Transplantation is the moving of an tissue or organ from one body to another (or from a donor site on the patient's own body), for the purpose of replacing the recipient's damaged or failing organ with a working one from the donor site as a treatment option. It can be done by operation or other ways.
By means of transplantation patient in fatal or dysfunctional condition survive in healthy way. Organs that can be transplanted include the heart, kidneys, liver, lungs, pancreas, and intestine. Tissues include cornea, blood, bone marrow and insulin secreting cells of pancreas.
In which diseases organ transplantation is a necessary treatment?
Organ transplantation is a necessary treatment when the organs become dysfunctional and there is no other medical treatment except transplantation. Currently it is the only treatment to cure patients having chronic and irreversible damage in their organs.
What is the organ transplantation from live donor?
Live organ donors can give one of their kidney or partly liver to other needs them. In these donations there is no evidence that donors have detrimental effect on their health. Risk of donor is the same with that of recipients as operational risk.
What is the organ transplantation from cadaver?
A organ to be transplanted is taken from a brain-dead organ donor.
Which organs and tissues can be transplanted?
Worldwide, organs and tissues that can be transplanted include the heart, liver, lungs, kidneys, pancreas, intestine, blood, bone marrow and insulin secreting pancreas cells. In Turkey heart, liver, lungs, kidneys, pancreas, cornea, bone marrow and blood transplantations are being performed successfully.
How many people are waiting for organ transplantation?
Worldwide, nearly one billion people are waiting for organ transplantation to survive. According to the recent data of Ministry of Health in our country there are nearly 30 000 people waiting for organ transplantation.
History of organ transplantation?
While organ transplantation has been conserved its actuality from prehistoric period worldwide in modern concept firstly it has been performed in animals as kidney transplantation by a Hungarian surgeon Ullman in Vienna at 1902. Then after in 1933 Voronov from USSR performed kidney transplantation using cadaver organ. As from 1950 American scientists began to perform organ transplantations successfully and it became a usual medical practice.
In Turkey Ankara and Istanbul firstly heart transplantations have been tried without success in 1969. First successful organ transplantation has been performed by Haberal and his team as kidney transplantation from mother to her son on 3rd of November 1975 in Hacettepe University Hospital. In 1979 National Organ Transplant Act numbered 2238 about "TAKING, STORING AND TRANSPLANTATION OF ORGANS AND TISSUES" has been effectuated and it has been provided legal framework of organ transplantation. After one month first kidney transplantation from cadaver has been performed. In 1990 liver transplantation between relatives has been performed children and adults firstly in Europe and Worldwide respectively. Up to date approximately 4800 kidneys, 320 livers, 75 hearth, 1 pancreas, 6000 corneas and 600 bone marrow transplantations have been performed in our country.
What is organ donation?
Organ donation is the removal of the tissue of the body from a person who has recently died or from a living donor, for the purpose of transplantation to the patient with chronic diseases.
Where and how is it done?
Legally organ donation is possible submitting a document that includes a statement about organ donation after dead in front of two witnesses. This document may be in a formal template or handwriting. If you have a driving license you may donate your organs checking the box of "I donate my organs" on the document. All or partial donation is possible. These options are available on the documents. Donation documents are recorded by competent authorities. If he/she takes the document with her/him in case of death their organs can be taken. It is also possible to cancel that donation with disposing of the document or having a document declaring that he/she does not donate organs. It is not possible in all case to take organs from somebody who does not want to donate. Organ donation is a humanistic behavior which should be done voluntarily and with willpower.
What is brain death? Who takes this decision?
Brain death is a legal definition of death that refers to the irreversible loss of brain activities. In brain death brain activities has been lost totally and irreversible. Cardiopulmonary functions can be continued by artificial ventilation and cardiac support but it is not possible for brain functions.
Definition of the brain death is operated by a team including neurologist, neurosurgeon, cardiologist and anesthesia/reanimation specialist after physical examination and required tests with using state of the art technologic facilities. It should be documented to be accepted. It is not possible to take organs before brain death has been documented. This is an independent team in which there is no one from transplantation team.
What are the predictions of Law numbered 2238 about organ donation?
For donation from live donor he/she should be more than 18 years old and sane.
It is forbidden with law that donor has financial interest from donation or doctor performed this transplantation knowing this.
For transplantation from cadaver it is necessary to have the brain dead document, organ donation document or consent of her/his relatives. If there is no relative and no document against donation it is permitted to be taken the organs by law numbered 2592.
Organs which have no detrimental effects on body integrity can be taken for transplantation (ex. cornea) without any donation or permission.
Organ trade is a crime required major punishments.
In forensic cases findings during the operation to take the organs are added to forensic report and autopsy is performed after that operation. Forensic procedures shall not delay the organ transplantation procedures.
Is organ transplantation suitable for religion?
Ministry of Religious Affairs describes the organ transplantation as one of the best aid between the people. It has been declared that it was religiously permissible with Directive dated 6.3.1980 and numbered 396. In all Muslim countries and the other religion this is valid. In Koran (Maide Sura, Verse 32) it has been declared that "GIVING LIFE TO SOMEBODY MEANS GIVING LIFE ALL PEOPLE".
Theological perspectives of organ transplantations?
Islam religion is clear about organ transplantation without any doubt and it is said that saving life is a merit.
Directorate of Religious Affairs in 1980 declared: "With the Decision dated 6.3.1980 and numbered 396 Religious Affairs Commission declares that organ transplantation is permissible. According to this decision organ transplantation should be performed in line with following conditions:
1. Report from a competent and reliable doctor that declares the necessity of organ transplantation to save the patient's life or organ.
2. Positive doctor opinion that this treatment can save patient's life.
3. Donor should be dead during the donation.
4. Consent of the patient who will receive the organ.
Responsibility of all behaviors of the patient who you will donate your organs is hers/him.
All religions including Christianity, Judaism, and Buddhism accept the organ transplantation is a part of human love and support the efforts about it with special contributions for organ donation.
Is it possible to be taken the organs before death?
No. Main responsibility of the doctor is to treat the patient. One of the Hippocratic rule was "first, do no harm" (primum nil nocere). Doctors had been trained and taken an oath to treat the patient without harm. After the patient dies despite all interventions or patient accesses to the doctor after death organs may be taken. There are some regulations to protect the doctors against liability. Brain death decision should made by an independent team in which there is nobody from treatment and transplantation team. Definition of the brain death is operated by a team including neurologist, neurosurgeon, cardiologist and anesthesia/reanimation specialist after physical examination and required tests with using state of the art technologic facilities. After documentation of brain dead there are various conditions to be taken the organs.
May organs from all patients having brain death be taken?
No. Organs cannot be taken from person who has a document that mentions she/he has no permission to do so. If there is no such document it must be asked to relatives. According to the verbal statement which had been done before death organs may be taken or not. Depending on the medical condition and medical history of the person some of the organs may be damaged so that they cannot be transplanted. Thus sometimes organs cannot be taken due to not only legal issues but also medical conditions.
In which conditions organs or tissues can be taken without any permission of relatives?
Organs or tissues can be taken from person who has a document that mentions she/he has permission to do so without asking to relatives. Organs or tissues which are not included in that statement cannot be taken even if relatives give permission. Organs and tissues can be taken from patients who have developed brain death even if there is no document and accessible relatives in case of the organs and tissues have no time to continue their viability. According to the Law, organs which have no detrimental effects on body integrity can be taken for transplantation without any donation or permission. However doctors try to take permission in any case to prevent any negative perspective against transplantation.
All donated organs and tissues with "donation card" can be taken?
No. "Donation cards", self-prepared statements or relevant parts of the ID cards are the expression of subject's intention. Organ or tissue transplantations require appropriate medical conditions. Without these conditions organs cannot be transplanted or taken.
If the person who had donated her/his organs is dead out of the hospital is it possible to be taken these organs?
It is not possible practically. After cardiac arrest organs of the cadaver become ineligible to transplant in ½-1 hours if they are not protected with special measures. While this is not easy in hospitals it is practically impossible out of the hospital.
Why these cards and documents are prepared if all donated organs cannot be used?
Organ transplantation is the only way to survive for patients with end stage diseases. Transplantation from live donor is a technical that can be used only in particular organs because every patient cannot have appropriate donor. Thus in most countries including Turkey there is a shortage of suitable organs for transplantation. Major organ sources are deceased donor who has dead in appropriate conditions. Body functions of these patients have been continued with medical support and it is not possible to balance for a long time. Therefore timing is the so important factor to be taken organs from cadaver. On the other side it is not easy to ask a decision from the relatives who have lost. They can make a decision easily if their relative mentioned to donate her/his organs. But they can understand if they donate their organs even if they could not know about the decision of their deceased relative. In conclusion, various activities such as "Donation cards", "Organ Donation Campaigns" "Transplantation Week" and "Transplantation Plays" have only purpose; to make awareness about life's that can be saved with our relatives who we lost and to be ready to decide.
