Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.
Histocompatibility, or tissue compatibility, is the property of having the same, or sufficiently similar, alleles of a set of genes called human leukocyte antigens (HLA), or major histocompatibility complex (MHC). Each individual expresses many unique HLA proteins on the surface of their cells, which signal to the immune system whether a cell is part of the self or an invading organism. T cells recognize foreign HLA molecules and trigger an immune response to destroy the foreign cells. Histocompatibility testing is most relevant for topics related to whole organ, tissue, or stem cell transplants, where the similarity or difference between the donor's HLA alleles and the recipient's triggers the immune system to reject the transplant. The wide variety of potential HLA alleles lead to unique combinations in individuals and make matching difficult.
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.
Sir Peter Brian Medawar was a Brazilian-British biologist and writer, whose works on graft rejection and the discovery of acquired immune tolerance were fundamental to the medical practice of tissue and organ transplants. For his scientific works he is regarded as the "father of transplantation". He is remembered for his wit both in person and in popular writings. Famous zoologists such as Richard Dawkins referred to him as "the wittiest of all scientific writers", and Stephen Jay Gould as "the cleverest man I have ever known".
Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. The duration of the surgery ranges from 4 to 18 hours depending on outcome. Favorable outcomes require careful screening for eligible recipient, as well as a well-calibrated live or cadaveric donor match.
Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).
Thomas Earl Starzl was an American physician, researcher, and expert on organ transplants. He performed the first human liver transplants, and has often been referred to as "the father of modern transplantation." A documentary, entitled "Burden of Genius," covering the medical and scientific advances spearheaded by Starzl himself, was released to the public in 2017 in a series of screenings.
Roger Stanley Williams CBE FRCS FRCP FRCPE FRACP FMedSci was a British professor of hepatology. He was Director of the Institute of Hepatology, London and Professor of Hepatology, King's College London. He was also Medical Director of the charity, the Foundation for Liver Research a UK registered charity and was the lead person of the Lancet Commission into Liver Disease in the UK.
Dr. A. M. James Shapiro is a British-Canadian surgeon best known for leading the clinical team that developed the Edmonton Protocol – an islet transplant procedure for the treatment of type 1 diabetes. Dr. Shapiro is Professor of Surgery, Medicine, and Surgical Oncology at the University of Alberta and the Director of the Clinical Islet Transplant Program and the Living Donor Liver Transplant Program with Alberta Health Services.
Sir Roy Yorke Calne, FRCP, FRCS, FRS is a British surgeon and pioneer in organ transplantation.
Organ transplantation in China has taken place since the 1960s, and is one of the largest organ transplant programmes in the world, peaking at over 13,000 liver and kidney transplants a year in 2004. Involuntary organ harvesting is illegal under Chinese law; though, under a 1984 regulation, it became legal to remove organs from executed criminals with the prior consent of the criminal or permission of relatives. Growing concerns about possible ethical abuses arising from coerced consent and corruption led medical groups and human rights organizations, by the 1990s, to condemn the practice. These concerns resurfaced in 2001, when a Chinese asylum-seeking doctor testified that he had taken part in organ extraction operations.
Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.
The American Society of Transplantation (AST) is an international organization of over 4,000 transplant professionals dedicated to advancing the field of transplantation through the promotion of research, education, advocacy, organ donation, and service to the community. It is the largest professional transplantation society in North America.
Dr. Arvinder Singh Soin is the Chief Hepatobiliary and Liver Transplant Surgeon & Chairman of the Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, India. A surgeon and pioneer in the field of liver transplantation, acknowledged for his work in establishing liver transplantation in India. Dr. Soin also runs the Liver Transplant institute at the Sir H. N. Reliance Foundation Hospital, Mumbai. Dr Soin has performed more than 3500 living donor liver transplants in India, which is the highest in the country, and the second-highest in the world.
Francis L. Delmonico, MD, FACS is a surgeon, clinical professor and health expert in the field of transplantation. He serves on numerous committees and is affiliated with various leading organizations and institutions. He is the chief medical officer of the New England Organ Bank (NEOB) and Professor of Surgery, Part-Time at Harvard Medical School in Boston, Massachusetts, where he is emeritus director of renal transplantation. He served as president of The Transplantation Society (TTS) from 2012 to 2014, an international non-profit organization based in Montreal, Canada that works with international transplantation physicians and researchers. He also served as the president of the United Network of Organ Sharing (UNOS) in 2005, which overseas the practice of organ donation and transplantation in the United States. He was appointed and still serves as an advisor to the World Health Organization in matters of organ donation and transplantation. He was appointed by Pope Francis to the Pontifical Academy of Science in 2016. In 2020, he became the recipient of the Medawar Prize of The Transplantation Society.
Sir Terence Alexander Hawthorne English is a South African-born British retired cardiac surgeon. He was Consultant Cardiothoracic Surgeon, Papworth Hospital and Addenbrooke's Hospital, Cambridge, 1973–1995. After starting a career in mining engineering, English switched to medicine and went on to lead the team that performed Britain's first successful heart transplant in August 1979 at Papworth, and soon established it as one of Europe's leading heart–lung transplant programmes.
Dorry L. Segev is the Israeli-born Marjory K. and Thomas Pozefsky Professor of Surgery at Johns Hopkins School of Medicine, professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, and associate vice chair of the Department of Surgery at Johns Hopkins Hospital. He has made significant contributions to the field of transplantation, including developing a mathematical model to facilitate a nationwide kidney paired donation program, both in the US and Canada. He is also known for his role in getting the HIV Organ Policy Equity Act signed into law.
BC Transplant Society (BCTS) founded in 1985 is now an agency of Provincial Health Services Authority (PHSA) in the Canadian province of British Columbia that registers consent to be donors of organs for Organ transplantation.
The British Transplant Society (BTS) awards the Medawar Medal each year for the best clinical and scientific research presentations by a scientist or doctor. The Medawar medal is the most prestigious award that the society can offer, is highly competitive, and cannot be won more than once by a single individual. The award is named after Peter Medawar, a Nobel Prize winner in Medicine or Physiology. Two medals are awarded every year.
René Küss was a French urologist and transplant surgeon who made pioneering contributions in renal tract surgery and kidney transplantation with the establishment of transplant programs. At a time of unavoidable transplant rejection, he was involved in two particularly historic transplant operations. The first was a human-to-human extraperitoneal kidney transplant procedure in 1951 and later a pig-to-human kidney transplant in 1966, both of which ended in abrupt rejection. He later introduced kidney transplantation schedules involving at first irradiation, later immunosuppressants, living-related and unrelated donors and later organs from deceased donors.
