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Organ transplantation Wiki2Web Clarity Challenge

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Study Guide: Organ Transplantation: Principles, Practice, and Ethical Considerations

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Organ Transplantation: Principles, Practice, and Ethical Considerations Study Guide

Fundamentals of Organ Transplantation

The fundamental purpose of organ transplantation is to replace a damaged or missing organ, thereby restoring vital physiological functions.

Answer: True

Explanation: The source explicitly states that the primary purpose of organ transplantation is to replace a damaged or missing organ to restore vital bodily functions.

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Corneal and musculoskeletal grafts are transplanted less frequently than solid organs such as kidneys and livers.

Answer: False

Explanation: The source states that corneal and musculoskeletal grafts are transplanted more than tenfold compared to solid organs.

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Tissues can generally be preserved and stored for up to five years, a significantly longer duration compared to the much shorter preservation window for organs.

Answer: True

Explanation: The source indicates that tissues can be preserved and stored for up to five years, while organs typically have a much shorter preservation window.

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What is the fundamental purpose of organ transplantation as a medical procedure?

Answer: To replace a damaged or missing organ and restore vital bodily functions.

Explanation: The source defines organ transplantation's primary purpose as replacing a damaged or missing organ to restore vital bodily functions.

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Based on the provided source, which organs are most frequently transplanted globally, listed in descending order of commonality?

Answer: Kidneys, Liver, Heart

Explanation: The source states that globally, kidneys are the most commonly transplanted organs, followed by the liver and then the heart.

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How does the typical preservation window for tissues compare to that for organs?

Answer: Tissues can be preserved and stored for up to five years, whereas organs typically have a much shorter preservation window.

Explanation: The source indicates that tissues can be preserved for up to five years, while organs have a much shorter preservation window.

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Types of Grafts and Transplant Procedures

Autografts involve transplantation within the same individual, while allografts are between genetically non-identical members of the same species.

Answer: True

Explanation: The source defines autografts as transplantation within the same person and allografts as transplants between genetically non-identical members of the same species.

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A rotationplasty, a surgical procedure where a distal joint replaces a more proximal one, constitutes an autograft, not an allograft.

Answer: False

Explanation: The source explicitly states that a rotationplasty is an example of an autograft, not an allograft.

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The principal challenge associated with allografts is the recipient's immune system recognizing the transplanted organ as foreign, which precipitates an immune response leading to rejection.

Answer: True

Explanation: The source identifies the recipient's immune system recognizing the transplanted organ as foreign, leading to rejection, as the main challenge with allografts.

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Isografts, while technically a subset of allografts, uniquely do not elicit an immune response due to the genetic identity between the donor and recipient.

Answer: True

Explanation: The source explains that isografts are between genetically identical individuals and thus do not trigger an immune response, unlike other allografts.

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Xenografts are generally not considered low-risk; rather, they pose significant challenges due to concerns regarding functional compatibility and potential disease transmission.

Answer: False

Explanation: The source states that xenotransplantation is considered extremely dangerous due to a higher risk of non-functional compatibility, severe rejection, and potential disease transmission.

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In a domino transplant, a patient undergoing a heart-lung transplantation procedure may donate their original, often healthy, heart to another patient requiring a heart transplant.

Answer: True

Explanation: The source provides the example of cystic fibrosis patients receiving heart-lung transplants, whose healthy hearts can then be donated to another patient, as a form of domino transplant.

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Kidney chains, a specialized form of domino transplantation, enable incompatible donor-recipient pairs to facilitate multiple transplants by circumventing blood type or antibody barriers.

Answer: True

Explanation: The source describes kidney chains as a scenario where incompatible donor-recipient pairs are matched to overcome blood type or antibody barriers, enabling multiple transplants.

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ABO-incompatible transplantation is more feasible in very young children than in adults, precisely because infants' immune systems are not yet fully developed.

Answer: False

Explanation: The source states that ABO-incompatible transplantation is particularly feasible in very young children because their immune systems are not yet fully developed and have not produced isohemagglutinins.

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UNOS regulations permit ABOi transplantation in children under two years of age if their isohemagglutinin titers are 1:4 or below, not 1:8.

Answer: False

Explanation: The source specifies that UNOS regulations permit ABOi transplantation in children under two years of age if their isohemagglutinin titers are 1:4 or below.

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Which statement accurately differentiates autografts from allografts?

Answer: Autografts involve transplantation within the same person, whereas allografts are between genetically non-identical members of the same species.

Explanation: The source clearly distinguishes autografts as within the same person and allografts as between genetically non-identical members of the same species.

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Which of the following scenarios exemplifies an autograft?

Answer: A skin graft from a person's thigh to their arm.

Explanation: The source defines an autograft as tissue moved from one part of a person's body to another part of the same person's body, and lists skin grafts as an example.

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What is the principal challenge associated with an allograft?

Answer: The risk of the recipient's immune system recognizing the organ as foreign and rejecting it.

Explanation: The source states that the main challenge with allografts is the recipient's immune system recognizing the transplanted organ as foreign, leading to rejection.

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What unique characteristic differentiates an isograft from other forms of allografts?

Answer: Isografts involve genetically identical individuals, thus avoiding an immune response.

Explanation: The source explains that isografts are unique because they are between genetically identical individuals, meaning they do not trigger an immune response.

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Which of the following represents a significant risk associated with xenotransplantation?

Answer: Potential transmission of diseases carried in the animal tissue.

Explanation: The source lists potential transmission of diseases carried in the animal tissue as a significant risk of xenotransplantation.

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Define the concept of a 'domino transplant'.

Answer: A series of linked transplant surgeries where one recipient's removed healthy organ is immediately transplanted into a second recipient.

Explanation: The source defines domino transplants as a series of linked surgeries where a recipient's removed healthy organ is immediately transplanted into a second recipient.

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What physiological factor renders ABO-incompatible (ABOi) transplantation particularly feasible in very young children?

Answer: Their immune systems are not yet fully developed and have not produced isohemagglutinins.

Explanation: The source explains that ABOi transplantation is feasible in very young children because their immune systems are not yet fully developed and have not produced isohemagglutinins.

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Medical Management and Complications

The management of transplant rejection involves identifying appropriate donor-recipient matches through serotyping and administering immunosuppressant pharmacotherapy.

Answer: True

Explanation: The source states that managing transplant rejection involves serotyping for donor-recipient matching and the use of immunosuppressant drugs.

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Robotic renal transplantation has significantly expanded access to kidney transplants for obese individuals who were previously considered unsuitable candidates.

Answer: True

Explanation: The source notes that robotic surgery has allowed over 100 obese patients, previously denied, to successfully receive kidney transplants.

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Human Herpesvirus 6 (HHV-6) reactivation in pediatric liver transplantation primarily affects the transplanted graft, potentially leading to complications such as graft-versus-host disease and allograft rejections, rather than solely impacting the recipient's cognitive development.

Answer: False

Explanation: The source states that HHV-6 reactivation in pediatric liver transplantation can lead to complications such as graft-versus-host disease and allograft rejections, impacting the graft and recipient health, not primarily cognitive development.

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Liver transplantation stands as the sole curative therapy for end-stage liver disease and is the second most frequently transplanted solid organ globally.

Answer: True

Explanation: The source identifies liver transplantation as the only curative therapy for end-stage liver disease and the second most frequently transplanted solid organ.

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Post-transplant monitoring primarily involves comprehensive diagnostic assessments such as lab draws and ultrasounds, rather than solely relying on daily physical examinations.

Answer: False

Explanation: The source states that post-transplant monitoring involves regular lab draws, ultrasounds, and other tests to assess organ acceptance and detect complications, implying more than just daily physical exams.

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What constitutes the primary medical challenge in managing organ transplantation, and by what means is it mitigated?

Answer: Managing transplant rejection, mitigated by serotyping and immunosuppressant drugs.

Explanation: The source identifies transplant rejection as the most challenging aspect, managed by serotyping and immunosuppressant drugs.

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How has robotic surgery principally influenced renal transplantation for obese individuals?

Answer: It has allowed individuals previously denied due to weight to successfully receive kidney transplants.

Explanation: The source states that robotic surgery has allowed obese individuals, previously denied, to successfully receive kidney transplants.

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What constitutes a significant concern regarding Human Herpesvirus 6 (HHV-6) reactivation in pediatric liver transplantation?

Answer: It can lead to complications such as graft-versus-host disease and allograft rejections.

Explanation: The source indicates that HHV-6 reactivation in pediatric liver transplantation can lead to complications like graft-versus-host disease and allograft rejections.

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Which specific organ transplantation procedure is identified as the sole curative therapy for end-stage liver disease?

Answer: Liver transplantation

Explanation: The source explicitly states that liver transplantation is the only curative therapy for end-stage liver disease.

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Which of the following is NOT enumerated as a primary complication subsequent to organ transplantation?

Answer: Nutritional deficiencies

Explanation: The source lists procedural complications, infections, acute rejection, cardiac allograft vasculopathy, and malignancy as main complications, but not nutritional deficiencies.

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Historical Evolution of Transplantation

J. Hartwell Harrison performed the initial organ removal for transplantation in 1954.

Answer: True

Explanation: The source confirms that J. Hartwell Harrison performed the first organ removal for transplant in 1954 as part of the first successful kidney transplant.

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The Indian surgeon Sushruta is credited with performing the first documented successful skin autograft for nasal reconstruction in the 2nd century BC.

Answer: True

Explanation: The source credits Sushruta with the first reasonable account of a successful skin autograft for nose reconstruction in the 2nd century BC.

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The first organ transplant in the modern sense, defined as implanting organ tissue to replace organ function, was a thyroid transplant performed by Theodor Kocher in 1883, not a kidney transplant.

Answer: False

Explanation: The source identifies Theodor Kocher's 1883 thyroid transplant as the first organ transplant in the modern sense, not a kidney transplant.

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Alexis Carrel was awarded the Nobel Prize for his pioneering work in surgical techniques, not for the discovery of cyclosporine, which was identified much later.

Answer: False

Explanation: The source states that Alexis Carrel received the Nobel Prize for his skillful anastomosis operations and new suturing techniques, not for discovering cyclosporine.

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The first successful human organ transplant was a kidney transplant performed in 1954, which achieved success primarily because the donor and recipient were identical twins, thereby obviating the need for anti-rejection medications.

Answer: True

Explanation: The source confirms the 1954 kidney transplant was successful because the donor and recipient were identical twins, eliminating the need for anti-rejection medications.

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Peter Medawar identified the fundamental immune reactions underlying transplant rejection and proposed the strategic use of immunosuppressive drugs to mitigate this response.

Answer: True

Explanation: The source states that Peter Medawar identified the immune reactions causing transplant rejection and suggested using immunosuppressive drugs.

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Early 1960s attempts at xenotransplantation using chimpanzee and baboon kidneys did not result in long-term survival for patients; most survived only for a few months.

Answer: False

Explanation: The source indicates that early xenotransplantation attempts in the 1960s resulted in very short survival times, with none surviving long-term.

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Christiaan Barnard performed the world's first human-to-human heart transplant in 1967, with the initial patient surviving for 18 days.

Answer: True

Explanation: The source confirms Christiaan Barnard performed the first human-to-human heart transplant in 1967, and the patient survived for 18 days.

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The median survival period for lung transplant patients worldwide between 2000 and 2006 was 5.5 years, not 7.5 years.

Answer: False

Explanation: The source states that the median survival period for lung transplant patients between 2000 and 2006 was 5.5 years.

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Who is credited with the earliest credible account of a successful skin autograft for nasal reconstruction in the 2nd century BC?

Answer: Sushruta

Explanation: The source credits the Indian surgeon Sushruta with the first reasonable account of a successful skin autograft for nose reconstruction in the 2nd century BC.

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Who performed the first organ transplant in the modern medical sense, characterized by implanting organ tissue to restore physiological function, and which organ was involved?

Answer: Theodor Kocher, Thyroid

Explanation: The source identifies Theodor Kocher's 1883 thyroid transplant as the first organ transplant in the modern sense.

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For what pioneering surgical contributions did Alexis Carrel receive the 1912 Nobel Prize in Physiology or Medicine?

Answer: Skillful anastomosis operations and new suturing techniques.

Explanation: The source states that Alexis Carrel received the Nobel Prize for his skillful anastomosis operations and new suturing techniques.

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The inaugural successful human organ transplant, a kidney transplant performed in 1954, achieved success primarily due to which factor?

Answer: The donor and recipient were identical twin brothers, eliminating the need for anti-rejection medications.

Explanation: The source states that the 1954 kidney transplant was successful because the donor and recipient were identical twins, meaning no anti-rejection medications were needed.

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What was the profound significance of Peter Medawar's contributions to the field of transplant surgery?

Answer: He identified the underlying immune reactions causing transplant rejection and suggested immunosuppressive drugs.

Explanation: The source credits Peter Medawar with identifying the immune reactions underlying transplant rejection and suggesting the use of immunosuppressive drugs.

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Who performed the world's first human-to-human cardiac transplantation, and what was the initial patient's survival duration?

Answer: Christiaan Barnard; 18 days

Explanation: The source states that Christiaan Barnard performed the first human-to-human heart transplant, and the patient survived for 18 days.

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Based on global data from 2000 to 2006, what was the median survival period observed for lung transplant patients?

Answer: 5.5 years

Explanation: The source states that the median survival period for lung transplant patients worldwide from 2000 to 2006 was 5.5 years.

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Emerging Technologies and Future Directions

Clinical trials for genetically engineered pig organs for human transplantation are currently on hold due to unresolved concerns regarding disease transmission from pigs to humans.

Answer: False

Explanation: The source states that clinical trials for genetically engineered pig organs are on hold due to concerns about disease transmission.

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Organovo is a company that leverages 3D bioprinting technology to develop functional human tissue, primarily for preclinical drug testing and discovery, with long-term aspirations for its use in surgical therapy and transplantation.

Answer: True

Explanation: The source describes Organovo as using 3D bioprinting to develop functional human tissue for drug testing and potentially future transplantation.

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Organ preservation research actively explores advanced perfusion techniques, which, despite increased logistical complexity and cost, offer significant benefits over static cold storage for clinical use.

Answer: False

Explanation: The source indicates that perfusion techniques are actively researched and show significant benefits, with hypothermic perfusion already used clinically, contradicting the idea that research primarily focuses on static cold storage due to cost/complexity.

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The first human penis transplant in 2006 was not successful long-term; it was reversed after 15 days due to psychological rejection.

Answer: False

Explanation: The source states that the first human penis transplant in 2006 was reversed after 15 days due to psychological rejection, indicating it was not long-term functional.

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The 2014 uterine transplant in Sweden was highly significant as it represented the first successful uterine transplant to result in a live birth.

Answer: True

Explanation: The source highlights the 2014 uterine transplant in Sweden as significant because it was the first successful one resulting in a live birth.

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The 'skin gun,' an innovation introduced in 2018, facilitates skin healing within days and aims to prevent scarring by spraying lab-grown skin onto burn-affected areas.

Answer: True

Explanation: The source describes the 'skin gun' as an invention from 2018 that allows skin to heal in days and prevents scarring by spraying lab-grown skin.

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In 2019, the United States witnessed the first successful drone delivery of a donated kidney for transplantation.

Answer: True

Explanation: The source states that the first drone delivery of a donated kidney for transplant occurred in the United States in 2019.

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The first heart transplant from a pig to a human in 2022 did not result in the patient's long-term survival without complications; the patient died due to porcine cytomegalovirus infection.

Answer: False

Explanation: The source states that the patient died because the pig's heart was infected with porcine cytomegalovirus, indicating it was not a long-term survival without complications.

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Left Ventricular Assist Devices (LVADs) serve as a crucial 'bridge' therapy to extend the survival of patients awaiting a heart transplant.

Answer: True

Explanation: The source states that LVADs are frequently used as a 'bridge' to extend the survival of patients awaiting a heart transplant.

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What is the current status of clinical trials involving genetically engineered porcine organs for human transplantation?

Answer: They are on hold due to concerns about disease transmission from pigs to humans.

Explanation: The source states that clinical trials for genetically engineered pig organs are currently on hold due to concerns about disease transmission.

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What is Organovo's primary contribution to the domain of organ transplantation research?

Answer: Designing and developing functional, three-dimensional human tissue using 3D bioprinting technology.

Explanation: The source describes Organovo as designing and developing functional, three-dimensional human tissue using 3D bioprinting technology.

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What primary methodology is currently under active investigation to enhance organ preservation prior to transplantation?

Answer: Perfusing the organ under hypothermic or normothermic conditions.

Explanation: The source states that active research focuses on improving organ preservation through perfusion techniques under hypothermic or normothermic conditions.

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What was the reported outcome of the initial human penile transplant performed in China in 2006?

Answer: It was reversed after 15 days due to the recipient's wife's psychological rejection.

Explanation: The source states that the first human penis transplant in 2006 was reversed after 15 days due to the recipient's wife's psychological rejection.

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What was the notable significance of the 2014 uterine transplant conducted in Sweden?

Answer: It was the first successful uterine transplant that resulted in a live birth.

Explanation: The source highlights the 2014 uterine transplant in Sweden as significant because it was the first successful one resulting in a live birth.

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What innovation in dermatological transplantation, introduced in 2018, facilitates rapid skin healing and mitigates scarring?

Answer: The 'skin gun'

Explanation: The source identifies the 'skin gun,' invented in 2018, as the innovation that allows skin to heal in days and prevents scarring.

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What significant advancement in organ delivery transpired in the United States in 2019?

Answer: The first successful drone delivery of a donated kidney.

Explanation: The source states that the first drone delivery of a donated kidney for transplant occurred in the United States in 2019.

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What was the reported outcome of the inaugural successful cardiac xenotransplantation from a pig to a human patient in 2022?

Answer: The patient died because the pig's heart was infected with porcine cytomegalovirus.

Explanation: The source states that the patient died because the pig's heart was infected with porcine cytomegalovirus.

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What is the principal function of Left Ventricular Assist Devices (LVADs) in the context of cardiac transplantation?

Answer: To serve as a 'bridge' to extend the survival of patients awaiting a heart transplant.

Explanation: The source states that LVADs are used as a 'bridge' to extend the survival of patients awaiting a heart transplant.

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