History of Development and Possibilities of Organ Transplantation Technology - Research Paper Example

? "Organ Transplantation/Replacement Technologies" Definition of the problem One of the leading causes of disability followed by death involves failure of organ(s) to function in an appropriate manner. Major organs like heart, lungs, liver, kidneys and pancreas play vital roles in the metabolic processes, survival and proliferation of an individual. Impairment affects the normal performance of the organ, causing altered metabolism or cessation of the appropriate function. The impact of organ dysfunction, affected by cancer or failure to carry out the desired function efficiently paves the way for replacement of the organ or organ transplantation (Cascalho & Platt, 2005). With the increase in the life expectancy and survival of the humans, organ transplantation is in great demand. Numerous technologies are looming to meet the growing demand of organs for transplantation, encompassing stem cells, cell culture, tissue engineering, cloning of cells and xenotransplantation. Still the prerequisites are not fulfilled by these technologies as the demand is far more as compared to the supply of organs for transplantation, moreover, the demand is growing largely (Cascalho & Platt, 2005). What is an organ transplantation? An organ transplantation encompasses a surgical operation where the damaged organ is replaced by a healthy one. It is a broad terminology that refers to the transplantation of solid organs like kidneys, lungs, heart, pancreas, intestines, cornea transplantation, bone marrow and liver transplantation. The sources of organs could be cadaveric organs or from the living person (Cascalho & Platt, 2005). Replacement of the organ is required because of numerous ailments. For instance kidneys, which are the most imperative organ as it plays vital role in the elimination of waste and toxic chemicals, therefore they are vulnerable for damage. Majority of the organ replacement or transplantation cases require kidney transplantation. The illnesses that lead to kidney damage encompass diabetes, polycystic kidney disease, lupus etc. Similarly, excessive alcohol consumption may lead to the cirrhosis of liver, cirrhosis can also occur due to hepatitis or other related diseases and thereby requires liver transplantation. Heart transplantation is required in case of coronary artery disease, cardiomyopathy or heart failure. In case of diabetes pancreas replacement is required for the appropriate insulin production. Lung replacement is required in cases like cystic fibrosis or COPD while small intestine requires replacement due to short bowel syndrome, Crohn's disease or other related diseases. In certain cases more than one organ is to be replaced and it is successfully done for the heart and lung transplantation. There are certain tests which determine the eligibility for the organ transplantation (Organ Transplant). Research studies are going on to understand the reasons responsible for the transplantation failure along with a better approaches towards health, nutrition and treatment paradigms. These paradigms in future may possibly reduce the requirement of organ transplantation and enhance the longevity of the organs and the individual (Organ Transplant). History Organ Transplantation The history of organ transplantation could be traced from 1954, when the first organ transplantation was performed by Dr. Joseph Murray and Dr. David Hume at Brigham Hospital, Boston, they transplanted kidney. This was followed by a successful transplantation of lung by Dr James Hardy in 1963, at the University of Mississippi Medical Center. The trend was followed by pancreas and kidney transplantation in 1966 by Dr. Richard Lillehei and Dr. William Kelly at the University of Minnesota in Minneapolis. This was followed by the first successful liver transplantation by Dr Thomas Starzl at the University of Colorado in Denver in the year 1967. The revolution in the history of organ transplantation was brought by the most popular heart transplantation performed by Dr. Christiaan Barnard at Groote Schuur Hospital in South Africa in the year 1967. The first successful heart transplantation in USA was performed in the year 1968 by Dr. Normal Shumway at Stanford University Hospital. Considering the boom in the organ transplantation, Uniform Anatomical Gift Act established the Uniform Donor Card in the year 1968. The card is referred as a legal document for an individual above 18 years of age and is willing to donate the organs legally. Taking into consideration the importance of kidney transplants, End Stage Renal Disease Act (ESRD) tiled the approach for Medicare Coverage of Renal Dialysis and Kidney Transplants in the year 1972. The trend for organ transplantation continued and the first successful hand transplant (limb transplantation) was performed by Dr. Earl Owen and Frenchman Dr. Jean-Michel Dubernard in France in 1998. Later Dr. Jean-Michel Dubernard along with Dr. Bernard Devauchelle performed first of its kind, a successful face transplantation in the year 2005. It was Dr. Michael DeBakey invented the devices that aid heart patients during the process of bypass heart surgery in the year 2008. Later in the year 2010, the full face transplant was performed in Spain (Transplantation). The process of transplantation is gaining prevalence in the current epoch, especially the kidney transplantation is becoming quite popular. History of transplantation reveals that the process of transplantation is a continuous process and physicians try to meet the upcoming challenges to relieve the sufferings, pain and agony of the people. In the present scenario kidney, lung and heart transplantation is becoming quite popular and several operations are being performed across the world to enhance the quality of life of the individuals. For these reasons organ transplantation is gaining prevalence and is considered as one of the major advances in the medical science which has revolutionized the therapeutic world. What social, political and technical forces caused one technology? Various social, political and technical forces are considered for the organ transplantation. Some believe that organ transplantation facility should be provided to the most needed individual while others believe that age factor should be considered for the organ transplantation i.e. an individual who is young should be given preference for the available organ for the transplantation. On the other hand, various ethical issues must be considered, a person who is dying without the organ replacement procedure should be given preference as compared to the one who can survive for a certain interval of time. Thus, the demand of organ transplantation has made it a business. People are adopting unfair means to sale organs in the market, smuggling organs, kidnapping individuals, operating them to procure their organs and then sale those organs at higher costs. Considering this as a great ethical and social concern, United States has adopted organ distribution method at every transplantation center to consider the medical requirement of the organ, the success prospects and the stipulating waiting period. According to Childress these are the important parameters while deciding the priority to be given to the person who is in need (UNOS; Childress, 2001; Hauptman, 1997). According to McChesney and Braithwaite (1999), organs available for transplantation are limited and a few social and ethical factors must be taken into consideration for the organ transplantation. Apart from the requirement of the organ due to illness there are various social and ethical norms which must be taken into consideration. Some of these issues are- Should an individual who already received an organ transplantation be given preference for the second organ transplantation? Is it ethical to transplant the organ of an individual who has adopted a lifestyle that includes smoking, drinking, drug abuse, obesity etc? Should an individual who attempted suicide or have the history or suicidal attempts be given an organ for transplantation? Preference should be given to the individual who possesses dependents as compared to the single individual (McChesney and Braithwaite, 1999). Organ transplantation may face severe rejections too, so they are treated with anti-rejection drugs which are known to be expensive. As such, organ transplantation is an expensive procedure and if an individual cannot afford for the anti-rejection drugs the body may not accept the transplantation and the organ goes waste. It is therefore also a matter of great concern to have a separate budget for complete procedure before going for the organ transplantation. Is it ethical for an individual who neither possesses any kind of insurance nor is capable of bearing the expenses be allowed to go for an organ transplantation? Should a destined prisoner be provided with the organ transplantation? All these issues must be considered before the organ transplantation is performed (McChesney and Braithwaite, 1999). How successful is an organ transplantation? Considering all the parameters, an organ is transplanted. The chronicle does not end here as the success of the organ transplantation is considered when the organ starts functioning properly. The success also depends on the kind of organ transplanted, the number of organs that are transplanted (in certain cases heart with lung transplantation is required). The disease which was responsible for the organ damage has been eliminated or not (Organ Transplant). How to prepare for an organ transplant? Preparation for the organ transplantation demands a complete investigation of the individual. Blood and tissue tests are being performed to match with the donor, it is essential for the patient to follow appropriate diet and exercise schedule prescribed by the physician. A discussion with the psychiatrist, psychologist or mental health counselor may be suggested (Organ Transplant). What can you expect after the organ transplant? An individual may feel better as soon as the organ starts functioning normally. The individual may remain on anti-rejection medicines even after the process of transplantation. As these medicines wane the immune system, the individual is required to stay away from the crowd to avoid exposure to any infection (Organ Transplant). Depression may occur after organ transplantation and must be taken care in the initial stages. Certain alterations in the life style may be suggested by the physician which should be followed strictly (Organ Transplant). Who can be an organ donor? An organ donor must be a healthy individual who does not have diabetes or high blood sugar. The donor must be free from any kind of mental illness (United Network for Organ Sharing). Future of Organ Transplantation One of the most challenging tasks in the medical science is to design a strategy for the organ transplantation. The critical condition which requires an urgent attention in medical science is the non functioning organ. It is the most imperative challenge as every organ in the body has an important role and a function to perform. Non-functioning of one organ affects the role of other organs as well. With the enhanced longevity and advances in medical science to cure most of the dreaded diseases individuals have longer survival rate. In certain cases, poor health condition or some kind of chronic abuse may result in the damage of a particular organ and therefore, the demand for the organ transplantation is augmenting with time. Although the demand is far more as compared to the supply and therefore, newer strategies are required to meet the growing demand of organ transplantation. Xenotransplantation is thought to provide some kind of solution where the damaged or non-functioning organ is replaced by the healthy animal organ. With the advent of stem cell research, the pleuripotency of stem cells is being exploited to generate human organs in an adoptive xenogeneic host. The process involves the collection of human tissues and subsequently implanting into the entity from whom the stem cells were acquired. The process helps in generating histocompatible organs. The technology provides an imminence to generate a complete organ which could function like the normal one. The technology has paved the way to pursue further research to generate organs which may be cost-effective and are available as per the requirement to relieve the individuals from sufferings at much faster pace with diminished waiting period (Cascalho, 2006). Conclusion History of organ transplantation reveals the advances made in medical science to eliminate the gloom and bring back the normal physiology of the individual by means of organ transplantation. Although organ transplantation has certain intricacies such as non-availability of the organs when required under the situation of emergency, compatibility issue even if the organ is available, rejection of the organ and consumption of anti-rejection drugs; still organ transplantation is gaining prevalence to improve the quality of life. Constant advances are being made to improve the technology so as to generate organs synthetically by means of tissue culture, organogenesis and stem cells. The pleuripotency of the cells is exploited to generate the organs, still it is a long way to meet the augmenting demand for organs for transplantation. References 1. Cascalho, M., Ogle, B. M., Platt, J. L. (2006). The future of organ transplantation. Ann Transplant. 11(2), 44-7. 2. Cascalho, M., Platt, J. L. (2005). New technologies for organ replacement and augmentation. Myo Clin Proc. 80(3), 370-8. 3. Childress, J. F. (2001). Putting Patients First in Organ Allocation: An Ethical Analysis of the 4. U.S. Debate. Cambridge Quarterly of Healthcare Ethics. 10(4), 365-376. 5. Hauptman, P. J., O'Connor, K. (1997). Procurement and allocation of solid organs for transplantation. New England Journal of Medicine. 336, 422-431. 6. McChesney, L.P., Braithwaite, S.S. (1999). Expectations and outcomes in organ transplantation. Cambridge Quarterly of Healthcare Ethics. 8(3), 299-310. 7. Organ Transplant. (n.d.) Retrieved from http://www.webmd.com/a-to-z-guides/organ-transplant-overview 8. Transplantation. (n.d.) Retrieved from http://www.donatelifeny.org/all-about-transplantation/organ-transplant-history 9. United Network for Organ Sharing. (n.d) Retrieved from www.unos.org. Read More