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Unit 6: Organ Donation (Donation Process (After death donations (Heart,…
Unit 6: Organ Donation
Anatomy and Immunology
Alexis Carrel (1902)
Joined blood vessels using sutures
Noble prize
Unsuccessful organ transplants in animals
Rejection of troubled organs
Discovered immunology of rejection in WW2
Radiation
Suppress bone marrow in transplants
Suppression was extreme
Patients unable to overcome infection
Successful transplant
Identical twins donated kidney
Identical immunity
New medications
6-MP
Allowed first kidney transplant
Used with steroids
Moderately effective
Cyclosporine
Preventing infection 80-90%
Tacrolimus 1990s
Inhibits one part of immune system
Heart and liver
Donation Process
Organs
Healthy organs
Any individual is potential donor
No strict age limitations
After death donations
Heart
Lungs
Liver
Kidneys
Pancreas
Small intestine
Brain dead to donate
Determined by 2 physicians
Consent process
Option to donate
Donor history
Illnesses
Surgeries
Medication
Travel history
Substance use
Tattoo or body piercing
Eligibility and Quality of Life
Potential candidates
Undergo tests
No diseases
No non-compliance
No advanced age
Healthy lifestyle
Waiting lists
Ranked according to severity
Compatible blood type
Few hours - several years
Equally sick
Patient who has waited longest
Ethics
Bioethics
Autonomy
Decisions based on beliefs and values
Existence after death
Family can refuse
Non-maleficence
Do not harm others
Beneficence
Help or benefit others
Justice
Treat other with equal concern
Make decisions fairly
Conflicts
Between beneficence and autonomy
Informed voluntary consent
Innovation
Living donors
Transplants more successful
No anti-rejection drugs needed
Most are parent to child
Artificial devices
Use of bridging devices
Use until organ is available
Can cause other health problems
Xenotransplantation
Use organs and tissues from animals
Pig
Immunological barriers
Antibodies
Proteins
Hormones
Anti-rejection medications needed
Retroviruses can effect humans
Stem cells
Develop into various cell types
Grown in culture tubes
Transplanted into patients
No anti-rejection drugs needed
Legal Matters
Organ donation governed by laws
Trillium Gift of Life Network Act 2000
Age restriction of 16 years
Donations after death
Donor card needed
Oral declaration with 2 witnesses
Family may give consent
Societal Matters
Expensive health care
New medical technology
Transplantation costs
Medical evaluation costs
Immunosuppressive drug costs
Cost of assistive devices
Moral choices
Is cost worth is?
Religious concerns and objections
Most approve and encourage donations
Transplantation Process
Heart transplant
When heart cannot sustain life
Common for obesity smoke high blood pressure diabetes
80% success rate
May require 2nd transplant
Liver transplant
Used when liver fails
Can occur within days
Live donor can donate portion
Recipient must live healthy lifestyle
Abstain from alcohol and drugs
85-90& successful
Kidney transplant
Disease progresses slow
Prevent with lifestyle changes
Dietary changes
No smoking
Exercise
Come from deceased or living donor
Living transplants 95% successful
Cadaveric donors 85-90%
Tissue and other organ transplant
Heart and lung transplant
Small bowel transplant
Liver and bowel transplant
Pancreas and kidney transplant
Islet for diabetes
Tissues
Cornea
Bone marrow
Skin
Bone