THEO 353L5 - Organ Donation

Lesson 5 – Organ Donation Introduction Organ and tissue transplantation: diseased organs are replaced by whole organs or individual cells in an effort to restore normal physiological function -from rare successes if ...

Lesson 5 – Organ Donation Introduction Organ and tissue transplantation: diseased organs are replaced by whole organs or individual cells in an effort to restore normal physiological function -from rare successes if donor & recipient were related  to high rates of success even with unrelated donors -key contribution to success is the development of anti-rejection drugs Early History  Captured human imagination throughout history  only successful the past 40 years  Transplantation conceived as early as 500-600 BCE  in the form of mythical monsters made of various animals  The Chimaera: “a fire breathing creature composed of the body and head of a lion, a dragon’s tail and the head of a goat arising from the centre of the spine” The First Transplant  Tsin Yue-Jin – exchanged the hearts of two soldiers  one endowed with a strong will but a weak spirit and the other with a strong spirit but a weak will Miracle of the Leg  Twin brothers Cosmas & Damian lived in 3rd century in Asia Minor  Early Christians committed to vows of poverty & regarded as physicians  “Miracle of the leg” –Transplantation performed by the brothers o Legend: the brothers amputated the leg of fellow Christian and successfully transplanted the leg of an Ethiopian soldier who had just died 20th Century and Beyond  Middle of the 20th century organ & tissue transplantations found success  Earliest organ transplantations were considered extraordinary measure o Only two persons survived the procedure before it was done in Canada in 1958  Ethical issues needed to be addressed  Most serious concern was the risks on the healthy donor  As more successful transplantations took place, they became more “ordinary” 1954: Successful kidney transplant between identical twin brothers This study source was downloaded by 100000826007268 from CourseHero.com on 05-14-2021 16:37:21 GMT -05:00 https://www.coursehero.com/file/34510241/L5-Organ-Donationdocx/ This study resource was shared via CourseHero.com 1958: kidney transplant between identical twin sisters  first in Canada Baie - d’Urfe, QC 1960: discovery of anti-rejection drugs 1967-68: first successful heart transplant 1983: first single lung transplant 1986: first double lung transplant 2005: first partial face transplant 2008: first double arm transplant 2011: first double leg transplant 2018: first facial re-transplant The State of Organ and Tissue Transplantation in Canada Organs are a Scarce Source  Strong commitment in Canada to promote organ and tissue donation o Valued medical procedure that most agree promote the good both individually and socially o Canada has one of the lowest rates of organ donors among developed donations  Canadian transplant methods are among the most sophisticated o Superior innovative tools to procure & use the most body parts  Only 15 per 1 million of those who die in hospitals donate o Compared to 34 per 1 million in Spain & 26 per 1 million in the US Critical shortage of organs for transplantation:  2014 – 592 deceased organ donors & 553 living donors o A living donor provides 1 organ but a deceased organ donor can provide up to 8 o Living donors – usually related to recipient Education on organ donation:  Organs are a scarce resource – funding will not substantially change this situation except in education programs  Education  provide valuable info that Canadian citizens need to know & understand to make an informed choice about donating their organs either while living or deceased This study source was downloaded by 100000826007268 from CourseHero.com on 05-14-2021 16:37:21 GMT -05:00 https://www.coursehero.com/file/34510241/L5-Organ-Donationdocx/ This study resource was shared via CourseHero.com Shifts in Procurement  Donation after cardio-circulatory death (DCD) was the criteria for procuring organs o Prior to respirators – critical care in the mid 20th century, cessation of cardiorespiratory function was the only criterion for determining death o When a potential donor’s heart & breathing stopped & they had given informed consent  organs could be procured 1968: the understanding of death shifted to brain death based on neurologic criteria 1969: the Harvard Ad Hoc Committee proposed adopting neurological criteria for determining death  NEUROLOGICAL criteria became widely adopted  Organs from “brain-dead” donors had better success rates than the soon abandoned “non-heart beating donors” (NHBD) or cardio-circulatory death methods (DCD) LAST 10-20 years: programs in Europe & the US have returned to DCD to meet increasing demands for organs  Canada: DCD was adopted in 2006 after 32 year old woman named Sarah Beth Therian died of a heart arrhythmia o Her parents followed her wishes to donate & asked the hospital to consider her organs under the “new protocol called DCD” o Therian became the first Canadian in four decades to donate organs after cardiac death  2016: 1/3rd of all donors are DCD