Abstract
The gap between organ demand and supply is an universal problem in organ and tissue transplantation therapy. The gap is growing in spite of efforts spent in medical, educational, social areas and mass media support. This reality has created the need for completely new therapeutic alternatives for the management of end-stage organ disease. The present research should continue in future aiming to discover systems and devices capable of totally replacing the traditional transplantation. On the other hand, a different progress in underway in transplantation. The indication for solid organ transplantation is to save life and promote quality of life. The new developing transplantations of composite tissue, uterus and face are performed with completely different indications. Facial defects caused by various insults cause serious functional and esthetic disorders, psychological and social problems. Facial transplant surgery is accomplished to overcome such problems. Uterus transplantation is emerging as an alternative to female infertility. Transplantation of composite tissue includes different organs. The main purpose of composite tissue transplantation is to restore reduced or completely lost functions and to increase the quality of life. Nerve regeneration must occur as a consequence of transplant to regain sensory and motor functions. It appears that the future of transplantation involves developments in two main streams; invention of completely new tools for solid organ transplantation and advances in the transplantation of different organs including uterus, face and composite tissue.
Highlights
The idea of replacing a malfunctioning diseased organ by the same organ dates back to antiquity, but major inventions and successful practice of transplanting solid organs have occurred in the second half of the 20th century
While organ transplantation will continue to be the definitive treatment for the present and foreseen future, the statistical evidence revealing the gap between demand and supply and the experience of the global medical community has clearly shown that even the centers with best figures of organ supply are far from meeting the growing need
While 93.8% of the participants stated that facial transplant failure, 91.1% mortality, and 78.8% chronic organ rejection are the points that should be discussed, the answers revealed that there is no consensus about the definition of mortality rates and facial transplantation
Summary
The idea of replacing a malfunctioning diseased organ by the same organ dates back to antiquity, but major inventions and successful practice of transplanting solid organs have occurred in the second half of the 20th century. Pioneering work in human-to-human organ transplantation started in the 1950’s and in following decade. Improvements in surgical techniques, better postoperative management in the intensive care units, the introduction of brain death concept and its beneficial effect of enlarging the donor pool, a better understanding of the natural course of the various diseases leading to organ failure, new immunosuppressive agents have all contributed to transplantation activities. Today organ transplantation is a definitive treatment for an end-stage disease with low morbidity and mortality rates. Efforts directed to the education of medical staff and the general public, controlled system of financial payment for the living donor, gifting to deceased donor’s family, extending the donor criteria, Organ Donation and Transplantation acceptance of paired organ donation, organ donation campaigns and media support are among the other measures to promote transplantation
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