How organ transplants work


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When a person needs an organ transplant, it is because one of their organs is working very poorly or failing. Undergoing an organ transplant can lengthen a person’s life and allow those with a chronic illness to live a normal lifespan.

Many people need an organ transplant due to a genetic condition such as polycystic kidney disease, cystic fibrosis, or a heart defect.

Infections such as hepatitis, physical injuries to organs, and damage due to chronic conditions such as diabetes may also cause a person to require a transplant.

Surgeons performed more than 36,000 organ transplants in 2018, but many more people need organs. In January 2019, more than 113,000 people in the United States were on organ transplant waiting lists. More than 2,000 children need organs.

The transplant process varies slightly depending on the organ, but the need for a matching donor is a consistent theme.

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What to expect

Surgeons doing an organ transplant.
A transplant may occur within hours of an organ becoming available. 

In most cases, a person will die if they do not have an organ transplant. On average, 20 people die each day waiting for an organ.

In other cases, an organ transplant improves a person’s quality of life, such as by removing the need for dialysis or restoring sight with a cornea transplant.

Because people who need organs typically have very serious illnesses, they may be very sick before the transplant.

The process will begin when a doctor puts a person on the organ transplant list. This requires a doctor to examine the person, diagnose a serious medical condition, and conclude that they are a suitable candidate for an organ transplant.

Organ transplantation is a complex process that requires a close match between the recipient and donor. The donor and recipient must have compatible blood types, for example.

Depending on the organ involved, other factors may also be relevant. For example, kidney donors and their recipients must have compatible antibodies and similar body sizes.

The Organ Procurement and Transplantation Network oversee the transplant waiting list. Somebody’s position on the list depends on many factors, including the severity of their illness.

Once a person reaches the top of the waiting list, they will receive a transplant when the next matched donor becomes available.

When an organ is available, the person seeking a transplant must respond quickly to the call from their doctor. Surgery may occur within just a few hours of this call, as organs cannot survive for long outside of the body.

After the transplant, the organ recipient will need to stay in the hospital for a few days as doctors monitor their condition. The length of their hospital stay will depend on various factors, including how well the surgery went and the organ recipient’s overall health.

Organ recipients who get sick can become severely ill. Their body may even reject the new organ, so it is important to see a doctor for any signs of infection such as a fever.

Recipients must take anti-rejection medications, as well as other types of medication, to support their long term health. These medications prevent rejection by weakening the immune system, which lowers its ability to fight infections such as the flu, so it is important for the organ recipient to avoid infections.

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Statistics

A person in a hospital bed having their heart rate monitored.
An organ donation may help a person live a longer and healthier life.

Every day, more than 80 people in the U.S. receive donated organs. Many more need to. According to the U.S. Health Resources and Services Administration, 95% of people in the U.S. support organ donation, but just 58% have signed up to be donors.

single deceased donor can save up to eight people’s lives, as well as improve the lives of more than 100 people by donating tissue.

Myths around organ donation deter some people from donating their organs. The following statements are untrue:

  • Doctors work less hard to save the lives of organ donors.
  • Organ donation makes it impossible to have an open casket.
  • Most religions oppose organ donation.
  • Families may have to pay when a loved one donates an organ.

Donating an organ is free and can save or lengthen a person’s life. Many people can live long and healthy lives with the help of an organ donor.

How an organ transplant will affect a person’s life expectancy varies depending on their age, the organ transplanted, and the reason for the transplant.

Not all transplanted organs last forever. A kidney from a living donor lasts an average of 12–20 years, whereas a kidney from a deceased donor lasts around 8–12 years.

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Finding a donor

For people who need an organ, finding a donor may take weeks, months, or longer. There are two legal ways to obtain an organ:

  • A person can wait for a donor to become available on the transplant list.
  • A person can find their own donor. This is usually a family member or friend of the person who needs a transplant, but some people are willing to donate to people they don’t know. Some people even advertise for donors using social media, radio, or billboards.

There are two types of donor:

  • Living donors can donate a kidney, a lung, or a portion of the pancreas, liver, or intestines. They must be in reasonably good health.
  • Deceased donors can donate two kidneys, two lungs, the heart, pancreas, corneas, and intestines. They may also donate body tissue, such as heart valves, tendons, or skin. Hand and face donation became an option in 2014.

It is illegal to buy or sell organs. However, a 2013 study claims that paying living donors $10,000 for kidneys could increase the rate of organ transplants and save many more lives.

Some nations, including Iran, allow paid organ donation. Sometimes, the system allows wealthy donors to pay much more for organs. This means that people in dire financial situations may be more likely to donate organs, raising concerns that they may sacrifice their health for financial gain.

Benefits

The benefits of an organ transplant depend on the organ a person receives. Some benefits may include:

  • avoiding medical procedures such as dialysis
  • living a longer life
  • living a healthier or less painful life
  • gaining an improved quality of life, such as when a cornea transplant restores a person’s sight
  • correcting congenital disabilities that endanger a person’s life
  • spending less time in the hospital, needing fewer surgeries, or taking fewer medications
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Risks

Two doctors consulting a man in hospital bed.
A person should seek medical advice about the benefits and risks of an organ transplant.

For almost all organ transplant recipients, the benefits far outweigh the risks.

Most people who need an organ will die or live a much shorter life without a transplant. However, organ transplants are risky surgeries, especially since those who need them often are very ill.

Some risks associated with organ transplant surgery include:

  • complications related to the use of anesthesia, including death
  • bleeding or other complications during the procedure
  • postsurgical complications, such as infection
  • a higher risk of infections and other illnesses due to anti-rejection or other transplant-related drugs
  • organ rejection
  • organ failure
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Outlook

The outlook for a recipient depends on the organ they receive, the reason for the transplant, their age, their overall health, and other factors.

Some people may need another organ transplant. A very young kidney recipient, for example, might outlive their organ. Others may live long lives without the need for another organ.

Most people, however, will need ongoing medical care, and they must continue to take anti-rejection drugs.

It is vital to discuss the risks and benefits of organ transplantation with a doctor. Because lifestyle directly affects organ health, including that of transplanted organs, organ recipients should talk with their doctor to get advice on how to lengthen their lives and protect their organs.

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