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By Diane M. Yoakam R.N., M.S.N., C.E.N., HealthAtoZ Contributing Writer
Medical advances have greatly enhanced the ability to successfully transplant organs and tissue. The first successful kidney transplant was performed in the United States in 1950, followed 20 years later by the first heart transplant. Statistics from the United Network for Organ Sharing (UNOS) show that between January 2007 and October 2007, more than 23,000 transplants were done in the U.S.
Although the number of transplants has risen sharply in recent years, the demand for organs far outweighs the supply. At the end of 2007, almost 105,000 people were on the national organ transplant waiting list.
Getting the word out about organ donation is an important first step. Many people don't know they could be suitable donors. There are relatively few medical reasons to prevent organ donation. Medical suitability for donation is determined at the time of death.
How do I become an organ donor?
If you have a valid driver's license, you can mark your intent to be an organ or tissue donor on the back of your license. Or you can carry an organ donor card. Even if you have a signed organ donor card, tell your family. When you die, your family or next of kin might be asked to give consent to authorize organ donation. Studies show family members are less likely to consent to organ donation if they have never discussed the topic with their loved one, even when an organ donor card has been signed.
Which organs or tissues are suitable for donation?
Organs that can be transplanted include:
- Heart
- Kidneys
- Pancreas
- Lungs
- Liver
- Intestines
Tissue that can be transplanted include:
- Cornea
- Skin
- Bone marrow
- Heart valves
- Connective tissue
A single donor might provide organs and tissue to eight or more people.
Who is responsible for the costs of organ donation?
The donor's family is not responsible for the costs of organ donation. The recipient, most times through the insurance carrier or Medicare, pays all costs related to the donation of organs and tissue.
Is it possible to sell your organs for transplantation?
No. Amid concern that selling of organs might lead to unfair access to donor organs, in 1984 Congress enacted The National Organ Transplant Act (Public Law 98-507). This law makes it illegal to sell human organs or tissues. Violators are subject to fines and even prison.
Why is the supply of organs so scarce?
Many factors contribute to the scarcity of organs. Thanks to better car safety systems and the enactment of helmet and seat belt laws nationwide, fewer people are dying in motor vehicle accidents. This has reduced the number of donors from car accidents.
Other factors leading to organ scarcity include:
- The failure of medical professionals to recognize potential donors
- Failure to notify organ procurement agencies of potential referrals
- The refusal by the family to donate a loved ones organs.
What happens after consent for organ or tissue transplant is given?
Everyone waiting for organ and tissue transplants in the U.S. is on a national registry. When an organ becomes available, a possible recipient is matched to a particular organ based on numerous factors. This includes blood and tissue typing, urgency of need, length of wait and geographic location.
A person awaiting a transplant often carries a beeper, so they can be alerted that a life-saving organ has become available.
How are organs and tissue retrieved?
The first step is to get consent for organ donation. Then a recipient for the organ is identified. Next, the organ is retrieved. Special care must be taken to make sure that the organ continues to "live" by getting needed oxygen and nutrients. This will ensure that the organ will work properly after it is transplanted.
A team of transplant surgeons travel to the site of the organ donor to surgically remove the organs and tissue that have been donated. There is a small window of time (usually between six hours and 24 hours) that an organ can be maintained outside the body. The procurement of organs must be completed quickly. Special techniques aimed at preserving organ function are put to use as soon as the organ or tissue is retrieved. The organ is then flown or driven to the site of the donor. At times the recipient may already be in an operating room, undergoing preparations for receiving the organ or tissue.
Typical Organ Preservation Times
- Heart: four to six hours
- Liver: 12 to 24 hours
- Kidney: 48 to 72 hours
- Heart and lung: four to six hours
- Pancreas: 12 to 24 hours
Is it possible for organ recipients to contact the families of the organ donor?
Laws protect the families of organ donors. Many times, it may be too traumatic for the family to make contact with the recipient of a loved ones organ. General information about both the donor and the recipient is sometimes gathered and shared by the organ procurement organization. In rare cases, when all parties have agreed, the organ recipient may contact members of the donor's family.
What is life like for someone who has been the recipient of an organ transplant?
For most people who have an organ or tissue transplant, the quality of their life and general overall health improves afterward. Transplant recipients usually must take a combination of medications to suppress their immune system and prevent the body from rejecting the new organ. They often will need frequent medical visits and tests to monitor the transplanted organ. At times, the body may reject the organ and it may need to be removed. These people will be placed back on the waiting list for another organ.
The U.S. Scientific Registry of Transplant Recipients keeps a database of post-transplant information. Follow-up data on every transplant are used to track transplant center performance, transplant success rates and medical issues that affect recipients.
When are living donors used for organ procurement?
For some organ transplants, a living donor may supply the needed organ or tissue. For example, a person (often but not always a close relative) may choose to donate a kidney to someone in need. Bone marrow can be retrieved from living donors and transplanted into a recipient. Sections of the liver have been transplanted from living donors, usually from a parent to a child.
Under these circumstances, a donor may offer his or her organ or tissue to a specific recipient. A series of medical and psychological tests are done to make sure that the organ or tissue is a good match for the recipient.
Can humans receive organs from other animal species?
Heart valves from pigs can replace damaged heart valves in humans. Blood vessels from cows were once used to replace damaged human blood vessels. Now synthetic materials such as Dacron and Gore-Tex are used. The Food and Drug Administration has approved no solid organ transplants from animals to humans.
Much research is being done in the field of xenotransplants, which is a transplant between species. Human organs are in short supply, so if animal organs could be transplanted safely, fewer people would die waiting for organs.
Incompatibilities between species have prevented successful transplantation of animal organs into humans. Another problem is the fear that animal viruses could be introduced into the human population. Scientists say that there is no sure way to know if xenografts will ever become possible. Too many unanswered questions remain.
This article was reviewed and updated June 2007.
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