Introduction
Transplantation of organs, tissues, and cells has become a powerful mode of treatment for dozens of life-threatening diseases affecting millions of Americans. Today, doctors routinely transplant more than 25 different organs and tissues to treat kidney failure, Type 1 diabetes, leukemia, end-stage pulmonary disease, liver disorders, cardiovascular disease, and many other disorders.
Two major impediments to successful transplantation remain, however. The first of these is immune system rejection. Recent research advances have provided a much clearer understanding of the immune mechanisms that cause graft rejection. These insights have, in turn, led to better therapies to suppress the immune system and thereby allow a graft to survive and function. As a result, 1-year graft survival rates have increased for all organs and tissues and, in many cases, now exceed 80 percent. But despite this improvement, long-term graft survival rates have not increased nearly as much.
The second barrier to wider use of transplantation is a critical shortage of donor organs and tissues. Nationwide, there are more than 90,000 candidates on waiting lists for organ transplantation: 66,200 for kidneys; 17,500 for livers; 2,500 for pancreas or combined kidney/pancreas transplants; 3,200 for hearts or heart-lung transplants; and 3,000 for lung transplants.66 This demand far outstrips the supply of donor organs in the United States. In 2005, 14,492 individuals were organ donors. Unfortunately, many candidates die while awaiting a suitable organ.
66 Reference: The Organ Procurement and Transplantation Network [Internet]. Data. Available from: www.optn.org/data. Accessed March 31, 2006.
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