Documente Academic
Documente Profesional
Documente Cultură
HISTORY
09/07/1905
First successful cornea
transplant by Eduard Zirm
(18 March 1863 - 15 March 1944),
was born in Vienna, Austria.
December 1954
First Kidney transplantation
HEART
1946 - THE FIRST HETEROTOPIC
HEART
TRANSPLANTATION
1946 - THE FIRST TRANSFER
COMPLEX HEART-LUNG
1979
First successful
live-donor partial
pancreas
transplant by
David E
Sutherland
2005
2008
First successful transplantation
of near total area (80%) of face,
(including palate, nose, cheeks,
and eyelid by Maria Siemionow
(Cleveland, USA
Introduction
Types(medico legally)
REGENERATIVE TISSUE: blood,
SOURCES OF ORGANS
Homologous donation : organ are relocated to the same
Legal aspect
THOA 1994(Transplantation of Human Organ Act)
June 1994 - Indian Parliament
July 8,1994- president of India gave his assent
Feb 4,1995- Came in force by a gazette notification
Regulates the removal of organ from living as well as the death.
The principal matters covered are:
Authority for the removal of human organ
Regulation of hospitals
Registration of hospitals
Offences and penalties
Normal
Cerebral Hemorrhage
Normal
Cerebral
Anoxia
Normal
Cerebral Trauma
DIAGNOSIS
(1) Clinical Evaluation (Prerequisites)
Establish Known Irreversible Cause of Coma
Exclusion of Potentially Reversible Conditions
Brain Death
Neurologic Examination
Occulo-Cephalic Response(A8,E3,5)
Occulo-Vestibular Response(A8,E3,5)
Cold Caloric Testing
Supraorbital Or
Temporo-Mandibular
Pressure
Pre-Oxygenation
100% Oxygen via Tracheal Cannula for 10 min
Achieve PaO2 = 200 mm Hg
Monitor PaO2 with pulse oximetry
Discontinue Testing
If BP drops to < 90 mm Hg
PaO2 drops to 85% by pulse Oxymetry for 30 Sec
If no respiratory drive observed after 08 min
Take next Blood sample for Blood gas studies
If respiratory movements are absent & arterial
PaCO2 is 60 mm Hg OR
20 mm Hg increase over a baseline normal PaCO2
The Apnea test result is POSITIVE
Supports the clinical diagnosis of brain death
Brain Death
Ancillary Confirmatory Testing
Recommended when
Proximate cause of coma is not known or
When confounding clinical conditions limit clinical
examination
1. EEG
2. Cerebral Angiography
3. PET : Glucose Metabolic Studies
4. Dynamic Nuclear Scan
5. Somato-Sensory Evoked Potential
Brain Death
Confirmatory Testing
Normal
Electro-Cerebral Silence
Cerebral Angiography
Normal
PET
Glucose Metabolism Studies
Normal
Hollow-skull sign
of brain death
Cerebral metabolism
globally reduced ~50%
5.
Committee or committees.
The ACs are of the respective States or Union
Territories is constituted to approve or "reject
transplants between the recipient and unrelated
donors.
The primary duty of the AC is to be able to establish
that the unrelated donors are not under any coercion
or undue influence by monetary consideration to
donate their organs
11. Act also provide provision for appeal
12. Punishments
RMP 1st offence: removal of name(2 yrs)
subsequent : permanently
must be respected
In untested body organ transplantation doctor must take every
precaution to ensure to rule out the risk of acquiring disease
Doing/taking organ without the consent(>18 yrs) and that of
relative-Unethical
For the benefit of guardian if consent is given-unethical
Unethical to go ahead with organ transplant-if the donor is mentally
unsound
Monster, anencephaly-unethical
Marriage done for organs (kidney Marriage)-unethical
Mutilating the foetus for benefit of others -unethical
Xenotransplant
Potential recipient and their
offence
-kidney buyers
-kidney marriage
-human organ shop
-surrogate mother
THANK U