Written by:
Arthi T
Organ transplantation represents one of the most significant breakthroughs in modern medicine, offering a vital lifeline to patients with end-stage diseases when other treatments prove ineffective. Although the concept of organ transplantation dates back to the 16th century, it wasn’t until 1990 that a successful procedure was achieved, dramatically improving patient survival rates. Dr. Thomas Murray received the Nobel Prize in Medicine for performing the first successful kidney transplant between identical twins, with the recipient living eight years with normal graft function. Since then, the field of organ transplantation has advanced remarkably, particularly over recent decades. Innovations in technology and modern medicine have made organ transplants a viable option, saving countless lives worldwide.
The current status
According to the Lancet Regional Health Journal, 2024 – India sees 17,000–18,000 solid organ transplants performed every year—the most in the world after the US and China—but remains behind several high-income countries in transplantation rates per million population (0.65). There has been progress in this area, such as an improvement in the harvesting of organs from deceased donors, with the average number of organ transplants per donor increasing from 2.43 in 2016 to 3.05 in 2022. However, the majority of these surgeries are done by the country’s private health sector, which makes them unaffordable to most patients.
Despite the progress in organ transplantation in India, particularly in nephrology, over the past five to six decades, inclusivity and equity for many patients is a big concern. The government is trying to promote deceased donor kidney transplantation, which is common in high-income countries. However, the utilisation of organs from deceased donors is suboptimal in the region, due to a multitude of factors such as religious and cultural beliefs, health-care system experiences.
An overview of the present state of organ transplantation suggests that future interest and work will be focused on three major points:
Increasing the frequency
Safety
Outcome of traditional transplantation activities
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Recent advances
Availability of new-era immunosuppressants and induction therapy
Recent advances in the availability of new-era immunosuppressants and induction therapy have significantly improved outcomes in organ transplantation. These innovations have led to more effective prevention of organ rejection while minimizing the side effects traditionally associated with immunosuppressive drugs. Newer immunosuppressants are designed to target specific pathways in the immune response, reducing the risk of broad immunosuppression and subsequent infections.
Induction therapy, which involves the use of potent immunosuppressive agents at the time of transplantation, has also evolved, offering more precise control over the immune system during the critical initial period post-transplant. These advancements not only enhance the longevity and functionality of transplanted organs but also improve the overall quality of life for transplant recipients by reducing complications and enhancing graft survival rates.
Future prospects
Development of invitro organs
The advancement of in vitro organs has the potential to completely transform the field of organ transplantation. This is due to the critical shortage of donor organs, and the need for a sustainable and ethically viable alternative. These lab-grown organs, which are developed from a patient’s own cells, offer the promise of eliminating the lengthy wait for donor matches and significantly lowering the risk of rejection, as they would be genetically identical to the recipient.
In line with the trend towards personalized medicine, in vitro organs can be customized to individual genetic profiles, thus improving transplant success rates and long-term outcomes. Biotechnological advancements such as 3D bioprinting, stem cell therapy, and organ-on-a-chip technologies are propelling this progress, enabling the precise construction of intricate organ structures. Despite the potential, challenges persist in ensuring functionality, scaling production, and navigating regulatory frameworks, underscoring the need for ongoing research and collaboration.
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Xenotransplantation
Xenotransplantation, which means transplantation of an organ, tissue, or cells between two different species, has regained attention because of advantages such as rich source, the chance of planning, and multiple transplants. The main disadvantages are the possibility of animal disease transmission, immunologic, and physiologic differences. In the last 30 years, researchers have determined that the pig is the most suitable animal for xenotransplantation. The reasons for this are short maturation time, the human similarity in size and physiological aspects, and low risk of animal disease transmission. Genetically modified pigs have been developed to overcome the molecular incompatibility between species.
Deceased organ preservation
Currently, transplants are required to be carried out within a few hours for it to be successful. Many organs are wasted as transplant recipients cannot be located nearby and due to logistic issues. Research is being progressed on deceased organ preservation which is crucial for ensuring the viability of donated organs for transplantation, significantly impacting transplant success rates. Emerging methods like normothermic machine perfusion (NMP) maintain organs at body temperature, showing promise in extending viability. Ongoing research, including the use of nanoparticles and gene therapy, aims to enhance these preservation techniques further. Efficient organ retrieval, ethical considerations, and timely coordination among medical teams are vital for optimizing preservation and improving transplant outcomes.
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Rare transplants
Composite tissue transplantation
Source: Experimental Surgery
When body structures composed of multiple tissues derived from ectoderm and endoderm is transplanted then the procedure is called composite tissue allotransplantation. Such transplants are also known as “vascular composite allografts”. The concept of composite tissue transplantation includes hand, face, larynx, joint, abdominal wall transplantations. This type of transplant has a life-changing nature, as the main goal is to restore reduced or completely lost functions and to increase the quality of life. Unlike solid organ transplants, nerve regeneration must occur in the transplant to restore sensory and motor functions.
Face, uterus, and extremity transplants
These opportunities are being explored and will likely be implemented in the future once long-term outcomes have been established. These types of transplants offer the potential to restore not only function but also a sense of normalcy and quality of life for patients who have suffered severe injuries or congenital conditions. Face transplants can significantly improve the appearance and social interactions of individuals with disfiguring facial trauma, while uterus transplants provide hope for women with uterine factor infertility to experience pregnancy and childbirth. Extremity transplants, such as hand or arm transplants, can restore vital motor functions and independence to those who have lost limbs. Although these procedures are still in the experimental stages, ongoing research and clinical trials are paving the way for their future implementation. Success in these areas will depend on establishing long-term outcomes, improving surgical techniques, and managing immunological challenges to ensure the safety and efficacy of these groundbreaking transplant options.
The good news is that Milaap will be there to assist you throughout your organ transplantation journey. Milaap plays a crucial role in bridging the financial gap for patients needing organ transplants. By providing a platform for individuals to raise funds, Milaap ensures that more patients can benefit from these cutting-edge treatments, ultimately leading to better health outcomes and improved quality of life for transplant recipients. This coordination between medical innovation and financial support emphasises the transformative potential of combining advanced healthcare solutions with community-driven funding initiatives. Start your fundraiser today!
Organ transplant success stories on Milaap
In times of need, support means everything, and with Milaap, you need not look any further. Milaap enables you to set up a fundraiser for any medical emergency within minutes, and you can easily raise funds for treatment expenses.
Do you know someone who could benefit from fundraising? Simply refer them to us and we’ll be happy to lend a hand.
Visit www.milaap.org or call us on +91 9916174848 to get started now.
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