Definition of “organ transplantation”Medical point of view including:

(a) Types of organ donation(b) kinds of organs that can be transplanted

(c) Types of transplant including advantages and disadvantages

Organ transplantation in different countries and their statistics

Brief description of transplantation processBioethical and religious issues

Main problems by which people don’t will to donate their organs

Various ways of promotion about donation of organs to the people who are in need.

A national “shortage”

Every 13 minutes… Every hour… Everyday…

A person is added to the list

4 more are added 17 lose the fight

Organ transplant is a surgical operation in which a falling or damaged organ in the human body is removed and replaced with a functioning one.

Process of taking cells,tissues or organs called a “graft” from one individual and placing them into a different individual

Types of organ donation

Cadaveric organ donation: Involves in removing organs from a recently deceased (dead) donor.

Living organ donation: involves in the donation of one of a paired organ (such as kidneys) in which the donor’s organ system is still able to function after the donation

Individual who provides the graft

“ DONOR”

Individual who receives the graft

“RECEIPIENT”

Eligible donors

THORACIC ORGANS

Heart Heart/lung lung

INTESTINE

KIDNEY STOMACH

PANCREAS

LIVER

ABDOMINALORGANS

TISSUE CELLSAND FLUIDS

corneaBlood

transfusion

Kinds of organs which could transplant

Autograft: is self tissue transferred from one body site to another in the same

individual

Isograft: is tissue transferred between genetically identical individuals

Allograft: is tissue between genetically different members of the same species.

Xenograft: is tissue transferred between different species

TYPES OF TRANSPLANT

It satisfies the humans needs when other alternatives therapeutic modalities failIt has a religious tone, all major religions do not forbid but encourage it on the

ground of saving human lifeIt presents the highest moral human values “love,sharity, cooperation and compassion”

Expensive, increase risk of infection due to immunosuppressive drugs.

Also organ could have some genetics charactersThe donor organ could not match the recipient body

Organ transplantation in different countries

Despite efforts of international transplantation societies, it is not possible to access an accurate source on the number,rates and outcomes of all forms of transplantation globallythe best that we can achieve is estimations. This is not a sound basis for the future and thus one of the crucial strategies for the Global Alliance in Transplantation is to foster the collection and analysis of global data.

KidneyKidney(pmp*)(pmp*)

LiverLiver(pmp)(pmp)

HeartHeart(pmp(pmp))

USAUSA 5252 1919 88

EuropeEurope 2727 1010 44

AfricaAfrica 1111 3.53.5 11

AsiaAsia 33 0.30.3 0.030.03

Latin AmericaLatin America 1313 1.61.6 0.50.5

Transplantation of organs in different continents/regions year/ 2000

In addition to the citizens waiting for organ transplants in the US and other developed nations, there are long waiting lists in the rest of the world. More than 2 million people need organ transplants in China. Donor bases vary in developing nations.

Traditionally, Muslims believe body desecration in life or death to be forbidden, and thus many reject organ transplant.

In Latin America the donor rate is 40–100 per million per year, similar to that of developed countries. However, in Uruguay, Cuba, and Chile, 90% of organ transplants came from cadaveric donors.

Cadaveric donors represent 35% of donors in Saudi Arabia. There is continuous effort to increase the utilization of cadaveric donors in Asia, however the popularity of living, single kidney donors in India yields India a cadaveric donor prevalence of less than 1 pmp.

Transplantation rates also differ based on race, sex, and income. A study done with patients beginning long term dialysis showed that the sociodemographic barriers to renal transplantation present themselves even before patients are on the transplant list.example, different groups express definite interest and complete pretransplant workup at different rates.

Previous efforts to create fair transplantation policies had focused on patients currently on the transplantation waiting list

In 1994, the Government of India passed the Transplantation of Human Organs Act that legalized the concept of brain death and, for the first time, facilitated organ procurement from heart beating, brain dead donors. However, this concept has not caught on well in India for want of public education and awareness. This in turn is perpetuating the commercial sale of human organs due to the widening gap between the demand and supply. Thousands oflives are lost in India annually from heart and liver failure since transplantation of unpaired organs like heart, liver and pancreas is either difficult or impossiblefrom living donors.This is only possible on a large scale if these organs are available from cadaver donors

ORGAN DONATION IN INDIA.

Within the European Union, organ donation is regulated by member states. Individuals who wish to donate their organs after death can use the OrganDonation Register, a national database. The UK has recently discussed whether to switch to an opt-out system in light of the success in other countries and a severe British organ donor shortfall. 

ORGAN DONATION IN EUROPE.

Transplantation Regions

Statistics

All organs 7282

Kidney 5827

Liver 743

Pancreas 106

Kid/Panc 182

Heart 211

Lung 200

Heart/Lung 1

Intestine 12

All organs 2662

Kidney 1498

Liver 610

Pancreas 86

Kid/Panc 115

Heart 174

Lung 144

Heart/Lung 5

Intestine 30

On Waitlist as of 1/9/09 (reg 10)

Transplanted in 2007 (reg 10)

Blood type (A,B,AB and O)

Human leukocyte antigen (HLA) tissue typing

Serology for HIV, CMV hepatitis

Cardiopulmonary,cancer screening

Pre transplantation evaluation

Matching of stem cell donor to a recipient is determined

by comparing their tissue typesAn individual’s HLA type is present on nearly all

tissues in the bodyThe white cells from a blood sample are a

convenient source of “tissue” that the laboratory

can use to determine an individual’s HLA type

HLA TISSUE TYPING

A 20-30 ml blood sample is required to perform HLA typing.The white cells are isolated from the blood and typing is

performed by two different methodsSerological testing : where the white cells are used

DNA testing: where DNA extracted from the white cells is used.Preliminary tissue typing takes 2 weeks. further high resolution (more detailed) tissue typing performed on the patient and any potentially matched donor samples may take

another 2 or 4 weeks.

HOW IS HLA TYPING PERFORMED?

Because the degree of HLA compatibility between donor and recipient will influence the outcome of the transplant

The function of the immune system is to fight against foreign particles that the body sees as “non-self” such as bacteria and

viruses. A stem cell transplant from an HLA mismatched donor can result in the recipient’s immune system recognizing the transplanted cells as “non-self” and attacking the cells as it would for bacteria or viruses.This can lead to rejection of the transplanted stem cells likewise cells from the donor’s immune system which are introduced along

with the transplanted stem cells (graft) can also recognize HLA mismatches and attack vital organs of the recipient’s body (host).This is called graft versus host disease (GvHD)

The more compatible the donor-recipient match, the less likely it is that rejection or severe GvHD will occur

WHY IS HLA TYPING IMPORTANT?????

HyperacuteRejection

Endothelialdamage

thrombosis Inflammation

Acute rejection

Interstitial Cell

inflammation

ParenchymalCell damage

Chronic rejection

Vascular abnormalities

Fibrosis

Effector mechanism of “graft” rejection

Bioethical issues

Certain groups, like the Roma (gypsies), oppose organ donation on religious grounds.

But most of the world's religions support donation as a charitable act of great benefit to the community. Issues surrounding patient autonomy, living wills,

and guardianship make it nearly impossible for involuntary organ donation to occur.

Political issues

There are also controversial issues regarding how organs are allocated to recipients.

For example, some believe that livers should not be given to alcoholics in danger of reversion, while others view alcoholism as a medical condition like

diabetes.Faith in the medical system is important to the success of organ donationAllowing or forbidding payment for organs affects the availability of organs.

“Generally, where organs cannot be bought or sold, quality and safety are high, but supply is not adequate to the demand. Where organs can be

purchased, the supply increases”

Only 38% are registered as organ “donors”

Not healthy enough 23%Black market 44%

Misunderstanding 50%

RegisterOpt-in at the DMWSign a donor card

Matching of organs between members of same ethnic

Reduce Confusion

Motivate

Change the perception

Provide clear response methods

Pursued action to become organ donor

MARKETING STRATEGY

1)choose marketing tactics that can reach target audience2) create messages that can:

Reduce Fair

Messaging strategy:Warm glow giving + community movement

outdoor advertising

outdoor advertising

Registering is the first step, as well as the most crucial part, of becoming an organ donor. There are a few different ways people can choose to do so. One of the simplest ways is to register at the DMV (Department of Motor

Vehicles). When a person goes in to renew their license they are always presented with the option of becoming a donor, which only requires ticking a box on a form and a signature. There is also a box that people can specify

which organs and tissues to donate, and if they would prefer not to have them used for science.

Another way for someone to become an organ donor is online. In 1998 a law was passed that allows Colorado citizens to register, confidentially, online to

become an organ donor. People can also designate whether or not they would like their organs and tissues to be donated to science. The process can be

completed in only a few minutes.

Becoming a donor….

One Person.mp4