Organ Transplant

Overview

An organ transplant is a surgery in which a diseased or failing organ is replaced with a healthy one from a donor. Transplants can be life-saving for people whose organs no longer work well enough to keep them healthy. The kidney is the most commonly transplanted organ, followed by the liver, heart, lung, and pancreas; certain tissues such as corneas and bone marrow can also be transplanted.

Donor organs come from living donors, who can give a kidney or part of the liver, or from deceased donors. Because the immune system treats a transplanted organ as foreign, recipients must take medicines that suppress the immune system for the rest of their lives to prevent rejection. With modern care, many transplant recipients live for many years with good quality of life.

Who Needs a Transplant

A transplant is considered when an organ has failed or is failing despite other treatments. Examples include:

• Kidney failure: When the kidneys can no longer filter the blood, often requiring dialysis.
• Liver failure: From cirrhosis or other severe liver disease.
• Heart failure: Advanced disease that no longer responds to medication or devices.
• Lung disease: End-stage conditions that severely limit breathing.

Not everyone with organ failure is a candidate; a careful evaluation determines whether a transplant is likely to help and be safe.

How It Works

The transplant process involves several steps:

• Evaluation: Tests confirm that a transplant is needed and that the person is healthy enough for surgery.
• Matching: Blood type and tissue markers are matched between donor and recipient to lower the risk of rejection.
• Waiting list: People needing a deceased-donor organ join a waiting list managed to allocate organs fairly.
• Surgery: The healthy organ is placed and connected to the recipient's blood vessels and, as needed, other structures.

Risks and Complications

Transplantation carries important risks that are managed closely:

• Rejection: The immune system attacking the new organ, which is why anti-rejection medicines are essential.
• Infection: A higher risk because the immune system is deliberately suppressed.
• Medication side effects: Long-term immunosuppressants can raise the risk of high blood pressure, diabetes, kidney problems, and certain cancers.
• Surgical complications: Bleeding, clots, and problems with the connected blood vessels.

Monitoring After Transplant

Lifelong follow-up protects the new organ:

• Regular blood tests to check organ function and medication levels.
• Biopsies if rejection is suspected.
• Watching for infection with prompt evaluation of fevers or new symptoms.
• Screening for the long-term effects of immunosuppression, including cancer surveillance.

Anti-Rejection Treatment

Preventing rejection is central to a successful transplant:

• Immunosuppressant medicines: Taken daily for life to keep the immune system from attacking the organ; doses are carefully balanced to avoid too much or too little suppression.
• Treating rejection episodes: Increased or additional medicines can often reverse rejection if caught early.
• Preventing infection: Vaccinations before transplant where possible, and preventive medicines afterward.

Taking medications exactly as prescribed and never stopping them without medical advice is one of the most important things a recipient can do.

Living Well After Transplant

• Take anti-rejection medicines exactly as prescribed and attend all follow-up visits
• Practice careful hygiene and food safety to reduce infection risk
• Stay up to date on recommended vaccinations as advised by the transplant team
• Protect skin from the sun and attend cancer screenings
• Maintain a healthy diet, stay active, and avoid smoking and excess alcohol

When to See a Doctor

Transplant recipients should contact their transplant team promptly for fever, chills, or other signs of infection, or for symptoms that the new organ may be struggling, such as reduced urine output after a kidney transplant, jaundice after a liver transplant, or breathlessness after a heart or lung transplant. Seek emergency care for severe symptoms such as difficulty breathing, chest pain, or sudden severe pain over the transplant site.

Related Topics

Frequently Asked Questions

References

1. U.S. Department of Health and Human Services. Organ Donation and Transplantation (organdonor.gov).
2. MedlinePlus, U.S. National Library of Medicine. Organ transplantation.
3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Kidney Transplant.
4. Mayo Clinic. Organ transplant.