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Transplant surgery is the surgical removal of an organ(s), tissue, or blood products from a donor and surgically placing or infusing them into a recipient.
Transplant surgery is a treatment option for diseases or conditions that have not improved with other medical treatments and have led to organ failure or injury. Transplant surgery is generally reserved for people with end-stage disease who have no other options.
The decision to perform transplant surgery is based on the patient's age, general physical condition, diagnosis and stage of the disease. Transplant surgery is not recommended for patients who have liver, lung, or kidney problems; poor leg circulation; cancer; or chronic infections.
The typical cut-off age for a transplant recipient ranges from 40–55 years; however, a person's general health is usually a more important factor. In addition, the percentage of transplant recipients over age 50 has increased since 1996.
On average, 66 people receive transplants every day from either a living or deceased donor. In 2002, about 24,500 transplants were performed in the United States:
The national waiting list for most transplanted organs continues to grow every year, even though the number of recipients waiting for a heart transplant has leveled off in recent years, and the waiting list for heart-lung transplants has decreased over the past few years. As of April 2003, there were about 81,000 eligible recipients waiting for an organ transplant in the United States.
Organ donors are classified as living donors or cadaveric (non-living) donors. All donors are carefully screened to make sure there is a suitable blood type match and to prevent any transmissible diseases or other complications.
LIVING DONORS. Living donors may be family members or biologically unrelated to the recipient. From 1992 to 2001, the number of biologically unrelated living donors increased tenfold. Living donors must be physically fit, in good general health, and have no existing disorders such as diabetes, high blood pressure, cancer, kidney disease, or heart disease. About 25% of all
Organs donated from living donors eliminate the need to place the recipient on the national waiting list. Transplant surgery can be scheduled at a mutually acceptable time rather than performed under emergency conditions. In addition, the recipient can begin taking immunosuppressant medications two days before the transplant surgery to prevent the risk of rejection. Living donor transplants are often more successful than cadaveric donor transplants because there is a better tissue match between the donor and recipient. The living donor's medical expenses are usually covered by the organ recipient's insurance company, but the amount of coverage may vary.
CADAVERIC OR DECEASED DONORS. Organs from cadaveric donors come from people who have recently died and have willed their organs before death by signing an organ donor card, or are brain-dead. The donor's family must give permission for organ donation at the time of death or diagnosis of brain death. Cadaveric donors may be young adults with traumatic head injuries, or older adults suffering from a stroke. The majority of deceased donors are older than the general population.
Author Info: Angela M. Costello, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Surgery, 2004
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