The practice of transplanting major organs has come a long way since the first patient received a new kidney in Chicago in 1950.
Now, transplant technology is developing in a new direction, say experts who have just attended a conference in Hong Kong. They say the most important improvements are new techniques to allow organ assessment and repair before operations.
"Instead of transplanting an organ immediately, it can be determined whether the organ will function properly after transplant by assessing it on an apparatus," Professor Francis Delmonico of the World Health Organisation said.
Delmonico, medical director of the New England Organ Bank and surgery professor at Harvard Medical School, was in Hong Kong last week to speak at the World Congress of Nephrology.
Apart from allowing harvested organs to be kept longer before transplant and improving the assessment of how well they will function, techniques scientists have been working on include repairing faulty organs.
In Europe and Canada, new assessment techniques have been successfully used on lungs, and trial repairs to harvested livers are being conducted in the Netherlands.
"[These developments] will expand opportunities of patients who died in hospitals to have their organs donated and transplanted successfully," Delmonico said. A lung that was affected by pneumonia, for instance, could be removed and treated for the infection before it was transplanted, he said.
"Here we are … taking the organ out and seeing whether we can repair it," he said. "We've got a long way to go, but it will happen."
Dr Wang Haibo, a member of the China National Organ Transplant Committee, said new assessment techniques were important for the mainland as most of its donated organs came from cardiac deaths.
With cardiac death, blood flow to the organs is affected straight away and their function deteriorates. But if these organs could be repaired, more usable organs would be available for transplant.
But Hong Kong's low organ donation rate remains a barrier to patients getting the transplants they need.
Only about four deceased Hongkongers in every one million residents donated their organs in a year, said Dr Alvin Ho Kai-leung, chairman of Rotary Hong Kong's organ donation committee. In the United States, the number was six times higher, he said.
Professor Lo Chung-mau, head of surgery at the University of Hong Kong, said the university was in discussions with Toronto researchers on co-operative studies in this area.