surgery, many people now use the terms operation
and surgeryinterchangeably.
See also ARTHROSCOPY; BARIATRIC SURGERY; CARDIAC
CATHETERIZATION; CATARACT EXTRACTION AND LENS
REPLACEMENT; CESAREAN SECTION; ENDOSCOPY; JOINT
REPLACEMENT; LASER SURGERY; MINIMALLY INVASIVE SUR-
GERY; MOHS’ SURGERY; PLASTIC SURGERY; REFRACTIVE
SURGERY; SURGERY BENEFIT AND RISK ASSESSMENT; TUBAL
LIGATION.
organ transplantation The surgical replacement
of a nonfunctioning vital organ with a functional
organ acquired from a donor. Most donor organs
are allogeneic, also called deceased donation or
cadaver donation, in which a specialized surgical
team removes the donated organs after a person’s
death when the person has previously authorized,
or when the person’s family authorizes at the time
of the person’s death, organ donation. In some cir-
cumstances a person may make a living organ
donation to another person, such as for kidney,
lung lobe, and partial LIVER. US surgeons perform
almost 27,000 organ transplantations each year,
nearly 7,000 of which are organs from living
donors. The most commonly transplanted organs
are KIDNEYS and livers. However, approximately
89,000 people remain on waiting lists for donor
organs.
TRANSPLANTED ORGANS AND TISSUESBONE MARROW CORNEA HEART
ISLETS OFLANGERHANScells kidney LIVER
lung PANCREAS SKIN
SMALL INTESTINE stem cells
Organ Allocation and Acquisition
Organ transplantation transitioned from experi-
mental to mainstream in the 1980s, riding a wave
of technologic advances and the success of
cyclosporine, the first effective immunosuppres-
sive DRUG. In 1984 the US Congress passed the
National Organ Transplant Act (NOTA), which
established the Organ Procurement and Trans-
plantation Network (OPTN) to ensure consistency
and equity in the allocation of deceased donor
organs. OPTN is a not-for-profit organization that
is a collaborative union of public and private
organizations. The United Network for Organ
Sharing (UNOS) administers OPTN under contract
to the US Department of Health and Human Ser-
vices. Hospital transplant programs across the
United States determine a person’s eligibility for
transplantation, then submit the person’s name
and health data (such as organ needed and blood
type) to the UNOS database.
A regional organ procurement organization
(OPO) receives notification from hospitals and
other health-care providers when deceased donor
organs become available within its geographic
boundaries. The OPO coordinates the effort to
match the organs with appropriate donors, initiat-
ing a “match run” from the UNOS database. The
match run identifies prospective transplant recipi-
ents waiting for the particular kind of organ, the
medical urgency of the transplant need, the gen-
eral health circumstances, and the geographic
proximity of the donor organ to the prospective
recipient. The matched names go on a list for
the organ, ranked in order of need. UNOS gener-
ates a new match run each time an organ becomes270 Surgery
Surgical Operation Purpose
THORACOTOMY operations on structures within the chest except the HEART
tonsillectomy remove chronically infected and enlarged tonsils
TRACHEOSTOMY create a passage from the TRACHEAthrough the surface of the neck
TYMPANOPLASTY repair or reconstruction of the TYMPANIC MEMBRANE(eardrum)
VASECTOMY remove a segment of the VAS DEFERENS