1. Organ Donation & Transplantation EXCI233 Online source: http://www.merckmanuals.com/home/immune_disorde rs/transplantation/overview_of_transplantation.html?qt =organ%20transplantation&alt=sh Leave out section on “Organ Distribution, Drugs Used to Prevent Transplant Rejection”

2. Transplantation The removal of cells or tissues or organs from the body, after which they will be transferred elsewhere in the same body or to a different body Blood transfusions are a type of transplantation More commonly, transplantation refers to transfer of organs or tissues

3. Transplantation Requires surgery and immunosuppressant drugs once the surgery is done Risks include possible rejection of the transplanted organ, and death as a result

4. Donors Organs can be acquired from either living or recently deceased persons Living donor transplants are preferred Kidney transplants from living donors are frequently performed, as the donor can function well with only 1 kidney Some organs cannot be donated from a living donor, e.g. heart, lung

5. Donors Many people give consent for organ donation by signing the back of their driver’s licence (or Medicare card) Family wishes are taken into account before organs are removed for transplantation The decision to take potential organs for donation should not be part of the decision to use life support for an injured/sick person

6. Donors One donor can potentially provide many transplanted organs or tissues Organs/tissues need to be retrieved and transplanted shortly, some organs within a few hours, some within a few days

7. Screening before Transplantation Potential organ recipients need to be screened to increase success of the transplant procedure

8. Tissue Matching Foreign tissue introduced into the body is usually attacked and destroyed by the recipient’s body-a process known as rejection Antigens on the surface of cells will alert the immune system of the presence of foreign tissue

9. Tissue Matching Many antigens have to be tested for in tissue and organ transplantation, with the aim to match the donor’s and recipient’s tissue types as closely as possible Testing is also done to ensure that the recipient does not have antibodies against donor tissue The presence of antibodies would result in immediate rejection of the donor tissue or organ Techniques to “clean” the blood or suppress the antibody reaction can make the transplant more effective if a close match cannot be found

10. Medical Screening of Donor Since some infections and illnesses can be transmitted from donor to recipient, medical screening is necessary for the donor If the donor organ has a cancer within it, no transplantation will take place If the donor had cancer previously within another organ, a transplant can be done if the donor’s cancer would not be likely to reoccur and would not have spread

11. Medical Screening of Donor Viral infections must be screened for as these may be present but not apparent in the donor’s body If the donor has had previous bacterial infections that were adequately treated then he/she can be permitted to donate

12. Medical Screening of Recipient The recipient receives immunosuppressant drugs in high doses at transplant time For this reason, the recipient must not have active cancer or infections if being considered for a transplant Those with poor overall health are not good candidates for transplantation, nor can transplants be done during pregnancy because of the risk of immunosuppressants to the infant A woman who has undergone a previous transplant can become pregnant, although adjustment of the immunosuppressant drugs will be needed

13. Psychosocial Screening of Recipient Receiving an organ transplant demands great input from the recipient in hospital and doctor visits, ongoing medication regimens Patients and families need to understand the commitment required after transplantation

14. Suppression of the Immune System Transplanted tissues can still be rejected even when there is a close tissue match Rejection must be prevented, as the transplanted organ will be destroyed in the process Rejection can be controlled with immunosuppressant drugs

15. Suppression of the Immune System Rejection can occur at any time after the transplant The immunosuppressant drugs control the body’s ability to recognize and destroy the foreign tissue

16. Complications of Immunosuppression Immunosuppression reduces the body’s ability to fight infections of any type, either related to the surgery or other situations The transplanted person is also at risk from unusual infections that they may have otherwise been able to resist Immunosuppressed individuals have shown increased risk of certain cancers Other increased risks include kidney disease, heart disease, osteoporosis, stunted growth in children

17. Complications of Immunosuppression Other side effects of immunosuppressant drugs include allergic reactions, excess facial hairiness, liver damage, high blood pressure, atherosclerosis, osteoporosis, stunted growth