transplantologist

A transplantologist is a practicing surgeon whose main task is transplantation of organs and tissues. The person who receives a new internal organ or tissue is called a recipient. And the one who donated a part of himself goes under the medical term – a donor.

In addition to direct operations, such a doctor deals with the creation of artificial organs. The first steps in this area were articular-type prostheses, which now do not surprise anyone. Also, an unusual surgeon is studying autotransplantation. This science is based on taking anatomical material from the patient himself with its subsequent transplantation into the affected area. Most often this applies to cases of skin grafting with extensive burns. But today, some experts even suggest pumping out the patient’s own fat from the patient’s body in order to transport it to the buttocks or chest. This is how plastic surgery became related to classical transplantology.

A huge problem of our time is the so-called black transplantology. They illegally collect donor material, and this does not always happen voluntarily on the part of the “donor” of the organ itself. Society is still fighting these illegal organizations that are growing so fast.

Professional Responsibilities

Many students of medical universities in the work of a transplantologist are attracted solely by the salary. But experts agree that the dangers and increased responsibility inherent in this specialty outweigh any monetary compensation.

At the same time, the doctor must be well versed in physiology and anatomy, be collected and always concentrated. He will also have to study throughout his career, as the methods of treatment and diagnosis do not stand still.

The chief specialist of the department should also develop a preparatory plan for surgical intervention. Since the operation usually lasts more than ten hours, the effectiveness of the measures will depend entirely on the correctly prioritized and sequence of the operational process.

Even at the preparatory stage, he does not abandon the patient. You can ask the curator a question about your own concerns, as well as be interested in how the search for suitable donors is going. It is far from always that those who are able to share an organ are relatives.

Many do not have them, while others simply do not have relatives due to medical contraindications. But due to the fact that in some countries donation is allowed only between relatives, patients are faced with the inability to receive quality treatment within their own country.

Today, almost every professional congress on this part ends with a debate in favor or against the fact that in countries closed to donation, they finally introduce permission for operations not between relatives. But a business built on the delivery of internal organs illegally spoils all the arguments “For”.

Because of this, the conference often fails to produce productive results, and people continue to die with no chance of successful therapy.

Since such operations are still rarely performed against the background of other types of surgical intervention, a consultation is collected for each individual patient. Such a congress of local specialists makes it possible to decide whether the extreme measure really justifies itself, and whether the donor and the recipient will be able to endure all the difficulties. Situations with minors and incompetent people are considered separately.

From the side of someone who is ready to donate an organ, a written confirmation of intentions is always required. And this applies even to situations where those who want to donate their organs to those in need want to do it after death. He just needs to pass a specific examination with a clinical examination, so that his ability to become useful after death is confirmed.

As soon as the main case comes to an end, the doctor has a new responsibility. He will have to determine the range of rehabilitation measures. He also has a dispensary record. The list here includes all people who received a transplant, regardless of the statute of limitations for the intervention.

In addition to the narrow category of transplantology called autotransplantation, there are many other specialized areas. Among them are:

• growing organs;
• xenotransplantation;
• isotransplantation.

The last option involves the use of material only between identical twins.

The most unfinished course is xenotransplantation. It involves the use of animal organs, which are then transplanted into humans. No officially recognized successes have been achieved in this area. But scientists do not give up, because some time ago they managed to use certain parts of the body of animals. We are talking about cartilage and tendons, which are necessary to replace the valves of the human heart muscle.

A relatively new type of science has become the cultivation of organs in an artificial environment. For this, stem cells obtained from embryos are used. In practice, such research has not yet been verified, as researchers are still poring over the theoretical part for the sake of the safety of future patients.

But here is a somewhat simplified scheme, when stem cells extracted from the body of the most affected person are used to stabilize the work of the bone marrow, has long been in demand. The main advantage of the procedure is the ability of such cells to renew themselves when damaged.

But most often the classical approach is used, and in fact many do not even know the name of this way of saving lives. In medical terminology, it is called allotransplantation.

Organs that can be healed

Despite many theories that the first one will appear very soon, to which the entire body will be transplanted, this is still far away. Instead of such fantastic theories, practitioners are replacing damaged or worn ones:

• kidney;
• heart;
• light;
• liver;
• bone marrow;
• pancreas.

After the operation is completed, doctors will have to monitor the slow process of engraftment of the transplanted organ. Such vigilant control is needed so that the transplanted kidney can fully take over the functions of the one that had to be removed.

Immune therapy deserves special attention, which involves taking a variety of specialized drugs that allow the body to quickly adapt to new life circumstances.

In order for everything to go smoothly, it is not enough just to find a person with ideal biological compatibility, even if this is not a relative. The prospective assistant must be completely healthy and not have a number of ailments like:

• diabetes mellitus;
• ischemia;
• oncology;
• tuberculosis;
• hepatitis B or C;
• HIV;
• syphilis;
• cytomegalovirus.

Nephrologists and other specialized doctors additionally take information regarding their usual lifestyle into service. Bad habits, features of sexual life fell into such a vague category. But even ideal results and better compatibility are no guarantee that the operation will be performed. But after surgery, new organs do not always take root well.

Entrusted diseases

Since any transplantation is a complex, multi-stage and time-consuming process, it is resorted to only in emergency cases. This applies to situations where it is impossible to save the patient in any other way.

The list of kidney diseases that force the patient to stand in the donor queue includes:

• progressive glomerulonephritis;
• diabetic nephropathy;
• chronic pyelonephritis.

If we consider the rating of operations in the context of the most frequently transplanted internal organs, then the liver will be in the leading position. Doctors turn to such a risky measure only when cirrhosis has advanced so much in its progress that nothing stops it.

Also among the reasons for applying for a liver replacement, the following diseases were recorded:

• liver failure at an acute stage, which is caused by poisoning with toxins;
• hepatitis C or B;
• autoimmune hepatitis;
• malignant neoplasms;
• serious genetic diseases.

Sometimes, to improve the quality of life, it is not necessary to wait for a suitable corpse to be delivered to the hospital. To cure most liver ailments from the list, a certain piece will be enough.

A little less often, experts practice lung transplants. The possibility affects those who have suffered from chronic respiratory failure. The primary sources of all problems are usually:

• fibrosis of the idiopathic type;
• cystic fibrosis;
• obstructive disease.

Most often, the lung is shown to be transplanted as a whole, which can only be obtained from the deceased.

If the victim was diagnosed with heart failure, or a serious pathology such as ischemia and a previous heart attack, then replacement of the heart muscle is indispensable.

Those with confirmed necrotizing pancreatitis should go to a transplant center for help. If the victim does not have diabetes mellitus or, along the way, a malignant tumor of the pancreas, then the organ will be successfully replaced.

Moreover, it can be either a partial transplant, when the tail is removed along with the islets of Lanegerhans, or the entire body of the pancreas. But in any case, only the recently deceased acts as a donor.

But with the use of bone marrow is completely opposite. Material may only be taken from living people. The resulting brain is used for subsequent healing from oncological, autoimmune and hematological diseases.

Situations when the patient was hospitalized with burns of the third degree are considered separately. If his skin is not affected everywhere, then he can help himself, because the surgeon will use his healthy skin from another place.

Required and not-so tests

Usually, people get to the transplant department only after a narrow specialist tries alternative methods of treating an established ailment. If the oncologist, nephrologist or any other doctor was powerless in the face of the disease, then they choose the transplantologist’s office as the last point of assistance.

Due to the fact that the range of organs that such a surgeon can transplant is extremely large, it is difficult to single out a specific list of characteristic symptoms, upon detection of which it is necessary to sound the alarm. Experts advise simply not to brush aside preventive examinations, and if you find any deviations in well-being, immediately run to the reception. It is likely that a disease caught at an early stage will not entail such a risky procedure.

If it was not possible to avoid such a situation, then the long path to recovery begins with a diagnosis. After passing a series of tests designed to confirm the diagnosis, a long-term collection of information begins, which then allows you to select the ideal donor.

The marathon of analyzes begins with standard tests like urine, blood, sputum, feces, biochemistry. It does not do without protocol tests for HIV, syphilis, hepatitis B and C, as well as cytomegalovirus. According to the circumstances, they require to pass flushing water or fluid from the bronchi. They can only be reached during bronchoscopy, which is performed under local anesthesia.

Additionally, you will need to check blood tumor markers, as well as pass an immunogram. One of the most important tests is the immunogenetic compatibility test between the recipient and the potential donor.

All this, together with the results of a biopsy of tissue fragments, is sent to the doctor assigned to the patient for examination. Based on the results obtained, permission for the operation is given.