Organ Transplants - Literature review Example

number Literature Review and Analysis on Organ Transplants Health Related Literature Organ transplantation is a surgical process which involves replacing a damaged or a failing organ with a new one. Not all organs can be transplanted. Most organ transplants are solid organs such as the heart, kidney, lungs, pancreas, liver, and intestines. There are other types of transplants such as corneal transplants, grafts, or skin transplants, and bone marrow transplants. Artificial or animal organs can also be used as transplantable organs. Organ transplantation is one of the successes of medicine and science (Watson & Dark 31). This field of science and medicine has improved a lot with transplantation capabilities and numbers improving over years. In the United States, for example, 27 578 organs were transplanted in 2007. These organs came from 14 399 organ donors. This shows that organ harvesting has also contributed to the success of organ transplants. There can be no organ transplants without organs donated. The number of lung transplants increased by 4.3 %, and there were a few changes in deceased donor intestine, heart, heart-lung, and pancreas transplants (Wolfea, Merionb, Roysa & Porta 1). Many years back, organ transplantation was not possible, but it was one of the scientists’ aspirations. Today this has been accomplished with various affected organs substituted with organs in perfect condition, which are able to ensure functional recovery. One problem, however, is the inadequate organs for transplantation. The number of organ transplants is increasing while the organs available for transplant are not enough, and even the level of donation is low. Watson and Dark indicate that organ transplantation has broken through various technical limitations. Scientists have worked hard and developed vascular anastomoses techniques, devised preservation solutions, and managed the immune response to transplantation. One problem, however, persists; this is the shortage of suitable donors. Current research on transplantation is focused on improving organ preservation. Advances in immune-suppression have not affected the chronic immune damage but have reduced the incidence of acute rejection. These innovations and improvements in preri-and postoperative management lead to more advances in organ transplantation. This means that there are more organ transplants being conducted and more still pending. The number of organs available for transplants, however, is not increasing (Watson & Dark 30). Most governments are currently working on new strategies that will improve organ donation (Hollomby, Germain, Shemie, Hollins & Young 8; NSW Government 4; NHS 7). Canadian Council for Donation and Transplantation and other health care providers, for example, seek to ensure that there are enough organs so that patients can have access to the services they need at the earliest opportunity (Hollomby, Germain, Shemie, Hollins & Young 8). The New South Wales Government also recognized shortage of organs for transplant and developed different strategies aimed at increasing organ donation. These included; dealing with information gaps about donation, for example, dealing with negative perceptions, and myths. Informing family members and significant others about the donor’s intentions to donate organs or tissues. Supporting clinicians in communication initiatives aimed at fully informing donor family members about donation, so that they can make informed decisions, and identifying all organ donation opportunities in all New South Wales hospitals (NSW Government 4). All these steps have improved, and continue to improve people’s quality of life. Scientists, however, have not stopped, and still continued research on issues that can help improve organ transplant services. There are various areas of concern, for example, a recent study by Quante, Heinbokel and Tullius, focused on obesity and kidney transplant. Obesity is one of the clinical challenges affecting transplantation. More specifically, are the higher complication rates and inferior outcomes reported in obese recipients. These complications affect the immune responses related to organ transplantation. Because the information regarding these complications and their effects were lacking, Quante, Heinbokel and Tullius’ research focused on finding out their effects to help improve organ transplantation among obese patients. Organ transplants are currently high because of advances in scientific research which provide better techniques of transplanting and solutions to various. Even current research studies are focused on making further improvements (Quante, Heinbokel & Tullius 28). Ethical Issues Surrounding Organ Transplant Organ and tissue transplant improve the quality and length of lives of individuals who benefit from it. Because of this, the demand has increased so much, to the extent that it has exceeded the supply. This has in turn affected the costs related to some transplants making them so high. This has brought questions about procurement methods, whether transplants should be covered by public resources, and how to fairly distribute limited resources (Center for Bioethics). Ethical Issues Concerning the Donor Organ donation is considered a praiseworthy act. This is also so, when one wills his or her body parts, or the whole body for the good of others after ones death. The catholic view on organ donation is as follows; one is allowed to dispose of his or her body, and to predestine it to noble, useful, and irreproachable ends. One of such ends is to donate one’s organs to help those who are suffering from chronic diseases. Such a decision should be positively justified (Wolfea, Merionb, Roysa & Porta 2). It is also argued that because scientists did put in a lot of exertion to make organ transplant possible, based on the advances they have made to save the lives of people, and increased tolerance to transplant; scientists hold that they should receive support from the people, medical professionals, and the law. It is, however, important to respect the will of the deceased donor (Wolfea, Merionb, Roysa & Porta 2). Organ donation from a person who is already dead benefits patients, and does not harm the donor. It is, therefore, considered lack of concern for the welfare of others if one cannot offer such a donation. People are, however, not obligated to donate. Some people do not support transplantation because it is against their religion, or for other reasons. Some are persuaded to donate organs because of the emotional responses that they see from survivors (Karger & Basel 57). Ethics demands that human cadavers be given the respect they deserve. Cadavers once bore the presence of a living person, for that reason, it is expected that people should them respect. Another ethical issue is with the donors’ health conditions. The donors may be critically ill at some point, and they usually have health care professionals to take care of them. These health care professionals provide or should provide the usual care given to any critically ill person. One cannot care for critically ill person to his or her last stages, and still be part of the transplant team that will harvest the organs. It is widely agreed that this is unethical practice (Flaman). Some religious groups do not approve of transplantation of brain cells, while others argue that if the brain cells are obtained from a donor with an irreversible cessation of all brain functions, then it is permissible. Transplant of reproductive glands is also considered unethical by some religious groups. They believe that such transplantation gives the recipient, the donor’s genetic individuality, therefore, passes on the donor’s generation rather than the recipient’s. Other issues that have come up in organ transplant is the use of brain dead human being to preserve the life of another, as in the case of a pregnant German woman, who was brain dead, but was kept alive for the babys well being. She consented to this, but some people still criticized this action as unethical. Others, however argued that this case was similar to other organ donation situations, and should not be considered as any form of disrespect for a woman. Various ethical concerns involving deceased donors have been discussed. These include; respect for the deceased, person’s family wishes, the common good, respect for the deceased and their wishes, and the issue of benefiting others. Because of these issues, the people who would want to donate their organs are advised to specify certain limits (Flaman). Ethical Issues involving transplants from living persons Transplants involving living persons are considered unethical by some people who feel that such procedures mutilate a living person’s body. Some consider bone marrow transplants and other others involving regenerative parts of the body, acceptable while others involving the kidney, heart, and other organs unacceptable. Religious beliefs also differ, for example, Catholics in the past argued that organ transplants involving living persons as donors violated the principles of totality. If one, therefore, had one part of the body removed, the body function would be affected hence the person’s health and life (Karger & Basel 58). It is true the removal of one part of the body affects the overall function of the body, but this argument is counteracted by the principle of fraternal love and charity. If the purpose of donation is to help others, it is argued that the donor will not be harmed. Some argue that when one donates an organ, he or she only looses the anatomical integrity and not the functional integrity. This is because one is never allowed to donate an organ that will impair the normal functioning of the body. Human beings have two kidneys, and the removal of one kidney does not impair the normal functioning of the other kidney, hence the individual’s well being. Human beings also have two eyes, but the removal of one eye to give to a recipient in need is not justified because the removal of one eye impairs the functional integrity of an individual (Flaman). The Business Perspective Organ transplant was an initiative by scientists and medical professionals meant to improve the quality of lives of people. As discussed above, the current problem medical professionals, are facing is the shortage of organs. According to Aleccia, about 98 000 people or more in the U.S, were in the waiting list for a kidney transplant in 2013. About 4500 people died while waiting for kidney transplants in 2012. There is a problem of shortage which is made worse by the decreasing number of donors compared to the increasing number of people in need of a kidney. This is just a case illustrating the need for one organ, although it has been established that it is the organ with the highest demand. In Canada, about 30% of patients in the waiting list for kidney transplants die while still waiting. Rettner also shows that the number of people in need of organ transplants has increased tremendously. In 2009, the number of people in need of organ transplants had increased from 31 000 people in the waiting list to 101 000. Among these were 80 000 people waiting to receive kidney transplants (Rettner). The shortage crisis has led to the development of new strategies of finding donors. One strategy is to offer incentives to the donors. One scientist proposed that if donors were offered $10 000, it would save the overall cost of per patient by $340. This would increase if more people were to donate (Aleccia). Rettner, however shows that offering such financial incentives leads to the development of an organ market which is not right. An organ market will be characterised by the rich and the poor, and rich will exploit the poor for their organs. Another issue with giving money for an organ was the screening of patients for healthy organs. There are fears that the extremely poor would be left out of the system because of high prevalence of kidney disease. This is because poverty is associated with kidney disease; therefore, it is most likely that the poor will be left out. The inability to regulate the market is one major problem. Rettner indicates that if the current society has not been able to regulate the current markets, with people cheating, and taking short cuts, there is no guarantee that if an organ market is created, the people will be able to effectively control it. Another concern is with the religious groups that would be discouraged by the idea of money for kidney. If they get discouraged, the numbers of donors will still go down. There is no guarantee that when money is given, then many people will donate organs. Proponents of this idea think that if cash were to be offered, transplant professionals would manage the situation by screening people for healthy organs. It would be safer and transparent than the organ trafficking schemes that have developed due to shortage of organs in various countries (Rettner). Selling of organs is against the law in the U.S and other countries like Canada, but some financial incentives have always been offered. Such are incentives that take the form of tax breaks given by the government, on expenses incurred during recovery in the case of a living donor, and compensation for funeral expenses in the case of a deceased donor (Stokes). Paying donors is still against the law and considered immoral, however, some people argue that more consideration should be given to the serious problem of the current system. They feel that the morality of preventing thousands of death due to the organ shortage should be weighed against the immorality of selling organs. This may be reason enough to resort to offering cash for organs, but effect of selling organs may be far much greater. Creating an organ market may prove dangerous because of the inability of the society to control it (Becker & Elias). Works Cited Aleccia, Jonel. “A kidney for $10,000? Paying donors actually pays off, new study finds.” The Associated Press 15 April. 2014. Web. http://www.nbcnews.com/health/health-news/kidney-10-000-paying-donors-actually-pays-new-study-finds-f8C11459939 Becker, Gary. S. and Elias, Julio J. “Cash for Kidneys: The Case for a Market for Organs”. The Wall Street Journal. 18 January 2014. Web. http://online.wsj.com/news/articles/SB10001424052702304149404579322560004817176 Center for Bioethics. “Ethics of Organ Transplantation.” 2004. http://www.ahc.umn.edu/img/assets/26104/Organ_Transplantation.pdf Flaman, Paul. “Organ and tissue transplants: Some ethical issues.” Web. http://www.ualberta.ca/~pflaman/organtr.htm Hollomby, David. Germain, Marc., Shemie, Sam., Hollins, Leah. and Young, Kimberly. “Improving organ donation in Canada.” CMAJ 176(8). Karger, S. and Basel, A. G. “Ethical issues in organ transplantation.” Medical Principles of Practice 12.1 (2003):54-69. NHS. Taking Organ Transplantation to 2020 A UK strategy. 2014. Web. http://www.nhsbt.nhs.uk/to2020/resources/nhsbt_organ_donor_strategy_summary.pdf NSW Government. Increasing Organ Donation in NSW Government Plan 2012. Web. http://www.seslhd.health.nsw.gov.au/NSW_Organ_Donation/docs/organ_donationstrategy.pdf Quante, Markus., Heinbokel, Timm. and Tullius, Stefan, G. “Obesity and Kidney Transplantation: Exploring Cross talks between Metabolism and Immune Responses.” Trends in Transplant. 8 (2014): 27-34. Rettner, Rachael. “Great Debate: Should Organ Donors Be Paid?” Scienceline 10 August 2009. Web. http://www.livescience.com/5606-great-debate-organ-donors-paid.html Stokes, Trevor. “Donating organs for cash sparks controversy.” MyHealthNewsDaily, 28 September 2012. Web. http://www.foxnews.com/health/2012/09/28/donating-organs-for-cash-sparks-controversy/ Watson, C. J. E. and Dark, J. H. “Organ transplantation: historical perspective and current practice.” British Journal of Anaesthesia 108.1 (2012): 29-42. Wolfea, R. A., Merionb, R. M., Roysa, E. C. and Porta, F. K. Trends in Organ Donation and Transplantation in the United States, 1998–2007. American Journal of Transplantation 9. 4 (2009): 2. Read More