1.
A Concise Presentation
By
Mr. Deepak Sarangi, M.Pharm
ORGAN TRANSPLANTATION

2.
 Introduction
 History of transplant
 Types of transplants
 Major organs and tissues transplanted
 Types of donors
 Timeline of successful transplants
 Heart transplant procedure
 Transplant rejection
 Immunosuppressive drugs
 Cost of transplants
 Conclusion
 References

3.
 DEFINITION :
An organ transplant is a surgical operation in
which a failure or damaged organ in human body is
removed and replaced with a functioning one. The
donated organ may be from a deceased donor, a living
donor or an animal.
 Organs that can be transplanted are the heart, kidneys,
liver, lungs, pancreas, intestine and thymus.
 Tissues include bones, tendons, cornea, skin, heart valves,
nerves and veins.
 Worldwide, the kidneys are the most commonly
transplanted organs, followed by the liver and then the
heart.

4.
SIR PETER MEDAWAR:
Father of transplantation worked
on graft rejection and acquired
immune tolerance in 1944 showed
that skin allograft between two mice
are rejected.
HISTORY

5.
ALEXIS CARREL:
The noble prize in physiology or
medicine 1912 was awarded to
Alexis carrel in recognition of
his work on vascular suture and
the transplantation of blood
vessels and organs.

6.
BRUCE REITZ:
On march 9th 1981 the first
successful heart lung transplant
took place at stanford
university hospital. The
surgeon, Bruce reitz, credited
the patients recovery to
cyclosporine-A.

7.
DR.EDUARD ZIRM:
The first successful human
Corneal transplant, a
keratoplastic operation
was performed by
Eduard zirm in Austria
1905.

8.
 Autograft
 Allograft
 Isograft
 Xenograft
 Split transplant
 Domino transplant

9.
 Autograft is a transplant of tissue from one to
oneself. Sometimes this is done with surplus tissue,
or tissue that can regenerate, or tissues more
desperately needed elsewhere (examples include skin
grafts, for CABG, etc.) sometimes this is done to
remove the tissue and then treat it or the person
before returning it.

10.
 An allograft is transplant of an organ or tissue
between two genetically non identical
members of the same species. Most human
tissue and organ transplants are allografts.

11.
 A sub set of allografts in which organs or tissues are
transplanted from a donor to a genetically identical
recipient(such as an identical twin). Isografts are
differentiated from other types of transplants because
while they are anatomically identical to allografts,
they do not trigger an immune response.

12.
 A transplant of organs or tissue from one species to
another. Xenograft is often an extremely dangerous
type of transplant because of increased risk of non-
compatibility, rejection, and disease carried in the
tissue. Examples include porcine heart valves, which
are quite common and successful. The latter’s
research study directed for potential human use if
successful.

13.
 Sometimes, a deceased-donor organ, usually a liver,
may be divided between two recipients, especially an
adult and a child. This is not usually a preferred
option because the transplantation of a whole organ is
more successful.

14.
 This operation is usually performed for cystic fibrosis
as both lungs need to be replaced and it is a
technically easier operation to replace the heart and
lungs. As the recipient’s native heart is usually
healthy, this can then itself be transplanted into
someone needing a heart transplant.

15.
CHEST:
 Heart (deceased-donor only)
 Lung (deceased-donor and living-donor)
 Heart/Lung (deceased-donor and domino transplant)
ABDOMEN:
 Kidney (deceased-donor and living-donor)
 Liver (deceased-donor and living-donor)
 Pancreas (deceased-donor only)
 Intestine (deceased-donor and living-donor)
 Stomach (deceased-donor only)
 Testis (deceased-donor and living-donor)

16.
TISSUES,CELLS AND FLUIDS:
 Hand (deceased-donor only)
 Cornea (deceased-donor only)
 Skin (deceased-donor, living-donor and autograft)
 Islets of langerhans (deceased-donor and living-
donor)
 Bone marrow (living-donor and autograft)
 Heart valves (deceased-donor, living-donor and
xenograft)
 Bone (deceased-donor, living-donor and autograft)

17.
LIVING DONOR:
In living donors, the donor remains alive and
donates a renewable tissue, cell or fluid(ex: skin,
blood) or donates an organ(primarily single kidney
donation, partial donation of liver, lung lobe).
DECEASED DONOR:
Deceased donors are people who have been
declared brain-dead and whose organs are kept viable
by ventilators or other mechanical mechanism until
they can be excised for transplantation.

18.
 1908- First transplant of a knee
 1909- First recorded kidney transplant, animal to human
 1936- First human-to-human kidney transplant
 1953- First successful surgery using heart-lung bypass
 1954- First successful kidney transplant
 1963- First successful lung transplant
 1967- First successful liver transplant
 1968- First successful heart transplant in the U.S
 1973- First successful bone marrow transplant
 1998- First successful hand transplant

19.
 When an organ that meets your requirements is
located, the transplant doctors will be checking the
donor organ while you are being evaluated and
started on medications in preparation for
transplantation.
 If the donated organ is good, you will then be taken
to the operating room, put to sleep with an anesthetic,
and one of the transplant surgeons will begin the
process of preparing the chest cavity for removal of
your heart.

20.
The surgeon will begin by exposing the chest
cavity through a cut in the ribcage.The surgeon
will then open the pericardium(a membrane that
covers the entire heart)in order to remove your
diseased heart.The back part of your own left
atrium will be left in place, but the rest of the
heart will be removed.

21.
Your new heart will be carefully trimmed
and sewn to fit the remaining parts of your
old heart. This transplant method is called
an "Orthotopic procedure".This is the most
common method used to transplant hearts.

22.
You will be given medications both before and
during the operation to prevent you from
rejecting the new heart. After the operation,
You will be taken to a special unit and hospital
floor for recovery. You will stay in the hospital
until your doctor believes you are ready to go
home. How long you stay in the hospital will
depend on the following factors:
•Your health
•How well the new heart is working
•Your ability to learn to take care of your new
heart transplant

23.
TRANSPLANT REJECTION
 Hyperacute
 Occurs minutes to hours after
transplantation
 No treatment (organ must be
removed)
 Acute
 Occurs days (one week) to month
after transplantation
 T- cytotoxic lymphocytes attack
to the transplanted organ
 Chronic
 Occurs over months to years
 Most common in lung transplants
SOME COMMON
SIGNS AND SYMPTOMS
 Pain at the site of the transplant
 Feeling ill
 Flu-like symptoms
 Fever
 Weight change
 Swelling
 Decreased urine output

24.
 Corticosteroids
Prednisolone
Hydrocortisone
 Calcineurin inhibitors
Cyclosporin
Tacrolimus
 Anti-proliferative
Azathioprine
Mycophenolic acid
 mTOR inhibitors
Sirolimus
Everolimus

25.
 Bone Marrow (autograft): $360,000
 Bone Marrow (allograft): $800,000
 Cornea: $25,000
 Heart: $1 million
 Intestine: $1.2 million
 Kidney: $260,000
 Liver: $575,000
 Lung: $550,000
 Double Lung: $800,000
 Pancreas: $290,000
 Heart/Lung: $1.2 million
 Kidney/Pancreas: $475,000
 Kidney/Heart: $1.3 million
 Liver/Kidney: $1 million

26.
Organ transplant is a successive therapeutic option for
treatment of end stage organ disease. Success depends
on improved surgical techniques, immunosuppression,
organ preservation and follow-up.

27.
 Manara, A. R.; Murphy, P. G.; O'Callaghan, G. (2011).
"Donation after circulatory death". British Journal of
Anaesthesia 108: 108–121.
 Frohn C, Fricke L, Puchta JC, Kirchner H (February 2001). The
effect of HLA-C matching on acute renal transplant
rejection, Nephrol. Dial. Transplant. 16 (2): 355–60.
 Yacoub, M. H.; Banner, N. R.; Khaghani, A.; Fitzgerald, M.;
Madden, B.; Tsang, V.; Radley-Smith, R.; Hodson, M. (1990).
"Heart-lung transplantation for cystic fibrosis and subsequent
domino heart transplantation". The Journal of heart
transplantation 9 (5): 459–466.
 West, L. J., Pollock- Barziv, S. M., Dipchand, A. I., Lee, K.-J. J.,
Cardella, C. J., Benson, L. N.; et al. (2001). "ABO-incompatible
(ABOi) heart transplantation in infants". New England Journal of
Medicine 344 (11): 793–800.

28.
 Fan X, Ang A, Pollock-Barziv SM, Dipchand AI, Ruiz P,
Wilson G, Platt JL, West LJ (2004). "Donor-specific B-cell
tolerance after ABO-incompatible infant heart
transplantation". Nature Medicine 10 (11): 1227–1233.
 Horisberger B, Jeannet M, De Weck A, Frei PC, Grob P,
Thiel G (October 1970). "A cooperative kidney typing and
exchange program". Helvetica Medica Acta 35 (4): 239–47.

29.
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