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    The history of organ transplantation

    Since ancient times, mythology has included tales of creatures made of an amalgamation of others, transferring body parts and skin. In the 1950s, with no other medical options for then incurable diseases, including nephritis, teams of scientists, surgeons, ...

    Proc (Bayl Univ Med Cent). 2022; 35(1): 124–128.

    Published online 2021 Oct 19. doi: 10.1080/08998280.2021.1985889

    PMCID: PMC8682823 PMID: 34970061

    The history of organ transplantation

    Kristen D. Nordham, BA and Scott Ninokawa, BS

    Author information Copyright and License information Disclaimer

    This article has been cited by other articles in PMC.

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    Abstract

    Since ancient times, mythology has included tales of creatures made of an amalgamation of others, transferring body parts and skin. In the 1950s, with no other medical options for then incurable diseases, including nephritis, teams of scientists, surgeons, and generous patients started the field of organ transplant with the first successful kidney transplant in a human. The scientific discoveries and innovations since that first successful transplant in 1954 have turned the mythical concept of transplant into reality. The overall success and public acceptance of organ donation and transplant today is thanks to multidisciplinary teams of basic scientists, immunologists, surgeons, and public advocates. Today, research is propelling the field forward with advancements like face transplants, experiments of lab-grown organs, and much more. In the United States alone, over 800,000 patients have had their lives saved or significantly improved thanks to transplant since national recording began by the Organ Procurement and Transplant Network in 1988.

    Keywords: History, surgery, transplantation

    The idea of transferring body parts appears in ancient mythology of civilizations around the world. Roman, Greek, Indian, Chinese, and Egyptian legends include tales of organ transplants performed by gods and healers using organs from cadaveric and animal origins. Here we delve into the transformation of transplantation from lore to medical practice.

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    LORE

    The first written mention of transplant is attributed to the Ebers Papyrus, written circa 1550 bc, which mentioned skin grafting for the treatment of burns.1 Around 600 bc, the Indian surgeon Sushruta, known as the father of surgery, is credited with performing the first plastic surgery operations, including full-thickness skin grafts.2 In “The Miracle of the Black Leg,” from Jacobus De Voragine’s 348 ad Legenda Aurea, limb transplantation was first mentioned in written literature. In this story, the Christian patron saints of medicine, pharmacy, and surgery, Cosmas and Damian, replace the cancerous leg of a Roman deacon with that of a recently deceased Ethiopian man.3 In 1817, French physician Henri Dutrochet wrote a letter to the editor of Gazette de Santé on skin transplant, based on a story from his brother-in-law, an army officer stationed in India. According to the letter, an army subordinate had been punished by having his nose cut off. The man sought out locals well versed in skin grafting and known for their ability to surgically reconstruct a nose, and he asked them to operate on him.

    Because the defect was already showing cicatrization, the wound edges were freshened. One of the man’s buttocks, which was to be the donor site, was beaten with an old shoe until a substantial swelling was achieved. From this swollen area, a triangular piece of skin, with subcutaneous fat, was then cut and placed on the defect. It was fixed in position with adhesive plaster. The graft healed, and the man continued to serve in the brother-in-law’s command.4

    While there is uncertainty regarding the veracity of Dutrochet’s letter, other sources have documented the practice of skin grafting in India hundreds of years earlier.5 Despite the doubt of whether these ancient surgeries took place as described, the accounts demonstrate long-standing fascination with transplanting body parts from one person to another. Only in recent history have these ideas of transplant become reality.

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    MODERN MEDICINE

    The first verifiably documented skin transplant occurred in 1869. Swiss surgeon Jacques-Louis Reverdin demonstrated success with epidermic grafting, in which he used small samples of epidermis pinched or shaved off superficial layers of skin. Pinch grafting is still used to expedite formation of granulation tissue and improve survival of larger skin grafts. Skin grafts continued to be used in burn treatment until World War I. For a short time, ointment treatments and use of tannic acid replaced grafts,6 but by World War II, it was discovered that tannic acid caused liver necrosis, and grafting again became common practice.7,8

    A particularly notable patient treated during World War II was a pilot, Charles Woods. On December 23, 1944, Woods set off with a load of 28,000 pounds of aviation fuel, which exploded on takeoff. He suffered severe burns over 70% of his body, including his face. The injury appeared to be nonsurvivable. However, 6 weeks after the accident, the medical team at the Valley Forge General Hospital in Pennsylvania grafted skin onto Woods from a recently deceased soldier. This graft was successful; “possibly because of his debilitated condition, his immune response had been tamed.”9 After 24 more operations over the next 2 years, Woods returned to a relatively normal life and went on to have a family and become a businessman. He died in 2004 at the age of 84.

    One of the physician members of Woods’ medical team was Joseph Murray. After finishing his surgical internship year, Murray was inducted into the US Army Medical Corps and stationed at Valley Forge. After the war, Murray returned to his surgical training at the Peter Bent Brigham Hospital in Boston. Having seen the success of Woods’ case, Murray was fascinated by transplantation, especially of organs. Despite a general consensus that transplantation of anything other than skin was not feasible due to rejection, Murray “knew something had tamed Woods’s immune system. So transplantation did not seem a futile quest to [him].”9

    Source : www.ncbi.nlm.nih.gov

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    Organ transplantation

    Organ transplantation

    From Wikipedia, the free encyclopedia

    Jump to navigation Jump to search

    This article is about animal organ transplantation. For plants, see grafting.

    Organ transplant

    Reenactment of the first heart transplant, performed in South Africa in 1967.

    MeSH D016377 [edit on Wikidata] Transplant Surgeon Occupation Names Physician Surgeon

    Occupation type Specialty

    Activity sectors Medicine, Surgery

    Description Education required

    Doctor of Medicine (M.D.)

    Doctor of Osteopathic medicine (D.O.)

    Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.)

    Bachelor of Medicine, Bachelor of Surgery (MBChB)

    Fields of

    employment Hospitals, Clinics

    Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

    Organs that have been successfully transplanted include the heart, kidneys, liver, lungs, pancreas, intestine, thymus and uterus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), corneae, skin, heart valves, nerves and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed by the liver and then the heart. Corneae and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than tenfold.

    Organ donors may be living, brain dead, or dead via circulatory death.[1] Tissue may be recovered from donors who die of circulatory death,[2] as well as of brain death – up to 24 hours past the cessation of heartbeat. Unlike organs, most tissues (with the exception of corneas) can be preserved and stored for up to five years, meaning they can be "banked". Transplantation raises a number of bioethical issues, including the definition of death, when and how consent should be given for an organ to be transplanted, and payment for organs for transplantation.[3][4] Other ethical issues include transplantation tourism (medical tourism) and more broadly the socio-economic context in which organ procurement or transplantation may occur. A particular problem is organ trafficking.[5] There is also the ethical issue of not holding out false hope to patients.[6]

    Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs.[7]

    Contents

    1 Types of transplant

    1.1 Autograft

    1.2 Allograft and allotransplantation

    1.2.1 Isograft

    1.3 Xenograft and xenotransplantation

    1.4 Domino transplants

    1.5 ABO-incompatible transplants

    1.6 Transplantation in obese individuals

    2 Organs and tissues transplanted

    2.1 Chest 2.2 Abdomen

    2.3 Tissues, cells and fluids

    3 Types of donor 3.1 Living donor 3.2 Deceased donor

    4 Allocation of organs

    5 Reasons for donation and ethical issues

    5.1 Living related donors

    5.1.1 Paired exchange

    5.2 Good Samaritan

    5.3 Financial compensation

    5.4 Forced donation 6 Proliferation 7 History

    7.1 Timeline of transplants

    8 Society and culture

    8.1 Success rates

    8.2 Comparative costs

    8.3 Safety 8.4 Transplant laws

    8.5 Ethical concerns

    8.6 Artificial organ transplantation

    9 Research 10 See also 11 References 12 Further reading 13 External links

    Types of transplant[edit]

    Autograft[edit]

    Main article: Autotransplantation

    Autografts are the transplant of tissue to the same person. Sometimes this is done with surplus tissue, tissue that can regenerate, or tissues more desperately needed elsewhere (examples include skin grafts, vein extraction for CABG, etc.). Sometimes an autograft is done to remove the tissue and then treat it or the person before returning it[8] (examples include stem cell autograft and storing blood in advance of surgery). In a rotationplasty, a distal joint is used to replace a more proximal one; typically a foot or ankle joint is used to replace a knee joint. The person's foot is severed and reversed, the knee removed, and the tibia joined with the femur.[]

    Allograft and allotransplantation[edit]

    Main article: Allotransplantation

    An allograft is a transplant of an organ or tissue between two genetically non-identical members of the same species. Most human tissue and organ transplants are allografts. Due to the genetic difference between the organ and the recipient, the recipient's immune system will identify the organ as foreign and attempt to destroy it, causing transplant rejection. The risk of transplant rejection can be estimated by measuring the panel-reactive antibody level.[]

    Source : en.wikipedia.org

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