Transplant Surgery | Organ Transplantation

Organ transplantation is the moving of an organ from one body to another, or from a donor site on the patient’s own body, for the purpose of replacing the recipient’s damaged or absent organ. The emerging field of Regenerative medicine is allowing scientists and engineers to create organs to be re‐grown from the patient s own cells (stem cells, or cells extracted from the failing organs).

Types of Transplant Surgery

1) Autograft is a Transplant of tissue to the same person.

2) Allograft is a transplant of an organ or tissue between two genetically non‐identical members of the same species.

3) Isograft ‐ A subset of allografts in which organs or tissues are transplanted from a donor to a genetically identical recipient (such as an identical twin).

4) Xenograft and xenotransplantation is a transplant of organs or tissue from one species to another. An example are porcine heart valve transplants, which are quite common and successful.

5) Orthotopic graft is a graft placed in its normal anatomical site.

5) Heterotopic graft is  graft placed in a site different from that where the organ is normally located.

Organs and Tissues for Transplant Surgery

Thoracic Organs

1) Heart (Deceased‐donor only)

2) Lung (Deceased‐donor and Living‐Donor)

3) Heart/Lung (Deceased‐donor)

Abdominal organs

1) Kidney (Deceased‐donor and Living‐Donor)

2) Liver (Deceased‐donor and Living‐Donor)

3) Pancreas (Deceased‐donor only)

4) Intestine (Deceased‐donor and Living‐Donor)

5) Stomach (Deceased‐donor only)

6) Testis

Tissues, Cells, Fluids

1) Cornea (Deceased‐donor only)

2) Skin

3) Islets of Langerhans (Deceased‐donor and Living‐Donor)

4) Bone marrow/Adult stem cell (Living‐Donor and Autograft)

5) Blood transfusion/Blood Parts Transfusion (Living‐Donor and Autograft)

6) Blood vessels (Autograft)

7) Heart valve (Deceased‐Donor, Living‐Donor and Xenograft)

8) Bone

Organs to be donated should be free from primary disease

  • Kidney: There should be no evidence of primary renal disease with good urine output and normal serum urea and creatinine level
  • Liver: There should be no hepatic disease
  • Heart: There should be no H/O heart disease with normal ECG
  • Pancreas – There should be no history of DM

Organ procurement

After dissection of the organs to be procured, they are perfused insitu. Heart is perfused with cold cardioplegia solution. Abdominal organs are perfused with chilled organ preservation solution via an aortic and portal canula. This procedure causes rapid cooling of the organ, decrease metabolic activity and preserves their viability.

Time for preserving the organ by transplantation are-

Resumption of function following organ transplantation

Heart, lung and liver resume satisfactory function immediately after transplantation. If not, rapid retransplantation is to be done. After kidney, pancreas or small bowel transplantation, immediate graft function is desirable but not vital.

Contraindication of Transplant Surgery

1) Presence of HIV infection

2) Hepatitis B infection

3) Active systemic sepsis – e.g. Major abdominal infection

4) Presence of malignancy within last 5 year, except

-Low-grade primary tumor of CNS

-Non –melanotic tumor of skin

-Carcinoma in situ of uterine cervix

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