FAQ On Changing Organs

I read about George Best, who was an alcoholic and had a liver transplant. I’m curious to know, with the advent of medical treatment, what sort of organs can be transplanted these days.

Nowadays, a lot of organs can be transplanted. Transplantation is actually the procedure of surgically removing an organ from one person and placing it in another person whose organ has been damaged through illness or injury.

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Your heart, lungs, liver, pancreas, kidney, intestine, bone marrow can certainly be transplanted. Corneal transplant is common for the eyes, and even your hand can be transplanted.

Certain tissues within your major organs can also be transplanted in isolation. The Islets of Langerhans (a certain island of cells in the pancreas), blood vessels, heart valves, bone and skin are in this category.

If you want to look at it in a certain way, a blood transfusion is a sort of transplantation, as it involves the transfer of blood from one donor to the recipient.

Are most transplants from dead or dying people? I’ve heard that some, like kidney and bone marrow transplant, are from living donors.

Organ donors can either be living or deceased (previously referred to as cadaveric, but since this is a morbid word, most people have dropped it).

For living donors, the donor of the organ about to be transplanted remains alive and (hopefully after the transplant) well. He or she donates a part of renewable tissue or fluid to the recipient. The donor’s remaining organ cells then regenerate and grow to fill in what was taken. This happens to donors of liver, small intestine or pancreas transplants.

As for kidney donors, the human body actually only needs one kidney to survive. The donor will be able to survive on his one remaining kidney.

A living donor may either be related to the patient or not, depending on the type of transplant.

Deceased donors are usually ones who have been declared brain dead and whose organs are being kept alive by ventilators until they can be harnessed for transplantation.

Heart, hand, cornea and combination heart-lung, liver-kidney transplants are usually deceased donor-only type of transplants. Imagine the donor surviving without a heart! However, pure lung transplants can be from a living donor.

When did transplants become popular? I’ve only heard of them since the latter half of the last century.

Actually, transplants have been recorded as early as the 2nd century B.C. An Indian surgeon called Sushruta performed a skin transplant in a nose reconstruction. No records exist on whether the patient survived.

Actually, medieval surgeons did possess the skills to carry out transplants. But since no one understood what organ rejection was then, post-operative survival of the patient was rarely achieved.

The first successful human transplant was a corneal transplant performed in Austria in 1905. In the 1950’s, doctors discovered immunosuppressive drugs to suppress organ rejection by the recipient. The first successful kidney transplant was done in 1954. And the first successful heart transplant was performed in 1967 in South Africa.

In 1970, the drug cyclosporine was discovered, and transplant surgery had found it a sufficiently powerful immunosuppressive.

If I want to be a donor, do I have to be completely healthy?

It’s best to consult a doctor to perform a full medical examination on you to determine your status. But only a few medical conditions will completely rule you out as a donor : if you are HIV positive, have actively spreading cancer and suffer certain severe, recurrent infections.

Even if you have a medical condition that has damaged some of your organs (such as high blood pressure or diabetes), you still have other organs that can be relatively healthy to donate.

Donors can be of any age.

I have heard of certain transplants where you can harvest a certain part of your own body for later use! Are there such things?

This is called an autologous transplant, usually involving stem cells harvested from the bone marrow. Here, you are your own donor. Your stem cells are harvested either from your bone marrow or blood, and then they are frozen.

Your body then undergoes chemotherapy or radiotherapy to rid you of your cancer (which is usually lymphoma or multiple myeloma in cases like these). Then your stem cells are thawed and given back to you through your blood, where they will seed your bone marrow again and regenerate your blood cells anew.

The good thing about autologous transplants is that you are getting your own cells back, so there is no risk of rejection. However, some cancer cells may be harvested together with the healthy cells and then reinfused back to the body. That’s why doctors today treat the harvested cells first with anticancer drugs to purge them of any cancer cell that might be present.

What happens when a body rejects a transplanted organ? It sounds like such a terrible thing.

Rejection is when your body’s immune system starts attacking your transplanted organ. That’s why you need immunosuppressive drugs. It should be noted that corneal transplants are hardly rejected because the cornea has no blood supply. Also, identical twin transplants are never rejected.

When your body rejects an organ, the organ in question will then fail to function properly. A rejected lung might give you shortness of breath. A rejected kidney produces less urine. A rejected heart will give you symptoms of heart failure.

Also, you might have a general feeling of discomfort or unease.

The treatment for this is again immunosuppressive drugs, though the doses may need to be increased this time through the rejection phase.


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