Episode 66 The Outs and Ins of Organ Transplantation

From the first skin grafts to the future of 3D printed organs, the science of organ transplantation has always seemed like something out of a sci-fi novel. How on earth can an organ from one person be removed and successfully placed into another person? Who first attempted such a monumental feat, and how long did it take for trial and error to become trial and success? Our episode this week seeks to answer these questions and so many more as we tackle the massive topic of organ transplantation. We begin by examining the immunological nitty gritty of transplant science and follow that up with the long and storied history of transplants. We round things out with a look at the numbers, which show the unfortunate reality that demand far outpaces availability, a reality that may soon be improved with innovative approaches towards bioengineering. And we are so excited to be joined by two fantastic guests, Carol Offen and Dr. Elizabeth (Betsy) Crais, who share their stories of what it’s like to donate or receive a kidney. 

Carol, who is a NKF Kidney Advocacy Committee member, has a great website that includes many resources where you can learn more about kidney donation as well as keep an eye out for Carol and Betsy’s book, The Insider’s Guide to Living Kidney Donation. You can also follow Carol on Twitter (@CarolOffen) and through her advocacy page on Facebook.

HistoryBiology
Hamilton, David. A history of organ transplantation: ancient legends to modern practice. University of Pittsburgh Press, 2012.Lechler, R. I., Sykes, M., Thomson, A. W., & Turka, L. A. (2005). Organ transplantation—how much of the promise has been realized?. Nature medicine, 11(6), 605-613.
Mickle, Shelley Fraser. Borrowing Life: How Scientists, Surgeons, and a War Hero Made the First Successful Organ Transplant a Reality. Imagine Publishing, 2020.Watson, C. J. E., & Dark, J. H. (2012). Organ transplantation: historical perspective and current practice. British journal of anaesthesia, 108(suppl_1), i29-i42.
Diethelm, Arnold G. “Ethical decisions in the history of organ transplantation.” Annals of Surgery 211.5 (1990): 505.Fishman, J. A. (2017). Infection in organ transplantation. American Journal of Transplantation, 17(4), 856-879.
Gibson, Thomas, and Peter B. Medawar. “The fate of skin homografts in man.” Journal of anatomy 77.Pt 4 (1943): 299.Starzl, T. E., Murase, N., Abu-Elmagd, K., Gray, E. A., Shapiro, R., Eghtesad, B., … & Fung, J. J. (2003). Tolerogenic immunosuppression for organ transplantation. The Lancet, 361(9368), 1502-1510.
Groth, Carl G., et al. “Historic landmarks in clinical transplantation: conclusions from the consensus conference at the University of California, Los Angeles.” World journal of surgery 24.7 (2000): 834-843.Platt, J. L. (1998). New directions for organ transplantation. Nature, 392(6679 Suppl), 11-17.
Matesanz, R., Mahillo, B., Alvarez, M., & Carmona, M. (2009, July). Global observatory and database on donation and transplantation: world overview on transplantation activities. In Transplantation proceedings (Vol. 41, No. 6, pp. 2297-2301). Elsevier.
Chinen, J., & Buckley, R. H. (2010). Transplantation immunology: solid organ and bone marrow. Journal of Allergy and Clinical Immunology, 125(2), S324-S335.
Phillips, B. L., & Callaghan, C. (2017). The immunology of organ transplantation. Surgery (Oxford), 35(7), 333-340.
Mahillo, B., Carmona, M., Álvarez, M., Noel, L., & Matesanz, R. (2013). Global Database on Donation and Transplantation: goals, methods and critical issues (www. transplant-observatory. org). Transplantation Reviews, 27(2), 57-60.
Rudge C. J. (2018). Organ donation: opting in or opting out?. The British journal of general practice : the journal of the Royal College of General Practitioners, 68(667), 62–63. https://doi.org/10.3399/bjgp18X694445
Arshad, A., Anderson, B., & Sharif, A. (2019). Comparison of organ donation and transplantation rates between opt-out and opt-in systems. Kidney international, 95(6), 1453-1460.
Javadi, S., Brooks, J. T., Obi-Umahi, G. A., & Ekwenna, O. (2018). New Frontiers in Transplantation and Stem Cell Technology: A Brief Synopsis. Open Journal of Organ Transplant Surgery, 8(02), 13
Ng, W. L., Chua, C. K., & Shen, Y. F. (2019). Print me an organ! Why we are not there yet. Progress in Polymer Science, 97, 101145.

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Additional links:
United Network for Organ Sharing (UNOS)
Polycystic Kidney Disease (PKD) Foundation
Live Donor Toolkit
National Kidney Registry
WoMen Encouraging Living Donation
Donate Life America