In this blog post, we will look at the medical advances in organ transplantation technology and the ethical and social issues that have arisen along with it.
Organ transplantation is a technique in which one’s own organs are transplanted to another part of the body or organs are received from another person to replace damaged or dysfunctional organs. It is recognized as one of the most effective surgical methods to date. However, the history of this idea being first proposed and researched is not as long as one might think.
Even in the 19th century, people believed that diseases were caused by a disruption in the balance of body fluids, the liquid components of the body, due to a poor lifestyle or environmental factors. Accordingly, it was believed that diseases could be cured by changing one’s surroundings or lifestyle or restoring the balance of body fluids through vomiting, purging, or bloodletting. However, some surgeons began to view the body as a structure composed of organs and tissues with specific functions. They proposed the idea that diseases could be treated by removing diseased organs and tissues or by performing surgeries to restore their functions.
In July 1883, Swiss surgeon Emil Theodor Kocher attempted to remove the thyroid tissue of a patient suffering from goiter and transplant it into another patient suffering from the aftereffects of thyroid removal. Although the transplanted patient did not live long, this attempt to treat complex symptoms by replacing organs is considered to be the first organ transplant case. It became the prototype for all subsequent organ transplants and marked the beginning of organ transplant research.
After that, doctors tried to improve organ transplant technology through various studies and experiments, but they encountered an unexpected barrier. It was the rejection reaction, the biggest problem in organ transplantation. The rejection reaction is a phenomenon in which the immune system attacks the transplanted organ or tissue because the body considers it to be a foreign substance. In 1980, French physician Jean Dausset discovered that the rejection reaction is controlled by leukocyte antigens. This discovery led doctors to recognize that the immune system in the body is the key cause of the rejection reaction and spurred the development of immunosuppressants.
Immunosuppressants are substances that artificially suppress the body’s immune system, reducing the attack capabilities of immune cells. Just as the development of penicillin played a crucial role in the history of antibiotics, the development of cyclosporine in 1972 was a groundbreaking event in the history of immunosuppressants. This inhibitor, extracted from fungi living in the soil, has strong efficacy with few side effects, and has dramatically increased the success rate of liver transplantation from 18% to 68%.
As such, organ transplantation has made a great contribution to restoring human health through surgical treatment. However, there are still many unresolved issues. One of them is the imbalance in organ supply, which is a social problem. There are more people in need of organ transplants than there are donors, and the number of brain-dead donors is less than 250 a year. According to the National Organ Transplant Center, people waiting for organ transplants have to wait an average of four to five years. This is why many patients are unable to receive organ transplants and often die while waiting. In addition, the demand for organs exceeds the supply, which leads to extreme problems such as illegal organ trafficking.
Another problem is that organ transplants raise ethical issues related to human uniqueness and the definition of life. Organ transplantation is a technology that transcends the boundaries of the individual body, which was previously taken for granted. For example, in the case of a head transplant, if all the organs below the neck belong to someone else, who is the person who has undergone the head transplant? Furthermore, the question of whether medicine will advance to the point where people can choose their own bodies as they wish if they have the money to do so is also raised.
Organ transplantation technology has achieved great results by introducing new values and thinking about diseases and expanding the range of treatments. However, the policy and ethical issues that underpin these technologies still coexist behind the scenes of scientific achievements.
