Introduction
Organ transplant is the medical practice where a healthy organ is removed from the donor and placed in the body of a recepient patient. This exercise is conducted to replace a damaged organ, thus saving a life. In some situations, organ or tissue transplant may occur within the same body where tissue is removed from one part and placed in the region that has already been damaged. This type of organ transplant is referred to as allografts. Historically, various types of organs have been successfully transplanted, thus strengthening the life of the patient. For instance, multiple patients have kidneys, heart, lungs, and liver that they have received from donors replacing their damaged parts. 1 Tissues such as bones, heart valves, and nerves have also been transplanted, indicating that technology has greatly advanced over the previous century. Though this technology has been recognized as an essential discovery in the field of health, it has been criticized for its adverse impacts. Organ transplant continues to evolve, but it has positive and negative effects.
History of Organ Transplant in the United States
The science of addressing organ or tissue failure has been in existence since the establishment of organ failure. For example, the science of transplanting an organ started in the middle ages with people trying to exercise transplants by transplanting borne. Despite these early attempts, scientific discovery and the practice of surgery began in the 19th and 20th centuries, increasing an opportunity for lengthening the life of an individual whose life was in danger after experiencing kidney or any other organ failure. 2 In the year 1900, medical practitioners first conducted a successful organ transplant starting with bone followed by skin. Therefore, the period between 1900 and 1920 marked a significant discovery in the field of medicine across the world after discovering organ transplant. Despite the establishment of this skill, storage facilities remained a compelling challenge that necessitated research to identify the technology that could be applied in storing organs and tissues that could be applied in the storage of organs and tissues for transplantation. However, the first storage facility was established in the U.S. Navy Tissue Bank in the year 1949. 3 This year marked the beginning of the discovery of the technology that could be applied in the processing and storage of tissues. This skill spread through different parts of the world, leading to the creation of approximately more than 300 nonprofit bone bank operations in the United States by the year 1986.
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Despite the earliest discovery in the year 1920, successful organ transplant started in the late 1950s when Joseph E. Murray performed the first successful kidney transplant in the world. The kidney transplant was conducted between identical twins in the year 1954. This discovery was followed by a series of other organ Transplant such as heart transplant that was performed by a South African surgeon. During this time, organ transplant had become common, with many medical practitioners adapted to this saving the lives of various people in the United States and across other nations. Though surgeons had understood the skills they required conducting successful organ transplant in the 19th and 20th centuries, there were several challenges related to technology that they faced. 4 Organ transplant indicates that organs from different bodies are brought together, creating an issue of the effectiveness of the immune system of the body. In some situations, the body organ system could reject the adoption of a particular foreign body making the process complicated. However, technology continued to evolve as surgeons had to give patients medications capable of suppressing the body to avoid the occurrence of life-threatening infections that could make the organ transplanted more complicated.
The history of organ transplant in the United States can be traced by considering the different organs that were transplanted each year since the first kidney transplant in the year 1949. The development of organ and tissue transplants experienced in modern society in the United States experienced different challenges that required technological development to address such drawbacks. As the technology of organ transplant accelerated over the year, ethical and legal concern emerged, requiring people to develop skills that could be applied in ensuring that there is the development of technology capable of addressing these issues. The commonly recognized ethical concern was the development of a mechanism that could be applied to clarify the subject of death, organ or tissue transplant. The first technological approach for addressing the ethical concern for death occurred in the 1960s requiring the body to be stored and maintained in artificial support only after the brain had died. Based on this discovery, the community implemented a new approach that could be applied to define death. 5 The first definition emphasized the situation where the whole brain had died while the second part of death involved a case where the brain stopped functioning.
Organ transplants in the United States began developing and improving at a very high rate in the 1970s due to rapid increase in population requiring organ or tissue transplants. For instance, the general population, growth, and expansion of older adults have caused an increasing demand for organ transplant services. Currently, it is assumed that approximately 600,000 Americans have benefitted from the technology of organ transplants. 6 As the application for organ transplant continues to grow, strategies have also been put in place in an attempt to minimize adverse impacts associated with organ transplant. For example, in the 1980s, the Food and Drug administration implemented strategies that could be applied in regulating tissue banking to avoid issues of misconduct and certain organ transplantation practices. For example, the implementation of this policy was implemented with the desire to avoid complications that would occur as a result of transplanting tissue or organ that is infected. 7 As a result, tissue stored for transplant should be screened and evaluated to test for the presence of any form of the condition that could affect the health of the recipient. The historical changes of organ transplants in the United States indicate that several changes have occurred since the implementation of the bone and kidney transplant.
Changes that have occurred in Organ Transplant in the United States
The changes can be grouped depending on the various changes that occurred in a particular period rather than considering the specific organs that were witnessed in different years. For instance, the first phase of organ transplants in the United States can be categorized as either an early organ transplant. During this period that occurred in the 800 B.C. 8 when medical practitioners focused on identifying mechanisms that could be applied in an attempt of addressing different illness associated with aspects such as burns and skin wounds that required intervention to save the life of the victim. During this period, several patients died after the organ transplant process because people developed different complications associated with organ transplants. As technology was developed to minimize these issues, organ transplant entered the next stage of development, leading to the creation of changes in the discovery of organ transplants.
The second phase of organ transplant involved frozen transport, which signified the adoption of anti-rejection drugs that could be applied in an attempt to minimize the organ rejection issues experienced in the early developmental stage of organ transplants. The implementation of this strategy resulted in the transplantation of sensitive organs such as lungs, heart, and kidney, showing advancement from the issues experienced in the early developmental stage. This period occurred in the 1960s when new storage known as ischemic had been established to address issues such as contamination that affected the level of organ rejection. This change provided a technology that allowed individuals to remove the organ from the body of the donor and keep it in a non-functioning state until they could be transplanted to the patient. This discovery became the highest discovery of the 1960s as the organ could be stored in the absence of blood circulation, and it remained to be effective in improving the lives of the patients without any form of complication. 9 This process was accompanied by the presence of procedural strategies that could be applied in obtaining the organ from the donor.
In the modern organ transplant technology, the process has shifted from the frozen storage process to the adoption of a mechanism that facilitate transport of the organs. This change has been witnessed as a result of the implementation of a Transmedics proprietary Organ care System that represents the first commercial and portable warm blood organ transport system. The effectiveness of this system originates from the fact that doctors developed a technology that they apply in conducting living organ transplant that is capable of obtaining the organ and keeping it warm when collected from the donor to the time when the patient has to receive this organ. 10 The implementation of this technology ensures that the organ obtained from the donor has a favorable condition outside the body to be maintained without interfering with its functionality. Additionally, surgeons could use this opportunity to explore and examine the functionality of the organs outside the body to prevent issues that could be witnessed after transplantation. The active transportation created a pool across the United States and other parts of the world as organs could be stored in controlled temperature to avoid the development of the disease that could affect its functionality.
Advantages of organ Transplant in the United States
Organ transplant continues to change with the health department identifying technology that can be used in conducting successful treatment for individuals in critical conditions. Therefore, organ transplant is advantageous in that it creates an opportunity for saving the lives of individuals who would have otherwise die. Though many people criticize the technology of organ transplants, the benefits of organ transplantation have been witnessed in the United States. For instance, approximately 100,000 people in the United States are waiting for surgical operations that could lead to that could save their lives. 11 These patients need different organs, such as the liver, kidneys, and heart. In organ transplant, there must emerge people who would want to register as organ donors to save lives for the people. From this view, it is observable that the practice of organ transplant leads to the creation of an opportunity for giving an individual a second chance to live. Though the process is costly, allowing organ transplants is helpful to individuals willing to live a life by spending their wealth. For example, a patient waiting for an organ transplant has to visit the dialysis clinic several times to have their blood screened and cleaned to avoid any form of complication that could arise after the exercise.
In situations where donations occur out of tragedy, they can have a positive impact by building a sense of closeness and friendship between the donor and the recipient. These benefits can extend to the families and especially in a situation where a son, daughter, father or mother has the feeling that he or she has made someone’s life continue after experiencing a critical health problem. For example, organ transplant has been an alternative approach for relieving the family the level of grief that could be encountered in situations where they lose someone for something they can assist. 12 In some circumstances, organ transplantation may be rejected, thus resulting in death. However, people develop the feeling that they have not lost their loved one out of vain. The sense of composure occurs because everyone in the family understands the effort they devoted to saving the victim. These benefits are attributable to the improvement in health technology that has made it possible for people to donate organs and tissues provided that there is a direct match between the victim and the recipient. The living donations across the world include portions of the pancreas or lungs, liver, and small intestines.
The relative cost of organ transplants is lower, making it affordable by the recipient and the donor. This process has made it easy for people to offer such services, thus increasing the possibility of people to receive treatments they could otherwise achieve if it were set at the medical cost. For instance, the operation and after transplant monitoring services offered to the donor are free, increasing the willingness of individuals to donate organs. The prices are also not passed to the donor because many transplant exercises occur in public hospitals rather than private healthcare facilities. The free services and low costs charged for organ transplants have increased successful organ transplant services offered in the United States. For example, the United States recorded more than 33 500 organ transplants in the year 2016, thus setting a new record for completed operations. 13 Success in innovations and improvement in medical procedures have contributed to the increase in successful organ transplant that has occurred that occurred between 2012 and 2016. As technology continues to increase in the rate at which people are seeking such services and achieving development in the United States. For example, the increasing trend reflects as the country registered more than 8000 organ transplants in the first quarter of the year 2017.
Disadvantages of Organ Transplant
Organ transplant has created an opportunity for patients to increase the chance of saving a life for loved ones. However, there is a challenge in the exercise because family members do not have control over the person to receive the organ removed after the occurrence of a tragedy. Organ donation exercise is a complicated process because it requires to be conducted procedurally to identify the possible health complications and infections that need to be screened and cleaned. Additionally, there must be a much between the donor and recipient, indicating that donors have little control over the person to receive the donated organs or tissues. 14 As a result, people from different faith and political allies are in a position to win the organ or tissue donated by an individual. This change does not always apply as some donations match the intended receiver though in rare cases.
Though there are no specific restrictions on the people who can donate transplants, there are some limitations that make it difficult for people to donate tissues and organs. For instance, several restrictions determine the people eligible for donating blood. For example, people develop an interest in ensuring that there is a minimization of complications that can be implemented in ensuring that there is a minimization of the issues that would arise in the case of mismatch. For instance, a donor cannot be over 80 years as the organ restriction transplants are limited to people below 60 years. 15 People diagnosed with several health issues such as HIV positive and metastasized cancer become a source of complication of problems that can affect people in the community. The restrictions exceed people aged below the age of 18 years require the consent of their parents to avoid any form of complications that can be witnessed through the permission of people in the community.
In some cases, organ transplantations result in complicated health issues. For an individual to be considered as a living donor, medical and surgical procedures should be conducted. Every surgery involves various risks, including death, as the process has to begin with a dead brain. In other situations, the method may result in a complicated challenge, such as lifestyle change. The lifestyle change has to become conducted as a result of ensuring that the person undergoes clinical checks to minimize the complications that worsen the life of an individual. According to medical research, there is a 10% chance that people are likely to receive diabetes. These activities also have an impact on extending the grieving period for friends and family members. The objective of conducting an organ transplant is to bring hope for life. However, it is always essential for any individual to be kept in the life-supporting machine. This practice ensures that organ donation is conducted in an attempt to ensure that the health support is conducted carefully. The organ transplant exercise can also be a risk, especially n situations where the life-supporting machine fails.
The cost of organ transplantation is relatively high, especially in the case of the recipient. Though the donor receives services free of charge, the prices charged on the recipient is large enough to cater for the services offered to the patient. For example, the cost of liver transplant in the United States is approximately $71,000, accompanied by other additional charges for monitoring the health of the individual. For example, an individual who has undergone an organ transplant should undergo a clinical check after every 30 days at the cost of $25, 000. 16 This cost indicates that many people can experience challenges associated with affordability, as very few Americans can afford to cater to these costs. The cost of a heart transplant is higher at approximately $130,000 and additional fees if $56,000 after every 30 days. As a result, many Americans who have undergone any form of organ transplantation have parted with between $1 million and $2.3 million. This cost is a bit cheap, and it makes it difficult for people in the middle class to afford the expenses for organ transplant exercise.
Conclusion
Organ transplant in the United States has saved several lives despite the adverse impacts associated with this medical technology. Since the establishment of this knowledge, several changes have occurred, making it safer and more effective and less risky. The first organ transplant started with the skin before establishing a kidney transplant that occurred in the year 1954. Since then, medical researchers engaged in several experiments improving the exercise as well as providing safety to patients and donors. Despite the adverse consequences associated with organ transplants, its benefits also need to be recognized through the increased demand for services in the United States. This technology has saved many lives over the years due to the changes witnessed in the technology project.
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1 Karia, Pritesh S., Jamil R. Azzi, Eliot C. Heher, Victoria M. Hills, and Chrysalyne D. Schmults. "Association of sirolimus use with risk for skin cancer in a mixed-organ cohort of solid-organ transplant recipients with a history of cancer." JAMA dermatology 152, no. 5 (2016): 533-540.
2 Bierman, Philip J. "Solid organ transplantation in patients with a history of lymphoma." Journal of oncology practice 14, no. 1 (2017): 11-17
3 Krajewski, Colleen M., Duvuru Geetha, and Veronica Gomez-Lobo. "Contraceptive options for women with a history of solid-organ transplantation." Transplantation 95, no. 10 (2013): 1183-1186.
4 Linden, Peter K. "History of solid organ transplantation and organ donation." Critical care clinics 25, no. 1 (2009): 165-184.
5 DeVita, Michael A., James V. Snyder, and Ake Grenvik. "History of organ donation by patients with cardiac death." Kennedy Institute of Ethics Journal 3, no. 2 (1993): 113-129.
6 Rana, Abbas, Angelika Gruessner, Vatche G. Agopian, Zain Khalpey, Irbaz B. Riaz, Bruce Kaplan, Karim J. Halazun, Ronald W. Busuttil, and Rainer WG Gruessner. "Survival benefit of solid-organ transplant in the United States." JAMA surgery 150, no. 3 (2015): 252-259.
7 Chin ‐ Hong, P. V., B. S. Schwartz, C. Bern, S. P. Montgomery, S. Kontak, B. Kubak, Michele I. Morris, M. Nowicki, C. Wright, and M. G. Ison. "Screening and treatment of Chagas disease in organ transplant recipients in the United States: recommendations from the Chagas in Transplant Working Group." American journal of transplantation 11, no. 4 (2011): 672-680.
8 MacNeil, Adam, Ute Ströher, Eileen Farnon, Shelley Campbell, Deborah Cannon, Christopher D. Paddock, Clifton P. Drew et al. "Solid organ transplant–associated lymphocytic choriomeningitis, United States, 2011." Emerging infectious diseases 18, no. 8 (2012): 1256.
9 Gruessner, Angelika C., and D. E. Sutherland. "Pancreas transplant outcomes for United States (US) cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR)." (2008).
10 Engels, Eric A., Ruth M. Pfeiffer, Joseph F. Fraumeni, Bertram L. Kasiske, Ajay K. Israni, Jon J. Snyder, Robert A. Wolfe et al. "Spectrum of cancer risk among US solid organ transplant recipients." Jama 306, no. 17 (2011): 1891-1901.
11 Engels, Eric A., Ruth M. Pfeiffer, Joseph F. Fraumeni, Bertram L. Kasiske, Ajay K. Israni, Jon J. Snyder, Robert A. Wolfe et al. "Spectrum of cancer risk among US solid organ transplant recipients." Jama 306, no. 17 (2011): 1891-1901.
12 Nakamura, T., H. Ushigome, T. Nakao, S. Harada, K. Koshino, T. Suzuki, T. Ito, S. Nobori, and N. Yoshimura. "Advantages and disadvantages of pre-emptive kidney transplantation: results from a single transplantation center." In Transplantation proceedings, vol. 47, no. 3, pp. 626-629. Elsevier, 2015.
13 Rana, Abbas, Angelika Gruessner, Vatche G. Agopian, Zain Khalpey, Irbaz B. Riaz, Bruce Kaplan, Karim J. Halazun, Ronald W. Busuttil, and Rainer WG Gruessner. "Survival benefit of solid-organ transplant in the United States." JAMA surgery 150, no. 3 (2015): 252-259.
14 Bierman, Philip J. "Solid organ transplantation in patients with a history of lymphoma." Journal of oncology practice 14, no. 1 (2017): 11-17.
15 Bierman, Philip J. "Solid organ transplantation in patients with a history of lymphoma." Journal of oncology practice 14, no. 1 (2017): 11-17.
16 Roh, Young-Nam. "Organ Donation." Organ Donation and Transplantation: Current Status and Future Challenges (2018): 1.
