The first heart transplant, performed in South Africa in 1967 |
Organ transplantation is the moving of an organ from one body to another or from a donor site to another location on the person's own body, to replace the recipient's damaged or absent organ.Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.
Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts),cornea, skin, heart valves,
nerves and veins. Worldwide, the kidneys are the most commonly
transplanted organs, followed by the liver and then the heart. Cornea
and musculoskeletal grafts are the most commonly transplanted tissues;
these outnumber organ transplants by more than tenfold.
Organ donors may be living, brain dead, or dead via circulatory death. Tissue may be recovered from donors who die of circulatory death, as
well as of brain death – up to 24 hours past the cessation of heartbeat.
Unlike organs, most tissues (with the exception of corneas) can be
preserved and stored for up to five years, meaning they can be "banked".
Transplantation raises a number of bio-ethical issues, including the definition of death, when and how consent should
be given for an organ to be transplanted, and payment for organs for
transplantation. Other ethical issues include transplantation tourism and more broadly
the socioeconomic context in which organ procurement or transplantation
may occur. A particular problem is organ trafficking. Some organs, such as the brain, cannot be transplanted.
Transplantation medicine is one of the most challenging and complex
areas of modern medicine. Some of the key areas for medical management
are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and
the need to immediately remove the organ from the recipient. When
possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs.
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