Advances in Transplantation
Recent medical advances have increased the opportunities for successful organ transplantations. Advancements in organ transplantation include:
Laparoscopic surgery, used to remove a kidney from a live donor, is less invasive than previously used methods. First, surgeons make a five-millimeter incision in the lower abdomen. In contrast, the traditional approach to removing a kidney requires a 12- to 15-inch incision extending from the donor's mid-back to the mid-abdomen. Due to the less invasive method of removing the organ, recovery time from the surgery for the live donor is decreased from five to six days to two to three days. Also, the living donor experiences less pain. Other benefits of laparoscopic surgery include: increased patient and graft survival rates, decreased amount of time the kidney is in cold solution before it is transplanted to the recipient, the ability to plan surgeries when the recipient is in optimal health, and decreased waiting time for the recipient to receive the organ. (Vernon, Ben, M.D., and Warren Kortz, M.D. Portfolio Newsletter, March/April 2000.)
Due to recent medical advances, living donors may give a single kidney, a lobe of a lung or part of a liver or pancreas. The kidneys and liver are the most typical organs transplanted using live donors. In 2000, the number of living donors rose by 16 percent. In 2001, for the first time, living donors outnumbered non-living donors. Living donors now account for slightly more than half of all organ donors. Currently, University of Wisconsin Hospital and Clinics performs live kidney and liver transplants.
In the last 20 years, advances in immunosuppressants have improved the living conditions for organ recipients. Immunosuppressants are a class of drugs that help prevent the body's immune system from rejecting transplanted organ. Significant advances allow different drugs to target specific parts of the immune response. This allows better prevention of rejection with fewer side effects. These drugs permit even a less than ideally matched transplanted organ to perform nearly as well as an exactly matched organ. Common immunosuppressants include mycophenolate, cyclosporin, tacrolimus, sirolomus, prednisone and thymoglobulin.
Xenotransplantation is the process of transplanting animal tissue and organs into humans. Researchers have made significant advances in this field. Before xenotransplantation can become a reality, research must be done to address the immune response and ensure that diseases common to animals cannot be transferred to humans who receive the animal organs. Also, ethical concerns exist, and people's perceptions of transplanting animal organs into humans will need to be addressed.
Artificial organs are being developed to help manage the shortage of organs. The artificial organs currently in development include bio-mechanical organs that perform the functions of the kidney, lung, liver, pancreas and heart. Many researchers in the transplantation community see artificial organs as a temporary aid until a suitable organ from a living or non-living donor can be transplanted.