Heart transplant is a surgical procedure to remove a person’s diseased heart (orthotopic approach) and replace by a healthy heart from an organ donor. Less commonly, heart transplant can be carried out without the removal of diseased heart and a healthy heart will be positioned (heterotopic approach) to encourage the recovery of the diseased heart of the recipient.
Cardiac surgeons will only perform heart transplantation, if only congestive heart failure was diagnosed in the patient. And there are many requirements need to be fulfilled for the transplantation to be carried out successfully. One of the limiting factors of the heart transplantation is the number of organ donors. Approximately 5000 cardiac transplants are performed in the world annually. More 2000 heart transplants are performed in the U.S yearly.
According to Fishbein, MD who specializes in cardiovascular pathology (2007), patients are required to change their lifestyle and take numerous immunosuppressive drugs. All potential recipients must undergo psychological evaluation to become qualified recipients. Most importantly, the immune system of the patient must compatible to the donor’s heart to decrease the risk of getting post-surgical complication.
In the U.S., United Network for Organ Sharing (UNOS) was established to provide services that are related to organ transplantation, including organ allocation, education for the public, policies development and so on.
Besides, the survival rate of heart transplant keeps rising due to the advancement of biomedical technology from time to time. It is believed that heart transplant will bring great improvement to the patients’ lives. They would be able to enjoy the daily activities after the recovery period.
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...g immunosuppressant, recipients are required to take immunosuppressant for most of the cardiac transplant.
4.2 Cardiac xenotransplantation
Cardiac xenotransplantation may improve the current shortage of transplantable hearts. Researchers still carrying research to study the mechanism of anti-Gal antibody and the elimination of α 1,3 galactose (αGal) carbohydrate antigen to reduce the risks of rejection of xeno-donors’ hearts). It is predicted that cardiac xenotransplantation may be an alternative of human heart transplant.
On the other hand, there are some who oppose xenotransplantation based on principle of animal rights and some religious perspectives. Also the potential of recipients getting xenozoonosis still remains unknown. Researchers are trying to find out a solution to overcome antibody mediated rejection before proceed to clinical trial
History was made on December 02, 1982 when Barney Clark became the first recipient of an artificial heart transplant, which was performed by the medical staff at the University of Utah Medical Center. Although Barney Clark was the center of attention, there were many events that led up to this historical moment.
Brendan Maher, in his article “How to Build a Heart” discusses doctor’s and engineer’s research and experimentation into the field of regenerative medicine. Maher talks about several different researchers in this fields. One is Doris Taylor, the director of regenerative medicine at the Texas Heart Institute in Houston. Her job includes harvesting organs such as hearts and lungs and re-engineering them starting with the cells. She attempts to bring the back to life in order to be used for people who are on transplant waiting lists. She hopes to be able to make the number of people waiting for transplants diminish with her research but it is a very difficult process. Maher says that researchers have had some successes when it comes to rebuilding organs but only with simples ones such as a bladder. A heart is much more complicated and requires many more cells to do all the functions it needs to. New organs have to be able to do several things in order for them to be used in humans that are still alive. They need to be sterile, able to grow, able to repair themselves, and work. Taylor has led some of the first successful experiments to build rat hearts and is hopeful of a good outcome with tissue rebuilding and engineering. Scientists have been able to make beating heart cells in a petri dish but the main issue now is developing a scaffold for these cells so that they can form in three dimension. Harold Ott, a surgeon from Massachusetts General Hospital and studied under Taylor, has a method that he developed while training. Detergent is pumped into a glass chamber where a heart is suspended and this detergent strips away everything except a layer of collagen, laminins, and other proteins. The hard part according to Ott is making s...
The major practical issue to be surmounted with any transplant is immunological. For a transplant to be successful the transplanted tissue must not...
“In 1984, a baboon heart was transplanted into a newborn infant, Baby Fae, who had hypoplastic left heart syndrome and lived 20 days after heart surgery” (Bailey LL, Nehlsen-Cannarella SL, Concepcion W, et al. Baboon-to-human cardiac xenotransplantation in a neonate. JAMA. 1985 Dec 20.
They have now invented a “beating heart transplant.” It consists of a mechanical system to keep the heart beating, while it is being transferred to the candidate. Statistics have proven that these candidates have a higher recovery rate, because of the “beating heart.” Throughout reading above, it is a given that organ donation is vital to saving lives, but it is not deemed proper to be made mandatory.
The issues surrounding the Baby Fae case raised some important questions concerning medical ethics. Questions were raised regarding human experimentation (especially experimentation in children), risk/benefit ratio, the quality of informed consent, and surrogate decision-making. Primarily, this case showed that new guidelines were needed to regulate radical procedures that offer little hope and high notoriety and recognition of the physician performing them. Dr. Bailey had been doing extensive research for years on xenografts, or cross-species transplantations, yet none of his animal recipients had survived over 6 months.16 His research was neither governmentally funded nor available for peer-review, and Dr. Bailey was even warned by colleagues that his procedure was not ready for human patients. Previous primate xenografts had been tried with humans, but all had been rapidly rejected.
Organ transplantation is process of surgically transferring a patient with end-stage organ failure with a healthy compliant organ. This can be done when a patient’s organ has ceased working or when the organ does not meet its opportune function. In the article Organ Transplantation: The Process, the author claims that end-stage organ failure can be the product of cardiomyopathy, cirrhosis, chronic obstructive pulmonary disease, coronary heart disease, cystic fibrosis, hepatitis, diabetes, hypertension, idiopathic pulmonary disease, and short gut syndrome.. Multiple organs can be transplanted at one time.
UNOS (United Network for Organ Sharing) is a system of allocation, what it does is arrange organs based on the region that the donations came from before being offered to outside regions. The focus is on the criteria for allocation that may be ethically defensible. It is maintained that organs are a resource of national community, for accidents are of geography and are “morally irrelevant” (DeVita, Aulisio, & May, 2001, p. 1). Many people are he...
The genes being inserted produce human decay accelerating factor (hDAF). This protein is found in human organs, and it prevents the body’s immune system from attacking the organ. Previous xenotransplants or organ donation among different species resulted in what is termed hyperacute rejection. The rejection of the organ occurred within minutes, which is too fast to be prevented by the immune suppressant drugs used in human to human organ transplants.
Organ Transplantation is often the best way of saving human life when a vital organ
However, use of pig xenografts is associated with major immunologic barriers, resulting in Hyper Acute Rejection (HAR) or Acute Vascular Rejection (AVR) when transplanted into a human recipient as humans have naturally occurring antibodies against pig cells. To resolve this issue genetically engineered pigs have been designed to reduce the expression of various immunogenic substances. Further the graft is given a break from attack when ci...
Many ethical and social implications arise with xenotransplantation. For example, if some countries allow xenotransplantation and others don’t, there may be a trend towards “xenotourists” – people who travel to get the surgery. They if these people were to contract a disease it could spread and even cause a pandemic. Their country of origin would feel the negative effects so making the decision not to allow this
heart valves, tendons, ligaments and bones. E. Organs and tissues are distributed according to a national waiting list managed by UNOS which stands for United Network for Organ Sharing.
It is essential to the human body that the heart pump sufficient nutrient rich blood to the body’s cells, because the body won’t be able to function normally otherwise. When a heart muscle is unable to pump enough blood through to meet the body’s regular demand it is characterized as heart failure. Heart failure can usually be treated through conventional heart therapies and symptom management strategies, however conventional therapies don’t work for all patients with heart failure, this is what is depicted as advanced heart failure or end-stage heart failure. In other words “End stage” heart failure is when the condition becomes so severe that all conventional treatments no longer work, the only treatment that works for end stage heart failure is to have a heart transplantation-surgery to remove a person's diseased heart and replace it with a healthy heart from a deceased donor. However there are two large encompassing problems with this treatment. The first problem is that the patient is subject to shortages in donor organ availability and thus possible further decompensation and potential death while awaiting transplantation. According to the American Heart Association, there are over 500,000 new cases of end-stage heart failure in the United States every year. With only 2200 donor hearts available every year nearly 20-30% of the patients who die while they await a transplant. The second problem with this mode of treatment is that not all patients qualify for heart transplantation. Patients who have another disease in addition to end-stage heart failure do not qualify for heart transplantation. The discrepancy between the clinical need for donor hearts and the total number of hearts available, as well as the lack of treatment o...
It is crucial that the affected person applies for a liver transplant. A liver transplant is an operation in which the patient’s damaged liver is replaced with a healthy liver from a donor.¬ There are three main types of liver transplant: orthotopic transplant, the most common type of transplant, where the patient’s liver is replaced by a liver from a deceased donor; living donor transplant, where a living person willingly donates his liver for the patient; and split type of liver transplant: where the liver of a deceased donor is split into the two lobes and given to two recipients, applicable if the patients are an adult and a child (Mandal, n.d.