Types of organs and tissues that can be donated for transplantation

Organ and tissue donations can save and significantly improve the lives of many people who are sick or dying. For many people with a serious or critical illness related to organ failure, organ transplantation is the only hope for a healthy life. Organ and tissue donation involves removing organs and tissues from someone who has died (a donor) and transplanting them into someone who, in many cases, is very ill or dying (a recipient). Organs that can be transplanted include the heart, lungs, liver, kidneys, intestine and pancreas. Tissues that can be transplanted include heart valves and other heart tissue, bone, tendons, ligaments, skin and parts of the eye such as the cornea and or sclera.

Source of Organs for Transplant

Source may be, Living or Deceased Donor

Living Donor Transplant:

• Near Relative donor (mother, father, son, daughter, brother, sister, spouse, grandchildren and grandparents)
• Other than near relative donor: Such a donor can donate only for the reasons of affection and attachment or for any other special reason and that too with the approval of the authorisation committee.
• By SWAPPING of near relative donors between pairs of unmatched donor and recipient

Deceased donor Transplant:

• Donor after Brain stem death: Organ Donation is practically possible in the situation of Brain stem death e.g. a victim of road traffic accident or cerebrovascular accidents etc. where the brain stem is dead and person cannot breathe on his own but can be maintained through ventilator, oxygen, fluids etc. to keep the heart and other organs working and functional.
• Donor after cardiac death (DCD): Practically in Indian scenario only tissues are donated after cardiac death. But few centres like PGI Chandigarh has started DCD

Organs that can be donated

Heart

The heart pumps blood around the body, and the blood carries oxygen to all other organs. If the heart cannot pump blood properly, the rest of the body can become sick very quickly. Some people with heart failure, viral infection, or a congenital heart defect, require a heart transplant to survive. Heart transplants are performed when all other forms of medical treatment have failed. Artificial hearts can be used temporarily until a human heart is available. If the whole heart cannot be transplanted, heart valves can still be donated.

Lung

The lungs provide oxygen to the blood and remove carbon dioxide. Lung transplants are often needed by people with cystic fibrosis or emphysema whose own lungs cannot provide enough oxygen to their bodies. The two lungs can be transplanted together into one recipient or separated and transplanted as single lungs into two recipients. Many people believe that smoking will prevent lung donation. However, this is not true. There are tests that can be done in Intensive Care to check how well the lungs work and these results determine suitability for donation.

Kidney

The main function of the kidneys is to filter waste products from the blood. When the body has taken what it needs from food, wastes are then sent to the blood, filtered by the kidneys, and sent from the body as urine. If the kidneys are damaged or diseased and not able to filter the blood properly, wastes begin to build up in the blood and damage the body. People with severe kidney failure are put on dialysis, which filters waste products from the blood when the kidneys cannot. However, many of these people will need a kidney transplant to stay alive. The two kidneys can be transplanted together into one recipient, or separated and transplanted into two people.

Liver

The liver is a complex organ with many functions. Its main functions are to maintain a balance of nutrients (e.g. glucose, vitamins and fats), to remove waste products and to regulate blood clotting. People with metabolic liver disease, Hepatitis B or C, and congenital liver defects such as Biliary Atresia can all require liver transplants to stay alive. The liver is a unique organ as it can regrow. This means that an adult liver can be reduced in size and transplanted into a small child where it can then grow with the child. Alternatively, the liver can be divided and transplanted into two recipients.

Pancreas

The pancreas contains cells called Islets that produce insulin to regulate the body's blood sugar levels. In people with Type-1 Diabetes, the Pancreas produces little or no insulin, and it can be extremely difficult to control blood sugar levels even with insulin injections. At present, the majority of pancreas transplants are performed on people who have Type 1 Diabetes which can also cause kidney failure. For this reason, the pancreas is often transplanted with a kidney from the same donor.

Tissues that can be donated

Eye tissue

Donation of eye tissue can allow transplantation of the cornea and the sclera. The cornea is the clear tissue which covers the coloured part of the eye. It allows light to pass through to the retina, giving sight. Corneal transplants restore sight to people who are partially or completely blind due to corneal damage following a genetic condition, illness or injury. The sclera is the white part that surrounds the eye. Scleral grafts are performed to prevent blindness due to injury or in people who have had cancer removed from their eye.

Bone

Donated bone tissue can be grafted to replace bone which has been lost as a result of tumours or through other disease or accidents. It is also used to aid fracture healing, strengthen hip and knee joint replacements, and to repair curvatures of the spine (scoliosis) in children and teenagers. Depending on the type of transplant required over ten people can benefit from a single bone donation.

Skin

People who have suffered extensive trauma, infection damaging or destroying the skin, or severe burns can require skin grafts to become healthy again. When skin is donated, only a thin layer is retrieved, somewhat like the skin that peels in sunburn. It is usually retrieved from the person's back and the back of their legs. On average, skin from three donors is needed for one recipient.

Tendons

Tissues which attach muscles to bones. Tendon transplants are recommended for patients who have lost muscle function due to nerve injury or damage to tendons. It improves the recipient's life and makes it pain free.

Heart tissue

While the heart can be donated as a whole organ, heart tissues can also be donated separately. Donated heart tissues such as heart valves are primarily used to repair congenital defects in young children and babies. The tissue is also used to replace diseased valves in adults.

Source : NOTTO