Organ Transplantation
Replacing a failing organ with a donor organ
Quick Facts
- Type: Major surgical and medical treatment
- Common organs: Kidney, liver, heart, lung, pancreas
- Key medicines: Lifelong anti-rejection (immunosuppressant) drugs
- Donor types: Living or deceased donor
Overview
Organ transplantation is a treatment in which a failing or failed organ is replaced with a healthy organ from a donor. It can be life-saving or greatly improve quality of life for people with severe organ failure. Commonly transplanted organs include the kidney, liver, heart, lung, and pancreas. Some organs, such as a kidney or part of a liver, can come from a living donor, while others come from deceased donors.
A transplant is not a single event but the start of lifelong care. To stop the body's immune system from attacking the new organ, recipients take anti-rejection (immunosuppressant) medicines and attend regular follow-up. These medicines and the surgery itself carry risks, but for many people transplantation offers an outcome that no other treatment can match.
When a Transplant Is Considered
Transplantation is considered when an organ has failed or is failing despite other treatments. Signs of advanced organ failure that may lead toward transplant include:
- Kidney failure: Needing or approaching dialysis (see kidney failure)
- Liver failure: Jaundice, fluid buildup, and confusion from advanced liver disease
- Heart failure: Severe breathlessness and fatigue despite maximal therapy
- Lung failure: Severe, progressive breathing difficulty
A detailed evaluation determines whether transplantation is suitable and safe for a given person.
Why Transplants Are Needed
The conditions leading to transplantation vary by organ:
- Kidney: Chronic kidney disease from diabetes, high blood pressure, or other kidney diseases.
- Liver: Cirrhosis from hepatitis, alcohol-related liver disease, fatty liver disease, or other causes.
- Heart: Advanced heart failure from coronary disease or cardiomyopathy.
- Lung: Severe lung diseases such as advanced COPD, pulmonary fibrosis, or cystic fibrosis.
Transplant is usually reserved for end-stage disease when other treatments can no longer maintain health.
Risks and Challenges
Transplantation carries surgical and long-term risks that the care team weighs carefully:
- Rejection: The immune system recognizing the organ as foreign and attacking it
- Infection: A higher risk because anti-rejection medicines weaken the immune system
- Medication side effects: Such as kidney effects, high blood pressure, diabetes, and bone thinning
- Higher cancer risk: Particularly certain skin cancers, over the long term
- Organ shortage: Waiting times for a suitable donor organ
Evaluation and Matching
Before a transplant, a thorough evaluation and matching process takes place:
- Assessment: Tests of overall health, the failing organ, and other organs to confirm a transplant is appropriate.
- Blood and tissue typing: Matching blood group and tissue markers to reduce the risk of rejection.
- Waiting list: For a deceased-donor organ, placement on a list with allocation based on need and matching.
- Living donor evaluation: Where applicable, careful assessment of the donor's health and suitability.
Treatment and Aftercare
The transplant operation is followed by lifelong medical care:
- Surgery: The donor organ is placed and connected to blood vessels and, where needed, other structures.
- Anti-rejection medicines: Immunosuppressant drugs are taken every day, usually for life, to prevent rejection. Doses are carefully balanced to protect the organ while limiting infection and side effects.
- Monitoring: Regular blood tests and clinic visits to check organ function, drug levels, and for signs of rejection or infection.
- Infection prevention: Vaccinations, hygiene measures, and sometimes preventive medicines.
- Healthy lifestyle: Managing blood pressure, blood sugar, weight, and avoiding smoking to protect the new organ.
With good care, many transplanted organs function well for many years.
Protecting a Transplant
- Take anti-rejection medicines exactly as prescribed and never stop them on your own
- Attend all follow-up appointments and blood tests
- Report fever or signs of infection promptly
- Keep up with recommended vaccinations and cancer screening, including skin checks
- Practice good hygiene and food safety
- Maintain a healthy lifestyle and manage blood pressure, sugar, and weight
When to Seek Help
Transplant recipients should know the warning signs of rejection and infection and contact their transplant team urgently for:
- Fever, chills, or feeling generally unwell (possible infection)
- Pain or tenderness over the transplanted organ
- Reduced urine output, swelling, or weight gain (for a kidney transplant)
- Yellowing of the skin or eyes (for a liver transplant)
- New breathlessness or a marked drop in how you feel
Because anti-rejection medicines weaken the immune system, infections can become serious quickly, so prompt assessment is important. Seek emergency care for severe breathlessness, chest pain, or collapse.
Frequently Asked Questions
What organs can be transplanted?
Commonly transplanted organs include the kidney, liver, heart, lung, and pancreas. Some, such as a kidney or part of a liver, can come from a living donor, while others come from deceased donors.
Why do transplant recipients take medicine for life?
The immune system would otherwise recognize the new organ as foreign and attack it, called rejection. Anti-rejection (immunosuppressant) medicines, taken daily for life, prevent this. Doses are balanced to protect the organ while limiting infection and side effects.
What is organ rejection?
Rejection is when the immune system attacks the transplanted organ. It can cause organ pain, reduced function, fever, or feeling unwell. Anti-rejection medicines and regular monitoring help prevent it, and many rejection episodes can be treated if caught early.
Why are transplant recipients more prone to infection?
Anti-rejection medicines deliberately dampen the immune system to protect the new organ, which also lowers defenses against infection. Fever or feeling unwell should be reported promptly, as infections can become serious quickly.
How long does a transplanted organ last?
It varies by organ, the underlying condition, and how well the transplant is cared for. Many transplanted organs function well for many years. Taking medicines as prescribed, attending follow-up, and a healthy lifestyle all help protect the organ.
References
- MedlinePlus, U.S. National Library of Medicine. Organ transplantation.
- Mayo Clinic. Organ transplant.
- Health Resources and Services Administration (HRSA). Organ donation and transplantation.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Kidney transplant.