The future of organ transplantation

Organ transplantation is a branch of medical science that is just over 60 years old. During this period, this science has been accompanied by very significant successes, so that it is known as one of the miracles of modern science. Many patients who used to struggle with death due to organ failure are now successfully treated with transplants, but organ transplants have their own problems.
The organ transplant process is such that a member must first be available to be transplanted. Therefore, one of the problems is the lack of transplanted organs. Unfortunately, due to this shortage, a significant number of patients will die before transplantation. The second problem is that until the organ is transplanted, the organ is out of the body and has no blood supply. This in itself harms the transplanted organ. The third issue is that this organ is a non-internal transplant and the body’s defense system intends to reject it, a problem known as transplant rejection. If these three problems are solved, more patients will be transplanted and the success of the transplant will be higher.
1- Lack of organs
One of the major problems of transplantation is the lack of transplanted organs. For example, in our country, one person dies every 7 minutes due to lack of a suitable transplant member. In the United States, more than 100,000 people are waiting for a transplant, and only 30,000 are transplanted each year, and many patients on the waiting list will die.
One solution to this problem is to make an organ out of the patient’s own stem cells. Not only can this solve the problem of organ failure, but it also solves the problem of transplant rejection because the cells themselves are sick and there is no need to take anti-transplant drugs.
These drugs themselves have many side effects and costs. For the first time, using patient stem cells and tissue engineering techniques, doctors were able to make a trachea (airway) and transplant it into a 2-year-old child during a 9-hour operation. This has already been done for 6 other patients. Researchers are trying to use these methods to make other organs sick using their own stem cells.
Another solution to the problem of organ failure is to make artificial organs such as a heart or kidney. If a person with kidney failure can be kept alive with a dialysis machine, why not treat the patient with a small dialysis machine that can be transplanted. Or did the same thing with an artificial heart. The heart is a pump. Researchers have developed a small artificial heart that can be attached to a patient or placed inside a patient’s chest to do the work of the heart. Researchers at the University of California, San Francisco, are building an artificial kidney that can be implanted in a patient’s body to do kidney work, which purifies the blood of toxins.
One of the new technologies that has helped build a transplanted organ is 3D printing. Researchers in the United States have succeeded in producing a 3D-printed bladder that can be transplanted into a patient. Or use this technology to make ears and transplant to the patient. Although this technology is in its infancy, it is hoped that with its development it will be possible to produce more complex organs such as the heart, lungs, liver or kidneys.
2- Rejection transplant
Because it is a non-native organ, the human immune system will fight it and intend to destroy it. Therefore, these patients should take anti-transplant drugs for the rest of their lives. This drug is not without side effects and has a high cost. In addition, despite the use of these drugs, transplant rejection sometimes occurs, which leads to organ failure.
Researchers at Harvard University in the United States have succeeded in using the bone marrow and kidney cells of the donor to create a state in which the immune system does not reject the kidneys. This condition is called tolerance. By doing this, the immune system will be composed of both donor cells and receptor cells, so that it recognizes the transplanted kidney and does not reject it. Therefore, these patients do not need any medication to prevent transplant rejection. It is hoped that this method can be used in other links as well.
3- Being out of the body
The transplanted organ is sometimes out of the body for hours until the person is transplanted and has no blood supply. This can lead to organ damage. Sometimes you have to wait for days or maybe weeks for the organ to work. During this period, for example, in a kidney transplant, a person can be dialyzed to use an organ, but in a heart or liver transplant, if the organ does not work, it may lead to the patient’s death.
Recently, devices have been developed that mimic the body’s environment outside to cause less organ damage, for example, in the UK, the kidney is placed on the device, which is a pump that delivers blood and oxygen to the organ until it is transplanted. They have done the same with the heart, lungs and liver. In this way, until the transplant, the organ is in the same position inside the body and continues to work. For example, in the case of the kidneys, it produces urine outside the body, or in the case of the liver, it produces bile.
It is hoped that with the advancement of science in the above fields, more people with organ failure will be transplanted and the transplant results will be better than they already are.

Dr. Reza Saidi Firoozabadi – Transplant surgeon