Organ Donation And Transplantation: A Few Facts On The Matter

An amazing medical achievement

1954 was the year when the first human transplant from a living donor was performed. The donated organ was a kidney, taken from Ronald Herrick and transplanted into his identical twin Richard. Dr. Joseph Murray was the surgeon in charge of performing the transplant, at Brigham Hospital in Boston, and this amazing accomplishment made him worthy of the Nobel Prize in Physiology or Medicine, in 1990.

Organ transplantation is not as easy as it sounds

Two main advantages helped in the success of the surgical procedure performed by Dr. Murray and the transplant on itself, which finally lead to extend the recipients life. First, the fact that the needed organ was a kidney and not a heart, for example, make it simpler to find a donor.

Following the transplant, Richard lived eight more years and his case opened a new alternative for patients with diseases where only an organ replacement could save their lives.

In 1967, the first heart was transplanted by Dr. Christiaan Barnard. Unfortunately, the recipient only lived 18 days after the procedure as a consequence of an infection caused by the immunosuppressive drugs that the patient had to take to reduce the risk of rejection. Still nowadays, organ rejection after transplantation is a major issue that has to be taken into account before performing a transplant.

Basics on organ donation and transplantation

Organ and tissue transplants involve the replacement of an injured organ or tissue for a healthy one, either taken from a deceased or a living donor. If the organ comes from a dead person, the donor must have expressed his or her wishes to donate the organs when alive. The process is a bit simpler if the organ comes from a living donor, which usually occurs when talking about kidney or bone marrow transplantations, for example. 

Unfortunately, the need of organs is much greater than the donation rate, which is why patients often have to wait for years before receiving a new organ. Just so you can have an idea, recipients sign into a waiting list, which in the U.S. is maintained by the United Network for Organ Sharing (UNOS), and that currently has around 123,000 patients signed in for a transplant.

Of Organ Donors And Recipients

Where do organs for transplantation come from? Live and deceased patients can become donors. The type of donor depends on the organ that the recipient needs. The heart can only be obtained from a deceased donor, but many other organs, as well as some types of tissues, can be donated in life. 

Deceased donors

Organs can be obtained from dead donors, but these deceased patients need to comply with certain characteristics in order to be eligible for organ donation, so in the end, very few dead organ donors actually become one.

These patients are considered to be clinically and legally dead, but their body can be kept functioning with the aid of mechanical ventilation and medication.  This helps in the process of organ donation, because since the heart is still beating and pumping blood, all organs are kept in optimal conditions.

It is possible however, to obtain certain tissues from these patients, such as bone, skin and corneas. 

In order to become a donor, you can get an organ and tissue donor card, which states your wish to become a donor in case of death. You also have to notify your family about your decision, so they know what to do in such case. In the U.S., each state has a donor registry, where people can register to become donors in case of death.

Becoming a living donor

Living donation is an alternative that patients have when the supply of organs from dead donors is not enough to cover the transplantation needs. Not all organs can be donated in life, though.

Donors are very often related to the patient, but living transplants can also be performed with an organ from a non-related person that is compatible with the patient. Sometimes the patient knows the donor; others, the organ comes from a voluntary unknown donor, and there is also the case where the related donor is not compatible with the patient, so the donation is still performed for a different recipient and the patient is matched with a compatible organ, from an unknown donor. This last type of living donation is known as paired-donation.

See Also: A Successful, World's-First Double Leg Transplant

The process to become a living donor is quite strict, but all regulations are aimed to ensure that both the donor and the recipient are as safe as possible before, during and after the procedure.

If you are interested in becoming a donor, there are many organizations worldwide that give information on how to become one. it is very important that you know exactly what becoming a donor means and that you let your family know about this life decision.