Topic Overview

What is an organ transplant?

An organ transplant replaces a failing organ with a healthy organ from another person. Organs most often transplanted are:

More than one organ can be transplanted at one time. For
example, a heart and lung transplant is possible.

Who can get a transplant?

Not everyone is
a good candidate for an organ transplant. Your doctor or a transplant center
will do tests to see if you are. You probably are not a good candidate if you
have an infection, heart disease that is not under control, a
drug or alcohol problem, or another serious health
problem.

If your tests show you are a good candidate, you are put
on a waiting list.

How successful are organ transplants?

Transplants are more successful
today than ever before. Organ transplant success depends on:

  • Which organ is transplanted.
  • How
    many organs are transplanted. For example, you could have a heart transplant or
    a heart and lung transplant.
  • The disease that has caused your
    organ to fail.

How do you prepare for an organ transplant?

First,
you’ll need to have blood and tissue tests done that will be used to match you
with a donor.

You’ll also need to take
care of your health. Continue to take your medicines as prescribed and get
regular blood tests. Follow your doctor’s directions for eating and exercising.
You also may want to talk with a
psychiatrist,
psychologist, or
licensed mental health counselor about your
transplant.

To learn more about what happens, talk to someone who
has had a transplant. Your transplant center or doctor can give you the name of
someone who is willing to share his or her experience with you.

You
may have to wait days, months, or years for your transplant. Be patient, and
ask your doctor what you can do while you’re waiting.

What can you expect afterward?

After a transplant,
many people say they feel better than they have in years. What you can and
can’t do will depend on the type of transplant you had, other health problems
you have, and how your body reacts to the new organ.

You will have
to take daily medicines to prevent your
immune system from rejecting the new organ. You will need less of these
medicines as time goes by. Because these medicines
weaken your immune system, you may have to stay away from large crowds for a while and
stay away from people who have infections.

You will also have
regular checkups and blood tests to see how well your new organ is
working.

Depression is common after an organ transplant. If you
think you may be depressed, get help. The earlier depression is treated, the
more quickly you will feel better.

You may need to make some
lifestyle changes to keep your new organ healthy and strong. This can include
eating healthy foods, getting regular exercise, and getting enough sleep.

Who can be an organ donor?

Most people can be
organ donors. If you are interested in donating an organ, contact the United
Network for Organ Sharing (UNOS) at 1-888-894-6361 or go online at www.unos.org
to get more information and to locate the nearest transplant center.

Many people choose to donate an organ upon their death. But a
person can donate certain organs while he or she is still living. These people
are called “living donors.”

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Learning About Transplants

How do you get on the waiting list?

Receiving a donor organ is a big responsibility. To get on the waiting list, you’ll have to
be committed to taking good care of yourself. The best way to do this is to take medicines as prescribed, get
regular blood tests, and make any necessary lifestyle changes to stay healthy.

To get on the waiting list, you will need to:

  • Obtain a referral from your
    doctor.
  • Call the transplant center where you choose to have your
    transplant. To locate a transplant center near you, ask your doctor or contact the United Network for Organ Sharing by going online at
    www.unos.org or calling 1-888-894-6361.
  • Schedule an appointment for
    an evaluation at the transplant center to find out if you are a good candidate
    for a transplant. Your transplant center can do all of the required tests,
    or your doctor can order the tests and send the results to the center.

During your evaluation, learn as much
as you can about the transplant center. Find out whether the
center will accept your insurance, what your options are if you
don’t have insurance, and whether support groups are available.

The transplant center will notify you within 2 weeks of your
evaluation to let you know whether you have been placed on the waiting list. If
you have questions about your list status, contact the transplant center where
you were evaluated.

It may be days, months, or even years before
you receive a new organ. When an organ is found, your transplant team will consider whether the donor is a good match for you,
the status of your current health, and how long you’ve been on the waiting list. Your team will also consider the location of the donated organ, because it must be transplanted quickly
to remain in working order.

Thinking about and waiting for a transplant can affect you emotionally. You
may find it helpful to see a
psychiatrist,
psychologist, or a
licensed mental health counselor about your
transplant.

What tests will you need before your transplant?

Tests that are done for all organ
transplant candidates include:

  • A cross-match for transplant. This blood
    test shows whether your body will reject the donor organ immediately. It will mix a donor’s blood with your
    blood to see whether your antibodies attack the antigens of the donor.
  • Antibody screen. A panel-reactive antibody (PRA) test measures whether you have
    antibodies against a broad range of people. If you do, it means you are at
    higher risk of having rejection, even if the cross-match shows that you and the
    donor are a good match.
  • Blood type.
    This blood test shows which type of blood you have. Your
    blood type should be compatible with the organ donor’s
    blood type. But sometimes it’s possible to transplant an organ from a
    donor with a different blood type.
  • Tissue type.
    This blood test shows the genetic makeup of your body’s cells. We
    inherit three different kinds of genetic markers from our mothers and three from our
    fathers. Tissue type sometimes plays a role in matching an organ recipient to a donor.
  • A
    mental health assessment.
    This test identifies any psychological issues that may
    prevent you from receiving and caring for your new organ. A living
    donor may also be required to have this test before donating an
    organ.

The results of these medical tests will be used to match
you with an organ donor. The more matches you have, the more likely your body
will accept the new organ.

What if you’re not a good candidate for an organ transplant?

You may not be a good candidate if you have an active infection, unstable heart disease, or another serious
medical problem. Also, you will not be considered for organ transplant if you have a problem with alcohol or drugs.

If you are told that you are not a good candidate for organ transplant,
find out if there are other treatments for your condition. Many people can live
for years with serious health conditions.

The goal of your care may shift to maintaining your comfort. Talk to your loved
ones about the type of care you would like to receive. Discuss their
expectations as well as your wishes, care needs, and finances and the needs of
your family. Your choices may change as your illness changes.

How successful are transplants?

Organ transplant success depends on:

  • Which organ is transplanted.
  • How many organs are transplanted. For example, you could have a heart transplant or a heart and lung transplant.
  • The disease that has caused your organ to fail.
  • The age of the donor organ. In general, the
    younger the organ donor, the healthier the tissue. But recent research is
    challenging this thought. It may be that some older organs work just as well as
    younger organs.
  • The length of time that the donor organ is out of
    the donor’s body. The more quickly an organ is transplanted after it is removed
    from the donor, the more likely that the transplant will be successful.
  • How well the
    organ was preserved just before transplantation. The donor organ must be
    properly preserved while it is being transferred, especially if it was
    transferred from a long distance.

Here are the chances of being alive 5 years after having an organ transplant. These numbers are averages. Your personal chances will depend on your health, the donor organ, and other things.footnote 1

  • Heart: About 8 out of 10 people
  • Intestine: About 6 out of 10 people
  • Kidney:
    About 9 out of 10 people
  • Kidney and pancreas: About 9 out of 10 people
  • Liver: About 8 out of 10 people
  • Lung: About 6 out of 10 people
  • Pancreas: About 8 out of 10 people

Organ rejection is possible. When a new organ is placed into your
body, your immune system sees it as foreign and tries to destroy it. Antirejection medicines can help prevent
your immune system from attacking the donor organ.

You may worry about organ rejection or that your surgery will not be successful for another reason. These thoughts are normal. Many people write an advance directive and
choose a health care agent when they are waiting for a transplant.

Writing an Advance Directive
Choosing a Health Care Agent

How can you get ready?

While you are
waiting for your
organ transplant, you will be given a pager or
cell phone so the transplant center can contact you to tell you an
organ is available. You may also wish to give
the transplant center several numbers where you can be reached and the name and
number of a few people who will always know how to reach you.

Arrange in advance for someone to go with you to the transplant center. This person can support you, listen to your doctor, and
help you remember important instructions. This person can
also report any change in behaviors or symptoms that you may have either before
or shortly after the transplant.

Have your suitcase packed with the things you need to take
with you to the transplant center. Your support person should also have a bag
packed and ready to go.

At the Hospital

When you arrive at the hospital or transplant center because a donor organ has been
found, you will immediately be prepared for surgery. Final tests will be done
to make sure the donor organ is one that will likely work for you.

  • If your doctors feel that a transplant with this organ has a good chance of being successful, you will have
    transplant surgery right away.
  • If your doctors decide that a transplant with this organ does not have a good chance of being successful, the organ will
    be given to a person who is a better match, and you will return home
    and continue to wait for your new organ.

If your current health
condition requires that you be hospitalized while you wait for a donor organ,
you will receive supportive and lifesaving care (such as blood pressure support
for
heart failure) until you are matched with a donor
organ. During that time, you will be given medicines to prepare you for the surgery and to prevent rejection.

After your transplant, the amount of time you’ll spend in the hospital depends on how healthy you
are before the surgery, which organ was transplanted, and how well your body
accepts the donated organ.

A longer hospital stay may be needed for a heart or
lung transplant than for a kidney transplant. Some people are out of the
hospital within a few days after their transplant. Others may need to
stay for a few weeks.

After the Transplant

Why does organ rejection happen?

Your immune system protects you from infection and
disease. It defends your body by producing
antibodies and “killer” cells that destroy foreign
substances (such as viruses and bacteria). Since the donor organ doesn’t match
your own tissue exactly, your body tries to destroy the transplanted organ by
rejecting it.

How can you prevent organ rejection?

Because your
immune system will try to destroy the new organ, you will need to take antirejection
medicines
, or
immunosuppressants, for as long as you have the donor organ.

These medicines weaken your immune system and
decrease your body’s ability to fight infections, cancer, and other diseases.
You will have to stay away from large crowds for a while and from people who have infections.

It may
help to talk to someone who has had a transplant. This person can talk to you about how you can make taking antirejection medicines part of your daily life. You will probably need fewer of these medicines over time. You may also need other medicines to fight infection or other health
problems related to your transplant.

How will you feel after the transplant?

Almost immediately after a transplant, many people
report feeling better than they have in years. The physical limitations you
have will depend on the type of transplant you had, other conditions you may
have, and whether your body rejects the donor organ. You will likely not face
major physical limitations after you have healed from your transplant.

You may also have side effects from your antirejection medicines, and you
may be at increased risk for getting conditions
such as diabetes.

An organ transplant may cause many emotional issues both for you and those who
care about you. When your organ comes from a deceased donor, you may sometimes
think about that and what that meant to the donor’s family.

It is common to have
some
depression after an organ transplant, although not
everyone does. If you think you may be depressed, it is important to tell your
transplant coordinator, doctor, or someone who cares about you. The earlier
depression is treated, the more quickly you will recover and the better you
will feel.

Staying Healthy

Preventing organ rejection

To keep your new organ healthy
and to help you live longer after an
organ transplant:

  • Keep your doctor appointments. Regular follow-up with your doctor is important to check for organ rejection.
  • Get regular blood and tissue tests
    so your doctor knows whether the new organ is accepted or rejected. Rejection doesn’t mean that you will lose the new organ. Adding or changing medicines may still prevent
    rejection.
  • Take your medicines exactly as
    prescribed
    .
    Talk with
    your doctor to make sure you understand what to do if you miss a dose.
  • Don’t take any nonprescription medicines, such as cold
    remedies or herbal remedies, before talking with your doctor. Other medicines may interact poorly
    with your antirejection medicines.
  • Know the side effects of the antirejection medicines. If you have severe side effects, tell your doctor right away.

Taking steps to stay healthy

To help you and your new organ stay healthy:

  • Get regular exercise. Activities like walking,
    exercises in the water, and
    yoga can help you keep your body and new organ healthy.

    Fitness: Walking for Wellness
  • Eat regular, healthy meals to control your weight, blood pressure, cholesterol, and blood sugar levels.
    Be sure to get plenty of calcium and
    vitamin D to help prevent osteoporosis, or thinning bones.
  • Watch for changes from how you normally feel, how much energy
    you have, and how active you are. This can help you identify new problems as they come up.
  • Tell your dentist that you have had an organ transplant.
    The antirejection medicines may increase
    your risk of mouth infections. Special precautions may be needed in teeth cleaning or other dental work.
  • Stay away from people who are
    sick.
    Your immune system is weakened by the antirejection drugs. Before you do any traveling, talk with your
    doctor to see if you need to take any precautions.
  • Carry a medical identification card or wear a medical ID bracelet that states that you have had an organ transplant.

Becoming an Organ Donor

Donor organs are needed-there are currently more than 100,000
people on the national
organ transplant waiting list. If you are interested
in donating an organ, contact the United Network for Organ Sharing (UNOS) at
1-888-894-6361 or go online at www.unos.org to get more information and to
locate the nearest transplant center.

You can donate an organ upon your death, or in some cases while you are alive. To learn more, see the topics:

Internet donor-matching services
are set up to help people who need an organ transplant
to contact potential living donors. Some experts believe these services undermine
the current system, which is based on donated organs going to people who are
most in need and those waiting the longest for a donor. Others believe online
donor matching services provide a useful resource for helping people who have
had problems finding a donor within the current system. For more information
about these services, talk to your doctor.

You do not have to be a blood relative (such as a sibling
or parent) of the person who receives your organ. You can be someone who is emotionally related to the person, such as a close friend or spouse, or
you can even be a stranger.

Other Places To Get Help

Organization

U.S. Department of Health and Human Services: OrganDonor.gov
www.organdonor.gov

References

Citations

  1. Organ Procurement and Transplantation Network (2017). Kaplan-Meier patient survival rates for transplants performed, 2008-2015.
    Based on OPTN data as of April 21, 2017. Organ Procurement and Transplantation Network. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/. Accessed April 26, 2017.

Other Works Consulted

  • Joyce D, et al. (2011). Surgical treatment of heart failure and mechanical ventricular support. In V Fuster et al., eds., Hurst’s The Heart, 13th ed., vol. 1, pp. 798-809. New York: McGraw-Hill.
  • Webster AC, et al. (2010). Interleukin 2 receptor antagonists for kidney transplant recipients. Cochrane Database of Systematic Reviews (1).

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Adam Husney, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Elizabeth T. Russo, MD – Internal Medicine

Current as ofMay 26, 2017