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Introduction
The human body is composed of an intricate system of cells, tissues and organs. During the embryonic stage, the cells undergo a complex process of differentiation to form more specialized tissues. A tissue is composed of various cells from a common origin which are not necessarily the same. These cells execute a dedicated function that is very special from others. In the human body, there are four types of tissues. The epithelial tissue lines organs, helping keep them separate and protected. The connective tissue provides additional support and gives the body its firm structure. On the other hand, the muscle tissue contracts and slides over one another allowing movement. Finally, the nerve tissue generates and conducts electrical impulses around the body (Widmaier, Raff, & Strang 4). The tissues are then organized to form organs. An organ contains more than one type of tissue that function together for a common duty with the skin being the largest organ in the human body.
For a person to be physiologically fit, all organs must be functioning properly to maintain the body at a homeostatic state. However, this is not always the case and major organs at times fail to perform their functions as expected. This result in a condition referred to as organ failure and speedy medical intervention is required to save the persons life. At times, multiple organ failure occurs in seriously ill patients leading to their death. It is for this reason that medical advancements have evolved into tissue transplant technology to prevent the deaths. This essay intends to give an overview on tissue and organ transplant to college level students of health sciences.
History of organ transplant
Organ donation involves the removal of human tissues and organs from a person who died recently or from a living donor, which is then transplanted to a living person to replace a failing one. However, this has raised many bio-ethical issues. Among them is that this procedure may lead to physical exploitation due to the high risks involved especially for a live donor. Financial exploitation also arises. In this case, there is the fear of rich people in developed countries taking this opportunity to cash in on the poor in Africa and parts of Asia. Finally, there is the fear that organ donation could lead to cannibalism that would see at risk people being killed so that their organs can be donated or sold to some recipient somewhere else in the world.
Although organ transplant is becoming a common phenomenon in modern day medicine, years ago it seemed like just another science fiction story. The first organ transplant that is recorded took place in the 2nd century B. C. It involved an Indian Surgeon Sushruta who transplanted a part of the skin and used it to reconstruct the nose of another person. The second recorded transplant also involved a skin graft in the 16th century and it was also in this century that the first rejection of a graft was recorded. The 20th century marked the most important era of transplantation. French Surgeon Alexis Carrel successfully transplanted veins and arteries and he was recognized for his works by winning a Nobel Prize in 1942. He also identified graft rejection by the recipient body when doing experiments with dogs. This baffled many scientists and doctors at that time. Dr. Joseph Murray performed a kidney transport that occurred between twins who shared the same genetic materials. He used the same procedure in 1962 to successfully transplant a kidney from a dead person to a live one. He used immunosuppressive drugs to stop rejection of the organ by the recipient. In the year 1963, another doctor, James Hardy performed a transplant of lungs to a patient with lung cancer. For the transplant, he used the lungs of a deceased person. However, the patient died after 18 days as a result of kidney failure. Currently, there have been major advances with successful vital organs being transplanted (Harris 3). This has been partly due to advance in medical technology and discovery of various immunosuppressive drugs which counter rejection of the organs. The Food Drugs Administration is testing some drugs which could reduce postoperative infections on patients who have received transplants (Harris para.1-4)
Donor Identification
Different countries have adopted diverse ways of identifying donors to minimize any unethical procedure that may occur. For instance, in Canada, consent should be granted before any organ is transplanted. For deceased donations they must have signed a consent form showing their willingness to offer their organs for transplantation in the case of death. The country condemns any buying or selling of human organs and if caught it may lead to prosecution. The physicians conducting these procedures face a lot of challenges in timely identification of physiological changes that occur due to brain death.
After formal consent the donor undergoes various medical procedures to ascertain his or her compatibility with the recipients genetics. First, there is blood group identification between both the receiver and the donor. If of the same blood group, the probability of rejection is minimized and there are hopes for the recipient. Next the physiological health of the donor is assessed to avoid any harm to them as a result of the transplant (Ronchi 50). Donors are advised to give up unhealthy lives like smoking and alcohol consumption. Failure to adhere to this leads to automatic disqualifications of the donors. If physiologically fit, other final procedures are conducted like counseling to minimize postoperative depressions.
Types of transplants
Transplants can either be from a living person or a dead one commonly referred to as cadaveric. The six types of tissue or organ transplants are; the autografts which involves collecting of tissue or organ and implanting it on the same person. It is done with extra tissue or regenerative tissues that are desperately needed somewhere else in the persons body. An example is stem cell autografts. The second type is referred to as allograft and it involves collection of organs from one person and implanting it to another whose genetic material is not similar. As a result, the recipients immune system recognizes the graft as foreign and produces antibodies against it leading to rejection. This leads to rejection unless immunosuppressants are given to halt the immune system from destroying the graft. The third category is the isograft where organs are shared between individuals who are genetically identical like the identical twins. In this case, the immune system is not activated and there is no rejection. The fourth type is the xenograft. It involves removal of organs and tissues from members of one species and transplanting it to a recipient who is from a different species. Although extremely dangerous due to issues of rejection, and non-compatibility, it has been successful as exemplified by pig heart valves which are quite common. The fifth is known as the split transplants where the donor is deceased and the organ mostly a liver is split between two recipients. In most cases, it involves an adult and a child. The procedure is not usually preferred as whole organ transplant is highly successful. The last type of transplant is the domino transplant. It is done on those suffering from cystic fibrosis. In such cases both lungs are supposed to be replaced as it is safe and easier to take out the heart and the lungs with a single operation. This term is also used in other procedures where the patients liver is often used for more old patients with a high probability of facing death from other causes (Widmaier, Raff, & Strang 36).
The surgical operation
After receiving the various authorizations for the organ removal, the various surgical teams commence their duty of organ recovery. Both the donor and recipient are taken to the operating room where they are anaesthetized before incisions are made. Complex procedures take place which involves the following processes; making an incision near the failing organ, then cutting the veins and arteries that serve the organ after which the failing organ is removed. The operating surgeons then insert the donated organ into the recipients body through the incision. After this, the veins and arteries are connected to the new organ and the incision is stitched back and the patient begins the long road to recovery.
Post operative care
Recovery from an organ transplant operation requires additional medication which involves frequent hospital visits. During the visits, doctors check for the proper healing of incision wounds and keep a close eye on the immune system to notice any change. This may be for a given period or for major transplants a life time process. The bodys immune system may decide to reject the graft due to the different genetic constitution. Three types of rejection may occur, and these are; hyper acute rejection that usually happens as soon as the organ is transplanted to the recipients body. This is due to already formed antibodies in the recipients blood to the antigens in the foreign graft. The second type is the acute rejection that happens after a few days of the operation. This is usually considered as normal due to the body recognizing the graft as foreign and appropriate measures are taken to minimize the effects. Finally, there is the chronic rejection which takes some time occurring after months or even years. After long time having passed, chronic rejection may have minimal effects to the body to the extent that the patient may fail to notice. Despite all this, various drugs are in use that protects the recipients from destruction of the grafts (Ronchi 14).
The future of organ transplant
Many years ago, transplant operations were considered to be risky due to rejection of the transplanted organ. However, the medical advances in immunosuppressive drugs have had a great impact and lowered the associated risks of transplant surgery. Presently, more operations are being carried out especially with complex organs like the heart, liver and even lungs with a high success rate being reported. Another major advance in the field of transplantation is the discovery and use of artificial organs. Developments in molecular biology and cell culture technology have contributed greatly with the year 2000 seeing the first culture in human embryonic stem cells being developed. Scientists have made advances in grafting of the thymus that enhanced T cells tolerance to pig tissues and were able to restore the competency of the immune system in mice that were immune compromised. This was a commendable achievement and Professor Megan Sykes states that the creation of a state of immune tolerance to cells and organs that have been transplanted was a holy grail to medical transplantation science and held a key to increasing the patients numbers benefitting from transplants (Discovery Company 5). Various scientists are working tirelessly on increasing the safety of transplant surgery and development of artificial organs in order to maintain the supply of organs across nations. This will definitely save many lives in the near future.
Conclusion
Organ transplant has for a long time been acknowledged as a phenomenal medical advancement of the 20th century. It has received acclaims for saving many lives of patients with either organ failure or multiple organ failure. Recently, the demand for transplant organs has greatly surpassed the supply due to increasing rates of organ failure. The medical society has made a call to the society at large to donate organs for transplant in order to meet this demand gap. These events have led to ethical and moral issues concerning organ donation. The high demand has led to sale of organs by immoral businessmen for financial gains. As a result there is exploitation of the poor especially from developing nations in Africa and Asia. It has also led to modern day cannibalism where innocent people are killed and their organs extracted for sale. As a result, various laws have been enacted to protect exploitation and crimes concerning organs. The future of organ transplant technology is bright as more immunosuppressive drugs are discovered that protects against organ rejection. It is a duty for every one of us to participate in saving lives whenever we can. Join up in organ donation whenever possible and together we can make the world a safer place to live in.
Works Cited
Discovery Company. How stuffs work. How Organ Transplants Work. 1998. Web.
Harris, Davis. How To Do Just About Everything. The History of Organ Transplantation. 1998. Web.
Ronchi, Elettra. Advances in Transplantation Biotechnology and Animal to Human Organ. Washington, DC: OECD, 1996. Print.
Widmaier, Eric, Raff, Hershel, and Strang, Kevin. Vanders Human Physiology. Maidenhead, UK: McGraw-Hill, 2003. Print.
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