K is for transplant

I know, I know ’tis the wrong place but needs must and all that and typepad has thrown a hissy fit and I am determined to post this on correct day (even if it is not on the right place:(

K is for transplant

It is time for more of those powerful magic makers, those who control life and death.  Every world build ought to have them. Different from natural magic, such as waterfalls, rainbows and the like, this magic is studied and many long years go into the making.

This magic did not appear very early in the world’s existence, indeed very late. Much application through the millennium was needed, because, this is as powerful as the use of genetics.  Scientists certainly aided these magicians but doctors, surgeons have to apply the spells.

We have to try to imagine the horror- horror? I am convinced it would have been horror – when this was first broached as a fit subject to pursue. If these particular scientists and doctors would use more melodious language their novels would outsell Stephen King in no time! I am a writer and would love to have their mind set to feed my imagination.

Picture the thought – the what if?

‘Let’s take a part of a body from this corpse and sew it into someone living!!!’

I was an adult when news of the first successful heart transplant whirled around the globe.  In 1967 Christian Barnard from South Africa was the man, was the name on everyone’s lips.  Amazing, stupendous achievement!!  His patient only survived 10 days yet, yet, the deed was done and over the next 2 years another 100 operations were performed.  Survival rate was still only 60 days, but Barnard’s second attempt had the patient surviving  19 months.  For someone who was going to die soon, an extra 2 or 19 months may seem like a bonus.  By 1984 survival rates had gone up to 5 yrs or more. Before I move on – think about it – this man transplanted a heart from one being into another being and it beat!! 

Where did that first idea come from?

          There are myths from ancient Rome, Greece and China of Gods and Goddess’s performing transplants.

              It is believed that by 800 BC    Indian doctors had begun to graft skin, using the patients own skin, to help burns.

         In the 16th century an Italian, Gasparo Tagliacozzi, had begun to reconstruct noses and ears from the patients own skin.

 The secret of these last two successes lies in the fact that nothing alien was being introduced.

 It is almost sure, many attempts had been made over the centuries.  Mankind would have found the challenge to great to resist.  However, this magic was long in the coming because, other magicians had to do their work first.  Science had to come up with the answer to some pretty stiff barriers to success. Not least of which was the body’s tremendous and formidable resistance to anything ‘not mine’.  The immune system is a magical thing in itself, think of all those bacteria and virus in the world, all the accidents and illness’s waiting to gain a toehold.  How many times did we die of them? Very few times, everything considered.  The body knows itself well, and doesn’t take kindly to having strange things being foisted on/in it.

       Until the immune system was understood, there was no chance.  Using the patients own skin was ok, the body would recognise it.

       Then, when it was understood, some means of persuading this argumentative system to accept an organ from someone else, maybe alive but usually dead.  Why would it?

       Even when that was done, there was the problem of the quality of the organ to be inserted into another; decay begins immediately death has visited. To keep an organ in a fit state to transplant, needed a great deal of thought, skill and the efforts of many.

      In 1909 a rabbit kidney was transplanted into a child, who died two weeks later

       1933 there was an attempt at a human-human kidney transplant, but they did not know about tissue/blood matching – the patient died

      The first successful kidney transplant was in 1954 – successful because it was between identical twins – so no reason for rejection.

As the 1950s wore on, drugs to suppress the immune system became more effective, the success rate slowly increased.

They never give up these ‘wise men’ of magic!

1st success

of Pancreas 1966

of  Liver 1967

Heart 1967

Heart and lung 1981

Hand 1998

Partial face 2005

Double Arm 2008

Full face 2010

Double leg 2011

At the moment, in the UK, 1000 people a year die while awaiting a transplant, of some kind or other. Kidney transplants are common-place, however the list of donors cannot keep up with the list of those wishing to have a transplant.

 Now there are more problems arising.  Because people expect this amazing life giver, because the list of those waiting transplants grows faster than donors can be found (tissue/blood have to be a match even with immunosuppressants) New ethical questions raise their heads.

Donations from the dead, you would think would not present problems; sign a donor card in life and ensure your nearest and dearest understand your wishes.  However, this business of the viability of the organ, means the fresher the organ is, the better.

What is ‘dead’? Should a person who is brain dead be kept ‘alive’ with machines, to preserve the organs, receive treatment which is of no use, except for someone else?

Should someone who has died from cardiac/ respiration failure, have the heart restarted, so that it can be transplanted in another?  These are two of the questions being asked now.

Another is that of the ‘exploitation’ of those in financial need from the richer patients, sometimes leading to a black market in organ trafficking with resultant kidnap and murder. There is money to be made – but is it moral or ethical to buy an organ?

There has been a suggestion that cloning for organs would be acceptable.  If just cloning organs. Maybe.  The fear of many is that whole people will be cloned (as you never know which organ would be needed) the stuff of nightmares – but, what if? Eventually kill your clone. Have you read ‘Never Let Me Go’ by Kazuo Ishiguro?

Is this another of those escapees from Pandora’s Box?

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14 thoughts on “K is for transplant

  1. Julie Glover says:

    First of all, what a beautiful story from shanjeniah. Your baby boy was indeed a hero! I can’t imagine how grateful the parents of that little girl were.

    There are indeed some ethical questions here, and I have real reservations about the cloning aspect. But I will state on public record right here that if I die and docs can jumpstart my heart and transplant it for someone else to live, go right ahead! I won’t need it anymore.

    Interesting post!

    • alberta says:

      :) we will remember it – you need to do more though if it is to be considered in reality. A hero indeed. and transplants are indeed amazing – it’s what comes next that will cause great debate i believe. Come back for T is for…

  2. […] read K is for Transplant, and was deeply moved to comment. M'boy! […]

  3. You left out one critical type of transplant–blood! The types have to match, but it was one of the first major successes in transplatation and still saves many lives.

    • alberta says:

      very true – I’m sorry – I concentrated more on organ transplants but of course blood transfusions were a very important part of this whole story – apart from saving lives on their own account they were /are a vital component of any of these operations above.

  4. Eden says:

    A poignant and ever present topic, especially as scientists and doctors get better at doing these operations.

    Just off the top of my head I can name several science fiction examples (beyond the obvious “Face Off”).

    In 2005 there was a movie called The Island (my husband introduced me to it) that deals with this issue on a very heartbreaking level. Equally, just in the news last week was the story of a boy in China who is now on dialysis because he’d sold a kidney for $3000 to buy an iPad and now needs a transplant of his own…. There was an episode of the X-Files in the 90s about the organ harvesting black market and extortion rings in Chinatowns…

    These were science fiction. Now they are fact. Which makes for another interesting question… What will be science fiction for the future?

    Ooh… Now there is a question for a blog post/discussion!

    • alberta says:

      Haven’t seen the film – the book I mentioned deals with this issue of having a supply of life donors, a work of fiction and yet, and yet. . . – some of my friends found it distasteful but there is I think a possibilty of it happenening.
      In my life time it was deemed impossible to put a man in space let alone on the moon, impossible to transplant, impossible … impossible… nothing it seems is impossible!

      I have just received a couple of books about possible future happenings based on what is happening now – they look interesting and there may well be a post or two.

      • Eden says:

        Sounds like fun, Alberta. I’ll be keeping an eye out for those posts. The things we can achieve always seems amazing… Yet, really, we have never stopped doing amazing things. Nor have most animals. Did you see the recent studies where they showed baboons recognizing words they’d never been taught before simply based on pattern recognition?

        Really… the world is amazing! I’m glad we’re here to experience it.

  5. shanjeniah says:

    On July 35, 2003, our family forever became part of this equation, when our 12 day old son, Elijah James, died as a result of massive brain injuries sustained at birth.

    We had arranged for him yo be a donor when we realized that death was likely (and merciful).

    Three years later, at a donor celebration, we learned that his heart valves had been received by a 2yo girl in the southern part of the US. She is an agemate of Jeremiah’s.

    We haven’t sought out her family, although we may use that option at some point. We were told the valves, since they came from a newborn, will grow with the girl and spare her many surgeries she would have had with artificial valves.

    We prefer to think that she is alive, and those valves opening and closing in a heart that pumps strong young blood through her veins, and that she takes in life an enjoyment Elijah never had the chance to know…..

    It is amazing to think that the newborn heart is about the size of a walnut, and the valves smaller still.

    Even if the girl died, our baby boy got to be her hero,

    And he will always be ours!

    Thank you for this bittersweet remembrance, Alberta. It’s like a hug from afar, which i can remember on the days my heart hurts the most…

    And, incidentally, tomorrow is the anniversary of the death of my late fiance, Tim, who suffered from cystic fibrosis and died the week before his appointment to be evaluated for a double lung transplant.

    Which makes this all especially poignant for me.

    • alberta says:

      A hero indeed, and I too hope the little girl is alive and flying because of your son. I am sorry if I stirred up unhappy memories for you. I remember so clearly that day we all heard about the first heart transplant, it seemed
      as if true magic had been ahieved.

      To this day although that initial awe has softened I still marvel at how they do it. Your mention of the size of a newborn heart brings it into perspective, they have to sew all the tubes, how fine is that sewing, how gentle those hands?
      Our medical brotherhood are trying to engage the public in the debate – I think an opt out of organ donation would be better than the opt in we have at the moment, but they, at the moment, wont have it. But people don’t wish to think about death, so do not do the necessary paperwork and when families are in shock and mourning is not the time to ask. The list grows and to help someone even after death surely is good.

      My sister and I are donating our brains(don’t laugh!) because Mum died from a progressive brain disorder PSP and brains are desperatly needed – esp old ones:)

  6. Mike Young says:

    Glad I tracked this down – well written. I can see clone banks in the near future, where you’d put aside major organs just in case. Not as part of any health plan though – only for the rich.

    • alberta says:

      oh you cynic you:) although it might well be the case- I like to think the NHS here in UK would be fair about the distribution, but the future is a strange place.

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