Transplantology

Transplantology is a branch of medicine and surgery focused on the transplantation of organs, tissues, and cells to replace disease- or failure-related loss of function. It encompasses surgical technique, donor-recipient evaluation, immunology, anesthesia, critical care, and postoperative management, with an emphasis on expanding donor pools, improving organ preservation, and reducing rejection and complications.

Organ transplantation includes kidneys, liver, heart, lungs, pancreas, and intestinal transplants. Kidneys are the most commonly transplanted organ, often from living related or unrelated donors or deceased donors. Liver, heart, and lungs are typically from deceased donors but can involve partial liver lobe or single-lung transplants. Pancreas and intestine transplantation are specialized. Tissue transplantation includes corneas, bone, skin, heart valves, and hematopoietic stem cell transplantation (bone marrow) from compatible donors.

Process: donation requires informed consent and ethical regulation; donor evaluation ensures suitability; allocation systems match based on urgency, compatibility (ABO, HLA), and time-since-death for deceased donors or donor health for living donors. Organs are preserved in cold preservation solutions and transported rapidly. Surgery implants the graft to the recipient, followed by immunosuppressive therapy to prevent rejection (calcineurin inhibitors such as tacrolimus or cyclosporine, steroids, antiproliferatives like mycophenolate; mTOR inhibitors).

Rejection can be hyperacute, acute, or chronic. Infections and malignancies are important post-transplant risks. Long-term success has improved with better matching, immunosuppression, and infection control. Transplantology faces ongoing ethical and logistical challenges, including donor shortage, equitable access, and transplant tourism; research advances include xenotransplantation, regenerative strategies, and immunomodulation.