Transplantation
Transplantation - in medicine, transplantation of any organ or tissue, for example, kidney, heart, liver, lung, bone marrow, stem hematopoietic cells, hair. An organism from which organs or tissues are taken for transplantation is called a donor. An organism to which tissues or organs are transplanted is called a recipient.
Bone marrow transplantation
Main article: Bone marrow transplantation
Other transplants
Main article: Intestinal transplantation
Main article: Liver transplantation
Lung transplantation
Main article: Lung transplantation
2023
For the first time in Russia, a child had a finger transplanted from his mother's leg
On December 12, 2023, specialists from the N. I. Pirogov High Medical Technology Clinic of St. Petersburg State University (St. Petersburg State University) announced a unique operation to transplant a donor finger to an eleven-year-old child with leukemia. This procedure will allow the boy to restore the brush function. Read more here.
The world's first whole-eye transplant was performed - from a dead donor. Photo
On November 9, 2023, American specialists from the Langone Health Medical Center at New York University announced the world's first successful whole-eye transplant operation. The most complex surgical procedure, carried out on May 27, 2023, lasted about 21 hours and was carried out under the guidance of Doctor of Medical Sciences Eduardo Rodriguez. Read more here.
Man who transplanted pig's heart dies
At the end of October 2023, Laurence Fawcett, the world's second patient to receive a pig heart transplant, died. He died six weeks after undergoing transplant surgery. Read more here.
The world's first device for monitoring the work of transplanted organs in real time is presented
On September 7, 2023, American researchers from Northwestern University announced the development of the world's first device for continuous monitoring of the state of transplanted organs in real time. Read more here.
Successful uterine transplant from living donor performed for the first time
On August 23, 2023, surgeons from Oxford Churchill Hospital announced the first Britain in a successful transplantations uterine operation from a living donor. More. here
Cardiac surgeons in Russia have learned to maintain a donor heart 1.5 times longer than usual
Cardiac surgeons from the E. N. Meshalkin National Medical Research Center in Novosibirsk were able to extend the life of the donor heart from four to six hours. This became known in June 2023.
Thanks to the new method, the organ can be delivered from remote regions. This means that patients will increase the chances of transplantation, reports TASS.
 | In the experimental group, we carry out the preservation of the donor heart outside the body for six hours using autoperfusion. During this time, we observe the function of the organ, its work, changes in parameters, blood composition, changes in the contractile abilities of the myocardium using ultrasound, - explained the cardiovascular surgeon Maxim Zhulkov. |  |
According to him, the heart is quite an autonomous organ, and under certain conditions, even being deprived of communication with the body, the central nervous system, it is able to maintain its functions for a long time. Deputy Director General of the Heart Center for Science, leading cardiovascular surgeon-aritmolog Alexander Romanov said that increasing the functioning time of the donor organ from four to six hours is already a big step towards the availability of heart transplantation. This will allow you to bring a donor organ, for example, from, to the Krasnoyarsk Novosibirsk region. According to him, scientists are striving to bring the solution in which perfusion is taking place before storing the organ for 24 hours. Zhulkov said that experiments are carried out on large laboratory animals. Heart moved in shipping container
By June 2023, scientists are working to create a solution in which the heart can be stored for 24 hours. This organ is quite autonomous and can maintain its functions for a long time even outside the body.[1]
An innovative coating has been developed to help all implants take root
On May 5, 2023, American researchers at the University of Illinois (UIC) at Urbana-Champaign announced the development of an advanced coating for orthopedic implants that helps in the fight against infections and prevents excessive mechanical loads. Read more here.
2022
Organ transplantation in Russia increased by 30%
Organ transplantation in Russia in 2022 increased by 30%: according to the results of that 12-month period, 2551 operations were carried out against 2316 a year earlier. Such data in February 2023 revealed the chief freelance specialist transplantologist of the Ministry of Health of Russia Sergey Gauthier.
According to him, the growth occurred, among other things, due to the increase in the regions of transplantation capacities. This type of operation by February 2023 is carried out by 66 medical centers in 36 regions, while in 2007 there were only 31 such clinics.
From 2007 to 2022, the number of heart transplants in Russia increased 16 times. By February 2023, under medical supervision in the country, 2 thousand patients with a transplanted heart. During the same period, the number of liver transplants increased 5.6 times, kidneys - 2.2 times. In Russia, the most medical centers transplanting kidneys are 57 centers in 30 regions, slightly fewer medical organizations with liver transplant departments - 30 clinics in 20 territories.
At the National Medical Research Center of Transplantology and Artificial Organs named after Academician V.I. Shumakov in 2022, 699 manipulations were carried out, and 1.8 thousand operations were carried out by specialists in regional medical institutions.
Transplantation is one of the priority types of medical care of the Ministry of Health of the Russian Federation for development in the regions. For example, the agency intends to introduce a special increasing coefficient for the federal subsidy to the regions for the provision of VMP outside the basic compulsory medical insurance program in order to stimulate local clinics to load existing transplant capacities.
In February 2023, Sergei Gauthier said that there were no difficulties with medicines for organ transplantation due to sanctions in Russia.
| | We can assume that there will be some logistical difficulties in the delivery of drugs, but so far we have monitoring of drug defects, this is not observed, "he said.[2] | |
Australia first to officially allow microbiota transplant
On November 9, 2022, the Australian company BiomeBank announced that it had received approval from the local Therapeutic Goods Administration (TGA) for its gut microbiota-based drug Biomictra. This is the first time that any regulator in the world has officially authorized a similar type of therapy. Read more here.
World's first partial heart transplant performed
In early September 2022, a team of specialists from the Duke Health Clinic performed the world's first partial heart transplant, in which living arteries and valves from a fresh donor heart were connected to the patient's existing heart. Read more here.
Why the law on organ transplantation is outdated in Russia
Adopted back in 1992, the law on organ transplantation in Russia is outdated, changes in it can save the lives of a large number of people. This opinion was expressed at the end of August 2022 by the author of the project "20 ideas for the development of Russia" Dmitry Davydov.
According to him, the condition establishing exclusively genetic kinship between the donor and the recipient was a necessity by the early 1990s. This clause of the law made the sphere of organ transplantation transparent and protected people from criminal schemes in which they were forced to give organs under pressure or for money. For 30 years, the situation in the country has changed dramatically, Davydov said.
Oleg Reznik, head of the Center for Organ and Tissue Donation at the Dzhanelidze Research Institute of Emergency Medicine, agrees with this position:
| | In today's digital world, it's very easy to test whether people actually live together and how long they live together, what they're motivated by. You can even make the court make a decision. | |
From the standpoint of today, one should also approach the proposal to create a unified base for the exchange of corpse organs by Russia, which also remained without comments from government agencies, Dmitry Davydov points out.
| | Technological solutions based on successful foreign experience, which I propose to pay attention to first of all, can create a reliable system of organ exchange among the constituent entities of the Russian Federation with the further possibility of scaling up to the international level, - said the author of "20 ideas for the development of Russia." | |
Another serious limitation on the path to an increase in the number of transplants in Russia, Dmitry Davydov considers the lack of a unified system for the exchange of organ donors-corpses. For many years, the country has been operating the presumption of consent to the transplantation of organs and tissues of dead people. Its essence is that after diagnosing brain death, it is possible to remove organs suitable for transplantation by default if the deceased or his relatives did not register their disagreement with such a procedure during their lifetime.[3]
First transplantation of organoid into human
On July 7, 2022, the research team of the Tokyo Medical and Dental University announced that it had managed to carry out the world's first clinical transplantation of a mini-organ to a patient with ulcerative colitis. Read more here.
Genetically modified pig heart successfully transplanted into humans for the first time
In January 2022, a genetically modified pig heart was successfully transplanted into humans for the first time. The operation was carried out by doctors at the University of Maryland, the patient was 57-year-old David Bennett, who suffered from terminal terminal heart disease. Read more here.
2021: Announcement of a device for transporting a donor heart, which was previously considered unsuitable
On September 7, 2021, TransMedics launched a product called Organ Care System (OCS) Heart. It is an apparatus for transporting a donor heart, which was previously considered unsuitable. Read more here.
2020
Organ transplantation in Russia has sharply decreased - from 2400 to 1960
In 2020, 1960 organ transplants were registered in Russia against 2400 a year earlier. At the same time, the number of such operations for children increased by 13.6%, to 256. Such statistics at the end of September 2021 were cited by the head of the Samara Center for Organ and Tissue Transplantation, the chief freelance transplant specialist of the Ministry of Health of the Samara Region, Alexei Mironov.
According to him, in 2020, children underwent 119 kidney transplants, 131 liver transplants and six heart transplants. Most operations were performed in Moscow federal centers.
At the end of 2020, a total of 1124 kidney transplants, 251 heart transplants, nine lung transplants, two heart-lung transplants, 559 liver transplants were performed in Russia.
As of the end of 2020, transplantation centers in Russia were located in 32 subjects with a total population of 99.3 million people. Kidney transplantation was performed in 44 centers, liver transplantation in 29, heart transplantation in 16, pancreas transplantation in three, lung transplantation in three, and small intestine transplantation in one.
The waiting list for kidney transplantation during 2020 in the Russian Federation consisted of 6929 potential recipients, that is, 11.5% of the total number of patients receiving treatment with hemo- and peritoneal dialysis (approximately 60 thousand).
In the period 2012-2020 in the Russian Federation, as the number of organ transplants increases, there is an increase in the number of patients on waiting lists: kidney transplantation almost twice, liver - 4.6 times, and heart - 1.8 times. At the same time, the average waiting time for organ transplantation has practically not changed.
In 2020, there were 8906 organ donors in Russia. Posthumous donors - 5644, living (related) donors - 3262.[4]
Russian Ministry of Health launches advertising for organ donation in social networks
On October 6, 2020, it became known about the intention of the Ministry of Health of the Russian Federation to launch an advertisement for organ donation on social networks. The agency announced the corresponding tender.
The winner of the competition will have to adapt and post two videos in the services "Vkontakte," "My World," "Odnoklassniki" and on YouTube within two days from the date of the conclusion of the state contract. The target audience for the content is men and women aged 18 and over. The end of applications for participation in the competition is scheduled for October 8, 2020.
The initial contract price is 2 million rubles. For this amount, the performer must provide at least 3.5 million video screenings at different sites aimed at increasing the awareness of Russians in organ donation for further transplantation to those in need.
On June 1, 2021, a federal law "On human organ donation and transplantation" may enter into force in Russia. It introduces the concepts of "donation," "donor organ," "posthumous donation" and "lifetime donation"... Its adoption stretched over 7 years. A bill replacing the current law of 1992 "On Organ and Tissue Transplantation" was proposed back in 2013, but its adoption was constantly postponed. First of all, due to the fact that the register of refusals from post-mortem donation was never created, so that, in accordance with the law, the presumption of consent could work if the deceased or his relatives did not declare a refusal to donate.
There are three main conditions for organ donation. First, a person can become an organ donor after death only if a strict protocol is followed, using which the slightest possibility of error is excluded.
The second condition is that a person can become an organ donor after death, if during his lifetime he did not have serious concomitant diseases, systemic or oncological.
Third, there is a presumption of consent in our country regarding organ donation. This means that if a person during his lifetime has not expressed an objection to becoming an organ donor after death, he can become an organ donor. [5]
First transplant of lab-grown heart cells
In late January 2020, the Osaka University team announced it had performed the world's first transplantation of lab-grown heart muscle cells.
The surgery was conducted as part of a clinical study of the safety and efficacy of therapy using induced pluripotent stem cells. They are grown from adult donor cells, having previously been reprogrammed into an undifferentiated state, similar to embryonic cells, from which internal organs are then formed.
Yoshiki Sawa, a professor in the Department of Cardiovascular Surgery at Osaka University, and his colleagues tried to transplant heart muscle cells for three years into 10 patients suffering from serious heart failure caused by ischemic cardiomyopathy. In January 2020, the team performed a successful operation. The patient was transferred from intensive care to a general ward. He continues to be monitored.
Transplanted cells on a special self-decomposing sheet attached to a patient's heart surface are expected to grow and release a protein that will help regenerate blood vessels and improve heart function. Each sheet with cells has a width of 4 to 5 centimeters and a thickness of 0.1 millimeters.
The team will continue to monitor the patient over the next year. The study includes a rigorous assessment of the risks, in particular the likelihood of cancer, and an assessment of the effectiveness of transplantation. This is the second clinical trial of pluripotent cells in Japan. The first was conducted among patients with eye diseases by the Riken Research Institute.
| | I hope that cell transplantation will become a medical technology that will save as many people as possible - I have seen enough patients who could no longer help, "Sava said at a press conference.[6] | |
2019: Doctors in Russia will be allowed to take the organs of the dead
In December 2019, the Ministry of Health introduced a bill on human organ donation and transplantation. The document records the conditions and procedure for the removal of organs, as well as their further transplantation. In addition, the bill describes the rights and obligations of organ donors, recipients, health professionals and relevant institutions.
It is reported that medical organizations will have the right to begin transplantation on the day of a person's death, unless his relatives declare their disagreement with the removal of organs in time. Also, the transplant will be made in the absence of the opportunity to inform relatives within two hours after death.
Also, the draft law provides for the automatic consent of an adult capable citizen to posthumously remove organs if two conditions are met, if he has not reported his lifetime refusal to posthumously donate orally to the attending physician in the presence of two witnesses, or in writing - in a medical organization.
The bill defines the legal age of the deceased for post-mortem donation.
| | A posthumous donor is a person aged 1 year and older, in respect of whom a death procedure has been initiated or death has been ascertained, and whose donor organs can be used for transplantation (transplantation) and which, when donating human organs, is recognized as a potential, acceptable, real and relevant donor, - according to a document published on the federal portal of draft regulatory draft legal acts. | |
By December 24, 2019, the bill is being publicly discussed. This stage will end on January 20, 2020, the law will enter into force on June 1, 2021, the explanatory note says.[7]
2018: World's first penis and scrotum transplant
At the end of April 2018, it became known about the world's first operation to transplant a penis and scrotum with surrounding tissues, carried out by an American soldier who was injured in the detonation of an improvised explosive device in Afghanistan. Successful transplantation was reported at the Johns Hopkins Hospital in Baltimore, USA.
As follows from the press release, excerpts from which are published by Reuters, the operation, which lasted 14 hours, was performed on March 26, 2018 by a team of nine plastic surgeons and two urologist surgeons. The patient, who wished to remain anonymous, has already recovered from the operation and will be discharged from the hospital by the end of April.[8]
| | We hope that the transplant will restore the urinary and sexual functions of a young person to almost normal levels, "said Dr. Andrew Lee, head of the Department of Plastic and Reconstructive Surgery at the Johns Hopkins University School of Medicine. | |
According to the Afghan war veteran, the wound he received was simply unimaginable, and it was very difficult for him to come to terms with it.
| | Waking up (after surgery), I finally felt more... normal. I felt confident that I was now in order, - the man recalls.[9] | |
As Dr. Andrew Lee explained, when reconstructing the penis, it is possible to use the patient's own tissues, however, with this option, an implantable prosthesis is needed to achieve an erection, due to which the risk of infection increases. In addition, due to other injuries, the man did not have enough tissues suitable for transplantation on the rest of the body, so it was decided to resort to organ transplantation.
It is worth adding that earlier, in December 2012, the surgeons of the clinic at Johns Hopkins University were the first in the United States to perform a transplant operation in which both hands were transplanted to an injured serviceman.
An operation in which parts of the body or tissue are transplanted from one person to another is called vascularized composite allotransplantation. This method includes transplantation of skin, muscles and tendons, nerves, bones and blood vessels. As with any transplant operation, there is a risk of tissue rejection, and therefore the patient is prescribed a course of immunosuppressive drugs. Johns Hopkins University specialists have developed an immunomodulation method that minimizes the use of drugs that prevent tissue rejection.
Notes
- ↑ Cardiac surgeons in Novosibirsk learned to maintain a donor heart 1.5 times longer
- ↑ The Ministry of Health denied difficulties with the availability of drugs for transplants
- ↑ Non-blood donor: how to reduce organ deficit for transplantation in Russia
- ↑ Doctors of Clinics SamGMU took part in the V Russian National Congress "Organ Transplantation and Donation"
- ↑ Provision of services for posting videos aimed at raising the level of awareness of citizens of the Russian Federation on the development of the human organ donation system for transplantation in the information and communication network "Internet"
- ↑ Osaka University transplants iPS cell-based heart cells in world's first clinical trial
- ↑ npa = 98296/Human Organ Donation and Transplantation Bill
- ↑ Wounded soldier gets world's first penis transplant in U.S. operation
- ↑ hopkins performs first total penis and scrotum transplant in the world Johns Hopkins Performs First Total Penis and Scrotum Transplant in the World
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