A Tipping Point: Organ Shortages and the Future of Transplantation
Transplant surgeons are consistently battling against insurmountable odds in their pursuit to save lives. This especially comes to play with the most pressing challenge of all: the critical shortage of organs. This struggle between the high demand and insufficient availability of organs is universal across the field of transplantation and was exacerbated by the Covid-19 pandemic.
Advancements in medical research and technology have become a mixed blessing in transplantation. While progress in research such as immunosuppressive drugs has led to a significant improvement in post-transplant survival rates, this success also increases the already high demand. Increasingly, more patients qualify for transplants, making addressing these organ shortages today’s most pressing issue in transplantation.
Bridging the gap in organ transplants: Power in technology, data and support
Advancements in the medical field can be encouraging and reassuring as patients hope to see quicker and more successful results, but there are also risks involved when implementing change. Cutting-edge techniques could be the next life-saving innovation but still require much research and exploration. Transplantation experts are eager for more data and predictive analytics to make new opportunities a reality.
In addition to the importance of data, there are also sociological impacts of organ donation. Whether an individual decides to donate their organ or tissue in honor of a loved one, to give back to the community, or for some other reason, their emotional and psychological wellbeing must be considered. Medical professionals can support the emotional needs for pre-emptive or living donors through counseling and the building of strong support systems. Similarly, recipients can also experience fear and anxiety around the hope of acquiring a donor and taking on the responsibility of taking another person’s organs. Medical systems need to prepare both sides with emotional support, transparent communication and clear psychological evaluations.
Innovation at the crossroads: Strategies for a sustainable future
When addressing organ shortages, medical professionals do not look only to deceased donor programs. Living donation programs are becoming a reliable source with selfless individuals donating a kidney or a portion of their liver for transplants. Despite the success of these programs in some regions, some raise ethical concerns around confirming that a donor’s decision is truly autonomous to avoid coercion and manipulation. Living donors should require pre-donation counseling and robust follow-up care to ensure that their health and well-being is prioritized and not being neglected following their generous donation.
Additionally, there are new programs like paired donation, which connect pairs of incompatible donor-recipients with others to ensure all who need a transplant are matched. Creating a larger network of donors and recipients enables healthcare professionals to increase the identification of compatible matches and ultimately, transplant more lifesaving organs.
While these newer processes aim to increase the quantity of viable organs, experts are also exploring other options such as machine perfusion and even the development of artificial organs. Kidneys and livers need to be preserved long-term to keep the organ viable following donation. Research around bioprinting and biocompatible materials is also continuing to be developed, creating even more potential to save lives.
With this wide variety of opportunity in transplantation and organ cultivation, both recipients and donors can feel more optimistic about donation, knowing that they will be in good hands with the medical professionals assisting them in this intense process.
It takes a village: Policy & educational growth in organ donation
We, as a community, can all raise awareness about the need for organs to support transplant patients. Whether through public awareness campaigns or working with policymakers, the public and government leaders can work to show the value of donation as a way of giving back to the community.
Donors and their families also desire reassurance that their organs are going to be utilized, requiring the need to implement clear protocols like the controlled donation after circulatory death (DCD) programs.
In addition to policy, educational campaigns can also help debunk misconceptions around organ donation. Community leaders can work together to reach out to new communities that may not be aware of how to donate. Donors and recipients can also share stories about their personal experiences that may inspire the next generation to consider how they can help someone in need.
While the public has a large impact on changing the general perception of organ donation, healthcare professionals can also speak with their patients and their families about the process. Given the sensitivity around organ transplants, healthcare professionals should come prepared with tools to navigate conversations in a safe space to help dispel misconceptions and address legitimate concerns. By continuing to have an open conversation with medical professionals, patients in need and their families will be more prepared with the tools and education to navigate this stressful process into a potentially heartwarming experience.
Building a future of abundance in organ donation
The transplantation process can be an intense emotional experience for all involved, including the surgeons that are witnessing the cost of organ shortages every day. Despite the many challenges that exist in the transplantation field, medical professionals and transplant experts are hard at work to implement as many solutions as possible. Through many years of research to explore organ preservation techniques and alternative options for securing viable organs, there is progress every day toward more people getting the help they need.
Photo: Getty Images, erhui1979
David Mulligan, MD, FACS, FAST, FAASLD, is an abdominal organ transplant surgeon performing both living and deceased donor liver, kidney, and pancreas transplants. He currently serves as Professor of Surgery, Transplantation, and Immunology in the Department of Surgery at Yale School of Medicine/Yale New Haven Health System. His clinical and academic focus surrounds living donor liver transplantation, expanding donation, and working on ways to utilize ex-vivo organ perfusion systems. Dr. Mulligan has performed over 250 living donor transplants and authored over 180 publications. He also has served on numerous international editorial review boards and contributed to the oversight and recommendations regarding the impacts of Covid-19 on solid organ transplantation in the United States. Dr. Mulligan is the past president of UNOS/OPTN as well as Director of Transplant Innovation and Technology at Yale University.
Matthew Cooper, MD, FACS, FAST is the Chief of Transplantation, Director of Solid Organ Transplant, and a Professor of Surgery at the Medical College of Wisconsin. He is the Mark B. Adams Distinguished Professor of Surgery. His clinical interests include kidney and pancreas transplantation in both children and adults; particularly the use of marginal organs and has chaired several national taskforces. He has authored over 280 peer-reviewed manuscripts, 300 abstracts and 12 book chapters. Dr. Cooper is involved in organ transplantation activities both nationally and internationally. He is an UNOS/OPTN Past President and a member of the Board of Directors for several national organizations
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