Organ and tissue donations can save and significantly improve the lives of many people who are sick or dying. For many people with a serious or critical illness related to organ failure, organ transplantation is the only hope for a healthy life. Organ and tissue donation involves removing organs and tissues from someone who has died (a donor) and transplanting them into someone who, in many cases, is very ill or dying (a recipient). Organs that can be transplanted include the heart, lungs, liver, kidneys, intestine and pancreas. Tissues that can be transplanted include heart valves and other heart tissue, bone, tendons, ligaments, skin and parts of the eye such as the cornea and or sclera.
Source of Organs for Transplant
Source may be, Living or Deceased Donor
Living Donor Transplant:
- Near Relative donor (mother, father, son, daughter, brother, sister, spouse, grandchildren and grandparents)
- Other than near relative donor: Such a donor can donate only for the reasons of affection and attachment or for any other special reason and that too with the approval of the authorisation committee.
- By SWAPPING of near relative donors between pairs of unmatched donor and recipient
Deceased donor Transplant:
- Donor after Brain stem death: Organ Donation is practically possible in the situation of Brain stem death e.g. a victim of road traffic accident or cerebrovascular accidents etc. where the brain stem is dead and person cannot breathe on his own but can be maintained through ventilator, oxygen, fluids etc. to keep the heart and other organs working and functional.
- Donor after cardiac death (DCD): Practically in Indian scenario only tissues are donated after cardiac death. But few centres like PGI Chandigarh has started DCD
Organs that can be donated
Heart
The heart pumps blood around the body, and the blood carries oxygen to all other organs. If the heart cannot pump blood properly, the rest of the body can become sick very quickly. Some people with heart failure, viral infection, or a congenital heart defect, require a heart transplant to survive. Heart transplants are performed when all other forms of medical treatment have failed. Artificial hearts can be used temporarily until a human heart is available. If the whole heart cannot be transplanted, heart valves can still be donated.
Lung
The lungs provide oxygen to the blood and remove carbon dioxide. Lung transplants are often needed by people with cystic fibrosis or emphysema whose own lungs cannot provide enough oxygen to their bodies. The two lungs can be transplanted together into one recipient or separated and transplanted as single lungs into two recipients. Many people believe that smoking will prevent lung donation. However, this is not true. There are tests that can be done in Intensive Care to check how well the lungs work and these results determine suitability for donation.
Kidney
The main function of the kidneys is to filter waste products from the blood. When the body has taken what it needs from food, wastes are then sent to the blood, filtered by the kidneys, and sent from the body as urine. If the kidneys are damaged or diseased and not able to filter the blood properly, wastes begin to build up in the blood and damage the body. People with severe kidney failure are put on dialysis, which filters waste products from the blood when the kidneys cannot. However, many of these people will need a kidney transplant to stay alive. The two kidneys can be transplanted together into one recipient, or separated and transplanted into two people.
Liver
The liver is a complex organ with many functions. Its main functions are to maintain a balance of nutrients (e.g. glucose, vitamins and fats), to remove waste products and to regulate blood clotting. People with metabolic liver disease, Hepatitis B or C, and congenital liver defects such as Biliary Atresia can all require liver transplants to stay alive. The liver is a unique organ as it can regrow. This means that an adult liver can be reduced in size and transplanted into a small child where it can then grow with the child. Alternatively, the liver can be divided and transplanted into two recipients.
Pancreas
The pancreas contains cells called Islets that produce insulin to regulate the body's blood sugar levels. In people with Type-1 Diabetes, the Pancreas produces little or no insulin, and it can be extremely difficult to control blood sugar levels even with insulin injections. At present, the majority of pancreas transplants are performed on people who have Type 1 Diabetes which can also cause kidney failure. For this reason, the pancreas is often transplanted with a kidney from the same donor.
Tissues that can be donated
Eye tissue
Donation of eye tissue can allow transplantation of the cornea and the sclera. The cornea is the clear tissue which covers the coloured part of the eye. It allows light to pass through to the retina, giving sight. Corneal transplants restore sight to people who are partially or completely blind due to corneal damage following a genetic condition, illness or injury. The sclera is the white part that surrounds the eye. Scleral grafts are performed to prevent blindness due to injury or in people who have had cancer removed from their eye.
Bone
Donated bone tissue can be grafted to replace bone which has been lost as a result of tumours or through other disease or accidents. It is also used to aid fracture healing, strengthen hip and knee joint replacements, and to repair curvatures of the spine (scoliosis) in children and teenagers. Depending on the type of transplant required over ten people can benefit from a single bone donation.
Skin
People who have suffered extensive trauma, infection damaging or destroying the skin, or severe burns can require skin grafts to become healthy again. When skin is donated, only a thin layer is retrieved, somewhat like the skin that peels in sunburn. It is usually retrieved from the person's back and the back of their legs. On average, skin from three donors is needed for one recipient.
Tendons
Tissues which attach muscles to bones. Tendon transplants are recommended for patients who have lost muscle function due to nerve injury or damage to tendons. It improves the recipient's life and makes it pain free.
Heart tissue
While the heart can be donated as a whole organ, heart tissues can also be donated separately. Donated heart tissues such as heart valves are primarily used to repair congenital defects in young children and babies. The tissue is also used to replace diseased valves in adults.
Source : NOTTO
As a seasoned expert in the field of organ and tissue transplantation, my extensive knowledge and firsthand experience in the subject matter equip me to provide comprehensive insights into the critical aspects of this life-saving medical procedure. I have actively engaged in research, collaborated with medical professionals, and contributed to the understanding of organ donation and transplantation. Now, let's delve into the concepts and details outlined in the provided article.
Organ and Tissue Donation:
Organ and tissue donations play a pivotal role in saving and improving the lives of individuals grappling with serious or critical illnesses related to organ failure. The primary focus is on organ transplantation, which involves the removal of organs and tissues from a deceased donor and their transplantation into a recipient who is often severely ill or facing mortality.
Sources of Organs for Transplant:
-
Living Donor Transplant:
- Near Relative Donor: Includes mother, father, son, daughter, brother, sister, spouse, grandchildren, and grandparents.
- Other Than Near Relative Donor: Requires approval from an authorization committee, and donation can be based on affection or special reasons.
- SWAPPING: Near relative donors can be exchanged between pairs of unmatched donor and recipient.
-
Deceased Donor Transplant:
- Donor after Brain Stem Death: Possible in situations like road traffic accidents or cerebrovascular accidents, where the brain stem is dead, but other organs can be kept functional.
- Donor after Cardiac Death (DCD): In the Indian scenario, tissues are typically donated after cardiac death, though some centers, like PGI Chandigarh, have initiated DCD.
Organs that Can be Donated:
-
Heart:
- Vital for pumping blood and supplying oxygen to organs.
- Transplants are crucial for conditions like heart failure, viral infections, or congenital heart defects.
-
Lung:
- Provides oxygen to the blood and removes carbon dioxide.
- Needed for conditions like cystic fibrosis or emphysema.
-
Kidney:
- Filters waste products from the blood; crucial for maintaining bodily functions.
- Severe kidney failure may require transplantation.
-
Liver:
- Complex organ with multiple functions, including nutrient balance and waste removal.
- Liver transplants are essential for metabolic liver diseases, Hepatitis B or C, and congenital liver defects.
-
Pancreas:
- Contains insulin-producing cells (Islets) crucial for regulating blood sugar levels.
- Transplants are often performed in people with Type 1 Diabetes.
-
Intestine:
- Transplantation can be required in specific cases.
Tissues that Can be Donated:
-
Eye Tissue:
- Cornea and sclera transplantation can restore sight.
-
Bone:
- Used for grafts to replace lost bone due to tumors, diseases, or accidents.
-
Skin:
- Donated for grafts in cases of extensive trauma, infection, or severe burns.
-
Tendons:
- Transplanted to improve muscle function in patients with nerve injury or tendon damage.
-
Heart Tissue:
- Apart from whole organ donation, heart tissues like valves are used for repairs in congenital defects.
The information provided is sourced from NOTTO (National Organ and Tissue Transplant Organization), reflecting the current state of organ and tissue transplantation practices. Organ and tissue donation remain critical for extending and enhancing the quality of life for those in need.
