Introduction
Organ transplantation saves lives in cases of end-stage organ failure, damage, or disease. In the human body, a group of cells known as a tissue performs a specific function. Examples of tissues include bone, skin, the cornea of the eye, the heart valve, blood vessels, nerves, and tendons. An organ is a collection of tissue that serves a particular purpose, such as the heart, lungs, kidney, liver, etc. Organ transplantation entails surgically removing an organ from an individual and placing it inside another. Giving an organ or a portion of the body to someone in need of a transplant due to advanced organ disease is known as organ donation.
What Kinds of Organs and Tissues Can Be Transplanted?
Examples of organs that can be transplanted are as follows:
- The liver and kidney can be transplanted.
- Pancreas.
- Heart.
- Lung.
- Intestine.
An example of tissue that can be transplanted:
- Corneas.
- Middle ear.
- Skin.
- Bone.
- Skeletal marrow.
- Cardiac valves.
- Composite allografts with vascularization (transplanting skin, uterus, bone, muscles, blood vessels, nerves, and connective tissue).
What Are the Different Types of Organ Donations?
Organ donations are of four types:
1. Living donation.
2. Non-living donations such as cadaveric donations.
3. Tissue donation.
4. Pediatric donation.
1) Living Tissue Donation:
A kidney, a portion of the pancreas (half of the pancreas is sufficient for preserving pancreatic functions), and a portion of the liver are the only organs a living donor can donate. The liver segments will regenerate in both the recipient and donor after some time. A healthy individual of at least 18 years or older, willingly donating any of their organs or tissues during their lifetime for therapeutic purposes, is considered a living donor.
Method of living organ donation:
- Residing close to related donors: Only immediate blood relatives, including parents, siblings, children, grandparents, and grandchildren, are typically approved as donors. Under the “ close family” clause, a spouse is also accepted as a living donor and permitted to donate.
- Individuals who are not the recipient’s relative or living close by but have a special bond or any other reason (for money) are also permitted to donate.
- Where a live-related donor and a recipient are incompatible, there is a provision for swapping donors between two such pairs when the first donor matches the second recipient and the second donor matches the first recipient. Only close relatives who are donors are allowed to do this.
2) Non- Living Organ Donation- Cadaveric Donation:
- In the event of cardiac or brain death, multiple organs, and tissue donations are possible from deceased (dead) donors.
- A donor’s organ can function in the body of another person.
- Anyone who has passed away (brainstem/cardiac) can become an organ and tissue donor, regardless of age, race, or gender.
- A close relative or someone legally possessing the dead body must consent. In the case of a minor donor (below the age of 18), the consent of a parent or other close family member approved by the parents is crucial.
- Medical eligibility for donation is assessed at the moment of death.
3) Tissue Donation:
- Giving the gift of life is frequently made through tissue donation. Donating organs like skin, bone, or heart valves can speed up the healing process and enhance the quality of life for the recipients.
- Two individuals can get the gift of sight due to cornea donation.
- Through tissue donation, one person can restore function in burn patients, women undergoing breast reconstruction, and athletes with torn ligaments or tendons.
- In vascularized composite allografts (VCA), several structures are implanted. One of the most popular kinds of VCA is the transplantation of the hand or face.
4) Pediatric Donation:
- Due to the complexity of donating to children, the pediatric donation is one of the four organ donation forms. The size of the donated organs is crucial for long-term success in a pediatric donation.
- This donation differs slightly from other organ donations because children respond better to child-sized organs.
What Are the Procedures for Organ Donation?
The organ recovery process is a complicated set of steps that are organized by medical professionals in hospitals and organ procurement groups. To guarantee that the procedure is carried out fairly and effectively, resulting in an equitable distribution of donated organs, the legislation known as the Transplantation of Human Organs Act (THO) was passed in India in 1994. The following steps are involved in the process:
How Do Hospitals Identify Potential Donors?
A potential donor is identified by medical personnel at a hospital. In cadaveric donation, the type of injury tells the doctor if the person is brain dead or close to dying (DCD, or donation after cardiac death).
How Is Donor Eligibility Assessment Done?
All patient fatalities and impending patient fatalities are recorded. The patient's medical condition is examined closely. The patient's medical and social history, as well as a physical exam, are all part of the evaluation. It will establish whether the patient is a good donation candidate.
Whose Permission Is Required to Recover Organ?
The family's permission is required for the donation procedure to move forward. Sometimes, the legal next-of-kin signs a donor consent form with the family's approval.
How Is the Recipient’s Medical Maintenance Done?
Together with the rest of the hospital team, the clinical coordinator takes care of the recipient's medical needs. On a consultation basis, medical support is occasionally required.
How Are Potential Recipients for Organs Identified?
The clinical coordinator gives details about the organs that are up for donation. The donated organs are subsequently matched with possible recipients via the UNOS computer. When choosing recipients, doctors look at things like blood type, body size, medical urgency, and how long the waiting list is. In the heart, liver, and lung transplants, blood type and body size should match. Genetic tissue type is also taken into account when matching is done for the pancreas and kidneys. If a match for a certain organ can't be found locally, the donor organ is offered in the region and, if necessary, across the country.
How Does the Allocation Process Work Between Donor and Recipient?
The coordinator contacts the transplant facility of the recipient, who matches the donor. The surgeon performing the transplant will determine whether to accept the organ. If it is unsuitable, the coordinator gets in touch with the transplant surgeon of the next recipient on the list. Each organ donation and transplantation goes through this procedure until all the recipients and organs have been properly matched.
How Does Surgical Organ Recovery Happen?
In the operating room, the surgical team extracted the organ and tissues from the donor through a surgical process. Federal legislation mandates that doctors recovering organs do not take part in the donor's care before brain death has been established.
How Do Patients Get Ready for Surgery?
While the organ recovery procedure is taking place at the donor hospital, the recipients are being prepared by transplant surgeons for the final pre-operative preparations. The recipients are taken to surgery once the organs are delivered to the transplant facility, where the transplants are carried out. A lymph node sample of tissue is sent to a lab to be tissue-typed and matched with the recipients. The surgical recovery teams transport additional organs directly to the recipients.
How Are the Funeral and Burial Processes Planned?
In the case of cadaveric donation, the donor family can move forward with funeral or burial plans when the process is complete. Donating organs and tissues is a good and devout act.
How Are Families and Hospitals Followed Up On?
Following each donation, the coordinators notify the donor's family, the hospital staff, the doctors, and the nurses in writing about the organs and tissues that have been collected.
Conclusion
When a person's organs fail to function, transplantation of an organ from a donor plays a very important role in saving the person's life. Several organs, like the heart, lungs, liver, kidney, etc., can be transplanted into another person. Apart from organs, some tissues can also be transplanted. For organ donation and transplantation, rules are made to make the process hassle-free and to avoid exploitation and unethical practices. The principles offer a broad ethical foundation for judgments made at the municipal, state, and federal levels regarding organ allocation policies, including the formulas employed in such decisions.
