Organ and tissue transplantation

Transplantation is a surgical procedure in which an organ/s, tissue or a group of cells are removed from one person (the donor) and surgically transplanted into another person (the recipient), or moved from one site to another site in the same person.

Organ and tissue donation and transplantation – can save lives. They can also restore function to improve quality of life. For example, transplanting the clear tissue that covers the eye (cornea) is not necessary for life, but can restore sight.

Types of transplantation

Transplantation is a complex area of medicine because when organs or tissues are transplanted from one person to another, the recipient’s immune system can reject and destroy the donor organ or tissue, and medication is needed to supress this immune response. The treatments used vary depending on the tissue or organ being transplanted, the level of compatibility between the donor and the recipient, and other factors.

Transplants of tissues in the same person

A transplant from one part of your body to another part is called an autograft and the process is called autotransplantation.

Some examples of autografts include:

• skin graft – uses healthy skin to help heal a wound or burn on another part of the body
• blood vessel graft – provides an alternative route for blood flow to bypass a blocked artery, for example, in heart bypass surgery
• bone graft – reconstructs a damaged area of the body, for example, in spinal fusion
• bone marrow graft – for example, in a person with cancer, bone marrow collected before chemotherapy can replace their blood stem cells after high-dose chemotherapy.

The advantage of an autograft is that the person’s body is unlikely to reject their own cells, so long-term medication to suppress the immune system (immunosuppressants) is not needed. However, the retrieval (collecting) of the tissue creates a new wound in addition to the transplant site, from which the person will need to recover.

Transplants from other people

A transplant between two people who are not genetically identical is called an allotransplant and the process is called allotransplantation. Donor organs and tissues can be from people who are living, or people who have died because of a significant brain injury or lack of circulation.

Allotransplantation can create a rejection process where the immune system of the recipient attacks the foreign donor organ or tissue and destroys it. The recipient may need to take immunosuppressive medication for the rest of their life to reduce the risk of rejection of the donated organ. Speak to your doctor if you are concerned about the long-term health risks of taking immunosuppressants.

For some transplants (especially bone marrow), there is also the possibility that immune cells in the donated bone marrow will recognise the host’s body as foreign and attack the cells of the host. This is known as graft-versus-host disease (GvHD). Doctors can take steps to try to reduce the risk of GvHD.

A transplant between identical twins is called an isograft. The recipient will almost never reject an isograft and so immunosuppressants are not needed.

For around 1,900 Australians currently on the organ transplant waitlist, it can be a matter of life and death. There are an additional 13,500 people on dialysis, some of whom may benefit from a kidney transplant.

One organ donor can save up to 7 lives and help many more through eye and tissue donation.

If you would like to become an organ and/or tissue donor you can join the Australian Organ Donor Register.

Ways to register your donation decision include:

• Visit the DonateLife website and register in one minute. You will need your Medicare card.
• Sign into your Medicare account on MyGov or on the Express Plus Medicare mobile app (Services Australia) where you can register in three taps.
• Call the Australian Organ Donor Register to register over the phone, or ask for a registration form to be mailed to you: Tel. 1800 777 203

Be sure to have the conversation with family and friends about your donation decision.

Transplants from other species

A transplant between species is called a xenotransplant and the process is called xenotransplantation. Heart valves from cows and pigs have been used for many years to replace faulty heart valves in people. The animal valves are treated before use to reduce the risk of the immune system rejecting the valve. Heart valves may also be replaced with human valves (allotransplant) or mechanical heart valves.

Organs and tissues transplanted

Transplants can be for:

• organs – heart, kidney, liver, lung, pancreas, stomach and intestine
• tissue – cornea, bone, tendon, skin, pancreas islets, heart valves, nerves and veins
• cells – bone marrow and stem cells
• limbs – hands, arms and feet.

Multi-organ transplants, while less common than single-organ transplants, occur each year. Common multi-organ transplants include heart and lungs, or pancreas and kidney.

The approach to transplantation varies greatly depending on the type of transplant. Talk to your medical team about surgical procedures, recovery and medication.

Where to get help

• Your GP (doctor)
• Medicare
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• DonateLife Victoria Tel. (03) 8317 7400