The miracles that new science brings

An overview of the problems of organ transplantation and the future facing this science

In the last decade, the science of transplantation has been associated with remarkable success; So that it is mentioned as one of the miracles of modern science. Many patients who used to struggle with death due to organ failure can be treated with transplantation with great success today, but organ transplantation has its own problems, which we will review in the following.

1- One of the major problems of transplantation is the lack of transplanted organ; For example, in our country, one person dies every seven minutes due to the lack of an improper transplant organ. In the United States, more than 100,000 people are waiting for a transplant, and only 30,000 people are transplanted each year, and many patients on the waiting list will die. One solution to this dilemma is to make an organ from the patient’s own stem cells. Not only can this solve the problem of organ failure, but because the cells themselves are diseased, it also solves the problem of transplant rejection and there is no need to take anti-transplant drugs. These drugs themselves have many side effects and costs. For the first time, doctors were able to make a trachea (airway to the lung) using patient’s stem cells and tissue engineering techniques, and transplant it into a two-year-old in a 9-hour operation. This has been done for six other patients. Researchers are trying to use these methods to make other parts of the body sick using their own stem cells. Another solution for 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 do the same with an artificial heart. The heart is actually a pump. Researchers have created a small artificial heart that can be attached to a patient or placed inside a patient’s chest to do heart work. Researchers at the University of California, San Francisco, are building an artificial kidney that can be implanted in a patient’s body to purify the blood of toxins. One of the new technologies that has helped build the link organ is 3D printing. Researchers in the United States have succeeded in making a bladder with a 3D print and transplanting it to a patient. Although this technology is in its infancy, researchers hope that as it progresses, they will be able to produce more complex organs such as the heart, lungs, liver or kidneys. Organ transplants from animals have long been on the minds of humans. At the Gate of Nations in Persepolis, there is a picture of a creature with a human head and members of different animals. Animal organ transplants were tested in kidney, heart, and liver transplants in the 1970s and 1980s, but were discontinued for decades due to unsuccessful outcomes and related ethical issues. Recently, with the use of genetic engineering technology, a glimmer of hope has been revived that animal organs may be used for transplantation.

2. Since it is a non-native transplanted organ, the immune system will fight it and intend to destroy it; Therefore, these patients should take anti-transplant drugs for the rest of their lives. These drugs are not without side effects and are very expensive. In addition, despite the use of these drugs, sometimes transplant rejection sometimes occurs and leads to organ failure. Researchers at Harvard University in the United States have succeeded in using bone marrow cells and donor kidneys at the same time to create a condition that does not detract from the kidney’s immune system. This condition is called tolerance. By doing this, the immune system will consist of both donor cells and recipient cells; So that the kidney knows the link and does not reject. As such, these patients do not need any medication to prevent transplant rejection. It is hoped that this method will be used in other links as well.

3. The transplanted organ may be out of the body for hours until it is transplanted to the recipient and has no blood supply. This can damage the transplanted organ. Sometimes you have to wait days or maybe weeks for an organ to work. During this time, for example in a kidney transplant, a person can be dialyzed to have an organ implanted, 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 simulate the environment outside the body so that the limb is less damaged. In the UK, for example, the kidney is placed on a device containing a pump that delivers blood and oxygen until it is transplanted into an organ. 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, it produces urine outside the body or bile around the liver.

It is hoped that with the advancement of science in these areas, more people with organ failure will be transplanted and the results of the transplant will be better than what we are witnessing now.

Dr. Reza Saidi Firoozabadi – Transplant surgeon