Patients and potential donors may have questions about the process.
- What is a transplant?
- When will I be placed on the organ transplant wait list?
- Why are there so many tests, and how long will it take me to complete them?
- How long will I have to wait for an organ transplant?
- How long will the transplanted organ last?
- What is immunosuppression medication? Will I have to take them for the rest of my life?
- How long will it be until I can get back to my normal life after my transplant?
- I have been told I am highly sensitized. Can I still receive a transplant?
- My potential donor and I have different blood types. Can I still receive a kidney from this person?
- Can I receive a transplant if I am HIV positive?
An organ transplant is when a healthy organ from a donor is surgically placed into a person with a failing organ due to illness or injury. A bone marrow transplant is when healthy bone marrow cells are injected into a patient whose bone marrow is not working properly.
You will be placed on the wait list after you have completed all of the necessary tests and received insurance approval, and the transplant selection committee at Scripps has had an opportunity to review the results and make sure it is safe for you to undergo a transplant. The committee may decide that you must fulfill certain additional requirements prior to listing.
The tests that are part of the evaluation process are required to make sure it is safe for you to receive a transplant. For example, if you were found to have heart disease during your evaluation, there may be some change in your medication or a procedure that you would require before it would be safe for your heart to undergo the transplant surgery. The entire evaluation process may take from one month to several months, depending on your condition and how quickly you can complete the necessary tests.
How long you will have to wait for your transplant depends on a number of factors, including:
- The type of transplant you require (liver, kidney, pancreas, or some combination).
- How quickly you complete the evaluation testing
- Whether you have other medical problems that require a waiting period. For example, you may receive a transplant after having certain types of cancer if you have received treatment and have demonstrated a long enough period without the cancer returning
- In the case of a liver transplant, how advanced is your condition
- Your blood type (certain blood types must wait longer than others)
- In the case of a kidney or pancreas transplant, how your immune system reacts to cells or organs from other individuals
- In the case of a kidney transplant, how long you have had kidney disease
In general, patients can wait months to years for a transplant from a cadaveric (deceased) donor. For patients with a living kidney donor, the wait can be significantly shortened since they need to wait only as long as it takes to complete both their evaluation and that of their donor (usually a few months). In addition, patients with kidney failure who agree to accept a kidney from an extended criteria donor currently wait less than a year at Scripps for their transplant.
How long the transplanted organ will last depends on a number of factors. In most cases, the new organ should last for the rest of your life. In some cases, a transplant does not last that long. This could be for several reasons including:
- Recurrence of the disease process that damaged your original organ
- Rejection of the organ by your immune system
- Drug reaction
Fortunately, in most cases these problems can be treated.
Yes, you will. When you first go home after your transplant, you will be on roughly 10-12 new medications. These medications lower or “suppress” the immune system so that it will accept an organ from someone else. Without these medications, your immune system would attack your new organ. These medications have a number of side effects including making your body more susceptible to certain infections. With time, that number will be reduced by your transplant physician.
Some patients cannot take traditional steroid-based drugs for immunosuppression. These patients may qualify for steroid-free immunosuppression.
Most patients can get back to a relatively normal life in about 3 months. You will be in the hospital for about a week. When you go home, you will need help taking care of yourself. For the first 4-6 weeks, you will be instructed not to lift anything heavier than a phone book. It will probably be 2-3 months before you are ready to drive and probably 3-6 months before you are ready to go back to work. For some patients the rate of recovery is faster, for some slower. It will depend on how ill you are before your transplant and whether you have any complications.
If you have a potential kidney donor to whom you are sensitized, you may be a candidate for the desensitization protocol at Scripps. In certain cases, this protocol can remove the sensitization and make the transplant possible. Please ask your transplant coordinator for more information if you have a donor to whom you are sensitized.
If you have a potential kidney donor who has a different blood type than you, he or she may still be able to donate a kidney to you. In certain circumstances, donors of one blood type can give a kidney to a recipient with a different blood type. Some cases require special medications and some do not. Please ask your transplant coordinator for more information if you have a donor who has a different blood type for more information.
Being HIV positive in and of itself is not a contraindication to receiving a kidney or liver transplant. What does matter is the following:
- Are you on stable HAART therapy?
- Have your physicians been able to help you maintain adequate CD4 counts?
- Have your physicians been able to help you maintain adequate suppression of the viral load?
- Have you had any AIDS-defining illnesses and if so, which?