Organ Donation 1st Edition
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ORGAN DONATION
Sarah Boslaugh
Health and Medical Issues Today
Copyright © 2022 by ABC-CLIO, LLC
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or
otherwise, except for the inclusion of brief quotations in a review, without prior permission in writing
from the publisher.
This book discusses treatments (including types of medication and mental health therapies),
diagnostic tests for various symptoms and mental health disorders, and organizations. The authors
have made every effort to present accurate and up-to-date information. However, the information in
this book is not intended to recommend or endorse particular treatments or organizations, or
substitute for the care or medical advice of a qualified health professional, or used to alter any
medical therapy without a medical doctor’s advice. Specific situations may require specific
therapeutic approaches not included in this book. For those reasons, we recommend that readers
follow the advice of qualified health care professionals directly involved in their care. Readers who
suspect they may have specific medical problems should consult a physician about any suggestions
made in this book.
Library of Congress Cataloging-in-Publication Data
Names: Boslaugh, Sarah, author.
Title: Organ donation / Sarah Boslaugh.
Description: Santa Barbara, California : Greenwood, [2022] | Series: Health and medical issues today
| Includes bibliographical references and index.
Identifiers: LCCN 2021032042 (print) | LCCN 2021032043 (ebook) | ISBN 9781440876219
(hardcover) | ISBN 9781440876226 (ebook)
Subjects: LCSH: Donation of organs, tissues, etc. | Transplantation of organs, tissues, etc.
Classification: LCC RD129.5 .B67 2022 (print) | LCC RD129.5 (ebook) | DDC 617.9/54—dc23
LC record available at https://lccn.loc.gov/2021032042
LC ebook record available at https://lccn.loc.gov/2021032043
ISBN: 978-1-4408-7621-9 (print)
978-1-4408-7622-6 (ebook)
26 25 24 23 22 1 2 3 4 5
This book is also available as an eBook.
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CONTENTS
Series Foreword
Preface
Part I: Overview
1 Organ Donation and Transplantation: Past and Present
2 Types of Organ Donation
3 The Process of Organ Donation, Matching, and Transplantation
4 Life after Donating or Receiving an Organ
5 Religious and Cultural Perspectives on Organ Donation
6 Alternatives to Human Organ Donation and Transplantation
Part II: Controversies and Issues
7 Practical and Logistical Issues in Organ Donation and Transplantation
8 Legal Issues in Organ Donation
9 Financial Issues in Organ Donation and Transplantation
10 Ethical Issues in Organ Donation
Part III: Scenarios
11 Case Studies
Glossary
Directory of Resources
Index
SERIES FOREWORD
Every day, the public is bombarded with information on developments in
medicine and health care. Whether it is on the latest techniques in treatment
or research, or on concerns over public health threats, this information
directly affects the lives of people more than almost any other issue.
Although there are many sources for understanding these topics—from Web
sites and blogs to newspapers and magazines—students and ordinary
citizens often need one resource that makes sense of the complex health and
medical issues affecting their daily lives.
The Health and Medical Issues Today series provides just such a one-
stop resource for obtaining a solid overview of the most controversial areas
of health care in the 21st century. Each volume addresses one topic and
provides a balanced summary of what is known. These volumes provide an
excellent first step for students and lay people interested in understanding
how health care works in our society today.
Each volume is broken into several sections to provide readers and
researchers with easy access to the information they need:
Section I provides overview chapters on background information—
including chapters on such areas as the historical, scientific,
medical, social, and legal issues involved—that a citizen needs to
intelligently understand the topic.
Section II provides capsule examinations of the most heated
contemporary issues and debates, and analyzes in a balanced manner
the viewpoints held by various advocates in the debates.
Section III provides case studies that show examples of the concepts
discussed in the previous sections.
A directory of resources and a glossary provide additional reference
material and serve as the best next step in learning about the topic at hand.
The Health and Medical Issues Today series strives to provide readers
with all the information needed to begin making sense of some of the most
important debates going on in the world today. The series includes volumes
on such topics as stem-cell research, obesity, gene therapy, alternative
medicine, organ transplantation, mental health, and more.
PREFACE
Humans have long been fascinated by the possibility of transplanting body
parts from one person to another, but not until the second half of the 20th
century did organ transplantation became a common part of medical
practice. The number of organ transplants performed annually has grown
steadily over the decades since, and this lifesaving procedure is now
available in many countries of the world. In the United States alone, almost
40,000 organ transplants were performed in 2020, while globally, almost
145,000 transplants were performed in 2018. One major limiting factor in
organ transplantation is the availability of suitable donor organs, resulting in
over 109,000 people in the United States being wait-listed for a donor organ
as of September 2020; sadly, about 17 Americans die each day while
waiting for a donor organ.
The process of donation and transplantation is complex and can be
confusing, particularly to those who are not professionals in this field.
Organ Donation offers an overview of the donation and transplantation
process, written for nonspecialists, including people needing a transplanted
organ, potential donors and their families, and students considering a career
related to organ donation and transplantation. While this volume is not
intended to replace medical or professional advice, it does offer discussion
and clarification of many issues, written for the nonprofessional, that might
be of concern to anyone considering becoming involved in the organ
donation and transplantation process.
The first section of Organ Donation offers an overview of the subject,
beginning with an historical summary of how the process of organ
transplantation evolved from a theoretical concept to the lifesaving
procedure it is today. A statistical summary of organ donation and
transplantation today, both in North America and globally, is also provided,
as well an overview of pertinent laws. Different types of organ donation are
discussed, including deceased and live donation, targeted and untargeted
donation, and donation by infants and children as well as adults. The
process of organ donation, matching, and transplantation is outlined, with
particular emphasis on issues that may be confusing to the nonprofessional,
such as how the waiting list for donor organs and the matching process
work. The possible experiences of live donors and organ recipients are also
discussed, including issues such as organ rejection and the need for
immunosuppressive drugs.
Because the process of organ donation and transplantation touches on
sensitive topics like body integrity, life, and death, an individual’s religious
background may affect how they regard organ donation. To help illuminate
how organ donation and transplantation are viewed in different religions,
Organ Donation includes a summary of how these topics are regarded in a
variety of religions, including Catholicism, Orthodox Catholicism, different
Protestant denominations, Judaism, Islam, Buddhism, and Hinduism. A
final chapter in this first section discusses alternatives to organ donation and
transplantation, including procedures such as dialysis that can provide
support for failing organs, as well as processes intended to increase the
supply of available organs, including xenotransplantation, the creation of
artificial organs, and organ bioprinting.
The second half of Organ Donation covers various controversies in the
field, from multiple points of view, with an eye to helping readers clarify
their own feelings on these topics. One key topic is the approaches taken in
various countries to help meet the unmet need for donor organs. These
approaches include switching from an “opt-in” to an “opt-out” system, and
organizing campaigns and incentives to encourage people to register as
organ donors. Legal issues covered include human organ trafficking,
transplant tourism, and the use of organs harvested from prisoners.
Financial issues are discussed with a particular eye to the United States,
which does not have a national health care system. Ethical issues are also
discussed, including different methods of defining death, criticisms of the
current organ allocation system, and concerns regarding xenotransplantation
and paid organ donation. Finally, five case studies personalize some of the
major issues in organ donation and transplantation, while a glossary helps
clarify key terms and a bibliography provides the reader with sources that
can be used to investigate issues of particular interest in further detail.
PART I
Overview
CHAPTER 1
Organ Donation and Transplantation:
Past and Present
Humans have contemplated organ transplantation for thousands of years, at
least, but only fairly recently has it become a standard medical procedure
offering the recipient a significantly increased life span and improved
quality of life. Worldwide, the Global Observatory on Donation and
Transplantation (GODT) estimates that over 139,000 solid organ transplants
were performed in 2017, with the most common organs transplanted being
kidneys (65%) and livers (23%). Despite these impressive numbers, the
GODT estimates that currently only about 10% of the need for organ
transplants is being met, due to a variety of reasons including an insufficient
number of donor organs and the cost and technical demands of organ
transplantation.
A HISTORY OF ORGAN DONATION AND
TRANSPLANTATION
Discussion of organ transplantation in literary and mythological texts
long predates any evidence of actual successful transplantation. For
instance, organ transplantation is mentioned in ancient mythology,
including sources from Greece, Rome, China, and India. The
transplantation of a leg is mentioned in accounts of the Christian martyrs
Cosmos and Damien, who lived in what is today Syria in the 3rd century
CE. The concept of transplanting a patient’s own skin to replace a missing
nose is mentioned as early at 600 BCE, and such techniques were used
successfully in 16th-century Italy by surgeons such as Gaspare Tagliacozzi.
In the 18th century, the Scottish surgeon John Hunter performed
experiments in which human teeth were transplanted into a cock’s comb,
and he suggested that humans could also benefit from tooth transplantation.
The study and practice of organ transplantation in humans became
substantially more scientific by the mid-19th century, and reasons for the
failures of earlier transplants became better understood. For instance, early
attempts at skin grafts were largely unsuccessful because surgeons
attempted to transplant full-thickness skin that included layers of fat and
other tissues; these extra layers prevented the transplanted skin from
developing vascularization. In 1869, the Swiss surgeon Jacques-Louis
Reverdin overcame this difficulty by transplanting small “pinch grafts” of a
patient’s own skin; these small grafts could be used to cover burns and open
wounds. The distinction between autografts (using the recipient’s own skin)
and homografts (using skin from another person) was not generally
appreciated during this time, and some surprising claims of successful
homographs exist from this period, long before antirejection drugs were
available. This may be due to poor record-keeping or complications that
interfered with truly observing the results of grafts, because in 1912 Georg
Schöne demonstrated convincingly that homografts always failed. Schöne
also discovered the “second set” response, which stated that when
subsequent homografts from the same donor were performed, each new
homograft would fail more rapidly than the previous. Other scientists
developed transplant procedures working with animal models, including the
French surgeon Alexis Carrel, who performed several successful kidney
transplants in dogs. Carrel also developed several important methodologies,
including cold graft preservation, and he was awarded the Nobel Prize in
Physiology or Medicine in 1912 for this work.
