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Dr Duncan

Organ transplants

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Most of you who are involved in preparing family meals, will have at some time or other cut your finger - and if you’re like me, some of you may even have sliced a piece off the top of your finger too! The amazing thing is that once you’ve recovered the missing bit from amongst the potato peelings and given it a quick wash, if you place it back where it came from on the finger and bandaged it in place, in the vast majority of cases it will heal perfectly and leave little trace of ever having been “sliced and diced” in the first place. However, if you took someone else’s skin and placed it on the raw wound, then your body would reject the replacement skin and leave you with a nasty scar.

Skin grafts are like giving yourself a transplant of your own skin, and small ones will heal quickly and well. The reason they work so well is that they contain your cells which your body’s immune system will recognize and not reject. But it’s a whole new ball game when you try and introduce someone else’s cells into, or onto, your body because your immune system is primed to seek them out and reject them.
The history of organ transplantation is the story of the last 100 years. Because our bodies have evolved over the millennia, they’ve developed an immune system that is focused on fighting off ‘invading forces’ and protecting the normal running of our vital organs. That’s why transplantation has been such a difficult thing to perform because circulating immune cells will reject anything introduced into our system. But certain areas of the body have no actual blood supply and that makes them potential targets for successful transplants.
The cornea on the eye is a great example of this and is probably the reason why it was the first case of successful transplantation in Moravia in 1905. Our heart valves are other structures that have no direct blood supply although they function full time bathed in blood. In 1955 our Canadian colleagues performed the first heart valve transplant and around the same time the Americans performed a kidney transplant from one identical twin to another. Because they were identical, there would be no concerns about rejection.
Back then, understanding how rejection worked was a whole new frontier with researchers using tools that had been invented back in the 19th century. But with advances in science and human biochemistry, organ transplantation began to really take off in 1962. That was the year that the world’s first kidney transplant was successfully completed in the US - just one year after the Americans had successfully placed a man into space! Our own first successful kidney transplant occurred in Adelaide in 1965.
 
Prof Christiaan Barnard performed the world’s first heart transplant at Groote Schuur Hospital in Cape Town South Africa at the end of 1967. The patient, Louis Washkanski survived what was a technically successful operation and even managed to get out of bed, but he died after only 15 days from infections caused as a result of the powerful immuno-suppressant medications he had been given. Needless to say, modern heart transplant recipients have far longer and happier outcomes!
Since those early pioneering days, organ transplantation has become a part of the normal set of surgical procedures, but we still have around 1,600 people registered on the organ transplant waiting lists. So to get you thinking about how you can help out, here are some facts:

  • One organ and tissue donor can transform the lives of 10 or more people.
  •  In 2012, 354 organ donors gave 1,052 Australians a new chance in life.
  • The number of organ donors and transplant recipients in 2012 was the highest since national records began.
  • Australia is a world leader for successful transplant outcomes.
  • The majority of Australians are generally willing to become organ (80%) and tissue (78%) donors.
  • Only around 1% of people actually die in hospital in the specific circumstances where organ donation is possible. The circumstances in which you can become a tissue donor are less limited .

End of life issues are not often discussed in families, but each one of us does need to make their own Last Will and Testament, and that’s one great time to discuss what you may want done with your body, once you don’t need it anymore. Other opportunities arise when you update your driving-license and there’s a box you can tick if you’d like your organs donated should you be involved in a fatal accident.
Most of us are blessed with good health in great bodies, but we can share that blessing by donating organs and tissues from our bodies to those less fortunate, once we have left our bodies behind.

Article written by Dr. Duncan Jefferson. More articles here. For more information on health care and private health cover, visit HBF Insurance at www.hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.

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