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Organ Transplant (cont.)

Learning About Transplants

How do you get on the waiting list?

Receiving a donor organ is a big responsibility. To get on the waiting list, you'll have to be committed to taking good care of yourself. The best way to do this is to take medicines as prescribed, get regular blood tests, and make any necessary lifestyle changes to stay healthy.

To get on the waiting list, you will need to:

  • Obtain a referral from your doctor.
  • Call the transplant center where you choose to have your transplant. To locate a transplant center near you, ask your doctor or contact the United Network for Organ Sharing by going online at www.unos.org or calling 1-888-894-6361.
  • Schedule an appointment for an evaluation at the transplant center to find out if you are a good candidate for a transplant. Your transplant center can do all of the required tests, or your doctor can order the tests and send the results to the center.

During your evaluation, learn as much as you can about the transplant center. Find out whether the center will accept your insurance, what your options are if you don't have insurance, and whether support groups are available.

The transplant center will notify you within 2 weeks of your evaluation to let you know whether you have been placed on the waiting list. If you have questions about your list status, contact the transplant center where you were evaluated.

It may be days, months, or even years before you receive a new organ. When an organ is found, your transplant team will consider whether the donor is a good match for you, the status of your current health, and how long you've been on the waiting list. Your team will also consider the location of the donated organ, because it must be transplanted quickly to remain in working order.

Thinking about and waiting for a transplant can affect you emotionally. You may find it helpful to see a psychiatrist, psychologist, or a licensed mental health counselor about your transplant.

What tests will you need before your transplant?

Tests that are done for all organ transplant candidates include:

  • A cross-match for transplant. This blood test shows whether your body will reject the donor organ immediately. It will mix a donor's blood with your blood to see whether your antibodies attack the antigens of the donor. If they attack, you are not a good match with the donor.
  • Antibody screen. A panel-reactive antibody (PRA) test measures whether you have antibodies against a broad range of people. If you do, it means you are at higher risk of having rejection, even if the cross-match shows that you and the donor are a good match.
  • Blood type. This blood test shows which type of blood you have. Your blood type should be compatible with the organ donor's blood type. But sometimes it's possible to transplant an organ from a donor with a different blood type.
  • Tissue type. This blood test shows the genetic makeup of your body's cells. We inherit three different kinds of genetic markers from our mothers and three from our fathers. The more of these markers you share with the organ donor, the more likely it is that your body will accept the donor organ.
  • A mental health assessment. This test identifies any psychological issues that may prevent you from receiving and caring for your new organ. A living donor is also required to have this test before donating an organ.

The results of these medical tests will be used to match you with an organ donor. The more matches you have, the more likely your body will accept the new organ.

What if you're not a good candidate for an organ transplant?

You may not be a good candidate if you have an active infection, unstable heart disease, or another serious medical problem. Also, you will not be considered for organ transplant if you have a problem with alcohol or drugs.

If you are told that you are not a good candidate for organ transplant, find out if there are other treatments for your condition. Many people can live for years with serious health conditions.

The goal of your care may shift to maintaining your comfort. Talk to your loved ones about the type of care you would like to receive. Discuss their expectations as well as your wishes, care needs, and finances and the needs of your family. Your choices may change as your illness changes.

How successful are transplants?

Organ transplant success depends on:

  • Which organ is transplanted.
  • How many organs are transplanted. For example, you could have a heart transplant or a heart and lung transplant.
  • The disease that has caused your organ to fail.
  • The age of the donor organ. In general, the younger the organ donor, the healthier the tissue. But recent research is challenging this thought. It may be that some older organs work just as well as younger organs.
  • The length of time that the donor organ is out of the donor's body. The more quickly an organ is transplanted after it is removed from the donor, the more likely that the transplant will be successful.
  • How well the organ was preserved just before transplantation. The donor organ must be properly preserved while it is being transferred, especially if it was transferred from a long distance.

Success rates usually state how many people who receive the transplant are living 5 years after the transplant.1

  • Kidney: About 8 or 9 people out of 10 (82% to 91%)
  • Liver: About 7 or 8 people out of 10 (74% to 79%)
  • Lung: About 5 people out of 10 (54%)
  • Pancreas: About 8 or 9 people out of 10 (85% to 89%)
  • Heart: About 7 people out of 10 (75%)
  • Intestine: About 6 people out of 10 (58%)

Organ rejection is possible. When a new organ is placed into your body, your immune system sees it as foreign and tries to destroy it. Antirejection medicines can help prevent your immune system from attacking the donor organ.

You may worry about organ rejection or that your surgery will not be successful for another reason. These thoughts are normal. Many people write an advance directive and choose a health care agent when they are waiting for a transplant.

Writing an Advance Directive
Choosing a Health Care Agent

How can you get ready?

While you are waiting for your organ transplant, you will be given a pager or cell phone so the transplant center can contact you to tell you an organ is available. You may also wish to give the transplant center several numbers where you can be reached and the name and number of a few people who will always know how to reach you.

Arrange in advance for someone to go with you to the transplant center. This person can support you, listen to your doctor, and help you remember important instructions. This person can also report any change in behaviors or symptoms that you may have either before or shortly after the transplant.

Have your suitcase packed with the things you need to take with you to the transplant center. Your support person should also have a bag packed and ready to go.

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