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Bioengineered Stem Cell Organs are the future of organ donations in the…

- - - - Living Donations include: Kidney, Lung Lobe, Liver and sometimes Pancreas and Intestine
      - People who get living donor organs receive a higher quality organ and much sooner than waiting for a dead donation.
      - SOURCE: Notecard "Living Donations"
    - - SOURCE: Notecard "Deceased Donation"
      - Deceased Donation when a registered organ donor becomes brain dead and is ruled a viable donor. Most common type of donor.
      - Deceased Donations include: Almost any organ except for the brain and skin, as well as the eyes or tissue at brain death.
    - - SOURCE: Notecard "Vascularized Composite Allographs"
      - VCA donations include: Skin, bone, muscle, blood vessels, and connective tissue. Most common VCA's are hand and face transplants.
      - Used primarily to bring identity and function to people who have gone through intense injury or illness.
  - - - Brain death is defined when there is loss of function in the brain and its brain stem. When a person is brain dead, they are considered dead both legally and medically. Brain death can be caused when there is an injury to the brain which causes swelling but because of the confinement in a human skull, there is now room for swelling to take place.
        SOURCE: Notecard "Brain death"
      - A patient needs to be checked by two doctors who have no relation to the transplantation to officially be pronounced Brain dead. After they are pronounced brain dead, the patient is referred to their local organ organization.
        SOURCE: Notecard "Referral"
        
        To identify brain death, both doctors must do extensive tests to make sure there is no probability for irreversibility of the coma. There needs to be a complete neurological exam that includes absence of spontaneous moment, posture, seizures, shivering, verbal stimuli response and noxious stimuli response provided through a cranial nerve. Spinal reflexes may be present during the exam.
        They also check pupillary reflexes to direct and consensual light.
        There will be absent corneal, oculocephalic, cough and gag reflexes. Oculovestibular reflex is tested with ice water being irrigated into the ear canal.
        The heart rate fails to increase more than 5 beats per minute after given 1-2 mg of atropine. This shows vagus nerve and nuclei are not functioning.
        There will also be absent respiratory efforts
        An apnea test is performed but only needs to be preformed once when results are conclusive. Before doing the apnea test the patient must have a core temperature of 97.7 degrees F, positive fluid balance for the previous 6 hours, and normal PCO2.
        If the patient is still eligible, the apnea test is conducted which includes connecting the patient to a pulse oximeter and disconnecting their ventilator delivering 100% oxygen into the trachea. They should look closely for any respiratory movement. Measure the PO2 and PCO2 and pH after 8 minutes and then reconnect the patient to their ventilator. If respiratory moments are absent and arterial PCO2 is lower or equal to 60 mm the apnea test is positive supporting the diagnosis of brain death
        SOURCE: Identifying brain death
      - A person could become brain dead from shock or hypotension, hypothermia, drugs in a high enough dose to alter neurologic and neuromuscular function, brain stem encephalitis, Gillian barre syndrome, encephalopathy caused from hepatic failure, uremia and hyperosmolar coma, and severe hyphosphatemia.
        SOURCE: Notecard "How can someone become brain dead"
    - - The Organ Procurement Organization is still the group who decide if the patient is suitable for organ donation. If that decision is made, that paves the way for the organ harvesting to begin. The OPO will speak to their family and tell them that the patient is an organ donor and begin the process.
        SOURCE: Notecard "Evaluation and Approach of Donation"
  - - - The sicker a patient is and how many treatments they have tried the higher on the list they are placed. If a patient is on a ventilator or living in the Intensive Care Unit they are more of an urgent case. Patients who are still able to survive outside of the hospital at home with help are less urgent. SOURCE: Notecard "Initial Transplant Chance Factors"
      - A patient is not immediately placed on the donor list, it takes a lot of tests and professional opinion are considered. They go through a right heart catheterization, a metabolic stress test to observe oxygen intake, and blood tests to screen for any diseases. Once on the list, a patient has to wait for a donor that has blood compatible with theirs, someone their same size and the doctors need to check for diseases or heart issues.
        SOURCE: Donor and Recipient selection and influence
      - Every 10 minutes a new patient is put in the United Network for Organ Sharing (UNOS) list
- - - - The research was controversial at the time and still is today, but if they had not done it, who knows when stem cells would have been found and we would be farther behind in the science.
  - - - Stem cell researchers used rats and their stem cells to create functional kidneys and lungs for rats. They use a detergent solution to strip the cells from the donor organ and replace them with the specialized heart generated stem cells. Using human hearts that were donated to the organ bank, they have tried the same process on a bigger scale. SOURCE: Notecard "Stem Cell rat kidney and lung"
    - - A team of Massachusetts General Hospital scientists and Harvard Medical School students have used the technique of stripping away old cells and using specialized stem cells to replicate a functioning human heart. The heart after two weeks was well structured immature heart, and after giving it a shock, it started to beat. SOURCE: Notecard "Scientists create beating human heart"
    - - Researchers used genetically engineered human blood and skin cells to create stem cells which were developed into intestinal cells that were grafted into the mice's kidneys allowing growth and multiplication on their own from their own blood flow. After six to eight weeks, the cells ballooned and developed into functional intestine tissue. The tissue was able to preform intestinal functions like food digestion and nutrient absorption. SOURCE: Notecard "Stem cell grown Intestine