Organ transplantation is the best method for replacing damage organs and tissues. It has very long history but frequently work on it start in 18th century. Now researchers are able to perform transplant easily and successfully. Take organ from donor that may be living or deceased. But the problem that matters a lot is that donor compatibility must be matched with the recipient. And the match occurs in very rare chances because perfect match found in identical twins. Rejection is a major problem for organ transplantation, but researchers control this problem by using specific type of drug name immunosuppressant that suppresses the immune response. Long term uses of immune suppressant also cause many diseases like diabetes, high cholesterol, high blood pressure etc.
Organ transplantation is a successful technique for replacing damaged organ from healthy and fit organ. Organs may be damaged due to injury or some other factors. At 18th century, researchers started their experiments on organ transplantation and they were failed many times and don’t get their desired results. After many years, they were successful in organ transplantation. Researchers have able to do organ transplantation of kidney, liver, lung, heart, pancrease, cornea etc . Organ transplantation are done on only those organ who have the ability to regenerate or those organ whose half number able to do full work like kidney, some portion of liver etc. Persons who donate their organs called donors and the persons who receive organ called recipients. Two common possibilities are present in organ transplantation. First is that both donor and recipient present at same place while second possibility is that both donor and recipient present at different places. Also, in some cases, transplantation occurs in same person and in some other cases, transplantation held in two different people . It has a very long history. Some evidence found that people of past also do organ transplantation. Full history of transplantation is given here.
300 — Allotransplantation (transplantation occurs between two non-genetically identical people) was first originated in human in middle ages. Leg of church caretaker name Deacon Justinian was cut to treat cancer and attach leg of non-genetically identical person.
1668 — Bone graft was successfully grafted. For this purpose, dog skull used. This all procedure held in Holland.
1746 — Nose successfully regrafted and this surgery is done by Dr. Garengeot in France.
1818 — A surgeon transfuses four-ounce blood from a man to his wife because she lost blood due to childbirth.
1878 — Human-human successfully bone transplant.
1869 — Successfully transplanted skin.
1906 — Cornea was successfully transplanted
1954 — Kidney was transplanted first time. Recipient is genetically identical twin.
1959 — Kidney transplantation occurs between fraternal twins.
1960 — Between Kidneys was transplanted .
1962 — Kidney, liver and lungs was removed from deceased person for transplantation.
1963 — Organs remove from brain dead person and use in transplantation.
1968 — Bone Transplantation was successfully achieved.
1968 — Harvard Ad Hoc Committee successfully developed a
definition of brain-dead people.
1976 — First Immunosuppressant drug was successfully
developed for minimize the risk of rejection by immune system.
First immunosuppressant drug is cyclosporine [4,5].
1980 — Uniform Determination of Death Act (UDDA)
developed the definition of death as stopping of circulatory/
respiratory systems or stops all function of the body.
1981 — Heart/Lung successfully transplanted.
1983 — First awareness week for national tissue and organ
1983— First workshop held on solid organ by a surgeon
name General Everett Koop.
1984 — first combined Heart, Liver and Lungs transplantation
1984 — Congress passed an Act and banned selling of organs
and tissues. Also make organ procurement network for equality of
1986 — First contract for OPTN by ministry of health of U.S.
OPTN work is to give facility that is totally based on equality.
1986 — Hospitals provide very good offers for close relatives
of deceased person if they donate the organ of their deceased
1987 — Intestine transplantation was successfully done
1988 — Split-Liver transplantation was successfully
performed. The benefit of this procedure is that two recipient use
liver of one donor.
1989 — Performed first small intestine transplantation.
1990— Award noble prize to Dr. Joseph and Dr. Donnall
Thomas for successful transplantation of kidney and bone
1990 — Living donor lung was used for transplantation.
1991 — National workshop on increasing donation of organs
and tissue and this workshop is held by summon of General
Antonia who is also a surgeon [5,6].
1998 — Hand was successfully transplanted.
1998 — Plasmapheresis was injected in body and the purpose
is that it helps to do transplant in those people who are not ABO
1999 — Act was passed for appreciating organ donor.
According to this act, if employee wants leave for organ donation
then they able to get full paid leave.
2001 — University of Louisville and Jewish Hospital successfully
perform hand transplant.
2001 — Rate of living donors is increase as compare to
deceased donor. And this was first time in U.S.
2002 — OPTN online the data of those patients who were
waiting for organ.
2003 — April was nominated as Donation Life month.
2005 — In France, partial face was successfully transplanted.
2006 — IOM issue a report in which they tell us about ethical
issues of transplantation and also tells us how deceased person
donors will increase.
2006 — In U.S. 100 million people were registered as donor.
2008 — National Medal awarded for those who donate their
2009 — A Campaign start that title is “END THE WAIT”. This is
due to increase the kidney donors to abolish waiting list of kidney
2010 — Full face was successfully transplanted.
2011 — Dr. Cavadas successfully transplant first double leg.
2014 — Uterine transplant successfully performed first time
2014 — In South Africa, penis was successfully transplanted
As described earlier that it is successful technique for
replacing damaged organ/tissue. Donors play a very good rule in
transplantation because if donor not agrees to donate his organ/
tissue then doctors not able to do transplant. Donor has two types.
1. Living donor and
2. Deceased donor
If a living person donate their organ, then it is called living
donor. If deceased person donates, then it is called deceased donor.
Sometime person is cardiovascular dead and sometimes it is brain
dead. If a doctor believed that this person is not more live, and
they will die soon then they contact to person closest relative and
suggest donating the patient’s organs. If relative allow then doctor
remove the patient organs and save it. Researchers have able to
save human organ for five to six years. Cornea is the only organ
that cannot be saved [3-11]. First doctor screens a person and
check that whether a person is eligible for transplantation or not.
If they found eligible then doctor advice a person to a specialist
transplantation center. Doctors of transplantation center again
screen a person and evaluate its health. Common process for
1. Cut the skin
2. Remove arteries and vessels that attach with organ.
3. Remove the organ
4. Take the new and healthy organ
5. Place it into the body
6. Attach arteries and vessels
7. Close the skin cut .
A necessary thing is that instruments are sterilized. Now days,
number of recipients is very high as compared to donors. People
wait many years for organ/tissue. Sometime people died due to
pain but cannot get any donor [13-15].
Transplantation occurs in those people who are not
genetically identical. Transplantation between genetically
different people can causes many problems like tissue rejection
because recognized the organ/tissue as foreign particle. Some
tests are present that measure organ rejection e.g. Panel Reactive
Antibody (PRA). PRA is simple test that check the person’s blood.
High PRA mean immune system make antibody against transplant
organ/tissue. Higher PRA, higher chances of rejection.
Transplantation occurs between two different species e.g.
porcine heart valve. This type is unsafe as compared to others and
rejection is very high. In addition, disease may also attack that
person. A scientist name Eugene Gu study on transplant type that
how heart of fetal can be transplanted into animal .
This type is commonly applied on those who have cystic
fibrosis disease. In CF, both lungs can be damaged. So, person
needs lungs transplantation. Heart also transplanted in CF
patient. The reason is that in some cases, one lung is large and
other is small as a result, heart location is disturbed. This type of
transplantation is very successful.
As we know that obesity is the excess accumulation of fat.
Obesity directly disturbs the health and causes many diseases.
Renal transplantation is not possible in obese people. In 2009,
researchers work on obese people and successfully performed
transplantation in obese by using Robotic technique .
Some people donate their organ and tissues to unknown
people and they do it for helping needy person and sometimes it
is due to the need of money. Jesus Christian was the first people
who donate their kidney to needy people [16-19].
Now days, organ transplantation is a business and people
sell and buy organs. This method is very common in worldwide
but this is illegal because donor demand money e.g. 16,000$ for
one kidney, 2000-4000$ in Iran. It is localized in some countries
like Australia. This method of donation is only acceptable in case
of kidney only because research on people reported that people
will able to survive with one kidney. Gary Becker reported that
free donation could solve the problems of that people who cannot
able to buy organ. He also gives an approximate calculation about
human organ prices. Average market price is 15,000$ for kidney,
32,000$ for liver. In USA, human organ sale is banned while in Iran,
it is legal since 1988. About 40-50% people that live in different
villages of Pakistan sale their one kidney for 2500$ .
Many organizations and authorities present in different
regions of world that do business of selling and buying organs.
World Medical Association gives a report that mostly prisoners
organs missed, and this is due to because these organizations
remove it forcefully. Another report that is given by Deputy
Minister of Health China that approximately 95% organs that are
used is transplantation are remove from prisoners. Another report
given that almost half of the organ sources that are transplanted in
last six years not know .
Researchers and patients both face many different challenges.
Many types of viruses are attacked when transplantation perform.
Or sometimes very lethal disease comes due to instruments that
cannot be sterilized. When private people forcefully remove the
organ then they use those instruments that needs sterilization.
Most common challenges are as fallow.
It is common problem that seen after most transplants. It
is due to the attack of immune system that protects our body
from different pathogens attacks that causes disease. It works
very accurately. When any foreign particle or pathogen enter in
body then the immune system active and check that whether a
particle is self or non-self. If it identifies as non-self, then release
specific proteins that are antibody for the destruction of that
foreign particle and also remove that particle . When doctors
do surgery and transplant organ into body then immune system
recognize it as non-self because particle that attaches on organ
are different to those that are naturally present or organ. So, it
releases immune response for destroy organ . Sometimes,
blood transfusion reaction occurs that make clogs of blood.
Rejection has commonly three types.
It occurs after many years of transplantation. Immune system
slowly damages the organ/tissue that is transplanted . Perfect
matching of recipient and donor can reduce the rejection risk.
But perfect match is not possible. 100% perfect match mean
genetically identical and genetically identical are only twins. So,
a doctor refers some drugs that suppress immune response, and
these are called immunosuppressant minimize the chances of
blood transfusion reactions. Cornea is the only part where blood
transfusion not occurs because blood is not present . It also
has two types.
1. Induction drugs — doctor or surgeon uses this drug at a
time of surgery.
2. Maintenance drug — it is use for long time for reducing
the risk of rejection . Maintenance drug further four types.
i. Calcineurin Inhibitor
ii. mTOR Inhibitor
These all are the type of maintenance drug and doctor
recommends it. But it is also not good for health. Its long-term use
causes many diseases like;
a. 100-degree fever
b. Severe cold and cough
c. Burning feels in urine
These are some symptoms that indicates that amount of
immunosuppressant is high in blood. If not notice these symptoms,
then risk of lethal disease is present. So, go to the transplant center
and tells doctor about symptoms and feeling [25,26].
No symptoms occur at start but it’s dangerous for health. It
creates clogs and blocked the blood vessels. So, blood can’t reach
every site due to clog that causes many diseases like paralysis etc.
In transplantation, cost is matters a lot. Some people sell their
organs and their cost is very high. Also illegal authorities also
active and involve in selling and buying organs. Price of kidney
in different countries of world like, in Manila, its price is 1000-
2000$, America (10,000$), South Africa (20,000$) and China
(70,000$). These prices are not affordable for poor person .
Transplant technique is control by FDA that makes very strict
laws. Use of un-sterilize instruments causes many lethal diseases
like HIV, hepatitis B, C. In past, a person who suffered Hepatitis B
and C donate their organs to needy and poor people. Doctors don’t
screen the donor and transplant the organs without checking it.
So, FDA makes laws and regulate transplant technique. People
who suffer from lethal diseases (diabetes, AIDS, Hepatitis) are not
able to donate their organs and tissues for transplantation .
Organ transplantation is basically a replacing of damaged
organ. Organs are damage due to some injury or any other
problem like a disease. Workers take organ from donor that
may be living or deceased and transplant it into recipient. Donor
donate their organ for many reasons like for loved one, forced
donation, for money, etc. In many countries, organ selling is illegal
like in America, but in some countries, it is legal like in Iran. About
90% organs are removed from prisoners who were not able to
take decisions and the authorities remove their organs forcefully
that increase the chance of disease transfer like HIV, Hepatitis
B & C, etc. We are able to reduce these risks by using sterilized instruments and also screen the donor for HIV, Hepatitis B & C,
etc, before removing organ. After transplant, some issues occur
like rejection, diabetes, high cholesterol etc. Doctors refer some
immunosuppressant for reducing the risk of rejection. But longterm
use of immunosuppressant causes many diseases like high
blood pressure, anxiety, etc.