Definitions
Transplantation is the procedure whereby cells, tissues or organs are moved from one site to another to provide structure and/or function. A graft is the organ or tissue transplanted. Autografting is transplantation from one part of a patient’s body to another e.g. toe to replace thumb. Allografting (also known as homografting) is transplantation between organisms of the same species (i.e. human to human). Xenografting is transplantation between organisms of different species (e.g. pig to human). Grafts may be placed in the ‘correct’ anatomical location (orthotopic transplantation; e.g. heart transplant) or in a non-anatomical location (heterotopic transplantation; e.g. kidney transplant). The graft comes from a donor and is implanted into a recipient (host). Donors may be cadaveric (usually brainstem death victims), living related (LRD) (family members sharing large genetic elements with the recipient) or living unrelated (LURD) (altruistic individuals donating one of a pair of organs). Natural or innate immunity refers to the non-specific immune response (macrophages, neutrophils, natural killer cells, cytokines). Adaptive immunity, refers to the response to a specific antigen (T-cells and B-cells).
- All but identical twin transplants require immunosuppression.
- Graft rejection can be hyperacute, acute or chronic.
- Long-term immunosuppression causes disease in its own right.
- Kidney, pancreas, liver, heart and lung transplantation are well established with high success rates. Small bowel transplantation is being progressively developed.
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