Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
Anti-Rejection Medications. These medications lower the activity of the body’s immune system to prevent rejection of a transplanted organ. They are also called immunosuppressive medications. Examples include cyclosporine, tacrolimus, sirolimus, prednisone, mycophenolate mofetil, rapamycin and azathioprine.
Bone Marrow Transplants. Most bone marrow transplants are performed for patients with leukemia. Bone marrow is collected from volunteer donors under anesthesia by aspiration from the pelvic bone.
Brain Death. Acceptable organ donors are those who are brain dead, but whose heart and lungs continue to function with the aid of a ventilator. Brain death means that brain function has ceased permanently, and it is a legal definition of death.
Corneal Transplants. Corneal transplants are done to restore sight to individuals whose vision has been damaged by disease or injury to the cornea. Corneal transplants are successful in restoring sight in more than 90 percent of the cases.
Cost of Organ and Tissue Donation. The donor’s family and the donor hospital are not responsible for any recovery expenses. The cost will be absorbed by the transplant center, the recipient’s insurance coverage, or in some cases, by the federal government.
Criteria for Transplant Recipients. Transplant recipients are selected on the basis of medical urgency as well as availability of a well-matched organ or tissue, but not race, sex or creed.
Donor Card. By signing this card, an individual indicates his or her wish to be a donor. In some states, however, the individual’s next-of-kin will still be asked to sign a consent form for donation at the time of death. People who wish to be organ and tissue donors should tell their families about their decision, so their wish will be honored at the time of death. An estimated 35 percent of potential donors never become actual donors because family members refuse to give consent.
Donor Registries. Many states have donor registries. Registering with one of these agencies is similar to signing a Donor Card or indicating your donation wishes on a driver’s license.
Eye Bank. An organization that obtains, evaluates and distributes eyes from non-living donors for use in corneal transplantation, research and education.
Family Discussion. It’s important for families to discuss their feelings about organ and tissue donation. At the time of death, family consent is sought before donation takes place. Making this decision is easier if every family member’s wishes regarding donation are known to the rest of the family. Studies have shown that donating a loved one’s organs and tissues helps in the grieving process by giving some sense of meaning to the loss of a family member or friend.
Graft Survival. Refers to the length of time a graft (transplanted organ or tissue) remains functional.
Laparoscopic Removal of a Kidney. This is a new procedure that is being used at sometransplant centers to remove kidneys from living donors. The kidney is removed through a very small incision, and the recovery time of the donor may be reduced greatly.
Living Donors. This refers to living individuals who donate an organ, such as a kidney bone marrow, to someone in need of a transplant. Living donors are often close relatives of the recipient, but may sometimes be a spouse, friend or even someone who is unknown to the recipient (non-directed donor).
Non-directed Donors. Someone who donates a kidney to anyone in need of a kidney transplant. Non-directed donors are not related to or known by the recipient, but make their “gift” purely out of altruistic motives.
Matching. The process of making sure blood and tissue types of donors and recipients are compatible, before performing an organ or tissue transplant.
Non-heart Beating Donor. A donor who has suffered a non-survivable cardiac event but has not progressed to brain death. Donation may take place when a Do Not Resuscitate order has been written, and the individual’s family makes the decision to withdraw care.
Deceased Donors. Individuals whose organs and tissues are donated at the time of their death. The annual increase in the number of donors has not kept pace with the growing list of patients waiting for life-saving and life-enhancing transplants. Deceased donors are sometimes called cadaver donors or non-living donors.
Organ Procurement Organizations (OPOs). These organizations recover organs from deceased donors and deliver them to transplant centers where a recipient “match” is located. Currently, there are 58 organ procurement organizations across the country.
Organ Procurement and Transplantation Network (OPTN). A national transplant network, established by an act of Congress, which maintains the national computer registry for matching donated organs to patients on the waiting list. The OPTN is administered by the United Network for Organ Sharing (UNOS).
Religious Views on Organ Donation. Virtually all religious denominations approve of organ and tissue donation as representing the highest humanitarian ideals and the ultimate charitable act.
Removal of Donated Organs. Donor organs and tissues are removed surgically, and the donor’s body is closed, as in any surgery. There are no outward signs of organ donation and open casket funerals are still possible.
Required Referral. All hospitals must have a required referral system in place. This requires the hospital to notify the local organ procurement organization (OPO) about all deaths. Whenever appropriate, the OPO will offer the deceased person’s next-of-kin the opportunity to donate their loved one’s organs and/or tissues for transplantation.
Solid Organ Transplants. These types of transplants include the following: kidney, liver, intestines, heart, lung and pancreas.
Stem Cell Transplants. These are done by infusing healthy stem cells (cells in the body that can grow into any other cells) into people who have had high-dose chemotherapy for leukemia, immunodeficiency, lymphoma, anemia or metabolic disorders. Healthy stem cells are collected from bone marrow, peripheral blood and umbilical cord blood. Once the healthy stem cells are infused into the patient’s blood stream, the cells move from the blood vessels to the center of the bones, where they begin making new blood cells.
Tissue Bank. An organization that obtains, evaluates and distributes tissues for transplantation, research and education.
Tissue Transplants. Tissues that can be transplanted include corneas, heart valves, blood vessels, tendons and ligaments, skin and bone. Many more individuals could benefit from these life-enhancing transplant, but only a small fraction of the tissue that could be used is donated.
Tissue Typing. This blood test is done in a laboratory before a transplant to see if the tissues of the donor are compatible with those of the patient. Each person’s tissues, except for identical twins, are different from everyone else’s. It is believed that the better the tissue match, the more successful the transplant will be over a longer period of time.
Transplant Centers. These are the hospitals that perform transplant surgery. Currently, there are 257 centers in the U.S. that operate solid organ transplant programs. In addition, approximately 120 centers operate bone marrow transplant programs. The types of transplants performed at different centers may vary.