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{{Short description|Transplantation between individuals of the same species}}
{{Distinguish|Allogenic succession}}
{{Distinguish|Allogenic succession}}
{{More citations needed|date=June 2021}}
{{Infobox medical intervention |
{{Infobox medical intervention |
Name = Allotransplants |
Name = Allotransplants |
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OtherCodes = |
OtherCodes = |
}}
}}
'''Allotransplant''' (''allo-'' from the [[Greek language|Greek]] meaning "other") is the [[Organ transplant|transplantation]] of [[cell (biology)|cells]], [[Biological tissue|tissues]], or [[Organ (anatomy)|organs]], to a recipient from a genetically non-identical donor of the same species.<ref>[http://www.ehealthmd.com/library/acltears/ACL_surgery.html#allograft Surgery For ACL Tears]</ref> The transplant is called an '''allograft''', '''allogeneic transplant''', or '''homograft'''. Most human tissue and [[organ transplant]]s are allografts.
'''Allotransplant''' (''allo-'' meaning "other" in [[Ancient Greek|Greek]]) is the [[Organ transplant|transplantation]] of [[cell (biology)|cells]], [[Biological tissue|tissues]], or [[Organ (anatomy)|organs]] to a recipient from a genetically non-identical donor of the same species.<ref>{{Cite web|url=http://www.ehealthmd.com/library/acltears/ACL_surgery.html#allograft|title=None}}</ref> The transplant is called an '''allograft''', '''allogeneic transplant''', or '''homograft'''. Most human tissue and [[organ transplant]]s are allografts.


It is contrasted with [[autotransplantation]] (from one part of the body to another in the same person), [[syngeneic]] transplantation (grafts transplanted between two genetically identical individuals of the same species) and [[xenotransplantation]] (from other species).
It is contrasted with [[autotransplantation]] (from one part of the body to another in the same person), [[syngenic]] transplantation of [[isografts]] (grafts transplanted between two genetically identical individuals) and [[xenotransplantation]] (from other species).


Allografts can be referred to as "homostatic" if they are biologically inert when transplanted, such as bone and [[cartilage]].<ref>(W. P. Longmire, ''J. National Cancer Institute'' '''14''', 669: ''The term ''homostatic graft'' might be applied to inert tissues such as bone and cartilage when transferred from one individual to another of the same species; and the term ''homovital graft'' might be used in reference to grafts whose cells must continue to grow and reproduce for the graft to be effective after similar transplantation''; H. Conway, ''The Bulletin of the Hong Kong Chinese Medical Association'' '''13''', 43: ''These grafts persist however as homostatic grafts and are completely replaced by host tissues in time.)''</ref>
Allografts can be referred to as "homostatic" if they are biologically inert when transplanted, such as bone and [[cartilage]].<ref>(W. P. Longmire, ''J. National Cancer Institute'' '''14''', 669: ''The term ''homostatic graft'' might be applied to inert tissues such as bone and cartilage when transferred from one individual to another of the same species; and the term ''homovital graft'' might be used in reference to grafts whose cells must continue to grow and reproduce for the graft to be effective after similar transplantation''; H. Conway, ''The Bulletin of the Hong Kong Chinese Medical Association'' '''13''', 43: ''These grafts persist however as homostatic grafts and are completely replaced by host tissues in time.)''</ref>


An immune response against an allograft or xenograft is termed [[Transplant rejection|rejection]]. An allogenic bone marrow transplant can result in an immune attack, called [[Graft versus host|graft-versus-host disease]].
An immune response against an allograft or [[Xenotransplantation|xenograft]] is termed [[Transplant rejection|rejection]]. An allogenic bone marrow transplant can result in an immune attack on the recipient, called [[Graft versus host|graft-versus-host disease]].


==Procedure==
==Procedure==
Informed consent is required before tissue is harvested from a donor, alive or dead. Proper screening for pathology and risk factors for communicable diseases such as [[HIV]] and [[Viral hepatitis|Hepatitis B and C]] is then conducted.
Material is obtained from a donor who is a living person, or a deceased person's body receiving mechanical support or ventilation, or [[Non-heart-beating donation|a deceased person's body whose heart stopped beating]]. Screening for pathology and risk factors for communicable diseases such as [[HIV]] and [[Viral hepatitis|Hepatitis B and C]] is then conducted.<ref name=":0" />


In the US, donor tissue must be harvested and processed adhering to the [[Current Good Tissue Practices]] rule. In most cases it is sent to tissue banks for processing and distribution. Each year, [[Food and Drug Administration]] regulated and [[American Association of Tissue Banks]]-accredited tissue banks distribute 1.5 million bone and tissue allografts.
In the US, donor tissue must be recovered and processed adhering to the [[Current Good Tissue Practices]] rule. In most cases, it is sent to tissue banks for processing and distribution. Each year, [[Food and Drug Administration]] regulated and [[American Association of Tissue Banks]]-accredited tissue banks distribute 1.5 million bone and tissue allografts.


==Transplantable organs and tissues==
==Transplantable organs and tissues==
{{main article|Transplantable organs and tissues}}
{{main article|Transplantable organs and tissues}}
A variety of organs and tissues can be used for allografts, including:
A variety of organs and tissues can be used for allografts, including:
*[[Anterior cruciate ligament]] (ACL) repair
* [[Anterior cruciate ligament]] (ACL) repair
*Joint reconstruction in the [[Knee replacement|knee]] and [[Ankle replacement|ankle]]
* Joint reconstruction in the [[Knee replacement|knee]] and [[Ankle replacement|ankle]]
*Meniscal replacement
* Meniscal replacement
*Reconstruction due to cancer or trauma
* Reconstruction due to cancer or trauma
*Ridge augmentation in dental procedures
* Ridge augmentation in dental procedures
*[[Shoulder surgery|Shoulder repair]]
* [[Shoulder surgery|Shoulder repair]]
*[[Spinal fusion]]
* [[Spinal fusion]]
*[[Urology|Urological procedures]]
* [[Urology|Urological procedures]]
*[[Skin]] transplants
* [[Skin]] transplants
*[[Cornea]]l transplants
* [[Cornea]]l transplants
*[[heart transplantation|Heart transplants]]
* [[heart transplantation|Heart transplants]]
*[[Heart valve]]s
* [[Heart valve]]s
*Lung transplantation
* Lung transplantation
*Intestinal transplantation (isolated small bowel, intestine & liver, multivisceral)
* Intestinal transplantation (isolated small bowel, intestine & liver, multivisceral)
*[[liver transplantation|Liver transplants]]
* [[liver transplantation|Liver transplants]]
*[[kidney transplantation|Kidney transplants]]
* [[kidney transplantation|Kidney transplants]]
*[[Pancreas transplantation]]
* [[Pancreas transplantation]]
*[[Islet cell transplantation]]
* [[Islet cell transplantation]]
*[[Bone marrow transplant]]s
* [[Bone marrow transplant]]s
*[[Bone]] allograft
* [[Bone]] allograft
*[[Ligament]] or [[tendon]] allograft
* [[Ligament]] or [[tendon]] allograft


==Laws and regulations==
==Laws and regulations==

⚫
In the US, the Federal government Food and Drug Administration (FDA) has regulated human tissue intended for transplants since 1993. In order to ensure the quality of donor tissue and reduce contamination and disease transmission risks, three regulations addressing manufacturing activities associated with human cells, tissues, and cellular and tissue-based products (HCT/Ps) were promulgated in May 2005: The first requires companies producing and distributing HCT/Ps to register with the FDA. The second, called the “Donor Eligibility” rule, proscribes criteria for donor eligibility. The third, the “Current Good Tissue Practices” rule, oversees overall processing and distribution practices of each company.
=== United States ===
⚫
In the US, the [[Food and Drug Administration]] (FDA) has regulated human tissue intended for transplants since 1993. In order to ensure the quality of donor tissue and reduce contamination and disease transmission risks, three regulations addressing manufacturing activities associated with human cells, tissues, and cellular and tissue-based products (HCT/Ps) were promulgated in May 2005:
* companies producing and distributing HCT/Ps must register with the FDA.
* "Donor Eligibility" rule: prescribes criteria for donor eligibility.
* "Current Good Tissue Practices" rule: oversees overall processing and distribution practices of each company.


==Other transplant options==
==Other transplant options==
*[[Autograft]], tissue transplanted from one site to another on the same patient. An autograft reduces the risk of rejection but requires a second surgery site, adding pain, risk and possible longer aftercare.
* [[Autograft]], tissue transplanted from one site to another on the same patient. An autograft reduces the risk of rejection but requires a second surgery site, adding pain, risk and possible longer aftercare.
*[[Xenograft]], a transplant from another species
* [[Xenograft]], a transplant from another species
*[[Isograft]], a transplant from a genetically identical donor, such as an identical twin.
* [[Isograft]], a transplant from a genetically identical donor, such as an identical twin.
*Synthetic and metal implants. Unlike allografts, such grafts do not corporate into the body.
* Synthetic and metal implants. Unlike allografts, such grafts do not corporate into the body.


==Risks==
==Risks==
As with many operations, allotransplantation also has some side effects. A limiting factor in tissue allotransplantation for reconstructive surgery deals with the side effects of immunosuppression (metabolic disorders, malignancies, opportunistic infections) which is a predominant issue. Also it can not be forgotten that the risk of transmitting infection is very high.<ref>{{cite web|title=Composite Tissue Allotransplantation and Reconstructive Surgery|pmc=1513974|website=US National Library of Medincine}}</ref>
As with many operations, allotransplantation risks some side effects. A limiting factor in tissue allotransplantation for reconstructive surgery deals with the side effects of [[immunosuppression]] (metabolic disorders, malignancies, opportunistic infections) which is a predominant issue. The risk of transmitting infection is high.<ref name=":0">{{cite journal|title=Composite Tissue Allotransplantation and Reconstructive Surgery|volume=237|issue=1|pages=19–25|pmc=1513974|journal=Annals of Surgery|year=2003|last1=Petit|first1=F.|last2=Minns|first2=A. B.|last3=Dubernard|first3=J. M.|last4=Hettiaratchy|first4=S.|last5=Lee|first5=W. P.|pmid=12496526|doi=10.1097/00000658-200301000-00004}}</ref>


==See also==
==See also==
*[[Allograft diseases]]
* [[Allograft diseases]]
*[[Medical grafting]]
* [[Medical grafting]]


==References==
==References==
Line 69: Line 76:


==External links==
==External links==
* http://www.aatb.org/files/safetyoftissuetransplants.pdf
* [https://web.archive.org/web/20160303183943/http://www.aatb.org/files/safetyoftissuetransplants.pdf]
* https://www.cdc.gov/ncidod/dhqp/tissueTransplantsFAQ.html#top
* [https://www.cdc.gov/ncidod/dhqp/tissueTransplantsFAQ.html#top]
* http://www.fda.gov/BiologicsBloodVaccines/TissueTissueProducts/default.htm
* [https://www.fda.gov/BiologicsBloodVaccines/TissueTissueProducts/default.htm Tissue & Tissue Products]
* http://www.organdonor.gov/donor/registry.shtm (How to register to be a donor in the USA)
* [https://web.archive.org/web/20101126080809/http://organdonor.gov/donor/registry.shtm OrganDonor.gov] (How to register to be a donor in the USA)
* [http://www.cancer.gov/dictionary?CdrID=270732 Allogeneic stem cell transplantation] entry in the public domain NCI Dictionary of Cancer Terms
* [http://www.cancer.gov/dictionary?CdrID=270732 Allogeneic stem cell transplantation] entry in the public domain NCI Dictionary of Cancer Terms
* [http://www.cancer.gov/dictionary?CdrID=45114 Allogeneic bone marrow transplantation] entry in the public domain NCI Dictionary of Cancer Terms
* [http://www.cancer.gov/dictionary?CdrID=45114 Allogeneic bone marrow transplantation] entry in the public domain NCI Dictionary of Cancer Terms

Latest revision as of 18:14, 10 November 2024

Not to be confused with Allogenic succession.
Allotransplants
MeSHD014184

Allotransplant (allo- meaning "other" in Greek) is the transplantation of cells, tissues, or organs to a recipient from a genetically non-identical donor of the same species.[1] The transplant is called an allograft, allogeneic transplant, or homograft. Most human tissue and organ transplants are allografts.

It is contrasted with autotransplantation (from one part of the body to another in the same person), syngenic transplantation of isografts (grafts transplanted between two genetically identical individuals) and xenotransplantation (from other species).

Allografts can be referred to as "homostatic" if they are biologically inert when transplanted, such as bone and cartilage.[2]

An immune response against an allograft or xenograft is termed rejection. An allogenic bone marrow transplant can result in an immune attack on the recipient, called graft-versus-host disease.

Procedure

[edit]

Material is obtained from a donor who is a living person, or a deceased person's body receiving mechanical support or ventilation, or a deceased person's body whose heart stopped beating. Screening for pathology and risk factors for communicable diseases such as HIV and Hepatitis B and C is then conducted.[3]

In the US, donor tissue must be recovered and processed adhering to the Current Good Tissue Practices rule. In most cases, it is sent to tissue banks for processing and distribution. Each year, Food and Drug Administration regulated and American Association of Tissue Banks-accredited tissue banks distribute 1.5 million bone and tissue allografts.

Transplantable organs and tissues

[edit]
Main article: Transplantable organs and tissues

A variety of organs and tissues can be used for allografts, including:

Laws and regulations

[edit]

United States

[edit]

In the US, the Food and Drug Administration (FDA) has regulated human tissue intended for transplants since 1993. In order to ensure the quality of donor tissue and reduce contamination and disease transmission risks, three regulations addressing manufacturing activities associated with human cells, tissues, and cellular and tissue-based products (HCT/Ps) were promulgated in May 2005:

  • companies producing and distributing HCT/Ps must register with the FDA.
  • "Donor Eligibility" rule: prescribes criteria for donor eligibility.
  • "Current Good Tissue Practices" rule: oversees overall processing and distribution practices of each company.

Other transplant options

[edit]
  • Autograft, tissue transplanted from one site to another on the same patient. An autograft reduces the risk of rejection but requires a second surgery site, adding pain, risk and possible longer aftercare.
  • Xenograft, a transplant from another species
  • Isograft, a transplant from a genetically identical donor, such as an identical twin.
  • Synthetic and metal implants. Unlike allografts, such grafts do not corporate into the body.

Risks

[edit]

As with many operations, allotransplantation risks some side effects. A limiting factor in tissue allotransplantation for reconstructive surgery deals with the side effects of immunosuppression (metabolic disorders, malignancies, opportunistic infections) which is a predominant issue. The risk of transmitting infection is high.[3]

See also

[edit]

References

[edit]
  1. ^ "None".
  2. ^ (W. P. Longmire, J. National Cancer Institute 14, 669: The term homostatic graft might be applied to inert tissues such as bone and cartilage when transferred from one individual to another of the same species; and the term homovital graft might be used in reference to grafts whose cells must continue to grow and reproduce for the graft to be effective after similar transplantation; H. Conway, The Bulletin of the Hong Kong Chinese Medical Association 13, 43: These grafts persist however as homostatic grafts and are completely replaced by host tissues in time.)
  3. ^ a b Petit, F.; Minns, A. B.; Dubernard, J. M.; Hettiaratchy, S.; Lee, W. P. (2003). "Composite Tissue Allotransplantation and Reconstructive Surgery". Annals of Surgery. 237 (1): 19–25. doi:10.1097/00000658-200301000-00004. PMC 1513974. PMID 12496526.
[edit]
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