By Dr. Chris Russell
Organ failure means that one of your body's vital systems is not doing its job properly. Life with a failing organ is very challenging and the condition can be imminently life-threatening.
Organ transplantation is when an organ or part of an organ is removed from one person (the donor) and put into another person (the recipient).
Modern transplantation began in the 1950s with the first successful kidney transplants. Heart, liver and pancreas transplants soon followed. Since then, the range of organs that can be transplanted as well as the understanding of transplantation has expanded.
Currently, approximately 1,600 Australians are waiting for a life-saving or life-improving transplant, and about 50 of those waiting are children.
Waiting for a transplant is not easy. It usually involves many trips to hospital and a very limited lifestyle. Most people wait between 6 months and 4 years, but unfortunately, some of those waiting will die from their disease before a transplant becomes available.
Which organs can be transplanted?
The list is growing. Currently, common transplants in Australia are:
- Eye tissue - approximately 1,500 people per year regain sight
- Heart - roughly 70 Australians per year receive a new heart
- Heart valves - this transplant helps to repair rather than replace a damaged heart
- Kidney - there are approximately 800 kidney transplants per year in Australia
- Liver - usually only part of a liver is needed for a successful transplant
- Bone & tendon - these transplants help mend difficult fractures & bone problems
Where do the organs come from?
Organs can come from deceased or living donors.
Deceased donors are people who have agreed in advance to give their organs to others when they die. This is sometimes called cadaveric donation, and is the source of most transplant organs. Organs from one cadaveric donor can sometimes enhance or save the lives of ten or more people.
Living donors are people who choose to give organs such as the kidney or liver to someone in need. Humans usually have two kidneys, but most can live healthily with just one. More than one-third of kidney transplants in Australia are now from living donors.
The liver has several lobes and regenerates very quickly, so it is sometimes possible to remove part of a liver from a living donor and give it to someone else.
What happens after a transplant?
Almost everyone who has a transplant will need medicines called immunosuppressants afterwards to keep the transplant working.
Each person has an individual code on each of his or her cells called an antigen, which is like a security pass for the body. A cell without the right pass is targeted for attack by the immune system. This is how the immune system normally identifies and fights invading bacteria and viruses. Unfortunately, transplanted organs do not have the right security pass, so the immune system can attack. This is called rejection.
Doctors try very hard to match donor organs so that they have antigens that are as near a match as possible to receiving person's own, but an attack by the immune system on the new organ can still happen.
Immunosuppressant drugs 'turn down' the immune system. The aim is to get the right medicine at the right dose to stop the immune system fighting the new organ, while allowing it to continue fighting infection. People who receive a transplant are monitored closely by their medical team to make sure this is happening.
A better understanding of immunosuppressant drugs, as well as improved surgical techniques have greatly improved success rates from organ transplants. Scientists are working on other exciting advances as well. They are working on growing organs in the lab from human cells called stem cells; if successful, the patient's own stem cells could be used to provide them with an organ.
About Dr. Chris Russell
Dr. Chris Russell is a member of the medical writing team at Medikidz. Medikidz provide children and teenagers with informative, accessible and fun comics to help them understand their bodies and illness.