Ethical Issues on the Horizon Surrounding Transplants

Syed Amin Tabish
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Syed Amin Tabish: Sher-i-Kashmir Inst. of Medical Sciences

Chapter Chapter 34 in Health Care Management: Principles and Practice, 2024, pp 735-747 from Springer

Abstract: Abstract Transplantation of human tissues, organs, or cells is a vital and often life-saving treatment for various congenital, inherited, and acquired diseases and injuries. These tissues include ocular, cutaneous, musculoskeletal, cardiovascular, and birth tissues. Benefits of transplantation include improved survival rates, restored movement, wound closure, heart function rehabilitation, and sight restoration. While xenografts and bioengineered alternatives are advancing, they cannot fully replace human-sourced tissues. Ensuring availability and access to human tissues remains crucial. Organ transplantation stands as the primary, and often sole, treatment for acute and chronic organ failure. Noncommunicable diseases, including diabetes and arterial hypertension, coupled with social determinants like alcoholism and obesity, contribute to conditions such as chronic kidney disease and liver cirrhosis—both ranking among the top 10 global causes of death. Kidney transplantation surpasses dialysis in terms of survival, quality of life, and cost-effectiveness. In cases of chronic or acute liver failure, along with certain cardiorespiratory conditions, transplantation remains the sole alternative to prevent mortality. Over 1.5 million patients have undergone haematopoietic stem cell transplants (both autologous and allogeneic) to date. While haematological cancers remain the primary indication, these transplants are now increasingly considered for non-malignant disorders and genetic diseases like haemoglobinopathies (such as sickle cell anaemia and thalassaemia). Previously, these inherited conditions had limited treatment options without the possibility of a cure. Organ transplantation is a critical field in medicine, addressing life-threatening conditions. Organ transplantation involves replacing a damaged or failed organ with a healthy one from a donor. It’s often the best or only treatment for acute and chronic organ failure. Benefits include improved survival rates, restored function (e.g., movement, sight), and enhanced quality of life. Types of Transplants are: Solid Organ Transplants (Heart, liver, kidney, lung, pancreas, and intestine); Tissue Transplants (Corneas, skin, bone, heart valves, etc.). Challenges and Implications are: Shortage of Organs: Demand exceeds supply due to limited donors; Immunosuppression (Recipients need lifelong immunosuppressive drugs); Ethical Allocation (Fair distribution of organs based on urgency and suitability); Donor Safety (Balancing donor rights and recipient needs), Xenografts and Bioengineered Alternatives (Developing alternatives to human-sourced tissues). Ethical Considerations: Donation and Procurement (Ensuring voluntary, informed consent); Allocation and Prioritization (Fair distribution based on medical need); Alternatives: Exploring non-human sources and bioengineering. Organ transplantation saves lives but faces complex ethical, logistical, and medical challenges. Researchers continue to explore innovative solutions to improve access and outcomes.

Date: 2024
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DOI: 10.1007/978-981-97-3879-3_34

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