NRS 433V Introduction To Nursing Research

Introduction:

With the growing prevalence of the disease and associated failures, transplantations have progressed with improvements of the survival methods in the medical field and gradually become a critical pathway in managing the death around the globe (Cid et al ; p: 301). It has become essential treatment modality in saving lives of individuals with severe clinical conditions. The procedure of transplantation involves the removal of the organ, tissue or cells from the deceased body and transfers it to someone who was diagnosed with the disease in surgical method with following all of the legal requirements (Araki, Daisuke, et al ;  p: 329). Despite progress in the medical field, certain barriers hinder the optimal progression of the transplantations. This paper will illustrate procedures of organ transplantations, the special precaution of the transplantation, the consequences of the transplantations and safer alternatives in the following paragraphs.

Discussion:

The procedure of the transplantations:

Transplantation is one of the most remarkable successes in the history of medicine. Over the past decades, the number of the patient waiting for transplantation is continued to be greater than the number of organ donors. Saran  et al. (2017), suggested that every year 114000 number of men women and children are waiting for the transplantation .According to Kirklin et al. (2015), 95% of the adults in the US support the organ donations but only 54% are actually signed up for the donation. Despite other barriers, immunology remains the most forbidden barriers of the organ transplantations, which involve both lymphocytic and humoral mechanisms. The key role of the immune system is to protect the body from the pathogenic microbes in its atmosphere (Kotton et al.; p: 930). In organ transplant, the adaptive immunity is defined as one of the greatest response that rejects the transplantation tissues because the major target of the immune response is the molecules expressed by the surface of major histocompatibility complex of donor cells and in turn, T cell activates the production of the cytokines, chemokines (Huprikar et al.; p: 1168). Consequently,   the productions recruit the elements of innate immunity such as NK Cells or macrophages. According to Hesselink et al. (2014), the possibility of the rejection decreases if organ transplantation takes place between individuals with identical MHC (HLA). The prime reason behind it is the immune cells portrayed the organ of the donor as non-self and induce subsequent immune responses (Huprikar et al.; p: 1168). Therefore, in order to conduct optimal transplantation process, matching of MHC of two individual is crucial.

Precautions of organ transplantation:

Since it saved thousands of lives in the previously, the precautions can be taken for preventing the loss of the transplantation. to support the successful transplantations, several clinical laboratories perform HLA tests which include HLA typing of donor and recipient, screening of the HLA antibodies of the recipient and detection of antibodies in the recipient that are reactive with the lymphocytes of a prospective donor (van et al.; p: 2016). History suggested that the process conducted by serological testing using antiserums in the complement-dependent cytotoxic assay. In the recent era, DNA based typing methods are used for evaluating the degree of HLA matching and survival of the patient. To avoid the hyperactive acute rejections, it is essential to identify the anti-HLA antibodies to the antigen expressed on the blood cells of the donor (van et al.; p: 2016).

     Moreover, immunosuppressant can be given to the patients to prevent the immune response during the transplantation. Immune suppressant such as cyclosporine, tacrolimus is a class of drugs that are used when the body has the tendency to recognize the donor tissue as foreign organ and induce the immune response (van et al.; p: 2016).

Worst consequences of the transplantation:

 Accumulated evidence enlisted a series of consequence that had been observed after Transplantations. Although immunosuppressant were given to the patient who is undergoing transplantation, these drugs are powerful and have potential side effects to affect the normal functionality of the body. The specific side effects may vary patient to patients such as nausea, headache, high blood pressure, swelling increased appetite and acne and other skin problem (Huprikar et al.; p: 1168). According to Hesselink et al. (2014), a considerate number of individuals experienced hair loss, unwanted hair growth. In severe cases, individually experienced transplant rejection. Rejection often observed within the first six months after transplantation. The rejection observed due to the proinflammatory signal such as cytokines, chemokines induced by the T cell response (Kotton et al.; p: 930). Literature also reported the death as the worst consequence of transplantation rejection (Kotton et al.; p: 930).

Safe alternatives of the transplantation:

 Transplantation procedures usually conducted by the physicians when the organ of patients failed to do the normal functions. Although the transplantation is the successful procedure in the history of medicines, certain side effects are massive barriers to the successful surgical method. Hesselink et al. (2014), suggested that researchers focused on some applications of stem cells to repair damaged organ instead of transplantation. However, this procedure is only applicable for the heart transplantations, further researches required in this domain (Cid et al ; p: 301). Other study focused on generating new tissues and organ. Because tissues and organs contain diverse cells in the anatomic array, the involvements of the stem cells are useful. Embryonic stem cells can be used as the replacement of organ transplantations (van et al.; p: 2016). However, these procedures abide by ethical concern.

 Conclusion:

  Thus, it can be concluded that with the growing evidence of chronic disease and organ transplantations, transplantation procedure gained massive success in the field of medicines. Despite progress in the medical field, certain barriers hinder the optimal progression of the transplantations Immune system plays huge barriers for conducting successful transplantation. In organ transplant, the adaptive immunity is considered as one of the greatest response that rejects the transplantation tissues. Immunosuppressant are usually administrated to the patient with organ transplantations. Certain side effects are also observed for the transplantations procedure. Accumulated evidence showed certain safer alternatives for organ transplantations, which prevent the failure of transplantation.

References:

Araki, Daisuke, et al. “Allogeneic hematopoietic cell transplantation for acute myeloid leukemia: time to move toward a minimal residual disease–based definition of complete remission?.” Journal of Clinical Oncology 34.4 (2016): 329.

Cid, Joan, et al. “Matching for the D antigen in haematopoietic progenitor cell transplantation: definition and clinical outcomes.” Blood Transfusion 12.3 (2014): 301.

Hesselink, Dennis A., et al. “The role of pharmacogenetics in the disposition of and response to tacrolimus in solid organ transplantation.” Clinical pharmacokinetics 53.2 (2014): 123-139.

Huprikar, S., et al. “Solid organ transplantation from hepatitis B virus–positive donors: consensus guidelines for recipient management.” American Journal of Transplantation 15.5 (2015): 1162-1172.

Kirklin, James K., et al. “Seventh INTERMACS annual report: 15,000 patients and counting.” The Journal of Heart and Lung Transplantation 34.12 (2015): 1495-1504.

Kotton, Camille N., et al. “The Third International Consensus guidelines on the management of cytomegalovirus in solid-organ transplantation.” Transplantation 102.6 (2018): 900-931.

Saran, Rajiv, et al. “US renal data system 2016 annual data report: epidemiology of kidney disease in the United States.” American journal of kidney diseases 69.3 (2017): A7-A8.

van der Net, Jeroen B., et al. “Regulatory T cells: first steps of clinical application in solid organ transplantation.” Transplant international 29.1 (2016): 3-11.