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Exploring the prevention measures to undertake a successful organ transplantation

By: Jiraporn Jensuriyarkun (Jamee), a Year 13 student at Harrow International School 

BACKGROUND

Organ transplantations are major operations that should only be offered when all other treatment options have failed. Consequently, it is often a life-saving intervention. Transplantation occurs when an organ system fails or becomes damaged as a consequence of disease or injury. The damaged organ be replaced with a healthy organ or tissue from a donor. The Immune system’s function is to detect harmful substances, which they find through spotting antigens. Antigens pose a significant barrier to successful transplantation because if the immune system detects these antigens and attacks the foreign substance, the transplanted organ or tissue will ultimately be destroyed. The small pool of eligible donors can make it difficult to find a donor-recipient match, so there is often a degree of rejection against the transplant. Moreover, this critical undersupply of donated organs means that waiting lists for transplants are extremely long, and individuals who need organ transplants may not always receive them. So what preventative measures should be taken to reduce the risk of rejection? First, we should explore the causes of organ rejection.

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THE CAUSES

When the donated organ is different or not “matched”, it can trigger a blood transfusion reaction or transplant rejection within the patient. Signs that this is occurring and the organ is not working properly are:

  • High blood sugar (pancreas transplant)

  • Less urine released (kidney transplant)

  • Shortness of breath and less ability to exercise (heart transplant or lung transplant)

  • Yellow skin color and easy bleeding (liver transplant)

If these symptoms are present, there may a transplant rejection. There are 3 types of rejection that may occur.

THREE TYPES OF REJECTION

Hyperacute rejection occurs a few minutes after the transplant when the antigens are completely unmatched. The tissue must be removed right away so the recipient does not die. This type of rejection is seen when a recipient is given the wrong type of blood.

 

Acute rejection may occur any time from the first week after the transplant to 3 months afterward. All recipients have some amount of acute rejection.
 

Chronic rejection can take place over many years. The body's constant immune response against the new organ slowly damages the transplanted tissues or organ.

Now, we can explore the preventative measures that should be taken to reduce the risk of these rejections.

PREVENTION

A biopsy of the transplanted organ can confirm that it is being rejected. A routine biopsy is often performed periodically to detect rejection early before the symptoms develop.

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ABO blood typing and HLA (tissue antigen) typing before a transplant helps ensure a close match. You will likely need to take medicine to suppress your immune system for the rest of your life to prevent the tissue from being rejected. Being careful about taking your post-transplant medicines and being closely watched by your doctor may help prevent rejection. 
 

Stem cell transplant -  Stem cells are cells that have the capacity to develop into a range of different types of cells in the body. Blood stem cells (haematopoietic stem cells) can develop into all the different cells found in the blood and are donated to replace damaged or destroyed blood cells. Haematopoietic stem cell transplants are used to treat certain types of cancer e.g. leukaemia, and blood diseases where the bone marrow has become damaged preventing the production of healthy blood cells. 

Ultimately, organ transplants are a valuable medical advancement, but the risks associated with them need preventative measures such as the ones discussed above. To read further on organ transplantations, please refer to the following sources.

By Jiraporn Jensuriyarkun (Jamee), a Year 13 student at Harrow International School

Sources and Further Reading

Julia Deathridge |British Society For Immunology| Transplant Immunology Available at : https://www.immunology.org/policy-and-public-affairs/briefings-and-position-statements/transplant-immunology
 

Transplant Rejection Available at : https://medlineplus.gov/ency/article/000815.htm
Thomas Volk (2018). A Change of Heart:My Transplant Experience |TEDxUWLaCrosse| Available at : https://www.youtube.com/watch?v=zU6mmix04PI

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