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Give and Let Live

April 5, 2012

Eva Gusnowski

April isn’t just for bunnies and chocolate eggs anymore. In Canada, the last full week of April is now known as National Organ and Tissue Donor Awareness Week, whereas the entire month of April is National Organ Donor Awareness Month in our neighbor to the south. I think the subject of organ donation is a topic that needs more awareness locally, nationally and ultimately globally. So in order to help spread awareness, for the month of April, let’s talk about organ transplants. Every Thursday. For a whole month. Don’t worry, you’re going to love it.

We’ve talked before about the idea of custom hearts someday being available for transplant. While this is just incredible science, the reality of it in everyday medical practice is still years and years away. So in the meantime, we are left with the next best option: organ donation and transplantation.

 

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The Canadian Institute for Health Information has shown that from 1998 to 2002, not even half of the people on the organ waiting list were given a transplant, and people continue to die while waiting. As of June 2011, 4539 people were waiting for an organ transplant in Canada, and I can’t imagine that this number is anywhere close to decreasing.

One of the big barriers to organ transplantation is our body’s own immune system. We recognize our own cells as “self” through recognition of a set of cell proteins called the human leukocyte antigens (HLAs). These HLA proteins allow our immune system to see you as you, and Sally as a foreign invader that must be destroyed. This defense mechanism is fantastic for recognizing what shouldn’t be there, which is exactly the problem that comes up with organ donation.

 

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We all have our own various set of HLA genes, which means that foreign cells are easily recognized. It is easy to appreciate then, that the best organs for transplant are from someone with a matching set of HLA genes, as these have the lowest chance of rejection. The odds of finding a matching set of HLA genes are greatest within a family, which is often why family members are encouraged to donate kidneys and other organs that are appropriate for live transplant. But it’s also easy to see that in order to find HLA matches within a population, the more people that are organ donors the better odds there are. It’s kind of like roulette: you’ve got much better odds the more numbers you can bet on matching.

Despite finding an HLA match, this isn’t the only hurdle a patient lucky enough to get a transplant will face. Transplant recipients must take immunosuppressive medications to help prevent organ rejection and are prone to infections and even cancers. A high cost, but a price well-paid for another chance at life.

As a species, I think it is incredible that we have been able to develop the technology necessary to switch out somebody’s heart, give them a new pair of lungs, slap in a piece of liver and they can survive through all of this. So on that note, I can think of no other way to end today than with BC Transplant’s slogan:

Live Life. Pass It On.

 

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