A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Organ Transplant 101!

Introduction

The act of surgically transplanting an organ or tissue from one person to another is known as organ donation. The person who is giving the healthy organ is known as the &lsquo;donor&rsquo; while the person receiving it is the &lsquo;recipient.&rsquo;

Transplantation is major surgery. It is also one of the most significant advancements in modern medicine. It is required only when the recipient&rsquo;s organ has failed or is so damaged by injury or disease that it can&rsquo;t be treated.&nbsp;

For instance, people require an organ transplant if they&rsquo;re suffering from congenital conditions, like a heart defect. An organ transplant may also be the need of the hour if the individual&rsquo;s organ(s) are damaged due to a chronic condition, like diabetes. Infections like hepatitis, too, cause irreparable damage to human organs, necessitating a transplant.

Unfortunately, the number of people who donate organs is much lower than the demand for them. According to statistics, more than 36,000 organ transplants were performed in 2018, while more than 113,000 people were on the waiting lists in the US alone. 20 people, on average, die waiting.<a href="#accordion">[1]</a> 
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Understanding the specifics of Organ transplant

In Pakistan, the Human Organ and Tissue Transplantation Law bans the commercialization of organ transplantation. Moreover, the law makes organ transplants from deceased donors illegal unless allowed by a living spouse, parent(s), or an adult member of the family.<a href="#accordion">[2]</a>

Currently, the Sindh Institute of Urology and Transplantation (SIUT) has a deceased donor program to save lives.<a href="#accordion">[3]</a> A person who has been declared brain dead but who&rsquo;s on a ventilator can be a potential organ donor if their family agrees to it. 
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<h5>What Organs Can Be Donated?</h5>

While the list of organs is expansive, some common ones are listed below:<a href="#accordion">[6]</a>

<ul>
	<li>Liver</li>
	<li>Kidney</li>
	<li>Heart</li>
	<li>Pancreas</li>
	<li>Lung</li>
	<li>Intestine 
	&nbsp;</li>
</ul>

According to the US Department of Health and Human Services, factors like age, ethnicity, and health don&rsquo;t matter in most cases. A living donor is eligible to donate one lung and one kidney, or a portion of their liver, pancreas, or intestines.&nbsp;

A deceased donor is eligible to donate both of their kidneys and lungs as well as their liver, heart, pancreas, and intestines. They can also donate tissues like skin or heart valves. Face and hand donations were allowed in 2014.<a href="#accordion">[1]</a>

Most of the time, a donor is a close friend or relative of the person who needs a transplant. 
&nbsp;

<h5>Are There Any Restrictions On Who Can Get A Transplant?</h5>

Medically, and ethically, anyone can need a transplant at any point in their lives. It doesn&rsquo;t matter if the person is 8 or 80; everyone deserves to improve their quality of life in any way they can. However, each transplant program has its own set of guidelines. One program, for instance, may not accept applicants older than 80 years old while another may not cater to young applications.&nbsp;

Sometimes, a transplant is rendered impossible due to some health concerns. Generally, an individual may not be listed if they have health issues that prevent them from having further surgery or taking long-term medication. For instance, a recent cancer diagnosis.&nbsp;

And it&rsquo;s not just the medical history of physical symptoms. An organ transplant takes a toll on mental health as well. Stress from a possible rejection of an organ is a prime example.&nbsp;

It&rsquo;s always best to talk to the healthcare team to learn more about the procedure itself and post-transplant care to accept and/or adapt to the new situation accordingly. 
&nbsp;

<h5>How Are The Organs Matched For The Transplant?</h5>

<ol>
	<li>Once a person is accepted as a candidate, then their blood type, medical urgency, and the transplant hospital&#39;s location are classified as important data.&nbsp;</li>
	<li>Similarly, the donor&#39;s blood type, body size, and hospital location are also noted by an organ procurement organization when they&rsquo;re giving their consent to become an organ donor.&nbsp;</li>
	<li>The computer system creates a &quot;match run,&quot; a rank-ordered list of candidates for each organ, by combining information about donors and candidates. This match is particular to each organ and donor. Those who are most in need of a transplant right away and/or who are most likely to survive a transplant are the candidates who will be ranked the highest. 
	&nbsp;</li>
</ol>

If you need a transplant, here&rsquo;s what to expect:

<ol>
	<li>A doctor refers you to a transplant center where the medical team evaluates your eligibility for a transplant.</li>
	<li>You will be added to the organ transplant waiting list if you are accepted as a transplant candidate. You can get your name added to the waiting list at more than one transplant hospital, possibly in other parts of the country. Just make sure to check their guidelines; hospitals differ in terms&nbsp;of the number of transplants&nbsp;and the characteristics of the recipient and donor pools. You can also request a living donor.&nbsp;</li>
	<li>You begin putting together your network of support. Connect with someone who has had a similar organ transplant. Ask your doctor any questions you have to prepare yourself for an organ transplant.</li>
	<li>You start working on your financial plan. Transplants are expensive. The cost of a heart transplant in 2020 was nearly $1.7 million.<a href="#accordion">[4]</a>&nbsp;Insurance coverage varies for an organ transplant.&nbsp;</li>
	<li>Waiting begins. There&rsquo;s no way to know how long you&rsquo;ll have to wait to receive an organ. Usually, patients are first matched for donor organs in their vicinity.&nbsp;</li>
	<li>Your transplant occurs. It&rsquo;s not just the individual experience that makes each transplant unique; transplant surgery time also differs depending on the type of organ you need. For instance, a liver transplant typically involves 6-12 hours whereas a kidney transplant requires 4-5 hours.</li>
	<li>It&rsquo;s time for post-transplant care. Depending on your health and the type of transplant, the hospital may shift you to critical care or an intensive care unit. During the time you spend at the hospital, your team of doctors will assess how successful your surgery was based on a comparison of how sick you were before and how quickly you&rsquo;ve recovered after the transplant. The focus will be on getting you up.&nbsp;</li>
	<li>Before you&rsquo;re allowed to leave the hospital, make sure to ask for all the information you need about any medications the doctors prescribe as well as about the side effects of the medications and the complications of the surgery. This is so you can know when something&rsquo;s off and can inform the doctor immediately. Also, ask about the activities you&rsquo;re allowed.</li>
</ol>

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<h5>Benefits Of Transplant</h5>

<ul>
	<li>Avoiding medical procedures like dialysis</li>
	<li>Living a longer life that is healthier and less painful</li>
	<li>An improved quality of life, like when a cornea transplant restores a person&#39;s sight</li>
	<li>Correcting congenital disabilities that put a person&#39;s life in danger</li>
	<li>Spending less time in the hospital, requiring fewer surgeries, or taking fewer medications&nbsp;</li>
</ul>

&nbsp;

<h5>Issues That May Occur Post-Transplant</h5>

Organ transplant has more benefits than complications. However, the surgery is still risky.&nbsp;

<ul>
	<li>An organ or tissue transplant may be rejected by your body. It tries to destroy it because it considers it an intruder.</li>
	<li>Anti-rejection medication can increase the risk of infections. A person with a weak immune system may be slower to fight germs.</li>
	<li>Infections may spread more easily in your body. It might be harder for you to recover from illnesses and infections.<a href="#accordion">[1][5]</a></li>
</ul>

&nbsp;

<h5>1. Organ Rejection</h5>

Sometimes the recipient&#39;s immune system recognizes the donor organ as foreign and tries to eliminate it. There are 3 types of rejections:

<ul>
	<li>Hyperacute Rejection&nbsp;- It occurs minutes post-surgery&nbsp;due to preexisting antibodies in the recipient that match the foreign antigens of the donor. The antibodies could be due to prior transplantations, blood transfusions, or multiple pregnancies. It necessitates another surgery to remove the tissue to save the recipient&rsquo;s life.&nbsp;</li>
	<li>Acute Rejection -&nbsp;It occurs 0-3 months post-surgery in almost all cases of organ transplants. Acute rejection can occur despite the use of immunosuppression and frequently results in chronic rejection.</li>
	<li>Chronic Rejection - It&nbsp;occurs weeks, months, or even years after a transplant. The transplanted organ is slowly damaged due to constant attacks by the body&rsquo;s immune system.</li>
</ul>

&nbsp;

While symptoms depend on the transplanted organ, rejection is usually characterized by:

<ul>
	<li>Fever (rare)</li>
	<li>Flu-like symptoms</li>
	<li>Uneasiness and discomfort</li>
	<li>Organ&rsquo;s performance deteriorates gradually</li>
	<li>Swelling or pain in the organ (rare)</li>
</ul>

&nbsp;

Every transplant involves some degree of rejection; the degree to which this rejection is clinically significant varies from person to person. Hospitalization may be necessary for some complications. You can be properly monitored and treated when you return to the hospital, allowing you to recover quickly.

&nbsp;

<h5>2. Infections</h5>

<ul>
	<li>There&rsquo;s a risk of contracting AIDS, Hepatitis B, other viruses, or cancer from the donor organ. Organ donors are thoroughly screened for these diseases but, in rare instances, they may not be detected and passed to the recipient.</li>
	<li>Blood loss in the operating room and the associated risk of infectious disease transmission from a blood donor may necessitate a blood transfusion. Although blood donors undergo rigorous screening, a disease that cannot be detected may pass to the recipient.</li>
	<li>The immunosuppressive drugs that recipients are given to avoid rejection can also affect their immune response, leaving patients susceptible to infections.&nbsp;</li>
	<li>Other side effects of drugs include impaired renal function and a higher risk of cancer.</li>
</ul>

&nbsp;

To Eat

1. Foods high in fiber, like raw fruits and vegetables

2. Foods high in calcium, such as low-fat dairy products and leafy green vegetables, and calcium supplements

3. Protein-rich foods, like meat, poultry, fish, eggs, unsalted nuts, and beans&nbsp;

4. Plenty of water unless advised otherwise 
&nbsp;

Not To Eat

1. Processed foods

2. Salt

&nbsp;

Giving someone a second chance at life through a living donation is a rare opportunity. Many recipients may be able to resume many of their normal activities with the help of a donation; work, sports, taking care of themselves, and enjoying life to the fullest. By taking one person off the waiting list, you not only have an impact on the life of one person or one family, but you also open the door for others who do not have a living donor. 
&nbsp;

Conclusion

Organ transplants are life-saving techniques for patients who are affected by terminal organ failures. However, there are many risks associated with organ transplantation and organ donation, such as organ rejection.

To ensure the longest potential lifespan for your donated organ, it&#39;s also essential to lead a healthy lifestyle. Typically, this involves engaging in a healthy diet, quitting smoking, and engaging in adequate physical activity. You&#39;ll likely receive special instructions on how to take care of your transplanted organ from your medical team. 
&nbsp;

Key Takeaways

<ul>
	<li style="list-style-type: decimal;">Organ donation is surgically transplanting an organ or tissue from one person to another. Transplantation is required because the recipient&#39;s organ has failed or been damaged by disease or injury.</li>
	<li>Organ transplant is one of the most significant advancements in modern medicine. It is usually suggested in case of a genetic condition, like polycystic kidney disease, cystic fibrosis, or a heart defect.</li>
	<li>A person may also require a transplant due to damage caused by chronic conditions, like diabetes, physical organ injuries, and infections like hepatitis.&nbsp;</li>
	<li>Unfortunately, the number of people who donate organs is much lower than the demand for them.</li>
	<li>Most of the time, a donor is a close friend or relative of the person who needs a kidney or liver transplant.</li>
	<li>Sometimes, the recipient&#39;s immune system rejects the donor organ. Every transplant involves some degree of rejection.</li>
	<li>Giving someone a second chance at life through a living donation is a rare opportunity. Many recipients may be able to resume many of their normal activities with the help of a donation; work, sports, taking care of themselves, and enjoying life to the fullest. By taking one person off the waiting list, you not only have an impact on the life of one person or one family, but you also open the door for others who do not have a living donor.</li>
</ul>