1. BY
B.E.N

2. COURSE OUTLINE
1. Introduction
2. Types of transplants
3. Major organs and tissues transplanted
4. Types of donors
5. Reasons for donation
6. Ethical concerns

3. Organ transplantation is the moving of an organ
from one body to another or from a donor site on the
patient's own body, for the purpose of replacing the
recipient's damaged or absent organ
The emerging field of regenerative medicine is
allowing scientists and engineers to create organs to be
re-grown from the patient's own cells (stem cells, or
cells extracted from the failing organs)

4. 2.TYPES OF TRANSPLANTS
i/ Autograft and autotransplantation
Transplant of tissue to the same person. Sometimes
this is done with surplus tissue, or tissue that can
regenerate, or tissues more desperately needed
elsewhere (examples include skin grafts)
 Sometimes an autograft is done to remove the tissue
and then treat it or the person, before returning it
(examples include stem cell autograft and storing
blood in advance of surgery)

5. ii/ Allograft and allotransplantation
 An allograft is a transplant of an organ or tissue
between two genetically non-identical members of
the same species.
 Most human tissue and organ transplants are
allografts. Due to the genetic difference between the
organ and the recipient, the recipient's
immune system will identify the organ as foreign and
attempt to destroy it, causing transplant rejection.

6. iii/ Isograft
 A subset of allografts in which organs or tissues are
transplanted from a donor to a genetically identical
recipient (such as an identical twin).
 Isografts are differentiated from other types of
transplants because while they are anatomically
identical to allografts, they do not trigger an immune
response.

7. iv/ Xenograft and xenotransplantation
 A transplant of organs or tissue from one species to
another.
Eg. 1). Porcine heart valve transplant, which is quite
common and successful.
2). Attempted piscine-primate (fish to non-human
primate) transplant of islet (i.e. pancreatic ) tissue.
 The latter research study was intended to pave the way
for potential human use, if successful.
 However, xenotransplantion is often an extremely
dangerous type of transplant because of the increased
risk of non-compatibility, rejection, and disease carried
in the tissue.

8. v/ Split transplants
 Sometimes a deceased-donor organ, usually a liver,
may be divided between two recipients.
 This is not usually a preferred option because the
transplantation of a whole organ is more successful.

9. vi/ Domino transplants
 This is the series of transplantation in which the first
recepient become the donor for another recipient
 Eg. 1. In patients with cystic fibrosis, where both
lungs need to be replaced, it is technically easier
operation with a higher rate of success to replace
both the heart and lungs of the recipient with those
of the donor. As the recipient's original heart is
usually healthy, it can then be transplanted into a
second recipient in need of a heart transplant
 2. Familial amyloidotic polyneuropathy

10. 3.MAJOR ORGANS AND TISSUES TRANSPLANTED
 Thoracic organs
 Heart (Deceased-donor only)
 Lung (Deceased-donor and living-related lung
transplantation)
 Heart/Lung (Deceased-donor and Domino
transplant)
 Abdominal organs
 Kidney (Deceased-donor and Living-Donor)
 Liver (Deceased-donor and Living-Donor)
 Pancreas (Deceased-donor only)
 Intestine (Deceased-donor and Living-Donor)
 Stomach (Deceased-donor only)
 Testis

11. Tissues, cells, fluids
 Hand (Deceased-donor only)
 Cornea (Deceased-donor only)
 Skin including Face replant (autograft) and
Face transplant (extremely rare)
 Islets of Langerhans (Pancreas Islet Cells) (Deceased-
donor and Living-Donor)
 Bone marrow/Adult stem cell (Living-Donor and
Autograft)
 Blood transfusion/Blood Parts Transfusion (Living-Donor
and Autograft)
 Blood vessels (Autograft and Deceased-Donor)
 Heart valve (Deceased-Donor, Living-Donor and
Xenograft [Porcine/bovine])
 Bone (Deceased-Donor and Living-Donor)

12. 4. TYPES OF DONORS
1) Living donor
In "living donors", the donor remains alive and donates a
renewable tissue, cell, or fluid (e.g. blood, skin), or donates
an organ or part of an organ in which the remaining organ
can regenerate or take on the workload of the rest of the
organ
 Eg.(primarily single kidney donation, partial donation of
liver, small bowel).
 Regenerative medicine is promising, one day may allow for
laboratory-grown organs, using patient's own cells via stem
cells, or healthy cells extracted from the failing organs.

13. 2) Deceased donor (formerly cadaveric)
 Deceased are donors who have been declared
brain-dead and whose organs are kept viable by
ventilators or other mechanical mechanisms until
they can be excised for transplantation.
 Brain-dead donors, have formed the majority of
deceased donors for the last twenty years, but nower
days are not enough donors as the demand for
transplants continues to grow.

14. 5. REASONS FOR DONATION
(i) Living related donors
 Living related donors donate to family members or
friends in whom they have an emotional investment.
 The risk of surgery is offset by the psychological
benefit of not losing someone related to them, or not
seeing them suffer the ill effects of waiting on a list.
(ii) Paired exchange
 A "paired-exchange" is a technique of matching willing
living donors to compatible recipients using
serotyping

15.  Eg. A spouse may be willing to donate a kidney to
his /her partner, but cannot since there is no
biological match.
 The willing spouse's kidney is donated to a matching
recipient who also has an incompatible but willing
spouse. The second donor must match the first
recipient to complete the pair exchange.
 Typically the surgeries are scheduled simultaneously
in case one of the donors decides to back out and the
couples are kept anonymous from each other until
after the transplant.

16. (iii) Good Samaritan
 Good Samaritan or "altruistic" donation is giving a
donation to someone not well-known to the donor.
 Some people choose to do this out of a need to
donate. Some donate to the next person on the list;
others use some method of choosing a recipient based
on criteria important to them.
 Websites are being developed that facilitate such
donation. It has been featured in recent television
journalism that over half of the members of the
Jesus Christians, an Australian religious group, have
donated kidneys in such a fashion

17. (iv) Compensated donation
(Sometimes referred to Organ sale or Organ trade)
 In compensated donation, donors get money or other
compensation in exchange for their organs.
 This practice is common in some parts of the world,
whether legal or not, and is one of the many factors driving
medical tourism.
 In the United States,
The National Organ Transplant Act of 1984 made organ
sales illegal. In the United Kingdom, the
Human Organ Transplants Act 1989 first made organ sales
illegal, and has been superseded by the
Human Tissue Act 2004. What about in Africa???

18. (v) Forced donation
Harvesting organs from executed/ condemned people
(who seem to be the undesirable/ unwanted) without their
consent.
 There have been various accusations that certain
authorities are harvesting organs from those the
authorities deem undesirable, such as prison populations.
 The World Medical Association stated that individuals in
detention are not in the position to give free consent to
donate their organs .
 Illegal dissection of corpses is a form of body-snatching
and may have taken place to obtain allografts

19. Comparative costs
 One of the driving forces for illegal organ trafficking
and for “transplantation tourism” is the price
differences for organs and transplant surgeries in
different areas of the world.
 According to the New England Journal of Medicine, a
human kidney can be purchased for $1000–$2000, but
in urban Latin America a kidney may cost more than
$10,000. Kidneys in South Africa have been sold for as
high as $20,000.
 Price disparity based on donor race are a driving force
of attractive organ sales in South Africa, as well as in
other parts of the world.

20.  In China, a kidney transplant operation runs for
around $70,000, liver for $160,000, and heart for
$120,000.
 Although these prices are still unattainable to the
poor, compared to the fees of the United States,
where a kidney transplant may demand $100,000, a
liver $250,000, and a heart $860,000, Chinese prices
have made China a major provider of organs and
transplantation surgeries to other countries.
 In India, a kidney transplant operation runs for
around as low as $5000 thus make it a place to go for
developing countries, Tanzania inclusive.

21. 6. ETHICAL CONCERNS
 The existence and distribution of organ
transplantation procedures in developing countries,
while almost always beneficial to those receiving
them, raise many ethical concerns.
 Both the source and method of obtaining the organ
to transplant are major ethical issues to consider, as
well as the notion of distributive justice.

22.  “transplantation tourism” has the potential to violate
human rights or exploit the poor, to have unintended
health consequences and to provide unequal access
to services, all of which ultimately may cause harm.

23. ARE WE GOING TO REACH???
THE END