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A Concise Presentation
By
Mr. Deepak Sarangi, M.Pharm
ORGAN TRANSPLANTATION
 Introduction
 History of transplant
 Types of transplants
 Major organs and tissues transplanted
 Types of donors
 ...
 DEFINITION :
An organ transplant is a surgical operation in
which a failure or damaged organ in human body is
removed an...
SIR PETER MEDAWAR:
Father of transplantation worked
on graft rejection and acquired
immune tolerance in 1944 showed
that s...
ALEXIS CARREL:
The noble prize in physiology or
medicine 1912 was awarded to
Alexis carrel in recognition of
his work on v...
BRUCE REITZ:
On march 9th 1981 the first
successful heart lung transplant
took place at stanford
university hospital. The
...
DR.EDUARD ZIRM:
The first successful human
Corneal transplant, a
keratoplastic operation
was performed by
Eduard zirm in A...
 Autograft
 Allograft
 Isograft
 Xenograft
 Split transplant
 Domino transplant
 Autograft is a transplant of tissue from one to
oneself. Sometimes this is done with surplus tissue,
or tissue that can ...
 An allograft is transplant of an organ or tissue
between two genetically non identical
members of the same species. Most...
 A sub set of allografts in which organs or tissues are
transplanted from a donor to a genetically identical
recipient(su...
 A transplant of organs or tissue from one species to
another. Xenograft is often an extremely dangerous
type of transpla...
 Sometimes, a deceased-donor organ, usually a liver,
may be divided between two recipients, especially an
adult and a chi...
 This operation is usually performed for cystic fibrosis
as both lungs need to be replaced and it is a
technically easier...
CHEST:
 Heart (deceased-donor only)
 Lung (deceased-donor and living-donor)
 Heart/Lung (deceased-donor and domino tran...
TISSUES,CELLS AND FLUIDS:
 Hand (deceased-donor only)
 Cornea (deceased-donor only)
 Skin (deceased-donor, living-donor...
LIVING DONOR:
In living donors, the donor remains alive and
donates a renewable tissue, cell or fluid(ex: skin,
blood) or ...
 1908- First transplant of a knee
 1909- First recorded kidney transplant, animal to human
 1936- First human-to-human ...
 When an organ that meets your requirements is
located, the transplant doctors will be checking the
donor organ while you...
The surgeon will begin by exposing the chest
cavity through a cut in the ribcage.The surgeon
will then open the pericardiu...
Your new heart will be carefully trimmed
and sewn to fit the remaining parts of your
old heart. This transplant method is ...
You will be given medications both before and
during the operation to prevent you from
rejecting the new heart. After the ...
TRANSPLANT REJECTION
 Hyperacute
 Occurs minutes to hours after
transplantation
 No treatment (organ must be
removed)
...
 Corticosteroids
Prednisolone
Hydrocortisone
 Calcineurin inhibitors
Cyclosporin
Tacrolimus
 Anti-proliferative
Azathio...
 Bone Marrow (autograft): $360,000
 Bone Marrow (allograft): $800,000
 Cornea: $25,000
 Heart: $1 million
 Intestine:...
Organ transplant is a successive therapeutic option for
treatment of end stage organ disease. Success depends
on improved ...
 Manara, A. R.; Murphy, P. G.; O'Callaghan, G. (2011).
"Donation after circulatory death". British Journal of
Anaesthesia...
 Fan X, Ang A, Pollock-Barziv SM, Dipchand AI, Ruiz P,
Wilson G, Platt JL, West LJ (2004). "Donor-specific B-cell
toleran...
For More ppts plz
contact on
sarangi.dipu@gmail.com
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Organ transplantation ppt

  1. 1. A Concise Presentation By Mr. Deepak Sarangi, M.Pharm ORGAN TRANSPLANTATION
  2. 2.  Introduction  History of transplant  Types of transplants  Major organs and tissues transplanted  Types of donors  Timeline of successful transplants  Heart transplant procedure  Transplant rejection  Immunosuppressive drugs  Cost of transplants  Conclusion  References
  3. 3.  DEFINITION : An organ transplant is a surgical operation in which a failure or damaged organ in human body is removed and replaced with a functioning one. The donated organ may be from a deceased donor, a living donor or an animal.  Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine and thymus.  Tissues include bones, tendons, cornea, skin, heart valves, nerves and veins.  Worldwide, the kidneys are the most commonly transplanted organs, followed by the liver and then the heart.
  4. 4. SIR PETER MEDAWAR: Father of transplantation worked on graft rejection and acquired immune tolerance in 1944 showed that skin allograft between two mice are rejected. HISTORY
  5. 5. ALEXIS CARREL: The noble prize in physiology or medicine 1912 was awarded to Alexis carrel in recognition of his work on vascular suture and the transplantation of blood vessels and organs.
  6. 6. BRUCE REITZ: On march 9th 1981 the first successful heart lung transplant took place at stanford university hospital. The surgeon, Bruce reitz, credited the patients recovery to cyclosporine-A.
  7. 7. DR.EDUARD ZIRM: The first successful human Corneal transplant, a keratoplastic operation was performed by Eduard zirm in Austria 1905.
  8. 8.  Autograft  Allograft  Isograft  Xenograft  Split transplant  Domino transplant
  9. 9.  Autograft is a transplant of tissue from one to oneself. Sometimes this is done with surplus tissue, or tissue that can regenerate, or tissues more desperately needed elsewhere (examples include skin grafts, for CABG, etc.) sometimes this is done to remove the tissue and then treat it or the person before returning it.
  10. 10.  An allograft is transplant of an organ or tissue between two genetically non identical members of the same species. Most human tissue and organ transplants are allografts.
  11. 11.  A sub set of allografts in which organs or tissues are transplanted from a donor to a genetically identical recipient(such as an identical twin). Isografts are differentiated from other types of transplants because while they are anatomically identical to allografts, they do not trigger an immune response.
  12. 12.  A transplant of organs or tissue from one species to another. Xenograft is often an extremely dangerous type of transplant because of increased risk of non- compatibility, rejection, and disease carried in the tissue. Examples include porcine heart valves, which are quite common and successful. The latter’s research study directed for potential human use if successful.
  13. 13.  Sometimes, a deceased-donor organ, usually a liver, may be divided between two recipients, especially an adult and a child. This is not usually a preferred option because the transplantation of a whole organ is more successful.
  14. 14.  This operation is usually performed for cystic fibrosis as both lungs need to be replaced and it is a technically easier operation to replace the heart and lungs. As the recipient’s native heart is usually healthy, this can then itself be transplanted into someone needing a heart transplant.
  15. 15. CHEST:  Heart (deceased-donor only)  Lung (deceased-donor and living-donor)  Heart/Lung (deceased-donor and domino transplant) ABDOMEN:  Kidney (deceased-donor and living-donor)  Liver (deceased-donor and living-donor)  Pancreas (deceased-donor only)  Intestine (deceased-donor and living-donor)  Stomach (deceased-donor only)  Testis (deceased-donor and living-donor)
  16. 16. TISSUES,CELLS AND FLUIDS:  Hand (deceased-donor only)  Cornea (deceased-donor only)  Skin (deceased-donor, living-donor and autograft)  Islets of langerhans (deceased-donor and living- donor)  Bone marrow (living-donor and autograft)  Heart valves (deceased-donor, living-donor and xenograft)  Bone (deceased-donor, living-donor and autograft)
  17. 17. LIVING DONOR: In living donors, the donor remains alive and donates a renewable tissue, cell or fluid(ex: skin, blood) or donates an organ(primarily single kidney donation, partial donation of liver, lung lobe). DECEASED DONOR: Deceased donors are people who have been declared brain-dead and whose organs are kept viable by ventilators or other mechanical mechanism until they can be excised for transplantation.
  18. 18.  1908- First transplant of a knee  1909- First recorded kidney transplant, animal to human  1936- First human-to-human kidney transplant  1953- First successful surgery using heart-lung bypass  1954- First successful kidney transplant  1963- First successful lung transplant  1967- First successful liver transplant  1968- First successful heart transplant in the U.S  1973- First successful bone marrow transplant  1998- First successful hand transplant
  19. 19.  When an organ that meets your requirements is located, the transplant doctors will be checking the donor organ while you are being evaluated and started on medications in preparation for transplantation.  If the donated organ is good, you will then be taken to the operating room, put to sleep with an anesthetic, and one of the transplant surgeons will begin the process of preparing the chest cavity for removal of your heart.
  20. 20. The surgeon will begin by exposing the chest cavity through a cut in the ribcage.The surgeon will then open the pericardium(a membrane that covers the entire heart)in order to remove your diseased heart.The back part of your own left atrium will be left in place, but the rest of the heart will be removed.
  21. 21. Your new heart will be carefully trimmed and sewn to fit the remaining parts of your old heart. This transplant method is called an "Orthotopic procedure".This is the most common method used to transplant hearts.
  22. 22. You will be given medications both before and during the operation to prevent you from rejecting the new heart. After the operation, You will be taken to a special unit and hospital floor for recovery. You will stay in the hospital until your doctor believes you are ready to go home. How long you stay in the hospital will depend on the following factors: •Your health •How well the new heart is working •Your ability to learn to take care of your new heart transplant
  23. 23. TRANSPLANT REJECTION  Hyperacute  Occurs minutes to hours after transplantation  No treatment (organ must be removed)  Acute  Occurs days (one week) to month after transplantation  T- cytotoxic lymphocytes attack to the transplanted organ  Chronic  Occurs over months to years  Most common in lung transplants SOME COMMON SIGNS AND SYMPTOMS  Pain at the site of the transplant  Feeling ill  Flu-like symptoms  Fever  Weight change  Swelling  Decreased urine output
  24. 24.  Corticosteroids Prednisolone Hydrocortisone  Calcineurin inhibitors Cyclosporin Tacrolimus  Anti-proliferative Azathioprine Mycophenolic acid  mTOR inhibitors Sirolimus Everolimus
  25. 25.  Bone Marrow (autograft): $360,000  Bone Marrow (allograft): $800,000  Cornea: $25,000  Heart: $1 million  Intestine: $1.2 million  Kidney: $260,000  Liver: $575,000  Lung: $550,000  Double Lung: $800,000  Pancreas: $290,000  Heart/Lung: $1.2 million  Kidney/Pancreas: $475,000  Kidney/Heart: $1.3 million  Liver/Kidney: $1 million
  26. 26. Organ transplant is a successive therapeutic option for treatment of end stage organ disease. Success depends on improved surgical techniques, immunosuppression, organ preservation and follow-up.
  27. 27.  Manara, A. R.; Murphy, P. G.; O'Callaghan, G. (2011). "Donation after circulatory death". British Journal of Anaesthesia 108: 108–121.  Frohn C, Fricke L, Puchta JC, Kirchner H (February 2001). The effect of HLA-C matching on acute renal transplant rejection, Nephrol. Dial. Transplant. 16 (2): 355–60.  Yacoub, M. H.; Banner, N. R.; Khaghani, A.; Fitzgerald, M.; Madden, B.; Tsang, V.; Radley-Smith, R.; Hodson, M. (1990). "Heart-lung transplantation for cystic fibrosis and subsequent domino heart transplantation". The Journal of heart transplantation 9 (5): 459–466.  West, L. J., Pollock- Barziv, S. M., Dipchand, A. I., Lee, K.-J. J., Cardella, C. J., Benson, L. N.; et al. (2001). "ABO-incompatible (ABOi) heart transplantation in infants". New England Journal of Medicine 344 (11): 793–800.
  28. 28.  Fan X, Ang A, Pollock-Barziv SM, Dipchand AI, Ruiz P, Wilson G, Platt JL, West LJ (2004). "Donor-specific B-cell tolerance after ABO-incompatible infant heart transplantation". Nature Medicine 10 (11): 1227–1233.  Horisberger B, Jeannet M, De Weck A, Frei PC, Grob P, Thiel G (October 1970). "A cooperative kidney typing and exchange program". Helvetica Medica Acta 35 (4): 239–47.
  29. 29. For More ppts plz contact on sarangi.dipu@gmail.com

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