ORGAN TRANSPLANTATION

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A Concise Presentation

By

Mr. Deepak Sarangi

M.Pharm

CONTENTS

INTRODUCTION HISTORY OF ORGAN TRANSPLANTATION TYPES OF ORGAN TRANSPLANTATION TYPES OF ORGAN DONOR MEDICAL REQUIREMENTS STATUS IN INDIA LUNG TRANSPLANTATION QUALIFYING CONDITIONS CONTRAINDICATIONS TRANSPLANT REQUIREMENTS TYPES OF LUNG TRANSPLANT POST OPERATIVE CARE MISCELLANEOUS INFECTIONS AFTER TRANSPLANTATION CONCLUSION REFERENCES

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INTRODUCTION

Organ transplant is the moving of an organ from one body to another, for the purpose of replacing the recipient’s damaged or failing organ with a working one from the donor site. Organ donors can be living or deceased.

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HISTORY OF ORGAN TRANSPLANTATION

The first human organ transplant was a kidney transplant performed in 1954. The recipient of the first heart transplant, performed in 1967 by Dr. Christiaan Barnard, lived only 18 days.

The recipient lived for eight years following the transplant and the surgeon who performed the transplant, Dr. Joseph Murray, went on to win the Nobel Prize for this work.

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TYPES OF ORGAN DONOR

Persons after death.

Living persons to related patients.

Living persons to unrelated patients.

Brain death persons (cadaver transplant).

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MEDICAL REQUIREMENTS

People of all ages.

Any healthy willing persons.

Only one exception is that HIV and active cancer patients cannot donate.

Donor blood group should match with recipient blood group.

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STATUS IN INDIA

o In India around 6,000 people die every day waiting for organ transplant.

o Every 17 minutes someone waiting for transplant.

o Every 30 minutes someone added to a waiting list.

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LUNG TRANSPLANTATION

Lung transplantation or pulmonary transplantation is a Surgical procedure in which a patient’s diseased lungs are partially or totally replaced by lungs which come from a donor.

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HISTORYJames Hardy of the University of Mississippi performed

the first human lung transplant on June 11, 1963. From 1963 to 1978, multiple attempts at lung transplant

failed because of rejection and problems with anastomotic bronchial healing .

The first successful transplant surgery involving the lungs was a heart-lung transplant, performed by Dr.Bruce Reitz of stanford University in 1981 on a woman who had idiopathic pulmonary hypertension.

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QUALIFYING CONDITIONS A variety of conditions may make such surgery necessary. As

of 2005, the most common reasons for Lung transplantation in

the United states were.27% Chronic Obstructive Pulmonary Disease(COPD).16% Idiopathic Pulmonary Fibrosis.14% Cystic Fibrosis.12% Idiopathic pulmonary hypertension.5% Alpha 1-antitrypsin Deficiency.2% Replacing previously transplanted lungs that have since

failed. 24% Other causes, including Bronchiectasis.

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CONTRAINDICATIONSDespite the severity of a patient’s respiratory condition,

certain pre-existing conditions may make a person

a poor candidate for lung transplantation. Concurrent chronic illness. Current infections, including HIV and hepatitis. Current or recent cancer. Current use of alcohol, tobacco or illegal drugs. Age. Psychiatric conditions. History of noncompliance with medical instructions.

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TRANSPLANT REQUIREMENTSRequirements for potential donor• Healthy• Size match• Age• Blood type

Requirements for potential recipient• End-stage lung disease.• No other chronic medical condition.• Acceptable psychological profile.• Financially able to pay for expenses.

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Cont…….Medical tests for potential transplant candidatesBlood typingTissue typingChest X-ray-PA and LATPulmonary function testsCT scanBone mineral density scan Gated cardiac blood pool scanCardiac stress test Electrocardiogram

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TYPES OF LUNG TRANSPLANT

1. Lobe

2. Single-lung

3. Double-lung

4. Heart-lung

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PROCEDUREWhile the surgical details will depend on the type of Transplant,

many steps are common to all these procedures. Before operating

on the recipient, the transplant surgeon inspects the lung(s) for

signs of damage or disease.

If the lung or lungs are approved, then the recipient is connected

to an IV line and various monitoring equipment, including pulse

oximetry. The patient will be given general anesthesia, and a

machine will breathe for him or her. A history of prior chest

surgery may complicate the procedure and require additional

time. 16

POST OPERATIVE CAREAfter the surgery immediately following care should be

give to the patient:The patient is placed in an intensive care unit for

monitoring normally for a period of a few days.The patient is put on a ventilator to assist breathing.Nutritional needs are generally met via total parenteral

nutrition and by nasogastric tube is sufficient for feeding.Chest tubes are put in so that excess fluids may be

removed.Because the patient is confined to bed, a urinary catheter

is used.

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MISCELLANEOUS

Post-transplant patients are held from driving for the first three months pending an assessment of the patients capacity to drive .

Lack of a strong immune system leaves transplant recipients vulnerable to infections.

Care must be taken into food preparation and hygiene as gastroenteritis becomes more of a risk.

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INFECTIONS AFTER LUNG TRANSPLANTATION

Common symptoms of infection include:Fever, chills, sweats.Sore throat.Productive cough.Increased fatigue.Swelling, pain or redness around incision or drains.New drainage from the incisions.Headache.Shortness of breath.

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HOW TO PROTECT YOURSELF FROM INFECTIONS AFTER LUNG TRANSPLANT

Preventing infection is mostly common sense. Protect yourself

by following these simple guidelines: Wash your hands with soap and water often to remove bacteria

and viruses.When you cough or sneeze, use tissues, dispose of them

immediately, and wash your hands. If someone you know has a cold or the flu, avoid close contact. Avoid stagnant water because it too harbors bacteria.

Wear a respiratory mask in crowded public areas and hospitals.

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CONCLUSIONIn recent years, the science of organ transplantation has

gotten better. Unfortunately, there are not enough organ donations for everyone who is in need.

Organ donors are needed to save thousands of lives every year. agreeing to donate organs does not affect the quality of care a person receives. Transplantation processes start only after the donor is no longer living.

The decision to donate organs is yours. If you decide become an organ donor, put it in your advance health directives and make sure your family and health care agent know about your decision.  

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