Organ Transplantation

Organ Transplantation

Organ transplantation is a medical procedure that entails removing viable organs from a donor and transplanting them into a receiver (especially someone with a defective organ, with organ failure, or who is very ill due to an organ pathology). The process is known to save the lives of people with malfunctioned organs or organs that are defective. (Linden, 2009)

Both organs and tissues can be transplanted; in Australia, organs that can be transplanted include the heart, kidneys, liver, lungs, intestine, and pancreas. Tissues that can be transplanted include heart valves, bone, tendons, ligaments, skin, and the eye.

Purpose of Organ Transplant

Persons with a defective organ that is not working anymore (end-stage organ failure) warranty an organ transplant. An organ transplant is usually considered after other possible treatments have been tried, tested, and probably failed- it is regarded as the final treatment option. A transplant can also be used to improve someone’s quality of life. For instance, a kidney transplant can be recommended for someone who has experienced kidney failure or other significant renal diseases. A tissue transplant may be considered in cases of severe burns to a sensitive area of skin, such as the face – the process of skin grafting. (Anthony et al.,2009)

Transplant rejection

Transplant rejection occurs when the recipient’s immune system attacks the transplanted organ or tissue. The causes of rejection include; rejection by the immune system- your body’s immune system is designed to protect you from substances that are deemed harmful like germs, poisons, and cancer cells. These harmful substances have proteins called antigens coating their surfaces. When the antigens enter the body, the immune system recognizes them as ‘foreign’ and thus attacks them. During transplant surgery, a person’s immune system may recognize the received organ as foreign; this is because the person’s immune system detects that the antigens on the organ cells are not “matched.” Mismatched organs can trigger a blood transfusion reaction or transplant rejection reaction. (Stussi et al. 2009)

To prevent the blood transfusion or transplant rejection reaction, doctors must type and match both the organ donor and the person receiving the organ. The more similar the antigens are between the donor and recipient, the less likely the organ will be rejected- and thus no rejection reactions.

Tissue typing is a medical procedure that ensures that the organ or tissue being transplanted is as similar as possible to the recipient’s tissues and organs. The match is usually not perfect since only identical twins have identical tissue antigens.

Doctors can also consider using some medicines to suppress the recipient’s immune system. The objective is to prevent the immune system from attacking the newly transplanted organ when the organ is mismatched. In most cases, the body will launch an immune response and destroy the foreign tissue if these medications are not used. (Halloran, 2004).

The only exceptions are; corneal transplants, which are rarely rejected because the cornea has no blood supply, and transplants between identical twins.

There are three types of rejection:

Hyperacute rejection occurs a few minutes after an organ transplant, where the antigens are completely unmatched. The tissue must be removed immediately to prevent the death of the recipient. This type of rejection is also seen when a recipient is given the wrong type of blood in blood transfusion reaction cases. For example, when a person has given type A blood when he or she is type B.

Acute rejection may occur any time from the first week secondary to the transplant to 3 months afterward. All organ recipient experiences some degree of acute rejection.

Chronic rejection occurs over several years, where the body’s immune response against the new organ slowly damages the transplanted tissues or organs.

Effects of transplantation on emotions

An organ transplant affects both an individual’s body and mental health status in addition to other effects. Most people experience stressful events from possible organ rejection or the side effects of the medications used. Others report finding difficulties in adapting to their new situation. Speaking with your healthcare provider team about how you feel following the procedure has shown to improve the patients’ mental health. You may also want to consider attending patient support groups to hear from people who have also had an organ transplant (Corbett et al. 2013)

Life after Organ Transplant

Life after an organ transplant will probably require an individual to take medications and have regular medical appointments and checkups.

Anti-rejection medications target the immune system to prevent transplant rejection reaction from happening. Anti-rejection medicines have side effects such as infection; hence you and your healthcare team will be required to work together to balance organ rejection risk with the risk of side effects.

An individual is expected to incorporate healthy habits into their lifestyle to allow the transplanted organ to stay longer. This usually includes healthy eating habits and a balanced diet, reducing smoking, and involvement in physical activity and exercise. Your healthcare team will give specific advice and information on taking care of your transplanted organ.

Organ transplant and personality changes

A story that appeared on the science news website -Medical Daily in July 2013 has once again been doing rounds on social media. The article claims that patients who have had transplants have been known to take on their donors’ personalities. This claim is based on the idea that cells have memories – an idea that is normally the preserve of quacks and homeopaths. Cellular Memory Theory explains it all.

Cellular Memory Theory is a theory that attempts to explain the many cases of organ donor recipients who experience and develop new traits, attitudes, and urges as soon as they start recovering from their transplant. According to Cellular Memory Theory, our personality traits make us who we are; so, when a donor recipients’ reports having new personality aspects immediately after recovery, it could feasibly be the influences of their donors (Dossey, 2008)

Cellular memory is the idea that memories and personality traits can be stored in individual cells or in other organs, not just in the brain. One study followed ten organ transplant recipients and found two to five parallels with the donor’s history per transplant recipient. These parallels included changes in food, music, art, sexual, recreational, and career preferences.

Another study that involved 47 transplant recipients found that 6% of patients reported that their personalities had changed due to their new organ. The heart is often seen as a source of love, emotions, and focus on personality traits (Pearsall et al. 2002). To shed more light on the problem of whether heart transplant patients feel a change in their personality after having received a donor’s heart, 47 patients who were transplanted over two years in Vienna, Austria, were invited to an interview.  Three groups of patients could be identified: 79% reported no changes in their personality traits postoperatively. In this group, patients showed massive defense and denial reactions, mainly by rapidly changing the subject or making the question ridiculous. Fifteen percent reported that their personality had changed, not because of the donor organ, but due to the life-threatening event. Six percent (three patients) reported a distinct change of personality due to their new hearts.

References

Anthony, S. J., BarZiv, S. P., & Ng, V. L. (2010). Quality of life after pediatric solid organ transplantation. Pediatric Clinics, 57(2), 559-574.

Corbett, C., Armstrong, M. J., Parker, R., Webb, K., & Neuberger, J. M. (2013). Mental health disorders and solid-organ transplant recipients. Transplantation, 96(7), 593-600.

Dossey, L. (2008). Transplants, cellular memory, and reincarnation. Explore-Journal of Science and Healing, 4(5), 285.

Halloran, P. F. (2004). Immunosuppressive drugs for kidney transplantation. New England Journal of Medicine, 351(26), 2715-2729.

Linden, P. K. (2009). History of solid organ transplantation and organ donation. Critical care clinics, 25(1), 165-184.

Pearsall, P., Schwartz, G. E., & Russek, L. G. (2002). Changes in heart transplant recipients that parallel the personalities of their donors. Journal of Near-Death Studies, 20(3), 191-206.

Stussi, G., Halter, J., Schanz, U., & Seebach, J. D. (2006). ABO-histo blood group incompatibility in hematopoietic stem cell and solid organ transplantation. Transfusion and Apheresis Science, 35(1), 59-69.