Sunday, June 23, 2013

It's Nice to Share...


Last week, a ten-year-old girl received a lung transplant from an adult donor. What amazed me about this story – aside from the fact that surgeons were able to successfully fit a child with adult lungs - was that her case barely made news. Thus a procedure once relegated to wishful thinking has now become commonplace.

According to the Organ Procurement and Transplantation Network, almost seven thousand transplants were performed in the U.S. between the months of January and March alone. So let’s take a brief stroll down memory lane and recount the history of these amazing procedures.
One of the oldest transplant stories is that legendary tale of Adam and Eve. According to scripture, Adam was gracious enough to donate a rib to procure himself a partner, yet was betrayed when Eve’s propensity for fruit landed them both in hot water. Transplantation was off to a rocky start.

True transplants began with that largest of organs, the skin. Hindu physicians back in the 6th century experimented by grafting the skin of a patient’s arm and using it to reconstruct his nose. Apparently the procedure was in great demand, thanks to the extreme judicial punishment of lopping off the noses of convicted thieves.


The transplant technique was later adopted by the Italians in the 16th century, who would create a flap of skin, leave it attached to the arm until it sprouted the necessary blood vessels, and then use it to create the nose.


It took another four hundred years for doctors to attempt kidney transplants. Unfortunately, they acquired the organs from an array of barnyard donors, namely pigs and goats. Not surprisingly, their patients didn’t survive, although I bet the hospital cafeterias remained well stocked.


In 1912, the French physician Alexis Carrell developed suture techniques he later used in the transplantation of blood vessels and organs. He practiced on dogs, successfully transplanting kidneys from one pooch to another. He also perfected methods of keeping tissues and organs alive outside the body, famously nursing one of his samples along for over thirty years.

It wasn’t until 1954 that a successful kidney transplant was performed on a human. The donor and recipient were identical twin brothers, Ronald and Richard, so rejection was not a issue. But it would take another six years for a British immunologist to receive the Nobel Prize for his discoveries in acquired immune tolerance, which opened the door for the creation of drugs that prevented rejection following transplants.

The 1960s also saw the first liver, pancreas, and lung transplants and, in 1967, the South African surgeon, Christiaan Barnard, made medical history by performing the first successful heart transplant. Unfortunately, the recipient, Louis Washkansky, died of pneumonia eighteen days later, but it was still a good effort.

In the 1980s, Congress passed the National Organ Transplant Act, which addressed ethical issues of transplants (who gets what, when) and also established a national registry for those awaiting organs. Folks at the Organ Procurement and Transplantation Network tell us there are currently over 118,000 anxious people awaiting organs, the majority keeping their fingers crossed for a kidney (over ninety-six thousand). Over three thousand are awaiting hearts, sixteen hundred are awaiting lungs, and forty-five truly desperate individuals are awaiting both. (And we complain about sitting in traffic.)

Today, transplant surgery has surpassed even sci-fi expectations. Facial transplants are becoming more common, providing victims of horrific trauma and devastating malformations the means to more normal lives. And as transplants become more common, the need for donors skyrockets.

This has bred a whole new industry: the illicit organ trade. In April, five people in Kosovo were arrested for running a clinic that procured kidneys from impoverished victims who came from as far away as Turkey to sell their organs. The victims were promised fifteen thousand euro; the recipients, mainly from Israel, were paying up to one hundred thousand euro for the transplants. Desperation lives at both ends of the organ trade spectrum.

In America, the majority of donors are those who die and leave their organs behind, and I am proud to be an official, card-carrying donor. I figure if I’m hit by a train or carried off by a twister, they can salvage whatever is left and harvest some much-needed body parts. Granted, my organs are exposed to frequent doses of gin, but aside from that, they’re in pretty good shape.


Here's an interesting read on the history of organ transplantation. Enjoy!