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BIOETHIC :

TRANSPLANTATION
Lupita Oktaviona (176090100111013)
Yeni Widyaningrum (176090100111017)
Dewi Ratih Tirto S. (176090100111022)

Department of biology
Faculty of mathematic and natural sciences
University of brawijaya
Malang, 2018
ORGAN AND TRANSPLANTATION

Transplantation involves
the removal of cells,
tissue or organs from
one organism and their
implantation into
another organism.
The appropriate moral stance for all use of animals in
research :
1. minimise animal suffering
2. maximise the benefits to medicine and health,
agriculture and fundamental understanding
Alternative Organ Source

• Animal organs (xenotransplantation)


• Artificial organs  ethical issue question about
the cost and effectiveness of it.
• Stem cells  cell that can specialize into the
many different cells found in human body.
• Aborted fetus
History of organ transplantation
• 1950s : 1st succesful kidney transplant
• 1960s : 1st cadaveric transplant (2 years worked), liver
transplant (>1 year), heart transplant (2 ½ weeks)
• 1980s : heart-lung transplant (5 years), artificial heart
transplant, a baboon heart transplant into baby faye (20 d),
living related liver transplant
• 1990s: split liver into more than one person
• 2000s : culture human embryonic stem cells
• Organ donors are of 2
types: living organ and
cardiac organ
Drawback to become a living donor
may include:
• Health consequences
• Psychological consequences
• Pressure
• No donor advocate
Scope of the Ethical Guidelines
These Ethical Guidelines inform ethical practice
in:
• Assessing the eligibility of an individual for
transplantation
• Assessing the suitability of donor organs for
transplantation allocating solid organs and
vascularised tissue composite allografts (such
as the hand or face) from deceased donors.
The Ethical Guidelines do not apply to:
• the process of organ donation
• transplantation of organs from living donors
• transplantation of human tissue other than solid
organs and vascularised tissue composite allografts
• transplantation of gametes, ovarian or testicular
tissue, or embryos for reproductive purposes medical
practice more generally
The process of determining eligibility for
transplantation

• referral by a specialist physician of


an individual to a transplant unit
• assessment against eligibility
criteria by a multidisciplinary team
Legal Basis of Transplantation
• Declaration of sydney on determinatiom of death and
recovery organ (1968, revised 2006)
• Statement on live organ (1985)
• Declaration on human organ transplantation (1987)
• Resolution on phsycians conduct concern human organ
transplantation (1994)
• Statement on human organ donation and transplantation
(2000, revised 2006)
• Statement on human tissue for tranplantation (2007)
• PMK No. 38 /2016 : Penyelenggaraan Transplantasi Organ
(Indonesia)
The Principle and Value of Organ
Transplantasi
• Respect
• Justice
• Equilty
• Solidarity
• Reciprocity
• Altruism
• Care and Welbeing
• Welfare and Security
• Transparency
• Effectiveness and Efficency
The Criteria are required to consider potential
recipients for a particular organ:

• Urgency
• Length
• Risks of transplantation
• General health
Animal model in Diabetes Mellitus research
The Pig as an Animal Model for Kidney
Transplantation

• Treatment of choice among human patients with


end-stage renal disease
• Urological system is very similar
• Three treatment : hemodialysis, peritoneal
dialysis and transplantation
• increases quality of life (Shrestha et al. 2010, de
Mendonça et al. 2014)
• Reduces the intensity of chronic pain (Nourbala
et al. 2007)
• Cost effective (OPTN 2012) and lengthens the
lifespan
Kidneys donated
• living donors
• deceased donors standard criteria donors (SCD)
extended criteria donors (ECD)
procedur
 Organ preservation
 Animals and Housing
 Anesthesia and analgesia
 Surgery
 Postoperative care
 ultrasound
 Blood analyses
 Urine sampling
Surgery

Donor nephrectomy Donated kidney placed in ice water and flushed


with cold HTK solution
Ultrasound
References

• ISHII, M., M. HAMAMOTO. 2009. Bioethics and Organ Transplantation in


Japan. JMAJ 52(5): 289–292.
• NHMR. 2016. Ethical guidelines for organ transplantation from deceased
donors. Australian Goverment.
• Manesh,S B. , R O Samani, & S B Manesh. 2014. Ethical Issues of
Transplanting Organs from Transgenic Animals into Human Beings. Cell J;
16(3): 353–360.
• Zakariasson, M. 2016. The Pig as an Animal Model for Kidney
Transplantation. Faculty of Veterinary Medicine and Animal Science
Department of Clinical Sciences. Swedish University

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