Organ Transplant

Overview

What is an organ transplant?

An organ transplant replaces a failing organ with a healthy organ from another person. Organs most often transplanted are:

More than one organ can be transplanted at one time. For example, a heart and lung transplant is possible.

Who can get a transplant?

Your doctor or a transplant centre will do tests to see if you are a good candidate for an organ transplant. If your tests show that you're a good candidate, you may be able to get a transplant from a living donor. Or you may be put on a waiting list.

Each transplant centre has its own criteria for who is a good candidate for an organ transplant. You may not be a good candidate if you are above a certain age or weight or if you have certain infections or medical conditions.

How successful are organ transplants?

Transplants are more successful today than ever before. Organ transplant success depends on:

• Which organ is transplanted.
• How many organs are transplanted. For example, you could have a heart transplant or a heart and lung transplant.
• The disease that has caused your organ to fail.
• Whether you have unhealthy behaviours such as smoking.
• How well you take your medicines as prescribed.

Here are the chances of being alive 5 years after having an organ transplant. These numbers are averages. Your personal chances will depend on your health, the donor organ, and other things.^{footnote 1}

• Heart: About 8 out of 10 people
• Intestine: About 6 out of 10 people
• Kidney: About 9 out of 10 people
• Kidney and pancreas: About 9 out of 10 people
• Liver: About 8 out of 10 people
• Lung: About 6 out of 10 people
• Pancreas: About 8 out of 10 people

What can you expect after a transplant?

After a transplant, many people say they feel better than they have in years. You'll take medicines to prevent your immune system from rejecting the new organ. You'll have checkups and blood tests to see how well the organ is working. You may need to make some lifestyle changes to keep the organ healthy. Screening for certain cancers is also very important after an organ transplant.

Who can be an organ donor?

Some people who are critically ill need an organ transplant to live. But there are a lot more organs needed than are available.

Many people choose to donate organs upon their death. But you can donate certain organs while you are still living.

Donor organs are needed. If you are interested in donating an organ, go to the Canadian Blood Services Organs and Tissues for Life web page (organtissuedonation.ca) to register.

What to know

• Most adults can become organ donors.
• You can donate to someone you know or to someone in need by donating to your provincial organ donor organization.
• Organs you can donate include your heart, kidneys, liver, lungs, and pancreas.
• If you have questions about organ donation, talk to your doctor, a trusted friend, or your faith leader.
• Most religions allow organ donation.
• You will not be denied life-saving care if you need it. Provincial laws and emergency medical practices ensure that your life comes first. The medical staff who take care of you are completely separate from the organ donation system. Only when a donor has died does a medical team contact the organ donation network to arrange a donation.

Learning About Transplants

Getting on the waiting list

Receiving a donor organ can be a long process. You'll first get an evaluation by a medical team. If they determine you are a good candidate for a transplant, you will be put on an organ donor waiting list.

To get on the waiting list, you will need to:

• Get a referral from your doctor.
• Call the transplant centre where you choose to have your transplant. To find a transplant centre near you, ask your doctor.
• Schedule an appointment for an evaluation at the transplant centre to find out if you're a good candidate for a transplant. Your transplant centre can do all of the required tests. Or your doctor may be able to order some of the tests and send the results to the centre.

During your evaluation, learn as much as you can about the transplant centre, and if support groups are available.

The transplant centre will notify you to let you know if you have been placed on the waiting list. If you have questions about your list status, contact the transplant centre where you were evaluated.

It may be days, months, or even years before you receive a new organ. And some people may never get an organ. When an organ is found, your transplant team will consider whether the donor is a good match for you, the status of your current health, and how long you've been on the waiting list. Your team will also consider the location of the donated organ. That's because it must be transplanted quickly to remain in working order.

Thinking about and waiting for a transplant can affect you emotionally. You may find it helpful to see a psychiatrist, a psychologist, or a licensed mental health counsellor about your transplant.

Tests you'll need before your transplant

You will need some assessments before you have an organ transplant. The results will be used to match you with an organ donor. Assessments that are done for all organ transplant candidates include:

A cross-match for transplant.

This blood test shows whether your body will immediately reject the donor organ. It will mix a donor's blood with your blood to see if your antibodies attack the antigens of the donor.

Antibody screen.

A panel-reactive antibody (PRA) test measures whether you have antibodies against a broad range of people. If you do, it means that you're at higher risk of rejecting an organ, even if the cross-match shows that you and the donor are a good match.

Blood type.

This blood test shows which type of blood you have. Your blood type should be compatible with the organ donor's blood type. But sometimes it's possible to transplant an organ from a donor with a different blood type.

HLA type.

This blood test shows the genetic makeup of your body's cells. We inherit three different kinds of genetic markers from our mothers and three from our fathers. HLA type sometimes plays a role in matching an organ recipient to a donor.

Mental health assessment.

At these visits, an evaluator looks at your emotional health, your social support, and how donation might affect you. A living donor may also be required to have this assessment before donating an organ.

What to do if you're not a good candidate for a transplant

If you are told that you are not a good candidate for organ transplant, find out if there are other treatments for your condition. Many people can live for years with serious health conditions.

The goal of your care may shift to maintaining your comfort. Talk to your loved ones about the type of care you would like to receive. Discuss their expectations as well as your wishes, care needs, and finances and the needs of your family. Your choices may change as your illness changes.

How well transplants work

Organ transplant success depends on:

• Which organ is transplanted.
• How many organs are transplanted. For example, you could have a heart transplant or a heart and lung transplant.
• The disease that has caused your organ to fail.
• Whether you have unhealthy behaviours such as smoking.
• The age of the donor organ. In general, the younger the organ donor, the healthier the tissue. But recent research is challenging this thought. It may be that some older organs work just as well as younger organs.
• The length of time that the donor organ is out of the donor's body. The more quickly an organ is transplanted after it is removed from the donor, the more likely that the transplant will succeed.
• How well the organ was preserved just before transplantation. The donor organ must be properly preserved while it is being transferred, especially if it was transferred from a long distance.
• How well you take your medicines as prescribed.

Here are the chances of being alive 5 years after having an organ transplant. These numbers are averages. Your personal chances will depend on your health, the donor organ, and other things. ^{footnote 1}

• Heart: About 8 out of 10 people
• Intestine: About 6 out of 10 people
• Kidney: About 9 out of 10 people
• Kidney and pancreas: About 9 out of 10 people
• Liver: About 8 out of 10 people
• Lung: About 6 out of 10 people
• Pancreas: About 8 out of 10 people

Organ rejection is possible. When a new organ is placed into your body, your immune system sees it as foreign and tries to destroy it. Anti-rejection medicines can help prevent your immune system from attacking the donor organ.

Learn more

Preparing for a Transplant

Take care of your health. Continue to take your medicines as prescribed and get regular blood tests. Follow your doctor's directions for eating and exercising. You also may want to talk with a psychiatrist, psychologist, or licensed mental health counsellor about your transplant.

Learn more about what happens. Talk to someone who has had a transplant. Your transplant centre or doctor can give you the name of someone who is willing to share their experience with you.

You may worry about organ rejection or that your surgery won't succeed for another reason. These thoughts are common. Many people write an advance care plan and choose a substitute decision-maker while they wait for a transplant.

Getting ready for the call

While you are waiting for your organ transplant, be sure you always have your phone close by and are available to answer so the transplant centre can contact you to tell you when an organ is available. You may also wish to give the transplant centre several numbers where you can be reached and the name and number of a few people who will always know how to reach you.

Arrange in advance for someone to go with you to the transplant centre. This person can support you, listen to your doctor, and help you remember important instructions. This person can also report any change in behaviours or symptoms that you may have either before or shortly after the transplant.

Have your suitcase packed with the things you need to take with you to the transplant centre. Your support person should also have a bag packed and ready to go.

Learn more

At the Hospital

When you arrive at the hospital or transplant centre, final tests will be done to make sure the donor organ is one that will likely work for you.

• If your doctors feel that a transplant with this organ has a good chance of being successful, you will have transplant surgery right away.
• If your doctors decide that a transplant with this organ does not have a good chance of being successful, the organ will be given to a person who is a better match. You will return home and continue to wait for your new organ.

If your current health condition requires that you be hospitalized while you wait for a donor organ, you will receive supportive and life-saving care (such as blood pressure support for heart failure) until you are matched with a donor organ. During that time, you will be given medicines to prepare you for the surgery and to prevent rejection.

After your transplant, the amount of time you'll spend in the hospital depends on how healthy you are before the surgery, which organ was transplanted, and how well your body accepts the donated organ.

A longer hospital stay may be needed for a heart or lung transplant than for a kidney transplant. Some people are out of the hospital within a few days after their transplant. Others may need to stay for a few weeks.

After the Transplant

After a transplant, many people say they feel better than they have in years. What you can and can't do will depend on the type of transplant you had, other health problems you have, and how your body reacts to the new organ.

You will have to take daily medicines to prevent your immune system from rejecting the new organ. You will need less of these medicines as time goes by. Because these medicines weaken your immune system, you may have to stay away from large crowds for a while and stay away from people who have infections.

You will also have regular checkups and blood tests to see how well your new organ is working. Screening for certain cancers is also very important after an organ transplant.

You may also have side effects from your anti-rejection medicines. And you may be at increased risk for getting conditions such as diabetes or some cancers.

An organ transplant may cause many emotional issues both for you and for those who care about you. When your organ comes from a deceased donor, you may sometimes think about that and what that meant to the donor's family.

It's common to have some depression after an organ transplant, but not everyone does. If you think you may be depressed, it is important to tell your transplant coordinator, doctor, or someone who cares about you.

You may need to make some lifestyle changes to keep your new organ healthy and strong. This can include eating healthy foods, getting regular exercise, and getting enough sleep.

Learn more

Staying Healthy

To keep your new organ healthy and to help you live longer after an organ transplant:

• Keep your doctor appointments.

  Regular follow-up with your doctor is important to check for organ rejection.

• Make taking anti-rejection medicines part of your daily life.

  It may help to talk to someone who has had a transplant. This person can talk to you about how you can make taking anti-rejection medicines part of your daily life. You will probably need fewer of these medicines over time. You may also need other medicines to fight infection or other health problems related to your transplant.

• Get regular blood and tissue tests.

  These tests help your doctor know whether the new organ is accepted or rejected. Rejection doesn't mean that you will lose the new organ. Adding or changing medicines may still prevent rejection.

• Take your medicines exactly as prescribed.

  Talk with your doctor to make sure you understand what to do if you miss a dose.

• Don't take any non-prescription medicines before talking with your doctor.

  These include cold remedies or natural health products. Other medicines may interact poorly with your anti-rejection medicines.

• Know the side effects of the anti-rejection medicines.

  If you have severe side effects, tell your doctor right away.

Taking steps to stay healthy

Here are some tips to help you and your new organ stay healthy.

• Eat regular, healthy meals to control your weight, blood pressure, cholesterol, and blood sugar levels.

  Be sure to get plenty of calcium and vitamin D to help prevent osteoporosis, or thinning bones.

• Get regular exercise.

  Activities like walking, exercises in the water, and yoga can help you keep your body and new organ healthy.

• Watch for changes from how you normally feel, how much energy you have, and how active you are.

  This can help you identify new problems as they come up.

• Tell your dentist that you have had an organ transplant.

  The anti-rejection medicines may increase your risk of mouth infections. Special precautions may be needed in teeth cleaning or other dental work.

• Stay away from people who are sick.

  Your immune system is weakened by the anti-rejection drugs. Before you do any travelling, talk with your doctor to see if you need to take any precautions.

• Carry a medical identification card or wear a medical ID bracelet that states that you have had an organ transplant.

Learn more

Becoming an Organ Donor

The following tips can help you plan to be an organ donor.

• Get more information.

  Most people can be organ donors. If you are interested in donating organs or tissues, go to the Canadian Blood Services Organs and Tissues for Life webpage (organtissuedonation.ca) to register.

• Put your name on your province's donor registry.

  Many provinces give you the option to become a donor when you apply for a driver's licence or when you renew your licence. Other provinces have a form you can fill out in person or online and file with your provincial organ donor registry. Either way, your name goes on a list of possible donors, and your status is noted on your driver's licence or provincial health care card. To find out what's required in your province, go to the Canadian Blood Services Organs and Tissues for Life webpage (organtissuedonation.ca) to register.

• Let your family, friends, and doctor know.

  Include your wish to be an organ donor when you prepare an advance care plan.

People of any age can register to be organ donors. In many provinces there's no minimum age, though an adult might have to sign for someone under age 18. There may be an upper age limit, depending on your province and the type of organ.

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