Transplant surgeon

A transplant surgeon is a surgeon who performs organ transplants. Among the many organs that can be transplanted are: kidneys. livers, hearts, lungs, the pancreas, the intestine (especially the small intestine), and recently, faces, tracheal (windpipe) tissue, and penises. At the present time, some organs, notably the brain and its constituent lobes and subdivisions, cannot be transplanted, and even if possible (recently, research has been done into the subject), would be very controversial for many. However, more extensive research into the transplantation of individual neurons and supportive brain tissue, or groups thereof (including glia, astrocytes, other neural connective tissue, and the surrounding meninges) has been done, and may be more practical and somewhat less controversial. A transplant surgeon is a surgeon who performs organ transplants. Among the many organs that can be transplanted are: kidneys. livers, hearts, lungs, the pancreas, the intestine (especially the small intestine), and recently, faces, tracheal (windpipe) tissue, and penises. At the present time, some organs, notably the brain and its constituent lobes and subdivisions, cannot be transplanted, and even if possible (recently, research has been done into the subject), would be very controversial for many. However, more extensive research into the transplantation of individual neurons and supportive brain tissue, or groups thereof (including glia, astrocytes, other neural connective tissue, and the surrounding meninges) has been done, and may be more practical and somewhat less controversial. Substitution of whole genes or chromosomes, or large portions thereof, for the purpose of genetic therapy or engineering (which is not actually transplantation, since these are not whole organs, or even tissues) is generally not yet feasible. While the use of tissue grafts- which is much more common- is not transplantation, since an entire organ is not transferred, these two are closely related (skin, hair, and subdermal tissue, connective tissue, musculoskeletal tissue, and corneas are commonly grafted). Sometimes, the separation of conjoined individuals requires transplantation of an organ or organs, especially if complications develop. End-stage renal disease (stages 5 and 6; either acute and non-reversible, or chronic), severe congestive or other heart failure or certain congenital cardiac structural defects (where the blood cannot be oxygenated or backflows, or where the ejection fraction or distribution of blood is insufficient); and advanced chronic obstructive pulmonary disease, cystic fibrosis (when the lungs are no longer able to function), or emphysema, are possible indicators for, respectively, renal (kidney), cardiac (heart), or pulmonary (lung) transplantation. There are distinct parameters for who is eligible for transplantation of the different organs. Broadly speaking (this is not meant to be exhaustive), these include: age, how long they have been on the waiting list, how urgently they need the organ (which is often related to how long they've been on the list, and whether they are actually in end-stage disease, which has its own laboratory and functional criteria per organ); their prognosis (how stable they are now- whether they can survive major invasive surgery and the anesthesia and post-op period, and how they have been, and how they likely will fare with and/or without the organ, versus with other therapies that are not transplantation- such as continued dialysis or getting an artificial heart or left ventricular assist device). Care must be taken when finding organs for the very young (this requires special training, or at least knowledge of, pediatric and newborn transplantation procedures), or certain very elderly patients (there may or may not be mandatory or preferred cut-off ages for receiving an organ or tissue, depending on the location, the institutions involved, the surgical team, whether the patient has any relevant co-morbidities and whether they are capable of caring for their new situation, how long and how well they might live, and the patient's and family's wishes). Transplantation rejection concerns, and the need to find willing donors or to have others give consent (for the deceased, in a cadaveric procedure), and the need to match them and to screen the needed blood products and other materials and maintain sterility and asepsis, are all very relevant issues, as is how to proceed if rejection becomes an issue (treatment, and if need be, removal), and how to deal with immune suppression post-transplant (this has become somewhat easier in recent years). Those with diabetes (particularly if it is advanced, and especially if it is not well-controlled), those who are culpably non-compliant with their medication and treatment plans, those who abuse substances (any drugs, alcohol, or tobacco), those who are uncooperative, those whose diseases or prognoses are not amenable to transplantation (or who may go on to need another of the same organ soon), those who have advanced and uncontrolled active liver or kidney disease, some prisoners, and those with advanced symptomatic AIDS or metastatic cancer with little chance of remediation are generally not candidates for transplantation (or would be low on the priority list independently of any other factors), though in certain cases exceptions can, especially recently, with better technology and better knowledge and protocols, be made, per the discretion of the organ network, the institutions, and the patient's doctor and surgical team. Not only are there donor issues with the receiver, but there are also some ethical issues when it comes to the giver. Life support victims seem to cause the most issues. When on life support, most people can donate their heart, lungs, liver, kidneys, skin, bones, etc. Before you can proceed with the donation, one needs to determine if the patient has already passed away. Once you get the clear from the doctor to go see a doctor at the transplant center, that's when you get all the information to see if you are able to get on the transplant list. You will go get a ton of testing done. Blood work, physical exam, lab studies, x-rays, CT scans, etc. Blood work is mostly to determine what your blood type is, and who could be your donor match. Once you get that testing done, you will either be determined too well or able to get a position on the donor list.