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Transplantology is one of the youngest and, as surgeons themselves often say, the most difficult field of modern medicine. Although we have made great strides in it over several decades, it is still waiting for its pioneers. Transplantology has been covered with many myths at the same time, while reliable knowledge is the best cure for fear.
Doctors estimate that one donor can save up to six people’s lives, and another four can significantly extend them. The most commonly transplanted organs are: lungs, skin, intestines, kidneys, liver, artery, pancreas, bone marrow, cornea, and heart.
Classification of transplants
The most common type of organ transplantation is currently allogeneic. It involves the transfer of a tissue or an organ between people with a similar genotype. Autogenous operations involve the transplantation of one’s own tissue, changing its position. It is used, for example, when there is a need for skin grafting after extensive burns. In turn, isogenic transplants are extremely rare, which we are talking about in the case of organs from genetically identical persons (identical twins). The last type is xenotransplantation, which exchanges organs between individuals of different species. Prof. In this way, Zbigniew Religa tried to replace the human heart with the heart of a pig.
Difficult beginnings
Despite the fact that the first successful organ transplant operations are in the second half of the 2th century. Twentieth century, this issue was already worked on in antiquity. According to Chinese chronicles, Asia’s first surgeon, Bian Que, attempted to perform a heart transplant around the XNUMXrd century BC between a man of “strong soul but weak will” and a man “of weak soul but strong will.”
The operation that St. Damian and Kosma on deacon Justinian who requires help. It involved the amputation of a leg affected by gangrene or advanced cancer and the transplantation of a body part taken from a recently deceased Ethiopian in its place.
However, we can talk about successful and documented transplants only from the end of the 60th century, when the Italian surgeon Gasparo Tagliacozzi performed a small allogeneic skin transplant and tried to define the causes of relapses of larger transplants. Only in the 70s and XNUMXs of the last century, with the rapid development of medicine, transplantology became a field of science that was truly life-saving.
Records – two hearts are better than one
The longest-lived person with an organ transplant is John McCafferty, 73, who underwent a heart transplant on October 20, 1982 at Harefield Hospital in Middlesex. It’s been 33 years since the transplant, although doctors estimated the patient would live no more than five.
The previous record belongs to the 51-year-old American, Tony Huesman, who also lived with a heart transplant for nearly 31 years. He died in 2009.
In our country the record holder is 89-year-old Tadeusz Żytkiewicz. In 1986, prof. Zbigniew Religa made the decision to transplant, despite the fact that the patient was already 61 years old and the procedure seemed to have little chance of success. “And you are that madman with a scalpel” – it is said that after similar operations he turned to prof. Religa, the SB officer supervising him. Interestingly, the patient later underwent a kidney transplant and cataract surgery.
Transplant religions. For or against?
The position of most monotheistic religions is overwhelmingly favorable to the idea and practice of transplantation. In the teaching of the Catholic Church, this gesture is a sign of solidarity with a neighbor in need. John Paul II in 2000 in Rome left no doubts about this fact, saying: “Transplantation is a big step forward in the service of science for man and nowadays many people owe their lives to a transplanted organ. Moreover, the transplant technique has proved to be a significant means of achieving the main goal of all medicine – serving human life. “
This issue, however, is no longer so simply defined in Islam. Sunni believers say that while you can accept organs from followers of other religions, it is no longer acceptable to do so in the case of people sentenced to death. Shiites, who are more stringent, only allow organ donation from deceased Muslims if it saves the life of another follower of Allah.
In Judaism, despite the many contradictory positions of individual rabbis who question the integrity of the body after the resurrection, the prevailing opinion is that saving human life is a priority activity. Jehovah’s Witnesses feel similarly, but they do not agree to blood transfusions during surgery. Buddhism, in turn, calls transplantation an act of heroism and supports organ donation to save another person’s life.
Transplantation like dominoes
Currently, the so-called chain grafts. The procedure is that a minimum of three people who do not know each other offer their kidneys to three people who need them in exchange for a genetically compatible organ from another donor that can be transplanted to a loved one. It is a hope especially for patients who cannot receive a transplant from a loved one due to immunological problems, a different blood group, etc.
In February 2012, the United States closed the “last link” of the chain of 60 people (30 donors and 30 recipients), resulting in 30 successful kidney transplants. The series of operations lasted as long as four months. In Poland, the first transplant of this type took place in June 2015. For over 12 hours, as many as six operations were performed, as a result of which three healthy kidneys were removed and successfully implanted.
Transplants in Poland
According to alarming statistics, a patient in Poland who waits for an organ transplant dies every five days. The average waiting time for the heart is 2 to 3 years, the kidneys – 11 months, and the liver – 6 months. From the beginning of Polish transplantation in 1966 to 2012, 24 were performed. transplants, including most of the kidneys (18,6 thousand), liver (2,8 thousand), hearts (2 thousand), pancreas (365) and lungs (77). To meet the transplant needs, however, more than twice as many operations would have to be performed (2 kidneys, 600 livers and 220 hearts each year).
Research conducted in October 2015 shows that 55 percent. Poles consciously consent to the posthumous organ donation, unfortunately only 20 percent. of them talked about it with their relatives. Although the law allows for organ donation if the donor has not objected while the donor was alive, families often do not consent, and as a result of a written declaration by two people confirming that the patient did not consent to the transplant while alive, the operation cannot be performed . It is therefore all the more important to clearly communicate your will and carry a declaration with you that confirms your readiness to be a donor.
Milestones of transplantology
World:
- 1954 – first kidney transplant (isogenic transplant) (USA)
- 1966 – the first simultaneous kidney and pancreas transplant (USA)
- 1967 – first liver transplant (USA)
- 1967 – first heart transplant (South Africa)
- 1981 – the first simultaneous heart and lung transplant (USA)
- 1998 – first forearm transplant (France)
- 2005 – first cadaver facial transplant (France)
- 2010 – first successful full face transplant (Spain)
Poland:
- 1966 – the first kidney transplant from a deceased donor (Warsaw)
- 1968 – the first kidney transplant from a living donor (Wrocław)
- 1969 – the first unsuccessful heart transplant attempt (Łódź)
- 1985 – first heart transplant (Zabrze)
- 1994 – first liver transplant (Warsaw)
- 2001 – the first lung and heart transplant (Zabrze)
- 2006 – first hand transplant (Trzebnica)
- 2013 – first complete face transplant (Gliwice)
- 2015 – the world’s first complex neck organ transplant (Gliwice)