their organs after death can use the OrganDonation Register, a national database. The UK has recently discussed whether to switch to an opt-out system in light of the success in other countries and a severe British organ donor shortfall.
ORGAN DONATION IN EUROPE.
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Transplantation Regions
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Statistics
All organs 7282
Kidney 5827
Liver 743
Pancreas 106
Kid/Panc 182
Heart 211
Lung 200
Heart/Lung 1
Intestine 12
All organs 2662
Kidney 1498
Liver 610
Pancreas 86
Kid/Panc 115
Heart 174
Lung 144
Heart/Lung 5
Intestine 30
On Waitlist as of 1/9/09 (reg 10)
Transplanted in 2007 (reg 10)
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Blood type (A,B,AB and O)
Human leukocyte antigen (HLA) tissue typing
Serology for HIV, CMV hepatitis
Cardiopulmonary,cancer screening
Pre transplantation evaluation
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Matching of stem cell donor to a recipient is determined
by comparing their tissue typesAn individual’s HLA type is present on nearly all
tissues in the bodyThe white cells from a blood sample are a
convenient source of “tissue” that the laboratory
can use to determine an individual’s HLA type
HLA TISSUE TYPING
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A 20-30 ml blood sample is required to perform HLA typing.The white cells are isolated from the blood and typing is
performed by two different methodsSerological testing : where the white cells are used
DNA testing: where DNA extracted from the white cells is used.Preliminary tissue typing takes 2 weeks. further high resolution (more detailed) tissue typing performed on the patient and any potentially matched donor samples may take
another 2 or 4 weeks.
HOW IS HLA TYPING PERFORMED?
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Because the degree of HLA compatibility between donor and recipient will influence the outcome of the transplant
The function of the immune system is to fight against foreign particles that the body sees as “non-self” such as bacteria and
viruses. A stem cell transplant from an HLA mismatched donor can result in the recipient’s immune system recognizing the transplanted cells as “non-self” and attacking the cells as it would for bacteria or viruses.This can lead to rejection of the transplanted stem cells likewise cells from the donor’s immune system which are introduced along
with the transplanted stem cells (graft) can also recognize HLA mismatches and attack vital organs of the recipient’s body (host).This is called graft versus host disease (GvHD)
The more compatible the donor-recipient match, the less likely it is that rejection or severe GvHD will occur
WHY IS HLA TYPING IMPORTANT?????
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HyperacuteRejection
Endothelialdamage
thrombosis Inflammation
Acute rejection
Interstitial Cell
inflammation
ParenchymalCell damage
Chronic rejection
Vascular abnormalities
Fibrosis
Effector mechanism of “graft” rejection
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Bioethical issues
Certain groups, like the Roma (gypsies), oppose organ donation on religious grounds.
But most of the world's religions support donation as a charitable act of great benefit to the community. Issues surrounding patient autonomy, living wills,
and guardianship make it nearly impossible for involuntary organ donation to occur.
Political issues
There are also controversial issues regarding how organs are allocated to recipients.
For example, some believe that livers should not be given to alcoholics in danger of reversion, while others view alcoholism as a medical condition like
diabetes.Faith in the medical system is important to the success of organ donationAllowing or forbidding payment for organs affects the availability of organs.
“Generally, where organs cannot be bought or sold, quality and safety are high, but supply is not adequate to the demand. Where organs can be
purchased, the supply increases”
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Only 38% are registered as organ “donors”
Not healthy enough 23%Black market 44%
Misunderstanding 50%
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RegisterOpt-in at the DMWSign a donor card
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Matching of organs between members of same ethnic
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Reduce Confusion
Motivate
Change the perception
Provide clear response methods
Pursued action to become organ donor
MARKETING STRATEGY
1)choose marketing tactics that can reach target audience2) create messages that can:
Reduce Fair
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Messaging strategy:Warm glow giving + community movement
outdoor advertising
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outdoor advertising
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Registering is the first step, as well as the most crucial part, of becoming an organ donor. There are a few different ways people can choose to do so. One of the simplest ways is to register at the DMV (Department of Motor
Vehicles). When a person goes in to renew their license they are always presented with the option of becoming a donor, which only requires ticking a box on a form and a signature. There is also a box that people can specify
which organs and tissues to donate, and if they would prefer not to have them used for science.
Another way for someone to become an organ donor is online. In 1998 a law was passed that allows Colorado citizens to register, confidentially, online to
become an organ donor. People can also designate whether or not they would like their organs and tissues to be donated to science. The process can be
completed in only a few minutes.
Becoming a donor….
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One Person.mp4
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