Transplants

When we talk about transplants, we are talking about more than just hearts, lungs and other organs. Transplants can include tissues such as corneas and ligaments, skin and blood vessels. It can include adult stem cells, bone marrow, blood products and more. Transplants occur when organs or tissues from one person - who is called the donor - are put into another person's body - called the recipient. People of all ages and backgrounds are possible donors.

Organs transplants

It used to be that when a body organ failed that was it; there was nothing that could be done. Most of the time, it meant death. But that has changed. It is now possible to get an organ transplant.

According to the Department of Health and Human Services (HHS), the organs of the body that can be transplanted at the current time include:

• kidneys (Read about "Kidney Disease")
• heart (Read about "The Heart & Cardiovascular System")
• lungs (Read about "Respiratory System")
• liver (Read about "The Liver")
• pancreas (Read about "Diabetes")
• intestines (Read about "Digestive System")

Kidney/pancreas transplants, heart/lung transplants, and other combined organ transplants also are performed. Organs cannot be stored and must be used within hours of removing them from the donor's body. Most donated organs are from people who have died, but a living individual can donate a kidney, part of the pancreas, part of a lung, part of the liver or part of the intestine, according to HHS.

Local organ procurement organizations (OPOs) around the country coordinate organ donation. OPOs evaluate potential donors, discuss donation with surviving family members, and arrange for the surgical removal and transport of donated organs. A national computer network, the OPTN (Organ Procurement and Transplantation Network) matches donated organs with recipients throughout the country.

There are no age limits on who can donate. Newborns as well as senior citizens have been organ donors. If you are under age 18, you must have a parent's or guardian's consent. If you are 18 years or older, you can show you want to be an organ and tissue donor by signing a donor card. In some states, you can state your intent to be an organ donor on your driver's license. Even if you sign a donor card and/or state your intent on your driver's license, make sure your family knows your wishes. Your family may be asked to sign a consent form in order for your donation to occur. You may also want to tell your family healthcare provider, lawyer and your religious leader that you want to be a donor.

Tissue transplants

Other types of tissue, other than complete organs can also be transplanted. Corneas, the middle ear, skin, heart valves, bone, veins, cartilage, tendons and ligaments can be stored in tissue banks. (Read about "The Eye" "The Ear & Hearing" "Skin" "The Heart & Its Valves" "The Skeletal System" "Vascular System") They can used to restore sight, cover burns, repair hearts, replace veins, and mend damaged connective tissue and cartilage in recipients. When multiple tissues are involved - for example skin muscle, tendon, bone - it is called composite tissue allotransplantation.

Most times these tissues are taken from donors who have died. Once again, you should let it be known that you are willing and in fact, want your tissues used to help others.

Blood stem cells

Blood stem cells can be used in the treatment of cancer. (Read about "Cancer: What It is") Chemotherapy and radiation therapy (Read about "Cancer Treatments" "Radiation Therapy") generally affect cells that divide rapidly. They are used to treat cancer because cancer cells divide more often than most healthy cells. However, because bone marrow cells also divide frequently, high-dose treatments can severely damage or destroy the patient's bone marrow. Without healthy bone marrow, the patient is no longer able to make the blood cells needed to carry oxygen, fight infection and prevent bleeding. Blood stem cells can used to replace stem cells that were destroyed by treatment.

Stem cell transplant can also be used in some non-cancerous conditions. For example, in aplastic anemia (Read about "Anemia"), where your bone marrow doesn't make enough new blood cells, the bone marrow can be destroyed, and then healthy stem cells can be added.

Healthy adults between the ages of 18-60 can donate blood stem cells. In order for a blood stem cell transplant to be successful, the patient and the blood stem cell donor must have a closely matched tissue type or human leukocyte antigen (HLA). Since tissue types are inherited, patients are more likely to find a matched donor within their own racial and ethnic group. HHS says there are three sources of blood stem cells that healthy volunteers can donate:

• Marrow - This soft tissue is found in the interior cavities of bones and is a major site of blood cell production and is removed to obtain stem cells. Bone marrow can be taken from the patient, a living relative or an unrelated donor.
• Peripheral blood stem cells - The same types of stem cells found in marrow can be pushed out into a donor's bloodstream after the donor receives daily injections of a medication called filgrastim. This medication increases the number of stem cells circulating in the blood and provides a source of donor stem cells that can be collected in a way that is similar to blood donation.
• Cord blood stem cells - The umbilical cord that connects a newborn to the mother during pregnancy contains blood and this blood has been shown to contain high levels of blood stem cells. Cord blood can be collected and stored in large freezers for a long period of time and therefore, offers another source of stem cells available for transplanting into patients.

Blood and platelets transplantation

Blood and platelets are formed by the body, go through a life cycle and are continuously replaced throughout life. This means that you can donate blood and platelets more than once. It is safe to donate blood every 56 days and platelets twice in one week up to 24 times a year. (Read about "Blood Donation Guidelines")

Blood is stored in a blood bank according to type - A, B, AB, or O - and Rh factor - positive or negative. Blood can be used whole, or separated into packed red cells, plasma and platelets, all of which have different lifesaving uses. It takes only about 10 minutes to collect a unit (one pint) of blood, although the testing and screening process means that you will be at the donation center close to an hour.

Platelets are tiny cell fragments that circulate throughout the blood and aid in blood clotting. Platelets can be donated without donating blood. When a specific patient needs platelets, but does not need blood, a matching donor is found and platelets are separated from the rest of the blood, which is returned to the donor. The donor's body will replace the missing platelets within a few hours.

If you need a transplant

Needing a transplant does not necessarily guarantee that you will get a transplant. Before being accepted at a transplant center, you will be evaluated to determine your ability to handle a transplant. For example, doctors may want to consider if you are healthy enough for the surgery, if you are willing to follow directions and take medications as needed, and if you have a good support network. It may also be recommended that you have you vaccinations (Read about "Immunizations") updated prior to surgery. After a transplant some vaccinations are not allowed because of the immune system suppression drugs you may be taking..

In many cases, the wait for a transplant can take a long time. During this time, it is important that you maintain as healthy a lifestyle as possible. Follow your doctor's directions for medication, diet and exercise during this time. Consider joining a support group and try to stay positive. It is also essential that you let the transplant center know how to reach you at all times. In many cases, there's no way of knowing when there will be a suitable donor, so you should also be prepared to get to the transplant center at a moment's notice.

After a transplant

Getting blood is a short-term transplant. Your own body will soon pick up the slack and produce the blood you need. Any blood cells you got from someone else will soon leave your body.

That isn't the case with other types of transplants. They are there permanently. Your immune system (Read about "The Immune System") may view the transplanted organ or other tissue as an invader and attack it. Because of that, you may need to take immune system suppressing drugs for the rest of your life.

Transplant recipients usually need to take an array of medications. Some will be new medications prescribed after transplant surgery. Some may be continued from before surgery. Certain medications may be taken several times a day while others are only taken on certain days. Transplant team doctors may have to change medications or adjust dosages every few days or weeks to find the best combination for maximum benefit and minimum side effects. In short, managing medications after transplant surgery can be complex and confusing.

Some medications may cause side effects. It is also important to remember that medications to suppress your immune system can make you more vulnerable to infections. (Read about "Microorganisms") You should discuss all your concerns with your doctor.