Organ Transplants - Research Paper Example

?Running head: ORGAN TRANSPLANTS Organ Transplants (school) This paper discusses organ transplants, including their applications, distribution, and ethical considerations. Organ transplants are carried out on patients with organ failures, and based on medical considerations donors for these patients include living patients as well as brain dead heart beating donors. The United Network for Organ Sharing, as well as the transplant centers is considered the governing body for organ distribution. Their function includes the crucial determination of organ procurement and distribution as supported by the ethical principles of distributive justice. As such, these determinations must be based on fair and equitable criteria, including rate of success, medical need, and length of time on the waiting list. In any case, these criteria have managed to ensure the logical, as well as the unbiased distribution of organs to those who need it the most. Organ Transplants Organ transplants are one of the many innovations in healthcare which are currently gaining popular clinical application. This practice is mostly done in order to replace a failing or diseased organ in the hope of extending and/or improving a patient’s life. This paper shall discuss about organ transplants and related information pertaining to its applications. This essay is being carried out in order to establish a clear and comprehensive understanding of organ transplants and how they apply to the clinical practice. Discussion WebMd (2010) discusses that organ transplants are medical procedures carried out in order to replace a “failing organ with a healthy organ”. Organs which can be transplanted include kidneys, liver, heart, pancreas, lungs, and small intestines (WebMD, 2010). Not all people can be considered for this procedure and a series of tests have to be undertaken first in order to determine a person’s viability for such procedure. Nevertheless, likely candidates include those with heart diseases, kidney diseases, liver problems, and intestinal issues. Granting that the tests reveal one’s viability for such transplant, a person may then be included in a waiting list or a database for possible organ recipients. Organ transplants have been carried in the United States since the 1950s and since then improvements in this process have been introduced. Now, many of these transplants are considered routine procedures for hospitals (WebMD, 2010). The rate of success for these procedures are based on various factors, including the organ being transplanted, the number of organs being transplanted, and the disease which causing the organ failure (WebMD, 2010). In the US, there are about 59 organ procurement organizations which furnish deceased donor organs to the transplant centers (Nathan, Conrad, Held, Pietroski, Siminoff, and Ojo, 2003). Out of these procurement groups, 50 operate independently, and nine are hospital-based. The procurement organizations have a connected geographical area which are considered as recovery centers for organs for the various hospitals in the area (Nathan, et.al., 2003). In determining the viability of organ donation, the time, the manner, and the place of the donor’s death are usually considered (POST, 2004). More often than not, organ donors are those whose brain functions have ceased, but whose organs are still viable and are “being maintained by medical support” (POST, 2004, p. 1). With current improvements in medical care, including the prolongation of human life, the number of these donors, otherwise known as heart beating donors, has decreased (POST, 2004). Other methods of procuring organs have been considered in order to fill in the gaps of organ need and most of the alternatives have been directed towards living donations, mostly for kidneys and livers. Some of these organs have also been retrieved shortly after patient deaths following critical illness and road accidents (POST, 2004). Since 2002, based on federal rules, the designation of the procurement organizations were made every four years. These organizations were called on to be members of the Organ Procurement and Transplantation Network (OPTN), an organization maintained by the United Network for Organ Sharing (Nathan, et.al., 2003). The regulations which were involved in organ allocations were established by the OPTN and the UNOS. Moreover, computer algorithms were utilized in order to determine possible matches. Patients wanting organ transplants from dead donors had to be entered in the database and at every time when an organ would be donated, the parameters and specifics of the organ were matched with the database of possible recipients (Nathan, et.al., 2003). Based on the assessment of the transplant center, as supported by a medical professional’s evaluation, an organ would be accepted or rejected in behalf of a potential recipient. Due to the risks which are often placed upon living donors, there is a significant amount of controversy on the use of living organ donors (Nathan, et.al., 2003). Risks relate to the requirement of efficient donor screening applications meant to evaluate donor’s psychopathology. Moreover, the most viable matches for these live organ transplants can mostly involve relatives or individuals with whom they have personal relationships (Nathan, et.al., 2003). Recently dead or dying donors are often preferred donors because there is less controversy in donating their organs. Adequate tests can be carried out on their organs and these tests and procedures can be carried out with minimal risks on both the donors and the recipients. Proposals to resolve the limited supply of human organs for transplantation have been forwarded; but most of these proposals have focused on increasing the supply of organs, not on decreasing the demand for these organs (Nathan, et.al., 2003). One of the new techniques for addressing this issue have been related to the increase of supply of only the better quality organs. One of these new techniques is being implemented in New Jersey; it is known as the ‘New Jersey Hero Act’ where individuals seeking driver’s licenses were required to decide on whether or not they would want to be organ donors in the future. Paying for organs have also been considered at some point, however, this method has proven to be controversial. The second technique is however rife with controversy because federal laws currently prohibit the sale of organs (Hartwell, 1999). Still, this does not mean that organ sales are not being carried out in the US and in other countries. Reports of organ sale have been heard in the Philippines, with these organs being sold for as low as $2000. In India, some fathers have also been known to sell their own kidneys in order to gain the financial benefits for such transaction (Hartwell, 1999). In China, executed criminals and their organs have often been removed immediately upon execution. These are incidents which have mostly been motivated by financial issues in organ procurement, issues which have prompted donors, as well as health professionals to resort to drastic means of organ procurement. Since the advent of organ transplantation, various issues have been raised on the impact and effects of these transplants. Issues have mostly revolved around the recipient’s immune system and organ rejection. In order to resolve these issues, tissue matching has been employed as the most effective remedy (Parliamentary Office of Science and Technology, 2004). Tissue matching has been known to reduce organ rejection and anti-rejection treatments have also been used to suppress recipient’s immune system. Improvements in tissue matching, surgical techniques, as well as improved methods in postoperative care have also helped improve success rates in organ transplantation (POST, 2004). Target improvements for the future include further minimization of immune responses in an effort to reduce organ rejection. In order to determine who among the thousands of potential recipients would be considered for organ transplantation, various ethical principles have been considered, including the concept of distributive justice. This principle discusses that there is no exact or right way to allocate organs, however there are many ways by which a person may justify the act of choosing one recipient over another (Center for Bioethics, 2004). Equal access is one of the prevailing concepts in distributive justice and this concept basically expresses that organ allocation must be supported by objective indicators including length of time waiting and age (Center for Bioethics, 2004). Those who support equal access argue that organ transplants are significant medical procedures, and therefore must be made available to all individuals who need it. This concept also helps prevent subjective demographic considerations like race, ethnicity, sex, and economic status to influence the determination of organ recipients (Center for Bioethics, 2004). Another concept considered under distributive justice is that of maximum benefit. The goal for this concept is based on medical need and potential for success of the transplant (Center for Bioethics, 2004). Maximum benefit supporters point out that organ transplants are also important interventions and organs must not be wasted due to their limited availability. In effect, in order to avoid waste, potential recipients must be ranked based on how sick they are and how successful the transplant would be (Center for Bioethics, 2004). The current organ distribution policies in the US are based on the transplant centers’ determination. Regardless of policy however, the UNOS supports the use of the following criteria in organ distribution: medical need, probability of success, and time spent on the waiting list (Center for Bioethics, 2004). This determination has been considered effective for many transplant centers, however, issues still arise in instances when two or more recipients equally fulfill the criteria. In these cases, the power of fair and equal discretion often needs application. Based on the above discussion, organ transplants are important medical procedures which are meant to save the lives of patients with severe or critical organ failure. Common transplants include kidney, liver, lung, heart, and intestines. Government agencies are assigned in order to help determine recipients. In recent years, a decrease in recipients has been seen and other methods of organ procurement have been considered. Ethical processes have also been applied in order to determine organ distribution. For the most part however, the concept of distributive justice has been deemed the most applicable concept in determining the process of organ distribution. References Center for Bioethics. (2004). Ethics of Organ Transplantation. University of Minnesota. Retrieved 02 December 2011 from http://www.ahc.umn.edu/img/assets/26104/Organ_Transplantation.pdf Hartwell, L. (1999). Global Organ Donation Policies around the World. Contemporary Dialysis & Nephrology. Retrieved 01 December 2011 from http://www.lorihartwell.com/GlobalOrganDOantionPolicies.pdf Nathan, H., Conrad, S., Held, P., McCullough, K., Pietroski, R., Siminoff, L., & Ojo, A. (2003). Organ donation in the United States. American Journal of Transplantation, 3 (Suppl. 4), 29–40. Parliamentary Office of Science and Technology. (2004). Organ Transplants. Retrieved 01 December 2011 from http://www.parliament.uk/documents/post/postpn231.pdf Patsner, B. (2008). Human Organ Transplantation in the U.S. – Crossing New Lines? University of Houston Law Center. Retrieved 01 December 2011 from http://www.law.uh.edu/healthlaw/perspectives/2008/%28BP%29%20organ.pdf WebMD. (2010). Organ Transplant. Retrieved 02 December 2011 from http://www.webmd.com/a-to-z-guides/organ-transplant-overview?page=2 Read More