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Springtime Is For...TRANSPLANTING?!?

As the glorious Texas bluebonnets dot our highways and byways, it can only signal ONE thing – SPRINGTIME! And, along with the blossoms (and the allergies they bring), April also heralds the beginning of baseball season, Fiesta and Spurs playoffs. However, in addition to everything else, you may not realize April is National Donate Life Month...which leads us to the idea of transplanting!

Yes, we DO transplant seedlings and other botanicals, hoping they will take root and grow – just like our goals with any medical transplant. Then, a #ChoiceCusbits trivia tidbit, posted on our Facebook Page last week, got us thinking about the whole idea of transplants....which led to quite a bit of surprising research into the subject. It was a REAL eye-opener!

Usually when we think about medical transplants, the "biggies" immediately come to mind: heart, kidneys, maybe a liver. Yet, this doesn't even scratch the surface! And, another common misconception holds that "transplants" are a relatively new medical innovation. WRONG! Check this out...

Anecdotal evidence goes all the way back to Roman Catholic accounts of Third-Century saints Damian and Cosmas replacing the gangrenous or cancerous leg of Roman deacon Justinian, with the leg of a recently-deceased Ethiopian. However, more likely early accounts deal with skin transplantation, with the first reasonable documentation occuring in the Second Century BC, as Indian surgeon Sushruta used autografted skin transplanted for a nose reconstruction. Not surprisingly, the success or failure of these procedures is not well-documented. 

Not to be deterred by a lack of success, experimentation continued. Centuries later, in the 1500s, Italian surgeon Gasparo Tagliacozzi performed successful skin autografts. And "autografts" definitely proved the source of ANY early successes; autografts come from the patients, themselves, whereas transplants performed between two patients of the same species are called allografts. Obviously, the rejection issue plagued those early allograft transplants from non-matching donors.

But, Is It A "Match"?

The advent of type-matching, along with advances in anti-rejection medications, allowed transplantation to take a GIANT leap forward. In fact, today we have successfully transplanted most major organs, including the heart, kidneys, liver, lungs, pancreas, intestine and thymus. And this doesn't even include tissue transplants. "Tissues" include bones, tendons (both referred to as musculoskeletal grafts), corneae, skin, heart valves, nerves and veins. 

Worldwide, kidneys are the most commonly transplanted organs, followed by the liver and then the heart. However, corneae and musculoskeletal grafts are the most commonly transplanted tissues –  outnumbering organ transplants by more than tenfold. And unlike most organ transplants, which must occur within 24 hours of the last heartbeat, harvested tissue (with the exception of corneae) can be preserved and stored for up to FIVE YEARS!

With all these obstacles, you might imagine no further major transplant breakthroughs occurred until the 20th Century...and you would be off by a couple of decades! Those centuries of work finally culminated with the first successful human organ transplant – in the "modern" sense (implanting organ tissue to replace an existing organ) – a thyroid transplant performed by Swiss surgeon (and later, Nobel laureate) Theodor Kocher in 1883! The next leap forward did not come for almost 20 years, in 1905 when Eduard Zirm successfully completed the first human corneal transplant at the Olomouc Eye Clinic, in the now-Czech Republic.

But that initial thyroid transplant soon became the model for a whole new therapeutic strategy: organ transplantation. By 1900, the idea of successfully treating internal diseases by replacing a failed organ through transplantation, actually gained general acceptance among the medical community. And that thyroid gland became the model for transplants of adrenal and parathyroid glands, the pancreas, ovaries, testicles and kidneys. Additional strides were made in surgical techniques in the early 1900s by French surgeon Alexis Carrel, along with Charles Guthrie, who transplanted arteries or veins.

And while Carrel continued to experiment – successfully moving kidneys, hearts, and spleens – that's when he also became one of the first to identify the rejection issue, which remained a major stumbling block for decades. Without a track record of substantial improvement and success, organ transplantation was largely abandoned after World War I. However, major steps in skin transplantation DID occur during that war, notably in the work of Harold Gillies. And Gillies' assistant, Archibald McIndoe, carried on their work well into the World War II in the form of – if you'll  pardon the pun – cutting-edge reconstructive surgery. 

Exploring New Frontiers

See, successful human transplants have a relatively long history of the required operative skills LONG before the necessities for post-operative survival were discovered. Rejection and its side effects were always the key problem. However, with the discovery of various tissue matching strategies and different immunity-suppressant agents in the late 1940s and early 1950s, transplantation grew by leaps and bounds!

Now, at this point we could explore an entirely different side of the transplant concept...TEETH. But, this is such a bizarre and fascintating history we've decided to explore that topic in an entirely separate post! In the meanwhile, let's circle back to where we started: that #ChoiceCusbit...

"Did you know, your TEETH contain STEM CELLS?!? That’s right...according to SingularityHub, some Dentists are using Dental stem cells to actually REGROW TEETH – allowing us to biologically REPLACE ADULT TEETH for the first time in HISTORY!"

And we're not just talking teeth, here. Not only are genetic specialists growing "designer" organs specifically matched to that one patient, but stem cells are proving a remarkable resource for additional medical uses. Add in the space-age techniques for using 3D printers to take biological material to PRINT ACTUAL ORGANS and we know we're living in wondrous times! However, until we start printing or growing new teeth for you, we want to remind you that an ounce of prevention is ALWAYS worth of a pound of transplanted cure!