"The measure of life is not its duration but its donation."
- Peter Marshall
Organ donation and transplantation is a fascinating medical field. Organ donation is the procedure of physically taking an organ or tissue from one person (the organ donor) and implanting it into another person whose organ has failed (the recipient). Organ failure could occur due to the recipient’s organ having been damaged by disease or injury, and one of its treatments, organ donation, has been a momentous advancement in the medical field. However, unfortunately, the demand for organ donors outnumbers the number of people willing to donate and while waiting for an organ transplant, 21 people in the United States die every day, and more than 107,380 men, women, and children are waiting for life-saving organ transplants.
Ruth Tucker became the first ever person to have a transplant surgery performed on. On 17 June 1950, in Southwest Chicago’s Little Company of Mary Hospital, Dr. Richard Lawler, Dr. James West and Dr. Raymond Murphy performed the first successful kidney transplant on 49-year-old Ruth Tucker. Tucker was diagnosed with Polycystic kidney disease(PKD), which damaged both her kidneys. One barely functioned, at only 10%, while the other no longer functioned. Tucker lost both her sister and her mother to PKD as dialysis was not a widely available option back then. In the 1940s and 50s, tissue typing was unavailable, hence organ selection was based on criteria including gender, blood type, age and physical size. Within a span of 5 weeks, a suitable donor was found for Tucker. Her doctor, Dr. Lawler, had performed a few experimental organ transplants on dogs and used the knowledge he gained from this experience to perform Tucker’s transplant surgery. The procedure took around 45 minutes, and was successfully completed by Dr. Lawler and 40 other physicians. After 30 days, Tucker was released from the hospital, however, because immunosuppressive agents and tissue typing did not exist at the time, the kidney was rejected by Tucker’s body and was removed after 10 months. Nevertheless, because the transplanted kidney functioned before having to be removed, it helped restore function in Ruth’s remaining kidney and allowed her to live another 5 years.
A remarkable story associated with organ transplantation is that of Charles Wood, who had about 24 transplant surgeries. A 22-year-old pilot named Charles Wood taxied down a runway in Kurmitola, India, on 23 December 1944 when, on takeoff, the plane exploded. Barely surviving, Woods suffered from severe burns and injuries in over 70 percent of his body. The fire destroyed his face, his nose, eyelids and ears. Woods’s indomitable will was remarkable as nobody lived with such severe burns. Six weeks after his accident, he received treatment at a military hospital in Pennsylvania. Still clinging to his life, Woods desperately needed new skin, and therefore the doctors resorted to taking skin from a deceased soldier and draping Woods with it. Under normal circumstances, this “foreign skin” would be rejected by his body rapidly, within a matter of just 10 days, leaving no time for his skin to grow back. However, possibly due to his debilitated condition, his immune reaction was weak. The “foreign skin” survived for over a month, buying Woods only enough time to save lots of his life. Over the next two years, he was operated on 24 times to build him a new face with a new nose, eyelids and ears. After the success of the transplant, Woods walked out into the open, raised a family and built successful businesses.
Another touching organ transplant story is that of the UK's youngest donor, a five-week-old baby who saved a woman's life (Samira Kauser) from kidney failure. Miss Kauser had suffered more than 90 percent kidney failure caused by a genetic condition that caused cysts to damage her kidneys beyond repair. She spent the majority of her day doing dialysis in desperate hope to cling on to her life. After the unnamed baby, sadly, died of heart failure, its small organs were transplanted to Kauser. 'Words cannot explain the gratitude I feel to the parents of this kid,' Miss Kauser said. Lead surgeon Dr. Niaz Ahmad carried out the 7 hour operation at Leeds St. James university hospital, and after six months of careful monitoring, the transplant surgery was declared a success. Such a surgery is possible because after 37 weeks in the womb, the kidneys of the fetus are fully functional and can be transplanted to an adult. The kidneys functioned well and grew to 7cm from 4cm, with the potential to reach 75 percent of adult size.
The difficulty of choosing a donor for an organ transplant is a problem in many countries. There are over 121,678 people waiting for the person whose organs might save their life. Determining whether one can be a donor is done through tests regarding blood types, crossmatch and HLA testing. The blood test is the first step in the process of donation and determines the compatibility. There are four blood types and the chart below demonstrates which blood types can donate to which.
If your blood type is: | You can donate to these blood types: |
TYPE O | TYPE O, A, B, AB |
TYPE A | TYPE A, AB |
TYPE B | TYPE B, AB |
TYPE AB | TYPE AB |
HLA Typing
HLA typing, also known as “tissue typing”, stands for ‘human leukocyte antigen typing’. Antigens are surface proteins on cells of living organisms. Out of the 100 different antigens that have been identified, six have been shown to play a crucial role in organ transplantation. Out of the 6, we inherit three from each parent. A person can produce an immune response against another person’s HLA antigens and make antibodies. This can result from blood transfusions, pregnancy, infections or even a viral illness. If a recipient has strong antibodies against a donor’s HLA, the risk of rejection is high and a donor would be declined for that recipient.
The field of organ transplantation has surely come a long way, and is ridden with many miraculous stories of life-saving surgeries. Today, the first ever pig heart transplant has also been carried out, and we can hope that the upcoming innovations in this field make organ transplants more accessible and easier than ever before.
Written by Bhavna Gopalan
References:
"Early Organ Donation". Lifesource, 2022, https://www.life-source.org/latest/early-organ-transplant/.
"Organ Donation And Transplantation: How It Works". Cleveland Clinic, 2022, https://my.clevelandclinic.org/health/articles/11750-organ-donation-and-transplantation.
Themes, U. (2017). The History of Medicine, Clinical Trials, Gene Therapy, and Xenotransplantation, 2022, https://basicmedicalkey.com/the-history-of-medicine-clinical-trials-gene-therapy-and-xenotransplantation/
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