The History of Solid Organ Transplantation

This chapter provides a brief history of solid organ transplantation. Although the focus is on the living donor, the history of living donor solid organ transplantation is intertwined with the history of deceased donor solid organ transplantation. This is particularly true in the early years of solid organ transplantation when the earliest success for some solid organ transplants began with living donors, e.g. kidney, and began with deceased donors for other solid organ transplants, e.g. liver. The history of each solid organ in which living donors have supplied grafts (kidney, liver, lung, pancreas, intestines, and uterus) is described even though some are rarely if ever performed today, e.g. lung, intestine, pancreas. We also discuss the living domino donor—a candidate-recipient (most commonly the recipient of a deceased donor liver or heart) whose own organ is not discarded but is transplanted into another person.

“THIS IS MY KIDNEY, I CAN DO WHAT I WANT WITH IT” – PROPERTY RIGHTS AND OWNERSHIP OF HUMAN ORGANS

If I am not a slave, nobody else owns me and I therefore must own myself. This is but philosophical speculation and not the law. According to the legal view, not only does no one own me or my body parts, but neither do I. Legal conceptions of “property” donot extend to self-ownership. A vacuum in law concerning the ownership of body parts exists and the only responses to questions concerning this type of ownership remain philosophical and obiter dicta in reported cases. This article explores property rights in human bodies and body parts in order to establish the position in law of excised human organs removed for the use in transplantation. It is necessary to highlight the historical progression in determining property rights in human body parts, but it should be borne in mind that the majority of laws and court decisions took place in an era when organ transplants were still in an experimental phase. For the sake of brevity foreign legislation and court judgments in only two common law countries will be scrutinised and compared to the current position in South Africa. The reasons why ownership in human organs are important will also be indicated.

Post-transplant malignancies in solid organ recipients: development mechanisms and risk factors

According to the International Agency for Research on Cancer, there were an estimated 19,292,789 new cancer cases in various localizations and 9,958,133 cancer deaths worldwide in 2020. These frightening figures clearly show that malignancies among the population is a pressing matter. The risk of post-transplant malignancy in solid organ recipients is 2–6-times higher than in the general population. Given the steadily increasing number of solid organ transplants worldwide and the gradual increase in life expectancy among organ recipients, studying the issues concerning risk factors and development mechanisms becomes a crucial task.

Organ donation and transplantation in the Russian Federation in 2020 13th Report from the Registry of the Russian Transplant Society

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on the 2020 data.Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. Between separate federal subjects of the Russian Federation and between transplantation centers, comparative analysis of data obtained over years was performed.Results. Based on data retrieved from the 2020 Registry, 44 kidney, 29 liver and 16 heart transplantation programs were functioning in the Russian Federation in 2020. The kidney transplant waitlist in 2020 included about 11.5% of the total 60,000 patients receiving dialysis. Organ donation activity in 2020 was 3.9 per million population, with a 74.6% multi-organ procurement rate and an average of 2.9 organs being procured from one effective donor. In 2020, there were 7.7 kidney transplants per million population, 3.8 liver transplants per million population and 1.7 heart transplants per million population. Same year, the number of transplant surgeries performed in the Russian Federation fell by 19.2% to 13.4 per million population against the background of the outbreak caused by the new coronavirus disease COVID-19. The city of Moscow and the Moscow region in 2020 accounted for 13 out of the 14 functioning organ transplantation centers, performing 66.3% of all kidney transplants and 72.4% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation have exceeded 130 per million population.Conclusion. In 2020, despite the new coronavirus disease COVID-19 pandemic and accompanying restrictive measures, transplant centers continued to perform organ transplants, run a waiting list and monitor organ recipients. However, the number of effective donors (–22.9%) and organ transplants (–19.2%) decreased, tentatively to the 2017 levels. In 2021, transplant centers with support from health authorities will have to restore the volume of transplant care with consideration to the real needs of the population and the donor resource. The COVID-19 factor, including vaccination of the population, as well as financial support to transplantation programs, will be decisive in shaping the trend of transplantation care and organ donation in the federal subjects of the Russian Federation in the coming 1–2 years.