Pub Date : 2020-12-15DOI: 10.5772/INTECHOPEN.94986
Ulasi Ifeoma, Ijoma Chinwuba, Ifebunandu Ngozi, Arodiwe Ejikeme, I. Uchenna, Okoye Julius, Onu Ugochi, Okwuonu Chimezie, Alhassan I. Sani, O. Obinna
Sub-Saharan Africa (SSA), occupying about 80% of the African continent is a heterogeneous region with estimated population of 1.1 billion people in 47 countries. Most belong to the low resource countries (LRCs). The high prevalence of end-organ diseases of kidney, liver, lung and heart makes provision of organ donation and transplantation necessary. Although kidney and heart transplantations were performed in South Africa in the 1960s, transplant activity in SSA lags behind the developed world. Peculiar challenges militating against successful development of transplant programmes include high cost of treatment, low GDP of most countries, inadequate infrastructural and institutional support, absence of subsidy, poor knowledge of the disease condition, poor accessibility to health-care facilities, religious and trado-cultural practices. Many people in the region patronize alternative healthcare as first choice. Opportunities that if harnessed may alter the unfavorable landscape are: implementation of the 2007 WHO Regional Consultation recommendations for establishment of national legal framework and self-sufficient organ donation/transplantation in each country and adoption of their 2020 proposed actions for organ/transplantation for member states, national registries with sharing of data with GODT, prevention of transplant commercialization and tourism. Additionally, adapting some aspects of proven successful models in LRCs will improve transplantation programmes in SSA.
{"title":"Organ Donation and Transplantation in Sub-Saharan Africa: Opportunities and Challenges","authors":"Ulasi Ifeoma, Ijoma Chinwuba, Ifebunandu Ngozi, Arodiwe Ejikeme, I. Uchenna, Okoye Julius, Onu Ugochi, Okwuonu Chimezie, Alhassan I. Sani, O. Obinna","doi":"10.5772/INTECHOPEN.94986","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.94986","url":null,"abstract":"Sub-Saharan Africa (SSA), occupying about 80% of the African continent is a heterogeneous region with estimated population of 1.1 billion people in 47 countries. Most belong to the low resource countries (LRCs). The high prevalence of end-organ diseases of kidney, liver, lung and heart makes provision of organ donation and transplantation necessary. Although kidney and heart transplantations were performed in South Africa in the 1960s, transplant activity in SSA lags behind the developed world. Peculiar challenges militating against successful development of transplant programmes include high cost of treatment, low GDP of most countries, inadequate infrastructural and institutional support, absence of subsidy, poor knowledge of the disease condition, poor accessibility to health-care facilities, religious and trado-cultural practices. Many people in the region patronize alternative healthcare as first choice. Opportunities that if harnessed may alter the unfavorable landscape are: implementation of the 2007 WHO Regional Consultation recommendations for establishment of national legal framework and self-sufficient organ donation/transplantation in each country and adoption of their 2020 proposed actions for organ/transplantation for member states, national registries with sharing of data with GODT, prevention of transplant commercialization and tourism. Additionally, adapting some aspects of proven successful models in LRCs will improve transplantation programmes in SSA.","PeriodicalId":272783,"journal":{"name":"Organ Donation and Transplantation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126378478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-12DOI: 10.5772/intechopen.94156
F. Kakaei
Solid organ transplantation is now the standard treatment for many types of diseases and using a standard surgical technique for organ procurement from the deceased donors is an important step in preventing complications after such complicated procedures. In most centers, retrieval of heart, lungs, liver, kidneys, small bowel, pancreas and other organs is done at the same time by different surgeons under supervision by a team leader who is most familiar with at least basic steps of surgical technique of procurement of all the solid organs. Each transplant surgeon, regardless of his or her sub-specialty, has to know how to prepare and dissect the delicate anatomical structures which are in common between the two adjacent organs for example portal vein (liver-pancreas), superior mesenteric vein (pancreas-small bowel), abdominal inferior vena cava (liver-kidneys), supra-diaphragmatic inferior vena cava (liver-heart) and pulmonary artery-veins (heart-lungs). This needs a multidisciplinary approach by the most experienced members of the transplant team to decrease the warm ischemic time of the organs without any harm to them by better coordination between all the surgeons. In this, chapter we briefly describe the multiorgan retrieval procedure in a deceased donor, and we hope that following these instructions results in better quality of the procured organs without jeopardizing their vital anatomical structures.
{"title":"Surgical Techniques of Multiorgan Procurement from a Deceased Donor","authors":"F. Kakaei","doi":"10.5772/intechopen.94156","DOIUrl":"https://doi.org/10.5772/intechopen.94156","url":null,"abstract":"Solid organ transplantation is now the standard treatment for many types of diseases and using a standard surgical technique for organ procurement from the deceased donors is an important step in preventing complications after such complicated procedures. In most centers, retrieval of heart, lungs, liver, kidneys, small bowel, pancreas and other organs is done at the same time by different surgeons under supervision by a team leader who is most familiar with at least basic steps of surgical technique of procurement of all the solid organs. Each transplant surgeon, regardless of his or her sub-specialty, has to know how to prepare and dissect the delicate anatomical structures which are in common between the two adjacent organs for example portal vein (liver-pancreas), superior mesenteric vein (pancreas-small bowel), abdominal inferior vena cava (liver-kidneys), supra-diaphragmatic inferior vena cava (liver-heart) and pulmonary artery-veins (heart-lungs). This needs a multidisciplinary approach by the most experienced members of the transplant team to decrease the warm ischemic time of the organs without any harm to them by better coordination between all the surgeons. In this, chapter we briefly describe the multiorgan retrieval procedure in a deceased donor, and we hope that following these instructions results in better quality of the procured organs without jeopardizing their vital anatomical structures.","PeriodicalId":272783,"journal":{"name":"Organ Donation and Transplantation","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132541531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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