Allotransplantation

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Allotransplants
MeSH D014184

Allotransplant (allo- meaning "other" in Greek) is the transplantation of cells, tissues, or organs to a recipient from a genetically non-identical donor of the same species. [1] The transplant is called an allograft, allogeneic transplant, or homograft. Most human tissue and organ transplants are allografts.

Contents

It is contrasted with autotransplantation (from one part of the body to another in the same person), syngenic transplantation of isografts (grafts transplanted between two genetically identical individuals) and xenotransplantation (from other species).

Allografts can be referred to as "homostatic" if they are biologically inert when transplanted, such as bone and cartilage. [2]

An immune response against an allograft or xenograft is termed rejection. An allogenic bone marrow transplant can result in an immune attack on the recipient, called graft-versus-host disease.

Procedure

Material is obtained from a donor who is a living person, or a deceased person's body receiving mechanical support or ventilation, or a deceased person's body whose heart stopped beating. Screening for pathology and risk factors for communicable diseases such as HIV and Hepatitis B and C is then conducted.[ citation needed ]

In the US, donor tissue must be recovered and processed adhering to the Current Good Tissue Practices rule. In most cases, it is sent to tissue banks for processing and distribution. Each year, Food and Drug Administration regulated and American Association of Tissue Banks-accredited tissue banks distribute 1.5 million bone and tissue allografts.

Transplantable organs and tissues

A variety of organs and tissues can be used for allografts, including:

Laws and regulations

United States

In the US, the Food and Drug Administration (FDA) has regulated human tissue intended for transplants since 1993. In order to ensure the quality of donor tissue and reduce contamination and disease transmission risks, three regulations addressing manufacturing activities associated with human cells, tissues, and cellular and tissue-based products (HCT/Ps) were promulgated in May 2005:

Other transplant options

Risks

As with many operations, allotransplantation risks some side effects. A limiting factor in tissue allotransplantation for reconstructive surgery deals with the side effects of immunosuppression (metabolic disorders, malignancies, opportunistic infections) which is a predominant issue. The risk of transmitting infection is high. [3]

See also

Related Research Articles

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Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

<span class="mw-page-title-main">Hematopoietic stem cell transplantation</span> Medical procedure to replace blood or immune stem cells

Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood in order to replicate inside of a patient and to produce additional normal blood cells. It may be autologous, allogeneic or syngeneic.

<span class="mw-page-title-main">Graft-versus-host disease</span> Medical condition

Graft-versus-host disease (GvHD) is a syndrome, characterized by inflammation in different organs. GvHD is commonly associated with bone marrow transplants and stem cell transplants.

<span class="mw-page-title-main">Skin grafting</span> Surgical transplantation of skin

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<span class="mw-page-title-main">Xenotransplantation</span> Transplantation of cells or tissue across species

Xenotransplantation, or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenografts or xenotransplants. It is contrasted with allotransplantation, syngeneic transplantation or isotransplantation and autotransplantation. Xenotransplantation is an artificial method of creating an animal-human chimera, that is, a human with a subset of animal cells. In contrast, an individual where each cell contains genetic material from a human and an animal is called a human–animal hybrid.

<span class="mw-page-title-main">Cell therapy</span> Therapy in which cellular material is injected into a patient

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<span class="mw-page-title-main">Bone grafting</span> Bone transplant

Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. Some small or acute fractures can be cured without bone grafting, but the risk is greater for large fractures like compound fractures.

<span class="mw-page-title-main">Arthrodesis</span>

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Autotransplantation is the transplantation of organs, tissues, or even particular proteins from one part of the body to another in the same person.

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Articular cartilage repair treatment is focused on the restoration of the surface of an articular joint's hyaline cartilage. Over the last few decades, surgeons and researchers have made progress in elaborating surgical cartilage repair interventions. Though these solutions do not perfectly restore the articular cartilage, some of the latest technologies start to bring very promising results in repairing cartilages from traumatic injuries or chondropathies. These treatments are especially targeted for patients who have articular cartilage damage. They provide pain relief, while at the same time slowing down the progression of damage or considerably delaying the joint replacement surgery. Articular cartilage repair treatments helps patients to return to their original lifestyle with reduced pain, regaining mobility, going back to work, and even practicing sports again.

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Transplantable organs and tissues may refer to both organs and tissues that are relatively often transplanted, as well as organs and tissues which are relatively seldom transplanted. In addition to this it may also refer to possible-transplants which are still in the experimental stage.

Demineralized bone matrix (DBM) is allograft bone that has had the inorganic mineral removed, leaving behind the organic "collagen" matrix. It was first discovered by Marshall Urist in 1965 that the removal of the bone mineral exposes more biologically active bone morphogenetic proteins. These growth factors modulate the differentiation of progenitor cells into osteoprogenitor cells, which are responsible for bone and cartilage formation. As a result of the demineralization process, DBM is more biologically active than undemineralized bone grafts; conversely the mechanical properties are significantly diminished.

TK is an experimental cell therapy which may be used to treat high-risk leukemia. It is currently undergoing a Phase III clinical trial to determine efficacy and clinical usefulness.

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Nerve allotransplantation is the transplantation of a nerve to a receiver from a donor of the same species. For example, nerve tissue is transplanted from one person to another. Allotransplantation is a commonly used type of transplantation of which nerve repair is one specific aspect.

<span class="mw-page-title-main">Shimon Slavin</span> Israeli professor of medicine

Shimon Slavin, M.D., is an Israeli professor of medicine. Slavin pioneered the use of immunotherapy mediated by allogeneic donor lymphocytes and innovative methods for stem cell transplantation for the cure of hematological malignancies and solid tumors, and using hematopoietic stem cells for induction of transplantation tolerance to bone marrow and donor allografts.

References

  1. "None".
  2. (W. P. Longmire, J. National Cancer Institute14, 669: The term homostatic graft might be applied to inert tissues such as bone and cartilage when transferred from one individual to another of the same species; and the term homovital graft might be used in reference to grafts whose cells must continue to grow and reproduce for the graft to be effective after similar transplantation; H. Conway, The Bulletin of the Hong Kong Chinese Medical Association13, 43: These grafts persist however as homostatic grafts and are completely replaced by host tissues in time.)
  3. Petit, F.; Minns, A. B.; Dubernard, J. M.; Hettiaratchy, S.; Lee, W. P. (2003). "Composite Tissue Allotransplantation and Reconstructive Surgery". Annals of Surgery. 237 (1): 19–25. doi:10.1097/00000658-200301000-00004. PMC   1513974 . PMID   12496526.