An organ transplant is a life-saving procedure to remove diseased or damaged organ and replace it with a healthy donor organ. Certain organs can be transplanted from a living donor, though most come from deceased individuals who, in life, registered as organ donors. Matching an organ to a recipient is a complex and often lengthy process. Post-operative complications of organ transplantation may arise, and lifelong care is necessary to a recipient's survival. A successful transplant, however, can vastly improve the health and life expectancy of a patient.

The History of Organ Transplants

The first successful kidney transplant took place in 1954 when a man donated one of his organs to his twin. By the late 1960s, surgeons had achieved the first successful heart, liver, and pancreas transplants. Over the next 30 years, organ donation became a common practice, and lawmakers passed significant legislation. As a result, practice and research in organ transplantation progressed, and methods and procedures evolved and improved. In 1977, transplant professionals created the United Network for Organ Sharing (UNOS) in collaboration with the US Health and Human Services department. UNOS facilitates all aspects of organ donation and transplant in the United States, including managing the transplant list and matching donors to recipients.

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Replacing Failing Organs

Patients are placed on an organ transplant list when one or more of their organ is no longer capable of performing its role. This may occur when a person is in the end stage of a chronic disease or has sustained an irreversible injury. Temporary treatments to mimic the function of the damaged organ are vital before a transplant, such as dialysis for kidney failure. Following a successful transplant, such measures are often no longer necessary.

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Transplant Waiting List

When an organ ceases to function properly, a doctor will refer his or her patient to a transplant center. The specialists at a transplant center qualify a person's candidacy for the Organ Procurement and Transplant Network (OPTN) administered by UNOS. There are regularly more than 100,000 people on the OPTN waiting list. How long a person remains on the list depends on the organ he or she needs, the immediacy of the need, and the availability of matching donor organs. Priority is often granted to cases of acute organ failure and people determined to have a high probability of success and survival.

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Finding the Right Match

In addition to organ recipient data, the OPTN contains living and deceased donor information. Organ matches within the network are based on several donor and recipient factors, including waitlist status, blood type, body size, immune system compatibility, and location. UNOS facilitates match runs with recipient and donor data based on these factors.

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Coordinating Organ Recovery and Receipt

When a match is determined, organ recovery and receipt must be carefully and entirely coordinated. The interval between the two procedures varies depending on the organ. A kidney can be sustained up to 48 hours. A heart, on the other hand, must be transplanted within four or six hours of recovery. Time and proper organ storage are essential.

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The Possibility of Rejection

Rejection of the donor organ is a complication of every transplant, though the severity of rejection varies. Immunosuppressants, which decrease the body's immune response, help minimize rejections. The organ recipient must take this medication for the rest of his or her life and will require regular monitoring for rejection. Chronic rejection occurs when the immune system repeatedly rejects the donor organ. Though a second transplant may be an option, chronic rejections are often fatal. The possibility of chronic rejection rises when the immune system compatibility between donor and recipient is less than ideal. However, the risk of rejection decreases with time.

transplant rejection immunosuppressants medication Eva-Katalin / Getty Images


Recovery and Prognosis

Immediate relief of chronic symptoms is often experienced immediately following a successful transplant, but the procedures are still major surgeries with a high risk of complications. Full recovery may take up to six months, and lifelong medical treatment and monitoring are required. Most organ recipients can resume life as normal in the absence of the disease or symptoms that previously limited their activities. Though rejection and complications of the transplant are possible, studies demonstrate a high rate of survival five years following most organ transplants.

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Donors and Donations

Organ donors may be living or deceased. Living individuals can donate a kidney, liver segment, lung lobe, and, in rare cases, segments of the intestine or pancreas. This type of donation often occurs between relatives or close friends. Organs donated by deceased donors include the heart, kidneys, lungs, liver, intestine, heart valves, eyes, and skin. As the science of transplantation progresses, more and more organs are becoming viable for transplantation.

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Emerging Transplant Procedures

Advancements in the field of organ transplantation are opening the door to previously impossible procedures. In the late 1990s, doctors in France performed the first hand transplant, and, in 2010, Spain was home to the first successful face transplant. In 2014, legislation classified these vascular composite allografts (VCAs) as organs, establishing the regulation of their transplantation. VCAs are body parts composed of several tissue types, including blood vessels, bones, and connective tissue. Face, hand, and arm transplants are becoming more common as VCA transplantation progresses.

hand transplant emerging procedures tommaso79 / Getty Images


Saving Lives

Most organ transplants are successful and are instrumental in curing diseases and symptoms. Donor organs, however, are in short supply, and people die every day waiting for a transplant. Though organ donation registration is increasing, the ratio of donors to those in need of transplants is still low. One organ donor can save the lives of as many as eight people. Talk to a doctor or visit donatelife.net to find out how to register as an organ donor.

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