The term organ transplantation refers to the replacement of a body organ of a person with that of another person. Such transplantation becomes necessary when any critical organ of a person becomes damaged or non functional due to some disease or accidents. Organ transplant is done by surgically removing the damaged organ and reconnecting the new organ. The person who lends the organ is called donor and the person who receives the transplant is called recipient. Kidneys are the most commonly transplanted organs in the world. Other human organs suitable for transplant are liver, heart, lungs, pancreas, intestine, thymus and skin. Tissues such as bones, tendons, cornea, heart valves and so on are also grafted.(Source- About.com and Wikipedia)
While organ transplant is a key life saving process in many cases, availability of organs for transplant in adequate numbers is a problem in most countries. Needy donors are generally able to get kidneys, mostly from their own relatives. Getting kidneys is easier because each human body normally has two kidneys and a person can survive on one. Other organs are usually available from persons who turn brain dead or die in accidents. At least in respect of one organ, namely, cornea, public awareness has been created in many countries to encourage eye donation. People pledge their eyes to eye banks, who arrange for timely removal of corneas when the person dies. Eye banks also arrange for proper ‘banking’ of corneas for supply to needy persons registered with them.( Source- Straits Times)
Apart from the issue of organ availability, transplants also face the problem of rejection by the recipients’ auto immune system. While medical bodies and government agencies are tackling these issues, it is found that the number of patients seeking transplants has been going up. Sedentary lifestyle, junk food, pollution, smoking, alcohol, stressful occupations and other such causes are leading to more organ fatigue and failures. Sometimes organ damage and failures are caused by accidents. Improvement in economic conditions, better affluence levels, improved medical facilities and availability of medical insurance covers have also together raised the demand for organ transplants.
Organ transplants involve complicated medical procedures. Doctors have mastered the procedures. Life support systems are also much better now and can support transplant patients much more effectively. However, transplants often run into difficulties due to rejection by the recipients’ immune system. To minimise risks, doctors carefully assess donor recipient match before organ transplants. Still the immune system often launches attacks on the ‘foreign’ organ. Doctors use immuno-suppressant drugs to manage the issue of acceptability, but that can lead to side effects and susceptibility to other diseases. Most of the recipients lead a near normal life after successful transplants, but in many cases immune suppression drugs cause other problems like diabetes, high cholesterol levels, high blood pressure, gout, etc. Gastro intestinal disorders, anxiety and depression are also quite common. If not managed adequately, these irritants can create other problems that can be life threatening. Post transplant medicines and psycho therapy help in keeping the recipients alive.
Progress made by medical sciences has reduced transplant mortality. However, all organ transplant recipients cannot survive. Two major problems continue to be non availability of suitable donors and organ rejection by the recipients’ immune system. Scientists are researching with stem cell technology to re-grow organs using the patient’s own cells extracted from the failing organ. Advances in regenerative medicine can potentially solve both the problems.
Organ transplant involves dealing with ‘live’ organs obtained from living people or from cadavers. In the former case, the main issue is whether commercial organ donations should be allowed. If it is not allowed, patients have do depend on their relatives only. And if it is allowed, some unethical people could force donors in poor countries to ‘donate’ kidneys. There could be rackets involving doctors and touts who could cheat innocent, uneducated and poor persons in developing countries into parting with their kidney. There have been reports of patients from rich countries travelling to poorer countries to receive transplants. Likewise, sale of organs from one country to another, could even lead to killing of human beings for the sake of extracting their organs like heart or kidney.
It is generally accepted that organs from brain dead people could be used for transplants, but who should decide is difficult to say. Relatives of the dead or dying persons may not like in many cases to allow such extraction of organs. It is difficult to decide whether the state should have the authority to enact laws to make extraction mandatory. On the other hand, if it is left to the patients’ relatives, supply of organs would remain restricted. What is brain dead also needs to be clearly defined so that people who can revive are not ‘killed’.
There are issues around the priority or order in which patients should receive transplants. Should it be left to pure market pricing? In that case, all alcoholics and chain smokers with fat wallets would buy organs, whereas young, meritorious people with medical conditions but little money would end up dying. The state has to therefore enact proper laws to govern organ donations and transplants with clear rules. As regards donation programmes, it may be better to have ‘opt-in’ provisions so that people are able take conscious decisions. It may limit the supply of organs to some extent, but may not result in a situation where people are forced to donate organs just because they forgot to ‘opt-out’. But ‘opt-out’ can work in a small, developed and honest country like Singapore.( Source- Hota)
AOK (Area of Knowledge)
This topic relates to Health and Social Education. This area of interaction handles key facets of development enabling complete and healthy lives. It covers physical, social, emotional health and intelligence.
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Act, expanding the, Mr Khaw said that each year the organs of more than 20 people who die from non-accidental causes, and such as uncontrollable bleeding in the brain. "Singapore Human Organ Transplants Act (HOTA) ." 100-Acres of Singapore Medicine from an ex-NUS Medical Student (aka Winnie the Pooh). N.p., n.d. Web. 11 Apr. 2010. <http://www.geraldtan.com/medaffairs/hota.html>.