Organ procurement

Organ harvesting
Intervention
MeSH D020858

In immunology, organ procurement is a surgical procedure that removes organs or tissues for reuse, such as in organ transplantation.[1] It is mired in ethical debate and heavily regulated, but has largely become an accepted medical practice.

Procedures

The first step of organ procurement is to check the health condition of the organ. If the source is human, most countries require that the source is legally dead for organ transplantation purposes (e.g. cardiac or brain dead) or a voluntary healthy adult for the donation of some organs. Organs cannot be procured after the heart has stopped beating for long time. Thus, a brain dead donor is preferred, but only a small percentage of deaths are brain deaths. Therefore, the majority of human organ sources are post cardiac death.[2]

Donation after cardiac death (DCD) involves surgeons taking organs within minutes of the cessation of respirators and other forms of life support for patients who still have at least some brain activity. DCD had been the norm for organ donors before 'brain death' became the standard in the early 1970s. Since then, most donors have been brain-dead.

If consent is obtained from the source or the source's survivors, the next step is to perform a match between the source (donor) and the target (recipient) to reduce allergies. In the United States, the match between human donors and recipients is coordinated by groups like United Network for Organ Sharing.[3]

Co-ordination between teams working on different organs is often necessary in case of multiple-organ procurement.[4] Multiple-organ procurement models are also developed from slaughtered pigs to reduce the use of laboratory animals.[5]

Quality of the organ then is certified. If the heart stopped beating for too long then the organ becomes unusable[4] and cannot be used for transplant.

After organ procurement the organs are often rushed to destination for emergency transplanting or preserved for later use or study.

Ethical issues

As part of the organ transplantation this procedure is part of many ethical debates. The debates are less on donations between relatives, paired exchange or altruistic donation but more on illegal, forced or compensated transplantation like organ theft or organ trade, and to a less degree, on fair organ distribution, animal rights and religious prohibition on consuming some animals such as pork.

See also

References

  1. ↑ "Tissue and Organ Harvesting". Ncbi.nlm.nih.gov. Retrieved 2014-01-11.
  2. ↑ "Southwest Transplant Alliance" (PDF). Organ.org. Retrieved 2014-02-11.
  3. ↑ Organ Donation after Cardiac Death; Robert Steinbrook, M.D. N Engl J Med 2007; 357:209-213 July 19, 2007 DOI: 10.1056/NEJMp078066
  4. 1 2 An improved technique for multiple organ harvesting, TE Starzl, C Miller, B Broznick, Surg Gynecol Obstet. 1987 October; 165(4): 343–348.
  5. ↑ Multiple-organ harvesting for models of isolated hemoperfused organs of slaughtered pigs. C Grosse-Siestrup, C Fehrenberg, H von Baeyer. Dept. and Facilities of Experimental Animal Sciences, Humboldt University of Berlin, Germany
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