Organ Transplant

How long did a person live after the first heart transplant?

18 days 

Organ Transplant

surgical operation in which a failed or damaged organ in the human body is removed and replaced by a functioning one.

Where can these organs come from?

Living donor, deceased donor, or animal

What organs are most needed

kidneys, liver, and heart.

Organs that can be transplanted are

hearts, lungs, liver, kidneys, pancreas, and intestines. 

Tissues that can be transplanted are

cornea, tendon, valves, veins, skin, and bones.

What tissue types can be transplanted

connective, epithelium, nervous, and muscle.

What transplanted things are not common, but can happen

hand and face.

Common test to determine hand eye coordination

9 peg hole test

What is a type of transplantation (1)

Autograft

What is a type of transplantation (2)

Isograft

What is a type of transplantation (3)

Allograft

What is a type of transplantation (4)

Xenograft

Autograft

Graft in the same person from one part of the body to another.

Common transplants for autograft

skin graft, hair transplantation, Bone

Isograft

between two identical twins

Allograft

between different members of the same species.

Allograft common transplants

kidney transplantation, heart, lung, liver

Xenograft

between two different species like monkey to man

How do you match donors (1)

Blood type

How do you match donors (2)

HLA Match

How do you match donors (3)

Serum Cross-matching

Antibodies in Type A blood

Anti-B

Antibodies in Type B blood

Anti-A

Antibodies in type AB blood

None

Antibodies in type O blood

Anti B and Anti A

Antigens correlate to what

what type of blood it is

Type A can receive what blood

A, O

Type B can recieve what blood

B, O

Type AB can recieve what blood

AB, A, B, O

Type O can receive what blood

O

HLA means what

human leukocyte antigen

HLA matches what

tissue matching

Antigens are what

proteins on the cell bodies

How many antigens are there/how many have been identified 

over 100/only 6 have been identified 

Plasma Cross matching layers - bottom

45% RBC

Plasma Cross Matching Layers - Middle

1% Buffy Coat (WBC and Platelets)

Plasma Cross Matching Layers - Top

55% Plasma (salt, minerals, proteins).

Plasma Cross Matching is what

when blood from donor and the reciever are mixed.

How many times is this done (PCM)

twice; one including before sugrey.

If recipient cells attack donors what does this indiacte

The recipient has antigens against the donor and is positive.

If recipient cells does not attacks donors what does this mean 

they are negative and can receive the organ

One Person can donate how many organs?

8; including heart, 2 lungs, pancreas, 2 kidneys, intestines, liver.

How does someone become a donor 

They must die in a hospital, be on a ventilator, meet medical criteria, and obtain authorization

8 truths (1)

anyone can register to be an eye, organ, tissue donor regardless of race, age and ethnicity. 

8 truths (2)

Your donation status does not affect medical care. 

8 truths (3)

donation does not become an option until death

8 truths (4)

all major religions support donation.

8 truths (5)

there is no cost to the donor of the family.

8 truths (6)

an open casket funeral is an option for donors.

8 truths (7)

donor and family are treated with the upmost respect.

8 truths (8)

A living donor can donate kidneys or parts of other body.

you are matched with donors and organs how

long-term survival

How is this long-term survival determined

The difference between life expectancy with transplantation and life expectancy without
transplantation.

Factors that contribute to recieving an organ

age, time on waiting list, infection, mental status, smoking, weight, diabetes.

Immunosuppresants

stop your immune system from damaging healthy cells and tissues

Prograf Drug

reduces t-cell proliferation

Mycolat drug

Reduces T & B Cell proliferation

Septrin drug

Prevents opportunistic infections

Valcyte

Prevents opportunistic infections

ranitdine drug

protects stomach

Prednisolone drug

Inhibits specific glucocorticoid signaling

why is open heart surgery difficult 

because your heart is always pumping and how do you maintain tissue oxygen in the absence of a pump

Cardioplegia 

a pharmacological therapy administered during
cardiac surgery to intentionally and temporarily arrest the heart.

what is cardioplegia made of 

Potassium Citrate 

why is cardioplegia made of Potassium Citrate

Bathing the heart with a compound high in K+ increases extracellular K+ concentrations and disrupts the generation of action potentials + contraction.

what is another form of cardioplegia 

ice cold cardioplegia which stops cellular metabolism and places the organ in a resting state

Steps of cardiopulmonary bypass

resevior-pump-o2-filter

arterial cannula goes where and comes from where

comes from the filter and inserts into aortic root

venous cannula comes from what and inserts into what

comes from right aortic arch inserts into resveior

How do you maintain tissue oxygenation without pump

Cardiopulmonary bypass machine

what does Cardiopulmonary bypass machine too

takes over the heart and lungs and pumps blood and oxygen in the body

How many people are on waiting list and die while on it 

Over 100k are on it and 17 people die a day

How many people are waiting for a heart

3500 people are waiting for a heart, and 1 out of every 7 will die and for kids it is 1 in every 4

Limiting factors of donation (1)

Some organs must be harvested from a recently deceased victim (tissues)

Limiting factors of donations (2)

Hearts can only be harvested from brain-dead patients, and only 150/6000 hospitals perform transplants, and hearts die 4-6 hours after being removed. 

Xenotransplations

can be traced back to the 1900’s, pigs and non-humans have similar heart and kidney anatomy to humans. The first case was monkeys to humans, but humans died due to rejection

CRISPR

geneticlly modifes DNA sequences and modify gene function

10 genes were involved in pig to human transplant

3 were hinder to be inactivated, 6 matched our HLA were inserted, and 1 was reudced to decrease pig heart growth.

Timeline of pig transplantation

2020- approved by FDA, 2021- Kidneys were transplanted, 2022-heart

How did the patient respond to the pig heart?

patient responded well, but died two months later

Questions to ask about the future?

Immunosuppressants on pig tissue, ethics, research on physiology of pig heart, pigs carry viruses, microbiome risk.