By- Ritanshi Jain
Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of recipient to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissue that are transplanted within the same person’s body are called auto grafts.Organs that have been successfully transplanted include the heart, kidney, liver, lungs etc. some organs like the brain and tissues like bones, skin and nerves etc cannot be transplanted. Organ donors may be living, brain dead or dead via circulatory death.
INDIAN LAWS ON ORGAN TRANSPLANTATION
According to Transplantation of Human Organs Act 1994,
Aim: ● Regulating removal, storage and transplantation of human organs for therapeutic purposes ● Accepting brain death and making it possible to use these patients as potential organ donors. ● Prevent commercial dealings of organs. The transplantation of human organs (amendment) bill 2009, ● The bill passed in 2009 made certain changes and alterations in the previous laws.
● The act permitted donations from living persons who are near relatives. ● The doctor had to inform the Patient or his relatives about the possibility about organ donation and made sure that they given their consent to it. ● The bill made an increase in the penalty for illegal removal of human organs and for receiving or making payment for a human organ. DURATION OF LIVING AGE AFTER TRANSPLANTATION A kidney transplant does not last forever. The average life-span of a transplanted kidney is twelve years for a deceased donor kidney, and about 15 years for a living related transplant. Percent of organ transplant are rejected
If organ function drops, doctors cut a tiny sample from the transplanted tissue to check for rejection, and then adjust patients' immune-suppressing drugs accordingly. About 25 percent of kidney recipients and 40 percent of heart recipients experience an episode of acute rejection in the first year after transplant. Prevention Medications after an organ transplant, you will need to take immunosuppressant (anti-rejection) drugs. These drugs help prevent your immune system from attacking ("rejecting") the donor organ. Typically, they must be taken for the lifetime of your transplanted organ. Immunosuppressant drugs Immunosuppressant drugs are a class of drugs that suppress, or reduce, the strength of the body's immune system. Some of these drugs are used to make the body less likely to reject a transplanted organ, such as a liver, heart, or kidney. These drugs are called anti-rejection drugs First organ transplant in 1950 This Day In Science June 17, 1950 – First successful kidney transplant operation was performed. On June 17th 1950 Dr. Richard Lawler performed the first successful kidney transplant. The recipient was Ruth Tucker, a 44-year-old woman who had polycystic kidney disease (PKD). TYPES OF TRANSPLANT
● Autograft ● Allograft and allotranspalntation ● Xenograft and xenotranspalntation ● Domino transplant ● ABO- incompatible transplant ● Transpalntion in obese individuals TYPES OF DONOR ● Living donor ● Diseased donor
SOCIETY AND CULTURE Comparative costs
One of the driving forces for illegal organ trafficking and for "transplantation tourism" is the price differences for organs and transplant surgeries in different areas of the world. According to the New England Journal of Medicine, a human kidney can be purchased in Manila for $1000–$2000, but in urban Latin America a kidney may cost more than $10,000. Kidneys in South Africa have sold for as high as $20,000. Price disparities based on donor race are a driving force of attractive organ sales in South Africa, as well as in other parts of the world. In India, a kidney transplant operation runs for around as low as $5000.
Safety
In the United States of America, tissue transplants are regulated by the U.S. Food and Drug Administration (FDA) which sets strict regulations on the safety of the transplants, primarily aimed at the prevention of the spread of communicable disease. Regulations include criteria for donor screening and testing as well as strict regulations on the processing and distribution of tissue grafts. Organ transplants are not regulated by the FDA.
Currently, the screens cannot pick up on the small number of antibodies produced in HIV infections within the last 90 days or Hepatitis C infections within the last 18–21 days before a donation is made. NAT (nucleic acid testing) is now being done by many organ procurement organizations and is able to detect HIV and Hepatitis C directly within seven to ten days of exposure to the virus. Transplant laws Both developing and developed countries have forged various policies to try to increase the safety and availability of organ transplants to their citizens. Austria, Brazil, France, Italy, Poland and Spain have ruled all adults potential donors with the "opting out" policy, unless they attain cards specifying not to be. However, whilst potential recipients in developing countries may mirror their more developed counterparts in desperation, potential donors in developing countries do not. The Indian government has had difficulty tracking the flourishing organ black market in their country, but in recent times it has amended its organ transplant law to make punishment more stringent for commercial dealings in organs. It has also included new clauses in the law to support deceased organ donation, such as making it mandatory to request for organ donation in case of brain death. Other countries victimized by illegal organ trade have also implemented legislative reactions. Ethical concerns The existence and distribution of organ transplantation procedures in developing countries, while almost always beneficial to those receiving them, raise many ethical concerns. Both the source and method of obtaining the organ to transplant are major ethical issues to consider, as well as the notion of distributive justice. The World Health Organization argues that transplantations promote health, but the notion of "transplantation tourism" has the potential to violate human rights or exploit the poor, to have unintended health consequences, and to provide unequal access to services, all of which ultimately may cause harm. Regardless of the "gift of life", in the context of developing countries, this might be coercive.
The practice of coercion could be considered exploitative of the poor population, violating basic human rights according to Articles 3 and 4 of the Universal Declaration of Human Rights. There is also a powerful opposing view, that trade in organs, if properly and effectively regulated to ensure that the seller is fully informed of all the consequences of donation, is a mutually beneficial transaction between two consenting adults, and that prohibiting it would itself be a violation of Articles 3 and 29 of the Universal Declaration of Human Rights. Artificial organ transplantation Surgeons, notably Paolo Macchiarini, in Sweden performed the first implantation of a synthetic trachea in July 2011, for a 36-year-old patient who was suffering from cancer Left-Ventricular Assist Devices (LVADs) as often used as a "bridge" to provide additional time while a patient waits for a transplant. For example, former U.S. vice-president Dick Cheney had a LVAD implanted in 2010 and then twenty months later received a heart transplant in 2012. In year 2012, about 3,000 ventricular assist devices were inserted in the United States, as compared to approximately 2,500 heart transplants.
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