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12.6. Transplants and donation of cells, blood and organs

Transplants and donation of cells, blood and organs

transplant consists of replacing a  diseased organ or tissue with another that works properly from a donor.

In recent years, much progress has been made and good results are obtained with transplants, but it is necessary that there be still a greater number of donors who can donate their organs.

Spain is the world leader, for 25 consecutive years, in the number of transplants performed. The Spanish model is taken as an example in other countries, where donations are made altruistically and transplants are carried out by the National Health System. But despite its good functioning, 10% of people who wait for a transplant die before receiving it.

In Spain, donation and transplantation are regulated by the Transplant Law, which is fundamentally based on:

  • The altruism of donation: you can not receive anything in exchange for the donation of any organ. In fact, donor and recipient are anonymous.
  • Equity in access to transplantation. All people have the same right to receive a transplant. A list is made with the characteristics of each patient and the ideal person receives the organ to receive it, for compatibility and urgency .

Organ transplant

The organ transplantation is the replacement of an organ malfunctioning by another person who has donated after death. In some cases, such as the kidney, it is possible for a person to give up one of theirs if they are working properly.

The organs that can be transplanted are the kidneyheartlungintestinepancreas and liver, coming from a person with irreversible brain damage or brain death. Although the person is dead, they still have enough blood supply to allow them to be collected, transported, and transplanted. Not all the deceased can donate their organs. Logically, donated tissues and organs are subjected to rigorous controls to prevent the transmission of other diseases .

Anyone whose organs do not function properly and cannot be cured with other medical treatment can be a transplant recipient, and transplantation is the only way to avoid death or to have a better quality of life. The recipient cannot receive organs from just anyone, they have to be compatible. The recipient's immune system recognizes the donor organ as foreign and tries to destroy it. Therefore, to avoid rejection, the donor and recipient cells have to be as similar as possible.

In Spain, the National Health System and the corresponding Autonomous Community take care of the transplant, so that any person, regardless of their economic capacity, can be transplanted.

Transplant information: National Transplant Organization.

Tissue transplantation

The transplant tissues are older than organ transplants, though less known. The most donated tissue is blood, the transplants of which are called transfusions. You can also donate corneasheart valvesartery and vein segments, and bone marrow. For example, leukemia patients need bone marrow transplants from a compatible donor who, in 30% of cases, can be found among their closest relatives .

The skin and cartilage are also used in  autologous transplants in people with burns or torn ligaments.

Blood donation

Being a donor is a social duty of all citizens. The blood can not be manufactured in the laboratory, and the only way to get blood through the solidarity of healthy people.

Transfusions are continually needed in cases of accidents, operations, etc. and it is our responsibility that there is enough blood available for others (or ourselves) to use.

Normally, from the blood that is donated, the different components are separated to be used in each case:

  • Use of blood components in hospitals:
    • Red blood cell concentrates. In cases of blood loss due to an accident, surgery, anemia, etc.
    • Fresh frozen plasma. In clotting problems or loss of blood plasma.
    • Platelet concentrates. In cases of shortage or malfunction of platelets.
    • Autotransfusion. The blood is donated by a person who is going to undergo surgery and will use it later.
  • Use of components for drugs:

Donación de sangre

By Remux (Own work) [CC BY-SA 4.0], via Wikimedia Commons

Cell transplantation

In the section on assisted reproduction , the issue of donation of gametes, eggs and sperm that are used in cases of sterility has already been discussed.

Another type of cells that can be donated are stem cells, which can come from embryos or from the umbilical cord. These pluripotent stem cells are not specialized, but they are capable of originating different types of cells that can help to heal, in the future, diseases such as cancer, Alzheimer'sParkinson'sspinal cord injuries, etc.