Regenerative Biology and Medicine - Report Example

HEART TRANSPLANT by HEART TRANSPLANT A heart transplant refers to the process by which a patient’s ill or injured heart is replaced with a healthy donor heart. This procedure is mainly performed on patients with final stage heart failure or with threatening illnesses. It is also referred to as cardiac transplantation. Such patients should have gone through all possible treatments without success. It is one type of surgical treatment meant to prolong or rather improve an individual’s life who risks death due to heart failure. A heart transplant represents a great advancement in the medicine world. Since 1960 when the first successful heart transplant was done, there has been a great transformation in medical practices in the modern technology. It created need for new instrumentation to allow measurement and observation beyond the capacity of physicians (Jain, 2011). For example, it led creation of electrograph in 1913 to be used in diagnosis and exploring heart functioning. The heart-lung machine was also invented to monitor heart and lung functions during surgery. Another important machine that came up due to this technology is the cardiac pacemaker for controlling irregular heartbeats. Today, the transplantation of body organs like the heart has become a routine that brings light to many lives. Each year, there are over 2000 transplant operations performed in the United States alone. In addition, about ten thousand people await transplantation at any given time. Research shows that the number of potential recipients is still high compared to donors, even though many people wish to be organ donors in case they die through an accident. These statistics are a clear indication that heart transplant technology has had a positive impact on a lot of peoples’ lives, bringing a revolution in the medical technology. Description Heart transplantation is a crucial type of transplant which raises new complex issues that must be faced promptly. Unlike in the kidney transplant where, in case of failure, the recipient may be kept alive for some period until another attempt is made (Bauer, Lang, & Schneider, 2012). Heart transplant is critical in the sense that the life of the recipient cannot be saved in case the attempt does not succeed. It is therefore important that adequate preparation and planning is done before any heart transplant is done to counteract these challenges. In order to ensure a successful transplantation, certain tests have to be conducted so that cases of graft rejection are eliminated. The donor undergoes physical examination and a serious check into his medical history is done. Some of the tests undertaken include: blood tests, whereby they check if the donor suffers from any contagious illness or malignant tumours. Viral testing is done to determine if the donor has been exposed to viral diseases like AIDS and hepatitis. Electrocardiogram and echocardiogram are tests carried out to establish whether the electrical activity of the heart is stable. CT scan is also done to analyse the anatomy of the donor’s liver and kidney. Tissue typing and the panel reactive antibody tests are also done. Panel reactive antibody test is where the doctors determine how strong the immune system can react against the new heart and prevent hyper cute reaction. The last test is cross matching, which marks the final screening step of immunology before a transplant is carried out. The recipient must also undergo testing to determine the seriousness of his heart condition, the compatibility with the potential donor organ and if he can survive the surgery (Murray, 2002). In the waiting process, the patient is put on regular check to ensure that his heart remains healthy and pumps enough blood. Due to a shortage in supply of healthy donor hearts, stern measures have been put in place to identify who qualifies for a heart transplant. For example, the following conditions do not qualify a heart transplant: hypertension, diabetes, mental illness, stroke, diseases of the artery and other active infections. A patient who is too weak cannot undergo the surgery because the chances of surviving are very minimal. In addition, some conditions which may still lead to the failure of the new heart are not recommended for transplant. Any person found suitable for a heart transplant is put on an organ waiting list of a heart transplant centre. Such patients are all registered by the united network for organ sharing (UNOS) (Madhavan, Oakley & Kun, 2008). This organisation connects all organisations for organ donors and all transplant centres through a special computer network. Once a donor heart is found, its details are entered on the network where the specialists compare it with the list of patients. The heart is then matched with the corresponding recipient after consultation and agreement by all transplant specialists. After the heart has been approved for the particular patient, it is packed hygienically in a sterilized cold solution and quickly transported to the hospital where the patient is waiting. Since heart transplant should be done as quickly as possible; the matching process always favours the local patients first for quick access to the hospital. The surgery always involves various steps which include; giving the patient general anaesthesia to reduce and prevent pain during the surgery (Vachss, Caruso & Mucha, 2010). Antibiotics are administered into the veins, commonly called intravenous antibiotics, to prevent infection of the wound by bacteria. The next process is cardiopulmonary bypass, which involves placing the patient on a heart machine to perform the heart functions of pumping blood during the surgery. After the surgeons are satisfied about the adequate blood circulation of the patient, his ailing heart is then removed. Next, the donor heart is subsequently connected to the blood vessels of the patient, and then it is warmed up to start beating. An electrical shock may be used to the heart. The heart machine is removed and the new heart is fuelled up with medicines for 5 days till it can work on its own. Immunosuppressive drugs are administered to the patient before and after the surgery to prevent the rejection of the new organ by the body (Taylor et al, 2007). The immune system which always attacks any foreign tissue in the body is suppressed and kept from recognising these tissues .A patient takes three to four drugs during this time and a certain dosage is prescribed for them to be taken for a lifetime. The patient is put in the intensive care unit for 24-72 hours, during which heart function, blood pressure and other critical body organs are closely monitored.24 hours after the surgery, the patient need to receive enough oxygen. The patient comes back for regular checkups 6-8 weeks after the surgery physical tests and medical examinations. Heart failure can be avoided if individuals embrace a healthy lifestyle in their daily activity. Such routines include eating healthy foods, maintain, keeping a low blood pressure, eat little amount of salt, and going for the doctor checkups. Cowen (1986) implied that a lot of ethical issues arise as a result of the concept of heart transplant. The fact that the heart is transferred from a dead body raises many ethical questions including the respect for the dead, their wishes and family wishes. Ethical concerns have also come up when choosing the suitable donor and recipient, adding to the complex and murky question of human experimentation ethics. However there are rules that guide the whole process to address theses ethical concerns worldwide. For instance, people are allowed to specify their limits in their wish to donate an organ upon their death. Those with mental cases can be helped by their guardians to make such decisions (Read, Green & Smyer, 2008). Illegal procurement of the organ by the recipient should be avoided at all costs. A team of specialist not related to either the donor or the recipient should undertake the process of choosing the right donor and the right recipient (Bird, 2010). Heart transplant is a risky process. Complications may arise after the process which includes rejection and infection (Levin, n.d). Other possible problems include bleeding, excess or shortage of blood in the circulatory system, pressure in the heart, irregular heartbeats and reduced cardiac output. Some patients develop coronary artery disease about 1-5 years after the surgery, a case that has been experienced in about half of the patients. In this case, the coronary artery supply blood to the heart, leading to chest pains called agina. Conclusion The use of biotechnology promises to revolutionalize the way of treating and preventing diseases, but much work remains to be done. The next few years should see the movement of many targeted medical therapies, including heart transplantation, from research laboratories into the clinic. This will highly alleviate human suffering. References Bauer, J. M., Lang, A., & Schneider, V. (2012). Innovation policy and governance in high-tech industries: the complexity of coordination. Berlin, Springer. Bird, C. E. (2010). Handbook of medical sociology. Nashville, Vanderbilt University Press. Cowen, Z. (1986). Reflections on medicine, biotechnology, and the law. [Lincoln, Neb.], University of Nebraska College of Law. Jain, K. K. (2011). Applications of biotechnology in cardiovascular therapeutics. New York, Humana Press. Levin, M. (n.d.). Regenerative biology and medicine. Amsterdam [u.a.], Elsevier. Madhavan, G., Oakley, B. A., & Kun, L. G. (2008). Career development in bioengineering and biotechnology. New York, NY, Springer. Murray, M. J. (2002). Critical care medicine: preoperative management. Philadelphia, Lippincott, Williams & Wilkins. Read, C. Y., Green, R. C., & Smyer, M. A. (2008). Aging, biotechnology, and the future. Baltimore, Johns Hopkins University Press. Taylor, D. O., Edwards, L. B., Boucek, M. M., Trulock, E. P., Aurora, P., Christie, J., ... & Hertz, M. I. (2007). Registry of the International Society for Heart and Lung Transplantation: twenty-fourth official adult heart transplant report—2007. The Journal of heart and lung transplantation, 26(8), 769-781. Vachss, A. H., Caruso, F. T., & Mucha, Z. (2010). Heart transplant. Milwaukie, Or, Dark Horse Books. Read More