Solutions to Organ Shortages for Transplantation
Patrick K. Kimuyu
Organ transplantation has become one of the most reliable life-saving medical approaches in the medical field. Miller et al. (2003) report “many lives have been saved that would not have been otherwise, and yet waiting lists for organs continue to increase” (par. 3). Historically, organ transplantation dates back to 1954 when the first human kidney was transplanted successfully. Later on in 1967, Christian Barnard carried out the first heart transplant. In general, a number of organ transplants were performed in 1960s including liver, pancreas and lung transplants, and this opened up treatment options for patients with organ failures. However, it is worth noting that, the success of organ transplant was enhanced by an array of clinical research findings. For instance, the discovery of immunosuppressive drugs, which prevented the rejection of organ grafts served as a significant breakthrough in organ transplantation.
Currently, organ transplantation has gained popularity owing to its reliability although organ procurement and allocation laws appear to have limited its clinical use. Abouna (2008) reports “In the United States, for example, the number of patients on the waiting list in the year 2006 had risen to over 95,000 while the number of patient deaths was over 6,300” (p. 34). However, organ transplantation has been faced with unprecedented organ shortage crises. It has been reported that about 18 patients in the waiting list die every day owing to the shortage of organ donations (Rall, 2013). Therefore, this paper will provide solutions which appear relevant in addressing the shortage of organs available for transplantation.
The Promise of Emerging Tissue Engineering Technologies
From a biological perspective, there are three principal approaches which can solve the problem of organ shortages in hospitals. These approaches include the adoption of stem cell technology in producing human organs in surrogate animals, review of organ procurement and allocation laws to facilitate that recruitment of donors and recipients, and implementation of educational programs to create awareness on the significance organ donation.
Stem Cell Technology
Stem cell technology emerged recently after the discovery of regeneration capabilities of some body cells. Ordinarily, stem cells are pluripotent cells with the capability of differentiating into virtually all body organs under appropriate chemical stimulus. This is the process involved during the embryological developments of the human fetus in which all organs are formed through a process referred to as organogenesis. Currently, there are numerous research studies which seek to develop different human organs in the body of other animals such as pigs and rats. For instance, research trial to develop human tracheal tissues for lung transplant using stem cells has been underway in which significant steps towards successful outcomes have been reported. On the other hand, scientists are working tirelessly to develop human liver in pigs through the use of a cocktail of stem cells.
Recently, Japanese scientists reported a significant breakthrough in developing a functional human liver in pigs, and this appears to be a remarkable step towards addressing the problem of organ shortage, which threatens the lives of patients. Takanori Takebe, one of the researchers involved in the research stated, “We are now assessing the applicability to other organs such as the pancreas and kidneys because they have a similar kind of developmental course as the liver. So far, we've had fascinating results” (Goodman, 2013 par. 8). Therefore, it is believed that advances in stem cell research may become a reliable approach of increasing the availability of human organs for transplantation, and this will annul the necessity of a human donor which encompasses ethical challenges.
Organ Policy Review
Another possible solution to the current organ shortage crises is the review of procurement and allocation of organ transplants. In the U.S, there are several laws surrounding the procurement and allocation of organs which govern the ethics of organ transplantation. Organ policy involves the Uniform Anatomical Gift Act of 1968 and the Organ Transplantation Act of 1984. The Uniform Anatomical Gift Act was designed to grant individuals the right to make organ donation decisions before death. In this law, an individual can decide to donate his organ to a desired recipient upon death. On the other hand, the Organ Transplantation Act addressed the procurement issue by creating a procurement network to facilitate organ matching. However, this law forbids direct compensation of organ donors, as well as buying and selling of human organs.
These laws advanced medical benefits for organ transplantation including equitable allocation of organs in the U.S healthcare system and the preservation of ethical limits, primarily with regard to use of the body and treatment of the dead (Miller et al., 2003). However, there are legal restrictions, which have limited organ procurement and allocation despite the enormous demand. Therefore, a comprehensive review of the regulations related to organ policy to remove some of the principal barriers to increase the availability of organs for transplantation. Some of the most significant policy review includes the implementation of an appropriate system of giving reward gifts for living donors, as well as families of the diseased donor, utilization of extended criteria donors and acceptance of ‘presumed consent.’ In addition, the establishment of a reliable system of organ donation from a donor to an unknown recipient and designation of altruistic financial payment system for donors will help in solving organ shortage (Abouna, 2008).
Currently, organ policy allows donation to a known recipient and this limit the accessibility of compatible organs from donors; thus, causing delays in the organ transplantation process. In addition, rewarding of donors and their families has been facing considerable challenges because the current organ policy prohibits direct compensation. Moreover, paired organ donation is not allowed under the current organ policy. Therefore, it is believed that appropriate review of the organ policy will lift some of the principal restrictions surrounding organ procurement and allocation leading to a significant increase of organ availability for transplantation to address organ shortage crises.
Implementation of Appropriate Educational Programs
The third significant approach for addressing organ shortage is through the implementation of appropriate educational programs. Currently, there are no appropriate educational programs for creating awareness on the benefits of organ donation. This is probably the reason as to why most people are reluctant in volunteering as donors.
In theory, an appropriate educational program, which covers the public and the hospital professionals, will enhance the process of organ procurement from the living and dead donors. This will be possible after the society is informed of social, ethical and religious criteria involved in organ donation because donors’ willingness will be promoted.
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- Patrick Kimuyu (Author), 2016, Solutions to Organ Shortages for Transplantation, Munich, GRIN Verlag, https://www.grin.com/document/381252