Organ transplant is the last suggested procedure in cases of organ failure and is undertaken to save lives as organs are no longer able to do their function to sustain the life of a person. In such situations, at the critical end of organ failure, a healthy organ/organs for transplant from a person living or deceased is transplanted into the organ transplant recipient, offering them a new chance of survival.

Organ donation helps people suffering from chronic illnesses to live a more fulfilled and healthier life up to an average lifespan. Organ transplantation may be required in cases of genetic organ defects such as congenital heart defects, some liver and kidney diseases. In such cases, medication can fall short of making a difference in the lifestyle or lifespan of the patient.

Chronic or acquired conditions such as diabetes or physical injuries can also require organ transplant surgery. Organs for transplant include the lungs, heart, pancreas, kidneys, liver, and intestine, and transplants for the face and limbs are also being undertaken more recently. Of these, kidney transplants are usually the most common form of organ transplant and have a high success rate.

While the organ transplant process has become more common over the years, with senior citizens being the most common demographic undergoing organ transplantation in developed countries such as the USA, the organ transplant surgery procedure remains a complex one, involving many delicate steps and requiring a highly skilled team of surgical experts. The criteria for organ transplant include a battery of tests to determine the kind of donor organ that fits the recipient best and prevent organ transplant rejection. Donor matching is a significant part of the organ transplant process. In cases of a kidney transplant, very often, a living family member with same blood group is the donor of the organ to reduce the chances of organ transplant rejection, However with the advances in the field of transplant we are successfully able to do transplant even in patients with different blood group organs, if same blood group kidney is not available.

For Organs like kidney and liver, both live and deceased organ transplantation is possible. Live kidney transplantation means a kidney will be donated by Donors from the family of patient suffering with end stage kidney disease. In case if no suitable donor is available in the family due to various medical health conditions patient will be registered with government for organ transplant waiting list to undergo disease donor transplant where patient gets kidney from a brain dead donor based on the seniority in their waiting list.

In case of heart and lung transplant, Once doctors determine that a patient is due to undergo the organ transplant process, they are then placed on an organ transplant waiting list to await a donor organ. The requirements for organ transplant require critical organ failure in the recipient patient. Once they are placed on the organ transplant list, the health of the patient is monitored at regular intervals to determine the feasibility of the organ transplant process once an organ becomes available. Organ matching is a critical part of the organ transplant process where age, organ transplant history, blood type matching and several such criteria for Organ Transplants are considered at the time of putting the patient on an organ transplant waiting list, as well as the time for organ transplant surgery nears. Considering the severity of conditions requiring organ transplant, the organ transplant guidelines surrounding the entire process are strict and continually monitored.

Why Is An Organ Transplant Done?

An organ transplant is done when a critical organ in the body is functioning very poorly and is determined to fail and cause mortality ultimately. To prevent the death of a patient whose organ failure is already defined, doctors will suggest organ transplantation as an end-state measure after determining the suitability of such a procedure for the patient. Some of the chronic conditions that require an organ transplant due to terminal organ failure include chronic kidney disease, cystic fibrosis, Heart failure and congenital heart disease (CHD). Liver failure due to cirrhosis and accidents and injuries are also reasons that an organ transplant process may be suggested. Organ transplant offers a recipient a new lease of life in cases where they are determined not to survive due to end-stage critical organ failure. Currently, organ transplant surgery has become highly specialised to cater to a significant population that can benefit from organ transplantation.

Types Of Organ Transplant

While organ transplants were initially restricted to the transplantation of vital organs, today, medical and surgical processes have developed to allow the transplantation of several organs that will enable a longer lifespan and an improved quality of life for recipient patients. Organ transplant types today include:

Heart transplant

Since the heart is a vital organ, an organ transplant is provided to the donor from a deceased patient who has suffered brain death, often in the case of an accident. It replaces the organ transplant recipient's damaged heart and offers them a completely new one to afford them a chance at an extended life. Strict organ transplant guidelines surround such a procedure, and organ transplant surgery is carried out by highly specialised doctors working round the clock to monitor the patient's vital signs throughout the organ transplant process. Due to a scarcity of donors, heart transplants are one of the most critical and least performed organ transplant surgeries, and operations are very few annually.

Lung transplant

Another vital organ, healthy lungs, is taken from a deceased patient and transplanted into the organ transplant recipient. Due to the lack of donors and the criticality of transport time, lung transplants also remain rare across the globe. The organ transplant process is highly dependent on finding a suitable donor to prevent organ transplant rejection and avoid the immune system attacking the new transplant.

Liver transplant

In cases of irreversible liver disease, a patient's unhealthy liver is removed and replaced with either a portion of a liver from a living donor, such as a relative, or with a completely healthy liver from a deceased donor. End-stage liver disease, especially cirrhosis of the liver due to alcohol abuse, is the most common reason for organ transplant surgery for the liver. Other causes may include chronic hepatitis B or chronic hepatitis C, autoimmune hepatitis, metabolic disorders and non-alcoholic fatty liver disease. The organ transplant success rate for liver transplants is relatively high, and 75% of patients are alive after five years of a liver transplant.

Pancreas transplant

Kidney and pancreas double transplant is the most common type of organ transplant surgery requiring a pancreas transplant; it is seldom carried out alone. Type 1 diabetes causing kidney failure is the reason for this type of organ transplant surgery, and in most cases, both organs come from a single deceased donor. It is possible, however, that in the kidney-pancreas double transplant, the kidney comes from a living donor, usually a relative, and only the pancreas from a deceased donor. In rare cases of Type 2 diabetes, organ transplantation involving a kidney as well as the pancreas may be advised.

In type 1 diabetes, the pancreas does not make enough insulin, and kidney failure is progressive. To help a patient survive through this, an organ transplant may be advised, and the transplanted pancreas can produce adequate insulin.

Cornea transplant

In cases where corneal tissue is scarred or otherwise irreparably damaged due to disease or injury, a corneal transplant is suggested. The organ transplant statistics for this type of organ transplant surgery show a high rate of success, and this is one of the more commonly performed organ transplantations. Since corneal eye disease is one of the most common reasons for blindness, corneal transplants are becoming more widely suggested, and the advances in this organ transplant type have been immense from a surgical perspective.

Some reasons for making a corneal transplant necessary include scarring from eye infections such as keratitis or herpes and other eye diseases such as keratoconus, where the shape of the cornea is distorted, making an organ transplant the only way to restore complete vision. Hereditary conditions can also cause corneal disease. Organ transplantation involving the cornea may also be suggested in cases where cataract and LASIK surgeries have been unsuccessful and caused further complications.

Kidney transplant

Renal disease affects a large part of the population today. Kidneys are:

An essential part of the human mechanism.

Helping to filter out toxins from the blood.

Ensuring an electrolyte balance that allows the body to function normally.

Kidney transplant is offered to patients who are suffering with downstairs kidney disease where these are failing to maintain the life in optimal condition and patient is no longer sustain without Kidney replacement therapy. The available treatment options for kidney failure are Either dialysis Or kidney transplantation. Among these two available options kidney transplant is the best treatment as it provides longer healthy and good quality of life to the patient compared to dialysis. Kidney transplant is one of the most successful transplantation programme with highest success rates near to 95-98%.

Receiving a kidney from a living relative reduces the chance of rejection of the organ and is suggested as a better choice for organ transplant. It also enables the patient awaiting transfer to bypass the wait of many years to receive the organ transplant.

Trachea transplant

One of the least conducted organ transplant surgeries, tracheal transplant, is performed when the trachea or the airway hardens or is scarred due to disease or injury. Tracheal transplant helps patients who are unable to have an everyday life due to trauma from tracheal dysfunction to have a more normal life. The organ transplant process involves procuring the trachea from a deceased donor and replacing the patient's trachea.

Skin transplant

Burn or other skin injuries that are too severe to be repaired by the body's system can be helped through skin transplants. This type of organ transplantation involves the grafting of donor skin onto a patient's body and the use of immunosuppressive drugs to prevent graft rejection. Once the organ transplant surgery is carried out, the patient is kept under medical observation for a length of time. This organ transplant process is usually only carried out in cases of severe injury where a patient's skin cannot be grafted. Once the donor's skin is successfully transplanted, doctors may also transplant the patient's skin onto other parts of their body.

However, more often, organ transplantation involving the skin does not require a donor. Healthy skin is grafted onto the burnt area of the patient's body. The injured skin can be more easily replaced as the chances of rejection of the organ transplant are lowered.

Finding A Donor

Organ donation lists are lengthy, and patients awaiting Organ Transplants have to wait for several years before receiving a donor organ. It is more feasible to find a living donor in case they are relatives, which enables patients to bypass the organ transplant waiting list and receive a transplant less likely to be rejected. However, organ transplant donation itself is often as easy as filling out a card, and any organ donor can donate multiple organs, saving many lives in the process.

Once a thorough evaluation is conducted of a patient, deeming them suitable for organ transplantation, the patient is put on an organ transplant list. This list matches an organ transplant patient with a donor at the earliest opportunity. The donor is usually deceased and has granted permission for organs to be donated after death. Organ allocation is a transparent process across the country and organ allocation is done by government based on the seniority in the waiting list.

Becoming A Donor

Becoming a donor will allow you to help a patient in need of an organ transplant, which is easy and worth considering. All people are potential organ donors, regardless of age or health considerations. Most people can donate at least some organs, such as cornea or skin. Organ transplant lists are long, and becoming a donor can help save many patients once the donor is deceased. Even newborns and senior citizens can register as organ donors. If one is under 18 years of age, they require parental consent to sign up as a donor for organ transplant patients.

It is also possible to become a living donor. When organ transplantation involves a kidney, pancreas, lung or liver, an organ donor can donate either a single kidney or lung or part of the pancreas or liver. The body compensates for the loss through regeneration or reduced activity.

Preparing For An Organ Transplant

Organ transplantation requires financial, psychological, mental, and physical preparation. Once a patient is on the organ transplant list, they must cultivate patience and a positive attitude to enable themselves to look forward towards a time without disease. It is necessary to be upfront with the medical team in charge of the organ transplant regarding psychological conditions and undergo treatment if deemed necessary. Once a patient is deemed fit to undergo organ transplant surgery, attention should be paid to the financial conditions that accompany such a situation. The waiting time for a patient awaiting an organ transplant from a deceased donor is often the best time to prepare for the organ transplant surgery. As much as can be achieved, physical fitness should be aimed for, and any suggested medication regimen should be rigorously followed.

The Organ Transplant Procedure

The organ transplant procedure depends entirely upon the organ transplant type and, in simple terms, involves the removal of a healthy organ from a donor, either living or deceased, and transplanting this into a patient with end-stage irreversible organ damage. Organ transplant surgery is preceded and succeeded by the use of drugs to prevent transplant rejection, as well as continuous medical evaluation to determine the feasibility of the transplant.

Risks And Complications

The major risk from an organ transplant surgery is the risk of rejection of the transplanted organ. The body's immune system automatically rejects what it immediately perceives as foreign tissue, causing several reactions. Wherever possible, doctors performing the organ transplant surgery will try to match the donor's and the recipient's blood and tissue types to reduce the chances of organ transplant rejection after organ transplantation is carried out and also use immunosuppressant drugs to help the recipient's body accept the organ more readily.

Other risks of organ transplant surgery also involve infection resulting from the surgery, heart failure during the organ transplant process, excessive bleeding and drug reaction. However, most of these threats are not manifest in most procedures today due to the diligence of the teams involved in organ transplant surgery, and organ transplant rejection remains the most critical and constant risk.

Medications Required After Organ Transplant

Precautions To Take

While the quality of life is improved for a patient who undergoes a successful organ transplant surgery, they have to take several precautions, often requiring a lifestyle change continually. In addition to a medication regimen, patients will have to monitor their activity, and depending on their doctor's advice, they may be prescribed higher or lower levels of physical activity. Patients who have undergone organ transplantation must also ensure a nutritious diet that regularly allows their body access to all micro and macronutrients. Organ transplant surgery will also see patients having to maintain strict hygienic conditions around their homes and offices and, in many cases, receive professional help from therapists to help with their mental and psychological conditions.

Road To Recovery And Aftercare

Recovery after any surgery is something that needs to be paid attention to, and despite feeling better overall, the body can undergo many changes resulting from an organ transplant surgery. Therefore, the road to recovery is planned for before the surgery itself and must be adhered to by the patient. Most patients who have undergone organ transplant surgery can return to everyday life after 2-3 months, and sometimes earlier in case of a skin or corneal transplant. The patient is kept under medical observation for a certain length of time after undergoing the organ transplant process, where the medical team continuously monitors their condition, response to drugs and vital signs. Once a patient is discharged into family care, they must follow lifestyle guidance and medication regimens and undergo regular follow-up medical evaluations.

If all steps are strictly followed, patients can live a fulfilling life after an organ transplant.

Organ Transplant Faqs: All Your Concerns Addressed

Q. Can I become an organ transplant donor?
A. Yes, you can become an organ transplant donor by signing up for donation. If you are below 18 years of age, you will require parental consent to pledge your organs. Signing up to be a donor for an organ transplant can help save many lives once you are deceased and does not hamper your current life in any way. If you are legally an adult, you can directly register as an organ transplant donor to consent to the use of your organs for the organ transplant process after your death.

Q. What are the chances of recovery after an organ transplant surgery?
A. Depending on the type of organ transplantation, overall health and the body's immune system response, the chances of successful organ transplant surgery and subsequent recovery range from the single digits to over 73% per cent for a five-year period. It is advisable to follow all instructions of the doctor in charge of the organ transplant surgery if you deemed suitable to become an organ recipient to aid chances of recovery.

Q. What organs and tissues can be transplanted?
A. Organs and tissues that can be transplanted include:

Heart

Heart valves

Lung

Liver

Kidney

Pancreas

Intestine

Cornea

Skin

Bone and bone marrow

Middle ear

Connective tissue

Vascularised composite allografts

Q. Would becoming an organ donor mean that I wouldn't be eligible to receive the best medical care possible?
A. Your decision to donate an organ does not affect the quality of medical care you receive.

Q. What are the benefits of organ transplantation?
A. Depending on the organ a person receives, the benefits of transplantation can vary. Some of them may include:

Living a healthier and longer life

No more pain due to a failed or dysfunctional organ

Avoiding medical procedures such as dialysis

Improved quality of life.

Treating congenital disabilities that endanger an individual's life

Needing fewer surgeries or taking fewer medications.

Q. What are the signs of organ rejection?
A. Some of the general signs of organ rejection include:

Pain at the transplant site

Flu-like symptoms

Children may feel cranky

Feeling unwell

Fever

Swelling

Changes in weight

Urinating less often

Changes in heart rate

Q. What can you expect from organ transplantation?
A. Organ transplant is performed in people who have a serious illness and will die without a new organ. There are other cases where the transplant is done to improve a person's quality of life, such as restoring sight with a cornea transplant.

The first step of the transplantation process is to get one's name on the organ transplant list. To do this, the doctor must examine the person, diagnose a serious medical condition, and conclude that the person meets all the criteria for organ transplant.

The process of organ transplantation is complicated. For the transplantation to work, the donor must be a close match to the recipient and have compatible blood types. Other relevant factors depend on the organ involved. For instance, donors and their recipients must have compatible antibodies and similar body sizes in kidney transplantation.

Once a person reaches the top of the waiting list, they can receive an organ transplant depending on the availability of the next matched donor. When an organ is available, immediate surgery is arranged, and the recipient gets the transplant. After the transplant, the recipient has to stay in the hospital for a few days so that their condition can be monitored. The length of the stay will depend on their overall health and how well the surgery went.

Q. What are the types of living-organ donation?
A. The living-organ donation can be of two types – directed and nondirected.

 Directed donation: Directed donation is a common organ donation where the donor directs the organ to a specific recipient for transplant. The donor can be the following –

A first-degree relative, such as a parent, brother, sister or adult child

Biologically related relatives, such as uncles, aunts or cousins

The donor can also be a biologically unrelated person who has a connection with the transplant candidate, such as a spouse, friend, or co-worker

·A person who has heard about the transplant candidate's need and offered to help

Nondirected donation: Here, the donor does not name the recipient. This type of donation is also called a good Samaritan or altruistic donation. The organ will be donated to a recipient based on medical requirements and blood type compatibility. In some cases, the donor may choose not to know the organ recipient, but in other cases, the donor and the recipient can meet if both agree and the transplant centre allows it.