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QUESTION: How are people identified as possible organ recipients?
ANSWER: Organ transplants are one treatment option when a particular organ is failing. Kidney failure, heart disease, lung disease and cirrhosis of the liver are all conditions that might be effectively treated by a transplant. For problems with the heart, lungs, and other highly sensitive organs, a transplant is typically the course of last resort. But if all other avenues have been explored and the patient is willing and able, transplantation is a good, viable option.
QUESTION: Which organs and tissues can be transplanted from a living donor, and which organs and tissues must be donated by a non-living donor?
ANSWER: Kidneys and livers may be transplanted from a living donor, since people can live with only one kidney and the liver is regenerative. Even a lung can be transplanted from a living donor, but that is extremely rare. For these procedures, a patient will generally find a donor from a living family member or friend. If the donor is a match, they can proceed directly to the surgery stage. A smaller number of living transplants come from generous strangers donating for the general good.
If a patient needs a heart transplant, a double lung transplant, a pancreas transplant or a cornea transplant, they will need to get it from a non-living donor. Kidneys, livers, and single lungs can also be donated by non-living donors. Generally, acceptable donors are people who are brain dead and on a ventilator. Even though they are technically dead, their body is still functioning, which means the organs remain healthy. Organs will deteriorate very quickly once the body has expired, making them unusable for transplant.
QUESTION: How are donated organs distributed, and how is the decision made as to whether a person is a candidate for transplantation?
ANSWER: In the United States, a patient who needs an organ transplant and does not know a living donor who is willing to donate must become part of an elaborate nationwide organ distribution system. This system, know collectively as Organ Procurement and Transplantation Network (OPTN), is operated by the United Network for Organ Sharing (UNOS), an independent nonprofit organization working under contract with the U.S. Department of Health and Human Services.
UNOS maintains a database of eligible transplant patient awaiting organs as well as detailed information on all the organ transplant centers around the country. Additionally, the UNOS board of directors, primarily made up of transplant doctors, transplant patients and donor families, establishes the policies that decide who will get which organs. To be included on the national waiting list, a patient must first find a transplant team that will treat him or her. The transplant team -- a group of surgeons, nurses, and other health professionals at a hospital -- evaluates the patient to decide whether he or she is a good candidate for transplantation. In addition to assessing the patient's physical condition, the team will consider the patient's attitude, psychological state and history of drug abuse, among other factors. Donated organs are a rare and precious commodity, so doctors don't want to proceed unless they are confident that a patient is physically and mentally prepared for the procedure, as well as for life after the procedure. For the most part, patients who are unwilling to give up unhealthy drugs, including cigarettes and alcohol in many situations, will be automatically disqualified.
QUESTION: What happens after a patient is identified as a good candidate to receive a donated organ?
ANSWER: If the transplant team feels that a patient is a good candidate for transplant, they will contact the UNOS Organ Center in Richmond, Virginia, in order to put the patient on the national waiting list. The Organ Center operators record all relevant information about the patient, including his or her physical condition, blood type, tissue type, and age. This information is entered into the national database.
QUESTION: How is the decision made relative to who gets a particular donated organ?
ANSWER: When an organ becomes available (when an organ donor is pronounced brain dead at a hospital, typically), the local organ procurement organization (OPO) will gather all relevant information about the donor and enter this data into a program maintained by the UNOS Organ Center. The program then generates a ranked list of potential recipients. The criteria include several factors, including the physical compatibility between the donor and the recipient, the health of the recipient, and how long the recipient has been waiting for an organ. The purpose of the criteria is to choose a recipient who is a good match and stands a good chance of recovery, while also taking into account who has been "in line" longer.
QUESTION: What happens after a particular person has been identified as the person to whom a particular organ will be offered?
ANSWER: The OPO will immediately contact the transplant team of the first person on the list. The transplant team will note all of the donor's information and make a decision whether or not to accept the organ. It may choose to decline the organ if it feels that the donor and potential recipient is not a close enough match or that the organ is unsatisfactory. For example, the donor may be much larger or older than the potential recipient, making the organ a bad fit, or the donor may have had health problems that could have damaged the organ. The transplant team might also decline the organ if the potential recipient is ill or otherwise unprepared for surgery. If the organ is declined, the OPO will move to the next name on the list.
QUESTION: Does geography play a factor in determining whether or not someone will be offered a particular organ?
ANSWER: In most cases, the OPO will first look for potential recipients in the local area. If there are no matches in the local area, the OPO will extend the search to anyone in the same UNOS region. (there are 11 regions across the country). If there are still no matches, the OPO will offer the organ to the person who is ranked first on the national list. The intention is to minimize organ transportation time and to encourage donation by offering donors a change to help out their local community.
QUESTION: What happens once a match is made?
ANSWER: When a recipient's transplant team accepts an organ, things start moving pretty fast. The team tells the recipient to hurry to the hospital for surgery preparation, and another team is dispatched to recover the organs from the donor.
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