Cybernation Infotech, Inc.
Time 2021-10-30 15:10:49Web Name: Cybernation Infotech, Inc.
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Introduction:
Organtransplantation is the moving of an organ from one body to another or from adonor site to another location on the persons own body, to replace therecipients damaged or absent organ.
There have been agreat achievement in RD in the mid 1990s and now we are fully aware of newmethods of surgeries like robotic surgery, micro vascular surgery, lasersurgery etc. Now the technology has beenmore advanced and very fast in this field of organ transplant. Those days has gonewhen the patient had to wait for years together with an ailing sickness orillness of any major organ say the hair, eye, liver, kidney, lung, pancreas, heartetc.The major organ failure today in India is the kidney failure and today lotsof lives have been saved in this field by doing renal transplant. So lets goback to peep in the past and talk about the first kidney transplant and then wewill come back as to the advancement in technology of this life savingachievement.
Kidney Transplant:The first kidneytransplant was done in December 1954 when RD in organ transplant was milesaway. This first kidney transplant wasdone between identical twins Ronald and Richard Herrick. This was done at theBrigham Hospital (BWH) Boston, Massachusetts.The three doctors involved in this kidney transplant were i) the donortransplant surgeon Dr. John Hartwell Harrison, who had served in the US ArmyMedical Corps and now had made Boston, Massachusetts his home, ii) Dr. JosephE. Murray the recipient transplant surgeon, and iii) Dr. John P. Merrill. This was the basic foundation stone laid downsome 61 years back on which basis the present techniques of transplantationsurgery have been renovated and revised for the betterment of human lives.
Chronic Kidney Disease (CKD):
What is CKD? What are its causes? Chronic Kidney Disease also known as chronicrenal disease is a progressive loss in renal function over a period of monthsor years. Our kidneys function is to filterwastes and excess fluids from our body. When the kidney stops working, and thenthe waste accumulates in the form of blood urea nitrogen and creatinine whichresults in complications like high blood pressure, anemia, weak bones, poornutritional health and nerve damage etc. Now let us look at the causes ofCKD. CKD can be hereditary ornon-hereditary. Looking at thehereditary aspect the polycystic kidneys is a major hereditary disease and isgene carrier. For non-hereditary or the chronic kidneydisease, there are two main causes ofdiabetes and high blood pressure which are responsible for up to twothird of the cases. Diabetes happens when your blood sugar is too high, causingdamages to many organs in the body, including Kidneys and heart, as well bloodvessels and nerves and eyes. High blood pressure, or hypertension, occurs whenthe pressure of your blood against the walls of your blood vessels increases.If uncontrolled, or poorly controlled, high blood pressure can be a leadingcause of heart attacks, strokes and chronic kidney disease or other disorders.Early detection and treatment can often keep chronic kidney disease fromgenetic worse. When kidney disease progresses, it may eventually lead to kidneyfailure, which in turn requires either dialysis or a kidney transplant tomaintain a normal healthy life.
Let me take breakhere the discussions on the organ transplant make you aware of my interest in writing thistopic now; one of my friends, a medical technologist, who had worked for twodecades in the field of medicine as a paramedics, worked in routine clinicallabs, hospital biochemical labs, and blood banks. When he heard the news that his wife is achronic renal failure patient when she had some ultrasound tests, he immediatelyresigned and came back home. At that time, she was at the initial stage ofdeterioration and that will be well monitored. After ten years, she was put on renal dialysisand in November 2009 she received her kidney and is doing well for the last sixyears. Here I think it will beworthwhile to mention here that renal transplant survival rate will be highbased on the lifestyle the patient undergoes.
Let us go back tothe main discussion, CKD. Now I willbrief you point wise facts about CKD.1)About 26 million American adults have CKD millions of others are at increased risk.2)Heart disease is the major cause of death for allpeople with CKD.3)Early detection can help prevent the progression ofkidney disease to kidney failure.4)Glomerular filtration rate (GFR) is the bestestimate of kidney function.5)Hypertension causes CKD CKD causeshypertension.6)Persistent proteinuria (protein in the urine) meansCKD is present.7)High risk groups include those with diabetes,hypertension family history of kidney failure.8)Two simple tests can detect CKD: Blood pressure,urine albumin serum creatinine.
There are seriesof tests to be performed on the list of transplant donor. The first being GFR (glomerular filtrationrate), it determines how well the kidneys are working. The second test is removal of fat tissue frombelly (tummy) just close to the umbilicus. Renal transplantation using donoradipose tissue derived esenchymal Stem Cells and Hematopoietic Stem Cells are implantedin the recipient (i.e. the patient) so as to establish a firm transplant.
Table 1. Action Plan according to CKD Stage Stage Action Plan 1 Diagnosis and treatment of comorbid conditions, slow progression, CVD risk reduction 2 Estimate progression 3 Evaluate and treat complications 4 Prepare for renal replacement therapy (Av fistula creation) 5 Renal replacement
Blood Groups:
Now let us discussthe blood group aspect to become the donor fit for transplant. To become the donor there is need for you tobe of the same group as that of the patient.If you are blood related say a brother, sister, father, or mother of thepatient, and having the same blood group, you can close your eyes and donate. Now let us discuss the different types ofblood groups.
There are fourtypes of blood groups A, B, O, and AB and along with that Rh factor (theantigen of the Rh blood group system). So in all, total eight differentcategories of blood group separately put aside for the classification as we putthe Rh factor in to two classes, the Rh factor positive one and the Rh factornegative. Now let us see there are A+and A-, B+ and B-, AB+ and AB-, and finally O+, and O-. For the donor transplant list always there isheading the blood group along with Rh factor and that it is vitally importantin that the donor should match the recipient blood group and the Rh factor.
The second is theage factor for the doctor. Generally,doctors do not take donors above 60s, and in rare cases where the donor isstill healthy at 60 and has insisted to be considered and that this aged personstill has a good GFR.
Further if thepatient does not get a donor in his/her circle then the patient goes in to thecadaver (corpse) list. There are a lotof accident cases coming in the hospital and the patient is breathing his lastand if he/she agrees or says the parents agrees to donate the organ of thispatient breathing his/her last breathe, then the doctors will operate him andremove the vital organs for the transplant.There are say about thousands of patient waiting for their turn to comeon the cadaver list and I have personally met a few who have received kidneyfrom a cadaver and are doing well.
Summary
Kidney transplantation is generally known as LifeExtending procedure. Because a patient will live 10 to 15 years longer withkidney transplant than if kept on dialysis. From the statistical data it hasalso been concluded that this increase in longevity is greater for youngerpatients, but even 75 years old patients with kidney transplant gain an averageof four to six more years of life. People generally have more energy, a lessrestricted diet and fewer complications with a kidney transplant than if theystay on conventional dialysis. Some studies also reveals that longer a patientis on dialysis before the transplant, the less time the kidney will last. Theexact reason for this is still not known, but it underscores for rapid referralto a transplant program. From the statistics by country, year donor type,it has been found that Mr. Robert Perry remains the longest- surviving Americankidney recipient from an unrelated donor, having received his kidney in 1974 atthe age of 23; he survived over 41 years, dying May 31, 2015.
Inaddition to nationality, transplantation rates differ based on race, sex andincome, but statistical data shows that the expenses undergoing transplant arethe least in India than any other country in the word.
Further more Iwish to add that a lot of awareness is necessary as there are still manypatients waiting for a transplant.
References:
https://en.wikipedia.org/wiki/J._Hartwell_Harrison
http://biomedfrontiers.org/stem-cells-2015-5-12/
http://www.indmedica.com/journals.php?journalid=6issueid=25articleid=237action=article
http://www.legacy.com/obituaries/chicoer/obituary.aspx?n=Robert-Allen-Perrypid=174998823.
Alexander, G. C.; Sehgal, A. R. (1998). "Barriers toCadaveric Renal Transplantation among Blacks, Women, and the Poor". Journalof the American Medical Association280(13): 11481152.doi:10.1001/jama.280.13.1148.PMID9777816 comments: HomeSubscribe to:Posts (Atom)Blog Archive 2016(1) November(1)Organ Transplant Episode 1 Kidney TransplantTotal Pageviews
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