The anticipation of receiving a life-saving organ transplant is a deeply emotional and agonizing wait, a poignant period filled with the hope that one's name will ascend to the summit of the transplant list, bringing with it the promise of renewed vitality. This hope is counterbalanced by the sobering reality that the number of individuals seeking organ transplants far surpasses the availability of these precious life-giving resources. To grasp the magnitude of this challenge, consider that in 2022 alone, the United States witnessed 42,887 organ transplants, yet over 100,000 individuals remained tethered to the organ transplant waiting list. Tragically, this dire situation translates to a heartbreaking statistic: an estimated 17 people succumb each day due to the unavailability of a suitable organ.
Seeing that we all know the importance of organs that are donated to the recipient, as well as the difficulty in performing the transplant surgery, we need to know that time is everything. The time needed to move the organ from one region to the other, the time needed to move the organ to the surgery room, and the time needed to transplant it. Time is important because, outside the human body, organs have a limited time to be viable. This is because when an organ is removed from the body thereby preventing blood and oxygen from getting into the organ, a list of events occurs such as hypoxia, hypostasis, and ischemia.
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The instant an organ is detached from its life-sustaining host, a series of intricate biochemical events are set into motion. Hypoxia, the scarcity of oxygen in organ tissues, initiates a cascade of metabolic adaptations. Cells, deprived of their oxygen lifeline, resort to anaerobic respiration, a less efficient process that yields lactic acid as a byproduct.
Accumulated lactic acid can inflict cellular damage, acidifying tissues and compromising organ integrity. The liver does the job of recycling it back to pyruvate via oxidation but when the organ is outside the body, the liver would not be there to perform that activity as there is no means to convert back to pyruvate and breathing is not continuous. This is why organs are placed on Ice, to delay this effect putting the organ in a hypothermic state of 4 degrees to 8 degrees celsius makes the cells less active and so it does not require much ATP and doesn't produce much waste.
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Its not like the organ to be transplanted is just placed in an Ice Box, it is first injected with preservation solution which is composed of salts (such as sodium, calcium, and potasium), and Amino Acids (such as Serine, Valine, and Cysteine), so it can give it a longer shelf life. Preservative solution such as Hypertonic citrate adenine (HC-A) for kidney transplant, and so on. The organ is placed in a bag of the solution, and then placed in another bag of saline solution which is then placed in a box of saline and Ice. While the Organ is kept cold, temperature below 0 or -0.55C degree celcius can lead to frostbite damage in protein thereby causing the organ to denature itself and destroying the organ.
When the organs are kept in the box, the organ is in a hypothermic state and the cells are less active and causing the sodium-pottasium pumps in the cells to the less active. This would lead to the inability of sodium to be pumped out of the cells thereby drawing water into it via osmosis causing the cell to be hypothonic which could lead to cell burst if excessive water gets into the cell. Let's not also forget that the lack of oxygen can lead to the death of the organ.
From my writing above, you must have seen reasons why organ transplant has to do with time. Also, depending on the organ being transplanted, they require different time from one another as a result of the type of tissue the organ is made of and tolerance level to oxygen. For instance, the Kidney can stay out of the body for about 36 to 48 hours, the Pancreas having a 15 hours ability to stay outside the body, the liver 12 to 15 hours but can become very acidic as a result of lactic acid production, heart 6 hours, lungs four to 6 hours, and the intestine about 8 to 16 hours. So, in the labyrinth of organ transplantation, time emerges as a formidable adversary and an indispensable ally. It can either determine the death or survival of the recipient among other factors.
- https://unos.org/news/2022-organ-transplants-again-set-annual-records/
- https://donatelife.net/donation/statistics/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593023/
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- https://pubmed.ncbi.nlm.nih.gov/7598460/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923544/
- https://www.nhs.uk/conditions/frostbite/
- https://www.ncbi.nlm.nih.gov/books/NBK536914/
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- https://www.organdonor.gov/learn/process/matching