Transplant services

Information

Transplant surgery is typically done to replace a diseased body part with a healthy one.

SOLID ORGAN TRANSPLANTS

• Auto islet cell transplant is done after a person has their pancreas removed due to chronic pancreatitis. The procedure takes insulin-producing cells from the pancreas and returns them to the patient's body.
• Corneal transplant replaces a damaged or diseased cornea. The cornea is the clear tissue on the front of the eye that helps focus light on the retina. It is the part of the eye on which a contact lens rests.
• Heart transplant is an option for someone with congestive heart failure that has not responded to medical treatment.
• Intestinal transplant is an option for patients with short bowel or short gut syndrome or advanced liver disease, or who must receive all nutrients through a feeding line. See: Total parenteral nutrition (TPN)
• Kidney transplant is an option for someone with chronic kidney failure. It may be done with a kidney-pancreas transplant.
• Liver transplant may be the only option for someone with liver disease that has led to liver failure.
• Lung transplant may replace one or both lungs. It may be the only option for someone with lung disease who has not gotten better using other medicines and therapies, and is expected to survive for less than 2 years.

BLOOD/BONE MARROW TRANSPLANTS (STEM CELL TRANSPLANTS)

You may need a stem cell transplant if you have a disease that damages the cells in bone marrow, or if you received high doses of chemotherapy or radiation.

Depending on the type of transplant, your procedure may be called a bone marrow transplant, a cord blood transplant, or a peripheral blood stem cell transplant. All three use stem cells, which are immature cells that give rise to all blood cells. Stem cell transplants are similar to blood transfusions and generally do not need surgery.

There are two different types of transplants:

• Autologous transplants use your own blood cells or bone marrow.
• Allogeneic transplants use a donor's blood cells or bone marrow. A syngeneic allogenic transplant uses cells or bone marrow from the patient's identical twin.

For more information, see: Bone marrow transplant

THE TRANSPLANT SERVICES TEAM

The transplant services team includes carefully selected experts, including:

• Surgeons who specialize in performing organ transplants
• Other medical doctors
• Radiologists and medical imaging technologists
• Nurses
• Infectious disease experts
• Physical therapists
• Psychiatrists, psychologists, and other counselors
• Social workers
• Nutritionists and dieticians

BEFORE A TRANSPLANT

You will have a complete medical exam to identify and treat all medical problems, such as kidney and heart disease.

The transplant team will evaluate you and review your medical history to determine if you meet the criteria for organ transplantation. Most types of organ transplants have guidelines detailing what type of patient is most likely to benefit from a transplant and will be able to manage the challenging process.

If the transplant team believes you are a good candidate for a transplant, you will be put on a national waiting list. Your place on a waiting list is based on a number of factors, which depend on the type of transplant you are receiving.

Once you are on the waiting list, the search for a matching donor begins. Types of donors depend on your specific transplant, but include:

• A living related donor is related to you, such as a parent, sibling, or child.
• A living unrelated donor is a person such as a friend or spouse.
• A deceased donor is someone who has recently died. The heart, liver, kidneys, lungs, intestines, and pancreas can be recovered from an organ donor.

After donating an organ, living donors can live a normal, healthy life.

You should identify family, friends, or other caregivers who can offer help and support during and after the transplant process.

You will also want to prepare your home to make it comfortable for when you return after being released from the hospital.

AFTER A TRANSPLANT

How long you stay in the hospital depends on the type of transplant that you have. During your time in the hospital, you will be seen daily by the transplant services team.

Your transplant services coordinators will arrange for your discharge. They will discuss with you plans for care at home, transportation to clinic visits, and housing, if needed.

You will be told how to take care of yourself after the transplant. This will include information about:

• Medications
• How often you need to visit the doctor or clinic
• What daily activities are allowed or off-limits

After leaving the hospital you will return home.

You will have periodic follow-ups with the transplant team, as well as with your primary care doctor and any other specialists that may be recommended. The transplant services team will be available to answer any questions that you may have.

References

Herman M, Keaveny AP. Organ Transplantation. In: Walsh D, Caraceni AT, Fainsinger R, et al, eds. Palliative Medicine. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 183.

Bishop MR, Pavletic SZ. Hematopoietic stem cell transplantation. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 32.

American Cancer Society. What is a Bone Marrow or Stem Cell Transplant? Accessed March 16, 2010.

Update Date: 2/7/2012

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.