To honor life to death
To honour life to death
In the past, our ancestors believed that there is afterlife. Therefore, they preserve the dead bodies as mummies, removing all organs and the brain, except for the heart, and bury them in a sarcophagus. However, nowadays we know our bodies will no longer be needed after we die. We could choose to bury our body as returning to nature, or we could choose to donate our organs, and save eight people’s lives. Which one would you choose?
Organ transplantation is often considered as the ultimate solution for chronic diseases such as heart failure caused by weakening of cardiac muscles — cardiomyopathy, or end-stage kidney failure caused by diabetes etc.
In terms of sources of organs, deceased organ donors are the most common source since only so little can a living human share. While thousands die in a day, as much as only 0.3% of those die in a way that allows for deceased organ donation, commonly known as brainstem death, usually being victims of traffic accidents.
It is when brain injury is suspected to have caused irreversible loss of consciousness and that patients can only rely on mechanical ventilation for breathing. For those patients, their hearts are still beating, and their chest rises and falls, yet there could rarely be any recovery. Normally, a panel of doctors will perform several assessments before confirming such death, followed by the harvesting of organs.
On the contrary, the suitability of the organ to the patient is also a major factor affecting the successful rate of a transplant. Unfortunately, most children have a significantly lower matching rate than adults due to the organ sizes. Many infants born with heart defects, or liver defects may be on the waiting list from the moment they were born, yet never have a chance to receive such lifesaving gifts.
In the light of modern technology, the types of living organ transplant that can take place has broadened from only the traditional kidney/liver transplant, to pancreas transplant, intestine transplant, and the recent living lung transplant in Japan. (The link of the news is provided at the end of the article for more info)
Difference in size of an adult heart and a child’s heart.
Lung transplant
In Japan, a woman, after her deadly infection of coronavirus, requires a lung transplant to live a machine-free life, which luckily, she was able to receive two lobes of lungs from her husband and son, each donated one lobe to form her brand-new pair of lungs.
A normal healthy human could donate a lobe of lung to another because even at maximum exercise intensity, one only uses 70% of the lung capacity, making living transplant possible. Even though this type of surgery is still at a clinical stage, this wonderful news has shed light to patients suffering from severe COPD (chronic obstructive pulmonary disease), pulmonary fibrosis — scarring the alveoli causing them to merge and causes shortness of breath (where coronavirus does the same), or cystic fibrosis — excessive mucus blocking airway, who may be waiting for a new pair of lungs for decades.
Liver transplant
Not to mention the most common yet underrated organ transplant surgery - liver transplant. Due to the liver’s unique ability in self-repairing, liver transplant is the most acceptable type of living transplant among donors. Believe it or not, as much as only 30% of the liver remains in the body of the donor, the liver can grow back to its original size and functions perfectly again in a time span of six months. But even so, why does the demand for liver transplant remains exceptionally high?
Granted that the liver has an excellent ability in healing, duplicating scratches and cuts, just like our skin, would form permanent scars, ultimately developing cirrhosis (when liver is too damaged to repair itself). At this point, liver function declines and liver transplant are the only cure. Scarring may be caused by liver diseases such as chronic hepatitis B or C (inflammation of liver) and alcoholic hepatitis, ultimately causing liver failure.
(note that liver disease does not equal liver failure. Liver disease is a condition that caused inflammation or damage to the liver while liver failure is when the liver has lost some or all its function.)
Patients who cannot receive a living liver transplant are usually ranked by a global-wise rating system known as the MELD score (Model for End-Stage Liver Disease). The scores range from 6 to 40 and is determined by the effectiveness of liver functions, such as excretion of bile, production of clotting factors in blood etc. The higher the score the worse the condition of the patient is, and the higher up they are on the list.
Likewise, acute liver failure also puts demand on liver transplant, except in a more urgent manner. Overdose of drugs, consuming poisonous mushrooms, or allergic reactions to prescription medications of antibiotics may lead to acute liver failure. Being diagnose acute liver failure is like skydiving, the quick you pull the parachute, the safer your landing is. These patients may die within weeks or even days if a transplant is not performed, thus in cases when an emergency living transplant is not available, they can usually skip the queue for liver transplant for acute liver failure is unpredictable and life-threatening. Consequently, they usually have a higher MELD score compared to chronic liver failure patients, who might have already waited years.
To solve those existing problems, measures would have to be put in place to secure enough organ available such as the opt out system where countries like the UK, France and Finland has already inaugurated. With the fact that only so little die with healthy organs, there are still many ways of showing kindness before or after we die regardless of our health conditions, such as corneal donation, heart valves donation, bone marrow donations and even amniotic membrane donation, which is used to treat damaged skin or ulcers of cornea or other parts of our body.
After all, don’t think of organ donation as giving up part of yourself to keep a total stranger alive. It is really a total stranger giving almost all of themselves to keep part of you alive. Perhaps this is the only way to turn death and sorrow to hope and a continual of life.
Sources:
Liver transplant
Meld scoring
Organ and tissue transplant
Lung transplant
News about the Japan living lung donation
Donation after brainstem death
