Organ transplant is one of the common and successful trends in healthcare today. It refers to the transfer of living tissues and or organs from one body part to another body. In the 1900s, it was a nightmare because health practitioners were just beginning to familiarize themselves with the human body (Gruessner & Sutherland, 2004).Today transplantation is possible with almost all parts of the body, such as kidney, eyes, and heart. There is a move to cadaveric transplants with body parts. This discussion is thus focused on the cadaveric transplants. These are transplants from dead human bodies. Cadaver is the medical term for these bodies mainly used for research (Abouna, Kumar & White, 1991).
Kidney failure is one of the common reasons for cadaveric transplants. Once the kidney fails to function the way it is supposed to, the best solution is normally a kidney transplant, either living or cadaveric (Hakim & Danovitch, 2001). To receive a cadaveric transplant, the health practitioners have to make sure that the donor organ is compatible with the recipient. They go through a process of genetic matching. The donor has to be screened carefully to ensure they do not have infections or diseases that can easily be transferred to the recipient (Gruessner & Sutherland, 2004). This makes cadaveric transplants more challenging than living ones. Living transplants are not as challenging as the cadaveric ones because the donors are mostly blood relatives. This makes genetic matching easier.
Research shows that recipients of living transplants have a higher chance of survival than those of cadaveric transplants (Griva, 2002). The reason behind this is the several side-effects and risks that come along with cadaver transplants. One main risk of cadaveric transplants is hyper acute rejection. This happens when proper matching is not done between the donor and the recipient. The result is rejection by the recipients body. This is mostly common when transplanting vital parts of the body that require a lot of blood to survive such as the heart, kidney, lung, pancreas, and liver. During transplantation, when blood is drained from the organ to the recipients blood circulation, the recipients body detects invasion of foreign substance (Abouna, Kumar & White, 1991). The immune system makes antibodies to fight against the foreign antigens, and in the process the antibodies inhibit metabolic action in the foreign organ (Hakim & Danovitch, 2001). This causes destruction to the organ and the transplant is unsuccessful.
However, this does not happen in ignorance. Its only unfortunate that the tests done before the transplant are not effective 30% of the time. Its therefore when serious reactions take place, which can happen during the transplant or until six months after. Most reactions are reversible if detected early enough. The recipients can undergo dialysis after the transplantation. However, when dialysis takes place later, it could have deadly consequences that cause complications in the body.
Another common risk of cadaveric transplant is delayed functioning of the graft organ (Hetzel, Klein, Brause, Westhoff, Willers, Sandmann, & Grabensee, 2002). There are several factors of the donor that lead to delay on the functioning of the graft. The processes that take place after brain death of a donor affect the quality of their organs (Quiroga, 2006). During this death process, the organ becomes exposed to factors that affect the transplant process, such as lack of blood flow. These factors affect the effectiveness of the outcome after the transplant. This increases the chances of delayed functioning of the graft (In Weir & In Lerma, 2014). Another factor is if the level of creatinine does not fall below ten percent within the first twenty-four hours of transplant, it causes delayed functioning of the graft (Koning, Ploeg, Bockel, Groenewegen, Woude, Persijn & Hermans, 1997).
Factors of the recipient also affect the functioning of the graft. Mostly when a recipient is receiving a second transplant, chances are higher that it may be rejected or fail to function (Koning, et al., 1997). This is caused by previous injury from the first transplant to the immune system. Rejection worsens if the previous injury has not fully recovered (Emson, 1987). Outside the recipients factors is the way an organ is preserved well. If the organ is not well preserved, this affects the way it functions in the recipient and cause rejection too.
Another factor is that cadaveric grafts tend to be sleepy in the early stages of transplant (In Weir & In Lerma, 2014). This is because it takes the time to recover from the death it had undergone while in the body of the donor. The risky situations are where the organs never recover from the death and cause complications to the recipients (Qiansheng, Wenqian, Keqin, Gang, Fengshuo, Xiaojiang & Dong, 2011). However, when the organ functions are delayed, the recipient undergoes postoperative dialysis in the first week in an attempt to recover the functioning state of the organ. It is not always automatic to undergo postoperative dialysis since the practitioners have to eliminate other factors such as urinary tract infections for kidneys, rejection, and hyperkalemia (Touraine, Traeger, Betuel, Dubernard, Revillard & Dupuy, 1997). If diagnosed that the recipient has such conditions, they have to undergo several treatments, which can affect them psychologically.
These treatments in most cases have to take place in the hospital. Staying in the hospital for so long sometimes it affects the patient (Emson, 1987). The hospital is not always convenient for quick recovery, especially when patients are on bed rest (Touraine, Traeger, Betuel, Dubernard, Revillard & Dupuy, 1997). There are also so many adaptive demands for organ recipients. For instance, in kidney transplants, the recipients body has to adapt to using one kidney (Griva, 2002). Psychologically, some patients deem it risky to have one kidney. They fear that it may not be sufficient, which may hinder the actual effectiveness of the organ (Decruyenaere & Decruyenaere, 2015).
This long-term treatments and stay in the hospital affect patients concerned. Some of them develop mental disorders during the treatment, such as personality changes, psychosocial dysfunction, emotional disorder and psychological rejection. (Qiansheng et al., 2011). Psychological rejection also affects the whole process. It occurs when the patients fail to accept mentally that they have a foreign body part. This emotional imbalance affects the recovery time of the transplanted organ. In extreme conditions, the organs never recover, leading to serious complications like rejection (Qiansheng et al., 2011).
Recipients of cadaveric transplants are expected to be under medication for a long time. The drugs administered are so powerful that they may affect the entire body (Abouna et al., 1991). That is why they are monitored continually for medical support. The immune system of the individual may weaken as it also adjusts to the new organ. According to Appelbaum, Forman, Negrin & Blume (2011), the recipient at that point stands a chance of getting another serious disease or having the previous one back. However, it is easier to manage the effects of medication than the condition before transplant (Griva, 2002).
When dealing with patients, it is important to let them know of both the long-term and the short-term effects they are going to experience. They need advice and psychological preparations so that they can remain stable. This makes the process of recovery easier for the patient (Griva, 2002). Any complication that shows up and is not expected should be attended to as soon as it shows up while reassuring the patient. Patients with high risk of complications should have frequent check-ups. The families of the affected should also provide support to them (Emson, 1987). This helps them cope with the process of adapting to a new state. It reduces chances of them experiencing mental disorders and engaging in psychosocial activities that only mess up the healing process (Collier, 2013).
In conclusion, organ transplant is inevitable. In order to save more lives the cadaveric transplants come in handy. Since some of the risks that come by cannot be eliminated it is important for the patients to be well prepared and well informed as this will go a long way in ensuring success of the transplantation. The emotional aspect should be well taken care of it as it appears equally complex to the treatment process. Medical practitioners should also take good care in the process of cadaver transplant for more successful results (Land & Dossetor, 1991).
Abouna, G. M., Kumar, M. S. A., & White, A. G. (1991). Organ Transplantation 1990. Dordrecht: Springer Netherland.
Appelbaum, F. R., Forman, S. J., Negrin, R. S., & Blume, K. G. (2011). Thomas' Hematopoietic Cell Transplantation. New York, NY: John Wiley & Sons.
Collier, C. (2013). Recovering the body: A philosophical story. Ottawa: University of Ottawa Press.
Decruyenaere, A., & Decruyenaere, P. (2015). Prediction of delayed graft function after kidney transplantation: Comparison between logistic regression and machine learning methods. Retrieved December 9, 2015, from http://www.biomedcentral.com/content/pdf/s12911-015-0206-y.pdf
Emson, H. (1987). The ethics of human cadaver organ transplantation: A biologist's viewpoint. Journal of Medical Ethics, 13, 124-126.
Griva, K. (2002). Quality of life and emotional responses in cadaver and living related renal transplant recipients. Nephrology Dialysis Transplantation, 17, 2204-2211.
Gruessner, R. W. G., & Sutherland, D. E. R. (2004). Transplantation of the pancreas. New York: Springer.
Hakim, N. S., & Danovitch, G. M. (2001). Transplantation Surgery. London: Springer London.
Hetzel, G., Klein, B., Brause, M., Westhoff, A., Willers, R., Sandmann, W., & Grabensee, B. (2002). Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome. Transplant International, 15(1), 10-16.
In Weir, M. R., & In Lerma, E. V. (2014). Kidney transplantation: Practical guide to management.
Land, W., & Dossetor, J. B. (1991). Organ Replacement Therapy: Ethics, Justice Commerce: First Joint Meeting of ESOT and EDTA/ERA Munich December 1990. Berlin, Heidelberg: Springer Berlin Heidelberg.
Kidney TransplantProcedures. Retrieved December 9, 2015, from http://www.ucsfhealth.org/conditions/kidney_transplant/treatment.html
Koning, O., Ploeg, R., Bockel, J., Groenewegen, M., Woude, F., Persijn, G., & Hermans, J. (1997). Risk Factors For Delayed Graft Function In Cadaveric Kidney Transplantation. Transplantation, 63(11), 1620-1628.
Touraine, J. L., Traeger, J., Betuel, H., Dubernard, J. M., Revillard, J. P., & Dupuy, C. (1997). Late Graft Loss: Proceedings of the 28th Conference on Transplantation and Clinical Immunology, 3-5 June, 1996. Dordrecht: Springer Netherlands.
Qiansheng, L., Wenqian, H., Keqin, Z., Gang, W., Fengshuo, J., Xi, L., Xiaojiang, J., & Dong, G. (2011). Delayed Graft Function, After the Kidney Transplant - The Patients and Their Allograft. Retrieved December 9, 2015 from: http://www.intechopen.com/books/after-thekidney-transplant-the-patients-and-their allograft/delayed-graft-function
Quiroga, I. (2006). Major effects of delayed graft function and cold ischaemia time on renal allograft survival. Nephrology Dialysis Transplantation, 21(6), 1689-1696.
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