An organ transplant replaces a failing organ with a healthy organ from another person. Organs most often transplanted are:
More than one organ can be transplanted at one time. For
example, a heart and lung transplant is possible.
Not everyone is
a good candidate for an organ transplant. Your doctor or a transplant center
will do tests to see if you are. You probably are not a good candidate if you
have an infection, heart disease that is not under control, a
drug or alcohol problem, or another serious health
If your tests show you are a good candidate, you are put
on a waiting list.
Transplants are more successful
today than ever before. Organ transplant success depends on:
you'll need to have blood and tissue tests done that will be used to match you
with a donor. This is because your immune system may see the new organ as
foreign and reject it. The more matches you have with the donor, the more
likely your body will accept the donor organ.
You'll also need to take
care of your health. Continue to take your medicines as prescribed and get
regular blood tests. Follow your doctor's directions for eating and exercising.
You also may want to talk with a
licensed mental health counselor about your
To learn more about what happens, talk to someone who
has had a transplant. Your transplant center or doctor can give you the name of
someone who is willing to share his or her experience with you.
may have to wait days, months, or years for your transplant. Be patient, and
ask your doctor what you can do while you're waiting.
After a transplant,
many people say they feel better than they have in years. What you can and
can't do will depend on the type of transplant you had, other health problems
you have, and how your body reacts to the new organ.
You will have
to take daily antirejection medicines to prevent your
immune system from rejecting the new organ. You will need less of these
medicines as time goes by. Because these medicines
weaken your immune system, you may have to stay away from large crowds for a while and
stay away from people who have infections.
You will also have
regular checkups and blood tests to see how well your new organ is
Depression is common after an organ transplant. If you
think you may be depressed, get help. The earlier depression is treated, the
more quickly you will feel better.
You may need to make some
lifestyle changes to keep your new organ healthy and strong. This can include
eating healthy foods, getting regular exercise, and getting enough sleep.
Most people can be
organ donors. If you are interested in donating an organ, contact the United
Network for Organ Sharing (UNOS) at 1-888-894-6361 or go online at www.unos.org
to get more information and to locate the nearest transplant center.
Many people choose to donate an organ upon their death. But a
person can donate certain organs while he or she is still living. These people
are called "living donors."
Health Tools help you make wise health decisions or take action to improve your health.
Learning about organ transplant and donation:
After a transplant:
Living with an organ transplant:
Receiving a donor organ is a big responsibility. To get on the waiting list, you'll have to
be committed to taking good care of yourself. The best way to do this is to take medicines as prescribed, get
regular blood tests, and make any necessary lifestyle changes to stay healthy.
To get on the waiting list, you will need to:
During your evaluation, learn as much
as you can about the transplant center. Find out whether the
center will accept your insurance, what your options are if you
don't have insurance, and whether support groups are available.
The transplant center will notify you within 2 weeks of your
evaluation to let you know whether you have been placed on the waiting list. If
you have questions about your list status, contact the transplant center where
you were evaluated.
It may be days, months, or even years before
you receive a new organ. When an organ is found, your transplant team will consider whether the donor is a good match for you,
the status of your current health, and how long you've been on the waiting list. Your team will also consider the location of the donated organ, because it must be transplanted quickly
to remain in working order.
Thinking about and waiting for a transplant can affect you emotionally. You
may find it helpful to see a
psychologist, or a
licensed mental health counselor about your
Tests that are done for all organ
transplant candidates include:
The results of these medical tests will be used to match
you with an organ donor. The more matches you have, the more likely your body
will accept the new organ.
You may not be a good candidate if you have an active infection, unstable heart disease, or another serious
medical problem. Also, you will not be considered for organ transplant if you have a problem with alcohol or drugs.
If you are told that you are not a good candidate for organ transplant,
find out if there are other treatments for your condition. Many people can live
for years with serious health conditions.
The goal of your care may shift to maintaining your comfort. Talk to your loved
ones about the type of care you would like to receive. Discuss their
expectations as well as your wishes, care needs, and finances and the needs of
your family. Your choices may change as your illness changes.
Organ transplant success depends on:
Success rates usually state how many people who receive
the transplant are living 5 years after the transplant.1
Organ rejection is possible. When a new organ is placed into your
body, your immune system sees it as foreign and tries to destroy it. Antirejection medicines can help prevent
your immune system from attacking the donor organ.
You may worry about organ rejection or that your surgery will not be successful for another reason. These thoughts are normal. Many people write an advance directive and
choose a health care agent when they are waiting for a transplant.
While you are
waiting for your
organ transplant, you will be given a pager or
cell phone so the transplant center can contact you to tell you an
organ is available. You may also wish to give
the transplant center several numbers where you can be reached and the name and
number of a few people who will always know how to reach you.
Arrange in advance for someone to go with you to the transplant center. This person can support you, listen to your doctor, and
help you remember important instructions. This person can
also report any change in behaviors or symptoms that you may have either before
or shortly after the transplant.
Have your suitcase packed with the things you need to take
with you to the transplant center. Your support person should also have a bag
packed and ready to go.
When you arrive at the hospital or transplant center because a donor organ has been
found, you will immediately be prepared for surgery. Final tests will be done
to make sure the donor organ is a good match.
If your current health
condition requires that you be hospitalized while you wait for a donor organ,
you will receive supportive and lifesaving care (such as blood pressure support
heart failure) until you are matched with a donor
After your transplant, the amount of time you'll spend in the hospital depends on how healthy you
are before the surgery, which organ was transplanted, and how well your body
accepts the donated organ.
A longer hospital stay may be needed for a heart or
lung transplant than for a kidney transplant. Some people are out of the
hospital within a few days after their transplant. Others may need to
stay for a few weeks.
Your immune system protects you from infection and
disease. It defends your body by producing
antibodies and "killer" cells that destroy foreign
substances (such as viruses and bacteria). Since the donor organ doesn't match
your own tissue exactly, your body tries to destroy the transplanted organ by
immune system will try to destroy the new organ, you will need to take antirejection
immunosuppressants, for as long as you have the donor organ.
These medicines weaken your immune system and
decrease your body's ability to fight infections, cancer, and other diseases.
You will have to stay away from large crowds for a while and from people who have infections.
help to talk to someone who has had a transplant. This person can talk to you about how you can make taking antirejection medicines part of your daily life. You will probably need fewer of these medicines over time. You may also need other medicines to fight infection or other health
problems related to your transplant.
Almost immediately after a transplant, many people
report feeling better than they have in years. The physical limitations you
have will depend on the type of transplant you had, other conditions you may
have, and whether your body rejects the donor organ. You will likely not face
major physical limitations after you have healed from your transplant.
You may also have side effects from your antirejection medicines, and you
may be at increased risk for getting conditions
such as diabetes.
An organ transplant may cause many emotional issues both for you and those who
care about you. When your organ comes from a deceased donor, you may sometimes
think about that and what that meant to the donor's family.
It is common to have
depression after an organ transplant, although not
everyone does. If you think you may be depressed, it is important to tell your
transplant coordinator, doctor, or someone who cares about you. The earlier
depression is treated, the more quickly you will recover and the better you
To keep your new organ healthy
and to help you live longer after an
To help you and your new organ stay healthy:
Donor organs are needed—there are currently more than 100,000
people on the national
organ transplant waiting list. If you are interested
in donating an organ, contact the United Network for Organ Sharing (UNOS) at
1-888-894-6361 or go online at www.unos.org to get more information and to
locate the nearest transplant center.
You can donate an organ upon your death, or in some cases while you are alive. To learn more, see the topics:
Internet donor-matching services
are set up to help people who need an organ transplant
to contact potential living donors. Some experts believe these services undermine
the current system, which is based on donated organs going to people who are
most in need and those waiting the longest for a donor. Others believe online
donor matching services provide a useful resource for helping people who have
had problems finding a donor within the current system. For more information
about these services, talk to your doctor.
You do not have to be a blood relative (such as a sibling
or parent) of the person who receives your organ. You can be someone who is emotionally related to the person, such as a close friend or spouse, or
you can even be a stranger.
Donate Life America is an organization supported by the transplant community. This group works at a local level to educate Americans on the need for organ donation. The website includes information on how to become an organ donor, other information on organ donation, and personal stories about organ donors and recipients. This group used to be called the Coalition on Donation.
Healthy Transplant is a website sponsored by the American Society of Transplantation. This website helps people learn about transplantation. Patients can build a profile and take an active role in their health care. The website was created to help patients and family members understand more about transplantation and help people be more involved in their health care.
The U.S. Department of Health and Human Services provides information on organ tissue donation and transplantation through its OrganDonor.gov website. It lists the number of people currently on the waiting list for transplants. It gives information on how to become an organ or tissue donor and describes the process of transplantation. It also provides information on research and guidelines, and it lists resources such as locations of transplant centers.
The United Network for Organ Sharing (UNOS) is a
nonprofit scientific and educational organization that administers the nation's
only Organ Procurement and Transplantation Network (OPTN). It was established
by the U.S. Congress in 1984. UNOS collects and manages data about every
transplant event occurring in the United States, facilitates the organ matching
and placement process, and brings together health professionals, transplant
recipients, and donor families to develop organ transplantation policy.
Health Resources and Services Administration (2009). 2009 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1999–2008. Available online: http://www.ustransplant.org/annual_reports/current.
Other Works Consulted
Carithers RL, Salvalaggio PR (2009). Liver and pancreas transplantation. In EG Nabel, ed., ACP Medicine, section 4, chap. 15. Hamilton, ON: BC Decker.
Hodson EM, et al. (2008). Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients. Cochrane Database of Systematic Reviews (2).
Joyce D, et al. (2011). Surgical treatment of heart failure and mechanical ventricular support. In V Fuster et al., eds., Hurst’s The Heart, 13th ed., vol. 1, pp. 798–809. New York: McGraw-Hill.
Klassen DK, Weir MR (2007). Renal transplantation. In DC Dale, DD Federman, eds., ACP Medicine, section 10, chap. 11. New York: WebMD.
Punch JD (2010). Organ transplantation. In GM Doherty ed., Current Diagnosis and Treatment Surgery, 13th ed., pp. 1233–1250. New York: McGraw-Hill.
Trulock EP (2007). Lung transplantation. In DC Dale, DD Federman, eds., ACP Medicine, section 14, chap. 17. New York: WebMD.
Webster AC, et al. (2010). Interleukin 2 receptor antagonists for kidney transplant recipients. Cochrane Database of Systematic Reviews (1).
January 3, 2012
E. Gregory Thompson, MD - Internal Medicine
& Anne C. Poinier, MD - Internal Medicine
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