Transplantology: Challenges for Today

Alternative Therapies in Transplantology as a Promising Perspective in Medicine

Despite continuous and rapid progress in the transplantation of cells, tissues, and organs, many patients die before receiving them. This is because of an insufficient number of donors, which leads to a significant disproportion between the need for donors and their availability. This review aims to present the possibilities offered by alternative therapies. We use the term "functional transplantology" to describe such alternative methods of transplantation that could help change the current state of transplantation medicine. Its purpose is not to replace a defective or removed organ with another but to replace its functions using complementary biological, mechanical, or biomechanical structures or devices. Implementation of many innovative solutions shown in the work for clinical applications is already a fact. In the case of others, it should be considered a future vision. We hope that the role of a defective or damaged tissue or a group of tissues will be taken over by different structures that are functionally complementary with the organ being substituted. Undoubtedly, developing the described methods based on functional transplantology will change the face of transplantation medicine. Thus, we show current trends and new directions of thinking and actions in transplantation medicine that combine technology and transplantology. The review considers the latest technologies, including 3D bioprinting, nanotechnology, cell encapsulation, and organoids. We discuss not only the advantages of new approaches but also the limitations and challenges that must be overcome to achieve significant progress in transplantation. That is the only option to provide a safe and efficient way of improving the quality of life of many patients.

Parents' attitudes towards children's transplantology

Introduction

Pediatric transplantation is an extremely complex and emotionally difficult area of pediatric medicine. The process of obtaining a pediatric donor by the staff is an extremely delicate topic, and for the family of the deceased child, often an unimaginable and painful process. The aim of the study was to analyze parents' opinions on pediatric transplantology.Methods: The research survey method was applied using an original survey questionnaire made available electronically using a Google form. The group analyzed included 203 respondents.

Results

The attitude towards making transplant decisions among the respondents was positive. Education, age of parents and number of children did not influence attitudes towards pediatric transplantology.

Conclusions

There is a need for social education in the field of pediatric transplantation and to facilitate access to professional psychological care for pediatric patients and/or their caregivers.

Attitudes Toward Organ Transplantation

BACKGROUND

The purpose of transplantation is to improve the health or save the life of the recipient. Although organ transplantation is a method generally accepted by society, there are still people who, referring to moral and ethical aspects, reject its validity. A great threat to transplantology is also the lack of knowledge of the society resulting from insufficient education.

AIM

The aim of this study was to find out attitudes and opinions about organ transplantation and to determine the level of acceptance of organ and tissue transplantation.

METHODS

The tool chosen for the study was a survey questionnaire. The research group consisted of 200 people. Approval from the Bioethics Committee was obtained to conduct the study.

RESULTS

The studies showed that more than half of the respondents (57%) would agree to organ donation for transplantation after the death of a loved one. Age was found to be statistically significant (P = .001). Older people showed more doubts about transplantation than people under 30. Over 80% of respondents agreed that initiatives to educate the public about transplantation are needed.

CONCLUSIONS

The respondents refer to transplantation positively as a method of treating and saving life, and more than half of respondents would agree to donate their organs for transplant after the death of a loved one. The majority of respondents described their attitude toward transplantation as positive, admitting that the objection to donating is due to the ignorance and too little awareness on the subject.

CRISPR/Cas Technology in Pig-to-Human Xenotransplantation Research

CRISPR/Cas (clustered regularly interspaced short palindromic repeats linked to Cas nuclease) technology has revolutionized many aspects of genetic engineering research. Thanks to it, it became possible to study the functions and mechanisms of biology with greater precision, as well as to obtain genetically modified organisms, both prokaryotic and eukaryotic. The changes introduced by the CRISPR/Cas system are based on the repair paths of the single or double strand DNA breaks that cause insertions, deletions, or precise integrations of donor DNA. These changes are crucial for many fields of science, one of which is the use of animals (pigs) as a reservoir of tissues and organs for xenotransplantation into humans. Non-genetically modified animals cannot be used to save human life and health due to acute immunological reactions resulting from the phylogenetic distance of these two species. This review is intended to collect and summarize the advantages as well as achievements of the CRISPR/Cas system in pig-to-human xenotransplantation research. In addition, it demonstrates barriers and limitations that require careful evaluation before attempting to experiment with this technology.

Selected Legal Aspects of Donation After Circulatory Death in Poland

Organ transplantation is one of the most critical ethical topics in law and medicine and a matter of debate in various countries. Lack of organs for engraftment to meet the existing demand has resulted in a substantial crisis due to organ shortage and a rise in the critical conditions of certain waitlisted patients, as well as increased mortality of patients while waiting. Organ shortages for transplantation raised the issue of procurement of organs not only from living donors and cadaveric donors after brain death, but also after circulatory death. Renewed interest in donation after circulatory death started in the 1990s, and has been on the rise in recent years, reaching up 40% of donation in some countries. Both legislation on and practice of donation after circulatory death differ significantly throughout the world. Lack of unified guidelines and regulations have challenged the medical, ethical, legal, and transplant communities. Moreover, studies on legal aspects of donation after circulatory death are still lacking. In this review, we present selected legal issues in regulation of donation after circulatory death, and we address the most important legal challenges in this regard with particular attention to category III of donors after circulatory death.