Preface

One of the most interesting and at the same time most challenging fields of medicine and surgery has been that of organ donation and transplantation. It is a field that has made tre‐ mendous strides during the last few decades through the combined input and efforts of sci‐ entists from various specialties including surgeons, hepatologists, nephrologists, immunologists, ethicists, and infectious disease specialists. What started as a dream of pio‐ neers has become a reality for the thousands of our patients whose lives can now be saved and improved. However, at the same time, the challenges remain significant and so do the expectations, for what was once an experimental treatment could eventually become the fu‐ ture of medicine, as it involves most organs including the heart, lungs, eyes, liver, kidney, pancreas, and small intestine.

This book with the contribution of an excellent group of world authorities in the field of organ donation and transplantation presents the challenges involved including the ethical, legal, and medical issues in organ donation and the technical and immunological problems facing experts involved in the care of these patients. In addition to the knowledge shared, the authors provide their personal clinical experience making this book an extremely useful tool for every scientist and physician practicing in the field of transplantation. The book is divided into a section dealing with donation-related issues and challenges and another one where the different types of transplantation are presented. The chapters include information on the current state and different types of donation, the challenges identified in increasing donation, and the potential solutions. Chapters in both the organ donation and the trans‐ plantation section provide us with a combination of the technical and surgical aspects, as well as a glimpse of the opportunities offered by molecular and basic science in achieving progress in the field of tolerance.

We can learn from the history of transplantation and, at the same time, tackle the remaining critical questions, such as achieving tolerance, which represents the Holy Grail of medicine.

Overall, this book represents a true tour-de-force of a variety of topics having to do with organ donation and transplantation. It should be stressed that the intended audience are sci‐ entists, physicians and surgeons of different specialties, which all have in common an inter‐ est in transplantation, improving the lives of their patients.

> **Georgios Tsoulfas, MD, PhD, FICS, FACS** Associate Professor of Surgery Aristotle University of Thessaloniki Thessaloniki, Greece

**Section 1**

**Organ Donation**

**Section 1**

**Organ Donation**

**Chapter 1**

**Provisional chapter**

**Organ Donation**

**Organ Donation**

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

DOI: 10.5772/intechopen.75487

Organ transplantation is the only way of giving the gift of life to the patients with organ failure; however, the inadequate supply of organs, especially from deceased donors, has created a wide gap between organ supply and organ demand. Many organs from deceased donors are still not being used worldwide because of lack of information, education, and social system. Effective systems such as opt-out, donation after circulatory death, and donor action programs are needed to promote deceased donations. Counseling on organ donations must be an essential step of families of brain-dead patients. Standard practice should include that physicians call an Organ Procurement Organization coordinator before meeting with the families of potential donors. Tight screening for potential organ donor in intensive care unit, decoupling, and professional counseling are key components. The authorities have to consider the establishment of an opt-out system, and social

Progress in transplantation science and medicine has been impressive in the last decades. Nevertheless, transplantation activity is constrained by the shortage of organs. How can we maximize the utilization of organs that are abandoned from the deceased donors? The process for organ donation is a complex one involving medical, psychological, ethical, and social scientific aspect. Public opinion on organ donation and social maturity is also important factors for a stable and sustainable social system for organ donation. This chapter describes the essential knowledge, principles, and considering factors for the promotion of

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

http://dx.doi.org/10.5772/intechopen.75487

systemic efforts are needed.

**Keywords:** organ donation, deceased donor, promotion

Young-Nam Roh

**Abstract**

**1. Introduction**

organ donation.

Young-Nam Roh

#### **Chapter 1 Provisional chapter**

#### **Organ Donation Organ Donation**

#### Young-Nam Roh Young-Nam Roh

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.75487

#### **Abstract**

Organ transplantation is the only way of giving the gift of life to the patients with organ failure; however, the inadequate supply of organs, especially from deceased donors, has created a wide gap between organ supply and organ demand. Many organs from deceased donors are still not being used worldwide because of lack of information, education, and social system. Effective systems such as opt-out, donation after circulatory death, and donor action programs are needed to promote deceased donations. Counseling on organ donations must be an essential step of families of brain-dead patients. Standard practice should include that physicians call an Organ Procurement Organization coordinator before meeting with the families of potential donors. Tight screening for potential organ donor in intensive care unit, decoupling, and professional counseling are key components. The authorities have to consider the establishment of an opt-out system, and social systemic efforts are needed.

DOI: 10.5772/intechopen.75487

**Keywords:** organ donation, deceased donor, promotion
