Transplantations

Transplantations refer to the transfer of an organ, tissue or cell from a donor to a recipient to replace a diseased or failing counterpart. It includes solid organ transplants (kidney, liver, heart, lung, pancreas, intestine), corneal transplants, bone marrow and stem cell transplants, and various tissue grafts such as skin, tendons, and vascularized composite allotransplants.

Donor sources include deceased donors and living donors. Successful transplantation relies on matching factors such as blood type, human leukocyte antigen (HLA) compatibility, and a crossmatch to reduce rejection. Allocation systems assess urgency, waiting time, tissue compatibility and size, and differ by country.

After transplant, recipients require lifelong immunosuppressive therapy to prevent rejection, usually with calcineurin inhibitors, antimetabolites, steroids, and sometimes induction therapy. Medication adherence and monitoring for rejection, infection, and drug toxicity are central aspects of care.

Transplantation raises ethical and logistical issues, including organ shortage, equitable access, and the ethics of living donation. Consent processes, donor eligibility criteria, and policies on organ allocation aim to balance donor altruism with patient need.

Outcomes have improved with better matching, surgical techniques, and immunosuppression, but risks remain, including acute and chronic rejection, infection, cardiovascular disease, and malignancy. Long-term graft function depends on multiple factors, including organ type, donor quality, and recipient health.

Ongoing research seeks to extend graft survival, improve preservation methods (such as ex vivo perfusion), reduce immunosuppression, and explore tolerance or xenotransplantation. Developments in regenerative medicine may influence the future landscape of transplantations.