Organ transplantation is the moving of an organ from one body to another or from a donor site to another location on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ.
Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, nerves and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed by the liver and then the heart. Cornea and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than tenfold. Some organs, such as the brain, cannot be transplanted.
In the US, there is a generally a very long waiting list for organ transplants. Sometimes, patients wait so long that they get very sick and are no longer eligible to receive a transplant. Sometimes, they die while waiting. Out of frustration, some patients contemplate leaving the US and traveling to a foreign country to obtain an organ transplant.
The question of organ donation and organ transplant is relevant to every country on the planet, and brings with it ethical debates, prevalence of black market organ procurement to blood relative donations that help bypass ever-growing list of individuals requiring an organ transplant for life.
The cost for organ transplants in the U.S. and Great Britain are extremely high, but some countries around the world, including India, Jordan and Turkey, have been providing affordable organ transplants for decades. The level of experience and expertise from surgeons performing organ transplants is also very high, leading many to search out options for organ transplants abroad.
Organs and Tissues for Transplant
One individual can help many through organ and tissue donation. Learn about what organs and tissues can be donated and transplanted.
- Organs for Transplant
- Tissues for Transplant
- Heart Valves
- Blood Vessels
The heart is the hardest working muscle in our bodies, pumping blood throughout the body. And just like any muscle, it can be subject to fatigue, especially if it has been weakened by a number of cardiovascular diseases.
A wide range of heart diseases may make transplantation necessary. This usually follows conditions such as coronary artery disease, cardiomyopathy or weakening of the heart muscle.
The only option, if no transplant is immediately available, is for the patient to be assisted with a mechanical heart called an LVAD (Left Ventricular Assist Device), which can be surgically implanted to maintain blood pumping until a transplant is available.
Donated hearts are allocated to patients based on medical urgency, blood type compatibility, size match and waiting list time.
A a donated heart can only remain outside of the body for about four hours before it must be transplanted.
The kidneys function as our body’s filters, cleaning blood of waste and impurities. They also release hormones that regulate blood pressure, control production of red blood cells, and promote growth of healthy bones.
Inherited kidney diseases such as polycystic kidney disease as well as diabetes and high blood pressure are the most common causes of kidney failure requiring transplant. If left untreated, kidney failure can be fatal. Prior to transplant, most patients require dialysis, a mechanical treatment to filter the blood to rid your body of harmful wastes, extra salt and water.
While most people are born with two kidneys, we can survive with one. That is how individuals are able to be living kidney donors, and help save the lives of a loved one or even a complete stranger.
- The kidney is the most commonly transplanted organ. More than 89,000 patients currently await kidney transplants in the U.S.
- Of those on the waiting list, more than one-third will wait three or more years for a transplan
The liver is the largest organ in the body. It is a complex organ responsible for hundreds of crucial functions such as the breakdown of harmful substances in our blood and the production of bile that aids in digestion.
Liver failure can be caused from viral infections, genetic disorders or even alcoholism. These liver diseases lead to cirrhosis, which creates scar tissue that blocks the flow of blood and thus impedes its functions. Primary biliary atresia, a malformation of the liver’s bile ducts, is the most common disease leading to transplant in young children.
Most liver transplants involve transplanting the entire liver, where the diseased liver is removed and replaced with a healthy one. But it is possible to transplant part of a liver, as the organ can regenerate itself within the body. This is how it is possible for people to be living liver donors, as both the transplanted lobe and the donor’s lobe will grow in their respective bodies.
- Hepatitis C is the most common cause of liver failure leading to liver transplantation.
- A liver donated by an adult can often be split and transplanted into two people.
- There are more than 16,000 patients currently awaiting liver transplants.
A healthy person breaths at least 12 to 14 times per minute removing carbon dioxide from the blood and exchanging it with oxygen.
While a person can live a normal life with only 30 percent of lung function. Lung transplants are recommended for those with severe lung disease, such as cystic fibrosis, COPD (chronic obstructive pulmonary disease) and emphysema.
Patients on the lung transplant waiting list are often severely disabled and might even require oxygen 24-hours-a-day. This is why it is crucial for these individuals to receive a transplant in a timely fashion. Living lung donation is a possibility in rare cases, as two living donors can each offer a lobe their lungs, which are then both transplanted into the patient
- More than 1,700 patients await lung transplants in the U.S.
- Lungs are allocated to patients based on several factors including distance from donor, medical condition, and age (lungs from pediatric and adolescent donors are offered first to pediatric and adolescent patients).
The pancreas is a gland behind your stomach and in front of your spine. It produces juices or enzymes that help break down food and hormones that help control blood sugar levels. Problems with the pancreas can lead to many health problems. These include pancreatitis, or inflammation of the pancreas, pancreatic cancer and cystic fibrosis, a genetic disorder in which thick, sticky mucus can also block tubes in your pancreas.
The pancreas also plays a role in diabetes. In type I diabetes, the beta cells of the pancreas no longer make insulin because the body’s immune system has attacked them. In type II diabetes, the pancreas loses the ability to secrete enough insulin in response to meals.
This can cause major problems in the body including kidney failure, heart disease, strokes or even death.
- The pancreas is most commonly transplanted in combination with the kidney.
- There are more than 1,300 patients awaiting pancreas transplants and more than 2,100 patients awaiting combine pancreas and kidney transplants in the U.S.
Small intestine transplants are rare and most often transplanted in combination with the liver, stomach and pancreas in small children.
The intestines – both the small and large – run 25 feet long throughout our bodies, digesting food and helping the body to absorb the necessary nutrients while also getting rid of the waste products. The small intestine handles much of the nutrient absorption, while the large intestines reabsorb water from digested foods and send it back into the blood stream.
Image of Intestine
The most common reason leading to transplant is short bowel syndrome caused by conditions like tumors, Crohn’s disease and other inflammatory bowel diseases, or congenital defects.
Tissue Donation and Transplants
Hundreds of thousands of people in the U.S. benefit from life-enhancing tissue transplants each year. While the donation of organs is primarily limited to patients who die as a result of brain death, virtually anyone who dies as a result of cardiopulmonary death — the heart stops beating — can be considered a tissue donor.
The cornea is the clear layer on the front of the eye. A corneal transplant is surgery to replace the cornea with tissue from a donor. It is one of the most common transplants done with a very high success rate. Corneal transplantation is recommended for people who have:
- Vision problems caused by thinning of the cornea, usually due to keratoconus
- Scarring of the cornea from severe infections or injuries
- Vision loss caused by cloudiness of the cornea, usually due to Fuchs’ dystrophy
Bones and tendons can be used to replace or reconstruct tissue destroyed by tumors, trauma or infection, saving limbs that would otherwise be amputated. Hundreds of thousands of patients benefit from transplants using donated bone for surgeries ranging from dental surgery, knee reconstruction and back surgery. Bone, tendon and related tissues are processed by bone banks and made available to surgeons on an as needed basis.
Donated heart valves can replace damaged ones, allowing the heart to function again. When used in young patients, these donated heart valves can actually “grow” with the recipient and reduce the need for repeated surgeries. Human heart valves have advantages over mechanical valves because of lower risk of infection and no need for blood thinning drugs required with mechanical valves.
Blood Vessels/ Veins
Donated blood vessels or veins can be used in patients who require coronary artery bypass surgery, a routine procedure that saves thousands of lives and allows these individuals to return to their normal lifestyles. For individuals suffering from diabetes or other diseases that cause a decrease in the blood flow, surgeons may use donated veins to repair damaged vessels and restore blood flow — in many cases saving a recipient’s leg from amputation. The saphenous vein, a long vein on the inside of the leg, is the primary vein recovered from donors for transplant.
Donated skin is needed for patients suffering from burns or trauma, and used as a temporary covering to protect the body from infection and promote healing. Donated skin is also used for cleft palate repair or mastectomy reconstruction. Skin is typically removed from a donor in tissue-thin layers from the back and thigh area.
Legal Organ Donations
Nearly every country in the world bans the selling of human organs, even though the demand for organs vastly exceeds donors. Organ donations may come from recently deceased individuals or a living donor. Individuals on an organ donation transplant waiting lists usually receive organ donation from a person who has recently died in an accident or an illness that does not affect the organs required by the donor.
A variety of laws both in the United States and abroad regulate tissue and organ donation and transplantation. Unfortunately, the need of individuals waiting for healthy organs vastly outweighs the number of individuals willing to donate an organ following their death, or those willing to engage in a live donation.
In the United States, the U.S. Department of Health and Human Services has promoted initiatives to increase organ donation. Every country offers specifics on what is considered legal and what is not. For individuals interested in traveling abroad for organ donations, caution and research are a must.
Relative donations, or live donations, are an option that families may utilize to get around long waiting lists. Living donor transplants are common for organs such as:
- liver segments
- entire kidneys
- lobes of a lung
- a portion of intestine
- a portion of the pancreas
Biologically related donors such as a brother or sister, a child, or a parent are preferred. However, unrelated donors may also include individuals such as friends, coworkers or acquaintances.
Matching donors to recipients is a long and complicated process. Donors and recipients must be compatible in blood type and anti-bodies, tissue typing, and blood tests. Radiologic testing and cancer screening is also performed on both donor and recipient in order to provide the most promising match.
National Waiting List
Nearly 112,000 people are on the waiting list for organs in the United States alone. Of those, a little over 10,000 are actually lucky enough to receive an organ in time. Every year in America, over 6,000 people die while waiting for an organ, while in Europe, 20% of those requiring an organ transplant die before they receive one. In six months, just over 11,000 organ transplants were performed in the United States, while the actual list of donors numbered just over 5,500.
Debate continues whether organ donation is legal and ethical in countries around the world. Culture and religion have a lot to do with the perception many people have regarding organ donation. However, the bottom line is this; anyone interested in traveling abroad for an organ transplant should verify legal avenues of procuring such organs or traveling to a foreign country to receive one.
The costs will vary for each patient, based on insurance coverage, the type of transplant and the location of the transplant center. Patients will also incur lifetime medical expenses for follow-up care and prescriptions.
Below is a list of average costs for transplants and first-year expenses. The actual costs may be higher or lower than the figures listed here:
- Bone Marrow (autologous): $360,000
- Bone Marrow (allogeneic): $800,000
- Cornea: $25,000
- Heart: $1 million
- Intestine: $1.2 million
- Kidney: $260,000
- Liver: $575,000
- Lung: $550,000
- Double Lung: $800,000
- Pancreas: $290,000
- Heart/Lung: $1.2 million
- Kidney/Pancreas: $475,000
- Kidney/Heart: $1.3 million
- Liver/Kidney: $1 million