Human organs for transplantation

Human organs for transplantation (stefanamer, iStockphoto)

Organ Transplantation

Let's Talk Science

Summary

Learn about organ transplantation - what it is, how it can save lives, how your immune system responds, and how the matching process works.

Do you know someone who has received or donated an organ? If so, they were involved in an organ transplant. Organ transplants were an important step in medical history. They provided a new way to help people suffering from organ failure or incurable disease. 

What is an organ transplant? 

An organ transplant involves removing a healthy organ from one person and surgically placing it in another person. The person who is giving the healthy organ is called the donor. The person who is receiving the healthy organ is called the recipient. Depending on the organ that’s being donated, the donor may be dead or alive. In Canada, on average, there are about 4 500 people waiting to receive a life-saving organ. Unfortunately, every year about 260 of those people die while they are waiting. 

Did you know? 

In Canada, 76% of people waiting to receive an organ require a kidney. The most required organs after the kidneys are the liver, lungs, and heart. 

You may be surprised by the types of organs and tissues that can be transplanted. They range from entire organs, such as the heart, lungs, and kidneys, to tissues such as bone marrow, ear structures, and heart valves. 

Potential types of organs and tissues for transplantation
Potential types of organs and tissues for transplantation (Let’s Talk Science using an image by Pikovit44 via iStockphoto).

History of Organ Transplants

When you think of your organs, what do you think of? Your heart? Lungs? Kidneys? Liver? All of those are organs that can be transplanted.

Do you ever think about your skin? That’s an organ, too. In fact, the first organ transplant was actually a skin transplant. A Swiss doctor named Jacques-Louis Reverdin performed the first successful skin transplant in 1869. This surgery paved the way for other types of organ transplants.

It wasn’t until 85 years later, in 1954, that the first successful kidney transplant took place. It was performed by Joseph Murray in Boston, Massachusetts. The recipient and the donor were identical twin brothers. Murray later won a Nobel Prize in Physiology and Medicine for his work. 

In 1960, the first successful kidney transplant between people who weren’t twins was performed. Then, in 1967 came three more first successful surgeries: pancreas, liver and heart transplants.

The Process of an Organ Transplantation

To understand the process of an organ transplant, let’s look at how kidney transplants work. Kidney transplants are one of the most common and necessary types of organ transplants. The kidneys remove urea and other liquid waste from the body in the form of urine. They help balance salts and other nutrients in the blood. They also help regulate blood pressure. 

The human body has two kidneys. But it can work with just one. This means that, unlike some organs, a donated kidney can come from a donor who is alive. This is called a living donation. But recipients can receive kidneys from a donor who has died as well. 

Once a recipient has been matched with a donor kidney, a transplant can take place. The patients are anesthetized, or put to sleep, for this type of transplant surgery. 

Then: 

  • the surgeon makes a long incision or cut along one side of the donor’s lower abdomen, under the ribcage.
  • The surgeon inspects the donor kidney.
  • The surgeon places the kidney in the recipient’s belly. A “left” kidney will be placed on the patient’s right side, and a “right” kidney will be placed on a patient’s left side. This makes it easier to connect the kidney to the bladder
  • The surgical team sews the renal artery and veins of the donor kidney to the corresponding artery and veins in the recipient's body.
  • The surgeon checks for proper blood flow between the recipient’s body and the new organ.
  • The surgeon attaches the ureter of the donor kidney to the recipient’s bladder. 
  • The incision is sewn shut.
  • The transplant is complete! 
The transplanted kidney is attached to the renal artery and veins and via a new ureter to the bladder
The transplanted kidney is attached to the renal artery and veins and via a new ureter to the bladder (Let’s Talk Science using an image by BruceBlaus [CC BY-SA] via Wikimedia Commons). 

Did you know? 

During a kidney transplant, the diseased or non-functioning kidneys are usually left in the body. The new kidney is just added in! 

Organ Donation Complications

A major issue with organ donation is rejection. Rejection occurs when a recipient’s immune system attacks a transplanted organ. 

Your immune system launches an immune response whenever it detects foreign substances or objects in your body. An immune response is triggered by proteins on the outside of a foreign object. These are called antigens. If the proteins on a donor organ are too different from the antigens in the recipient's body, the recipient’s immune system will attack the new organ. That’s why it’s very important for doctors to match a donor and recipient’s blood type and tissue type antigens as closely as possible. 

The more similar the protein antigens are between a donor and recipient, the more likely it is the transplant will be successful. Have you ever heard of someone getting an organ from a relative? That’s because doctors often look for an organ match in the family first. Relatives are more likely to have similar tissue and blood type antigens.

Rejection can happen in minutes, or it can take many years. Doctors closely monitor a patient the first few weeks or months after an organ transplant. The doctor wants to make sure the patient is not experiencing acute rejection. That’s the name for a complication within the first few months of a transplant.

Organ rejection was very common until the 1980s. Organ transplants weren’t done very often because of this. It was just too risky for the recipient. But now, doctors can give patients anti-rejection medications. Thanks to these medications, organ transplants are successful much more often than in the past.

Organ donors save lives

In Canada, 90% of people agree with organ donation. But only 20% have plans to donate. One organ donor can save up to 8 lives. One tissue donor can help improve the lives of over 75 people! 

Did you know?

Green Shirt Day is April 7. It is a day to raise awareness of organ donation and register organ donors across Canada. It is championed by the parents of Logan Boulet, a young hockey player on the Humboldt Broncos who became an organ donor after the terrible bus crash that took his and 15 other lives.

If you want to help make a difference, you can talk to your friends and family about becoming organ donors, or about becoming a donor yourself. To do this, you can join a donor registry. In Canada, each province has different regulations on how to register to become an organ donor

 

Learn More

The Messy Path to the First Successful Organ Transplants (2018) 

Humans have a long history of trying to improve our health through organ transplants. This video from SciShow (10:04 min) explains some of the first known experiments, and how they eventually led to successful operations. 

Why Canada struggles to perform just 600 organ donations per year (2019) 

This video by Global News (2:19 min) investigates the reasons why too few organ transplants happen in Canada. 

How do your kidneys work? (2015) 

This video by Emma Bryce (Ted-Ed) (3:54min) demonstrates how your kidneys work as internal sensors, balancing many important things in your body. 

How Your Blood Type Protects and Hurts You (2017) 

This video by SciShow (4:57 min) explains how your blood type can affect different aspects of your health. 

 

References

Cleveland Clinic. (2016). Organ Donation and Transplantation. https://my.clevelandclinic.org/health/articles/11750-organ-donation-and-transplantation

Johns Hopkins Medicine. (n.d.) Kidney Transplant. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/kidney-transplant

Medline Plus. (2019). Transplant rejection. https://medlineplus.gov/ency/article/000815.htm

The Organ Project. (2017). Facts and Figures About Organ Donation and the Waiting List. http://www.theorganproject.net/transplantation-statistics/

United Network for Organ Sharing. (n.d.) History of transplantation. https://unos.org/transplant/history/

US Government Information on Organ Donation and Transplantation. (n.d.) Timeline of Historical Events and Significant Milestones. https://www.organdonor.gov/about/facts-terms/history.html