Stem Cell and Tissue Engineering

Problem 1: The Donors and Recipients

Modified by: Kam Boon Horng Activity Owner : Terence Chong (Dr) Inputs : Alvin Teo (Dr), Ng Hian Cheong (Dr) Approved By : Song Sin Nee (Ms) Module Chair : Leong Wen Shing (Dr) 1
Copyright 2011 Republic Polytechnic, Singapore

The problem
The newspaper article entitled Organ donation gives recipients a second shot at life, gave e.g. of successful transplantations of organs and data on organ availability provided a snapshot of a reality that is faced by needy patients Explore, what are the social and technical issues that surround the transplantations of organs and suggest possible solutions to address these issues.
2
Copyright 2011 Republic Polytechnic, Singapore

What do you recognize?

Transplantation of organs are carried out to replace defective parts that results in disease Different organs can be transplanted Replacement organs need to compatible to the patient Organ availability is important in organ transplant

3
Copyright 2011 Republic Polytechnic, Singapore

An approach..
1.What organs are often transplanted? 2. What are some social concerns associated with organ transplantations? 3.What are some technical obstacles associated with organs transplantation? 4.Why is there a shortage? 5.Why are transplanted organs (grafts) not a cure for everyone? 6.What are some possible solutions to address this problem?
4
Copyright 2011 Republic Polytechnic, Singapore

What organs are often transplanted?

5
Copyright 2011 Republic Polytechnic, Singapore

What are some social concerns associated with organ transplantations?

Ethical Issues Should younger people get transplants before older people ? Should transplants be given to people who have chronic alcohol problems ? Commercialization of organ donation ? Religious issues Pragmatic Issues
 

Organ sale by people in third world countries Organ donation after death

6
Copyright 2011 Republic Polytechnic, Singapore

What are some technical obstacles associated with organs transplantation?

Human Donors
Donor organs have to be compatible to evade the recipient immune system. compatible blood type (ABO) compatible human leukocyte antigens (HLA) Immunosuppressants

Organs making factories ?

The technology is still NOT widely available Tissue-engineering systems & Transgenic animals for xenografts
7
Copyright 2011 Republic Polytechnic, Singapore

Why is there a shortage?

Shortage of donors Organ transplant is not 100% successful
Graft and patient survival rate (%) after organ transplantation

8
Copyright 2011 Republic Polytechnic, Singapore

Why are transplanted organs (grafts) not a cure for everyone?

Grafts are rejected by some patients (host) as it is seen as foreign This rejection is by the hosts immune system
Identifies graft as invader Its recognition system uses markers called human leukocyte antigens (HLA) as identifiers found on the surface of every cell in the body The immune system attacks anything without the proper identifiers including invading viruses and bacteria The graft does not carry the host HLA antigens hence it has to go!
9
Copyright 2011 Republic Polytechnic, Singapore

What are some possible solutions to address this problem?

Deal with Donor issues
Deal with fear? Mandatory harvesting
Singapores opt out scheme: HOTA

Deal with the immune system

Tissue matching Immunosuppressant drugs

Alternate sources for grafts

Xerographs (from other species) Artificial organs Cultivate organs from stem cells
10
Copyright 2011 Republic Polytechnic, Singapore

What are some possible solutions to address this problem?

Reduce transplant rejection
Immunosuppression drugs

Tissue Matching
ABO matching HLA matching

Graft Manipulation
Blood transfusion effect

Azathioprine Steroids Cyclosporin A Rapamycin

11
Copyright 2011 Republic Polytechnic, Singapore

What have you learnt?

Not all organs can be transplanted and the problems associated with shortage of organs Organs for transplantation need to be compatible with the patient Transplantation therapy is not 100% successful due to immune compatibility, tissue matching and the use of immunosuppression drugs

12
Copyright 2011 Republic Polytechnic, Singapore