1. Organ Transplantation

2. Transplant History Skin grafts – possibly as early as 2 nd century 1 st confirmed skin graft – 16 th century Tissue transplants – 1800’s - Blood transfusions 1 st successful organ transplant (kidney) in 1954 - Living donor and recipient identical twins

3. Transplant History continued 1 st patient-to-patient skin graft (16 th century) was unsuccessful; led to discovery of rejection 1951 – Cortisone used for anti-rejection; is a compound that suppresses immune system function 1970 – 1 st powerful anti-rejection drug, Cyclosporine, discovered; led to transplantation advancements

4. Transplant Possibilities Organs –Heart –Lungs –Liver –Kidneys –Pancreas –Intestines Tissues –Corneas (eye) –Heart valves –Veins –Skin –Bone –Ligaments –Cartilage –Tendons

5. Organ Transplant Facts 2010 -- 1,022 organ donors led to 2,103 transplant procedures -- an increase of only 5 donors and 29 transplant procedures from 2006. Need for kidneys has doubled in last 20 years; 3,362 waiting for new kidney in 2010 2010 -- there were 200 deceased donors in Ontario, up from 128 in 2001.

6. Organ Transplant Facts cont’d 229: The number of Canadians who died while waiting for an organ in 2010 3.7: years a patient who received a kidney from a deceased donor spent on dialysis. Patients who received a kidney from a living donor waited less than 1.5 years on dialysis. Canadian donor rate: 13/1,000,000 (US: 20/1,000,000; Spain: 31/1,000,000) Source: torontostar.com

7. Source:Living Donors Part or all of an organ donated - eg: lobe of one lung, part of a liver, a kidney - lungs don’t regerate, but have 5 lobes - able to live with 1 kidney - liver has regenerative properties Donor’s lives are minimally affected Donors usually are relatives

8. Living Donors - Benefits and Risks Benefits Recipient living a healthy life Satisfaction of saving a life (donor) Reduced wait time Researchers gaining knowledge Risks Rejection Infection Backup system for duplicate organs lost or reduced Inherent risks of any major surgery (both donor & recipient)

9. Source: Deceased Donors Source of majority of organ donations Organ donor cards Family consent Healthy, undamaged organs matched with potential recipients Factors: blood type, age, geography, need

10. Deceased Donors - Benefits and Risks Benefits Recipient living a healthy life Satisfaction of saving a life (donor/family) Researchers gaining knowledge Risks Rejection Infection Ethics (more later…) Inherent risks of any major surgery (recipient)

11. Source: Xenotransplantation Transplanting parts from one species to another - pig heart valves used to replace faulty/damaged human heart valves - pig skin tissue grafting Tissues are chemically treated so they’re no longer considered living tissue; used as framework for necessary parts No clinical trials are occurring in Canada as of yet

12. Xenotransplants - Benefits and Risks Benefits Recipient living a healthy life No need for human donor ‘Unlimited’ supply Reduced wait time Researchers gaining knowledge Risks Rejection Infection (Xenosis) Inherent risks of any major surgery (donor) Ethics

13. Controversy Deceased donors: when can organs be harvested? Brain death? Cardiac death? Xenotransplants: Not everyone wants an animal part in their body; support killing of animals for a source of tissues and organs; creation of new infectious agents For both: How do you regulate and control all of the various aspects associated with organ donation?

14. Transplant Examples http://www.cbc.ca/news/health/story/2012/03/28/f ace-transplant.htmlhttp://www.cbc.ca/news/health/story/2012/03/28/f ace-transplant.html Helene Campbell - Ottawa woman suffering from idiopathic pulmonary fibrosis - Received double lung transplant April 5 th, 2012 http://www.youtube.com/watch?v=rva7fU_zRys

15. Task On a separate sheet of paper, answer the following: 1)What are some of the reasons why organ donation rates are so low? 2)What reasons could exist to explain the low rates in Canada vs. other countries? 3)If you were of age, would you be an organ donor? Why or why not? 4)What is your position on xenotransplantation? 5)It’s been suggested that everyone should be required to be an organ donor. What are the arguments for and against this suggestion? Where do you stand?