Click the Type of Transplant Below to Learn More:
Kidney Transplant
What is a kidney transplant?
A kidney transplant is a surgical procedure where a healthy kidney from a donor is implanted into a recipient whose own kidneys are failing. It is typically performed on individuals with end-stage kidney disease to restore kidney function and improve quality of life. The transplanted kidney filters waste and excess fluids from the blood, replaces lost hormonal functions, and helps regulate blood pressure.
How does kidney transplant evaluation work?
Candidates for kidney transplants can find a transplant center near them by contacting their doctor or consulting the Scientific Registry of Transplant Recipients website.
The transplant center will then evaluate patients to determine if they are potential transplant candidates. This could involve several tests, including the exercise stress test, which measures heart fitness, the lung function test, which measures lung fitness, cancer screening, dental clearance, and more depending on the patient’s needs and circumstances.
Aside from these tests, the patient will undergo a Panel Reactive Antibody Test (PRA) to assess the level of antibodies in a patient’s blood that may react against donor tissue. It helps transplant teams determine the likelihood of a patient having pre-existing antibodies that could potentially cause rejection of a transplanted organ
What is the waitlist process like?
After a patient is approved for a transplant, they may either find a living donor or get on the waiting list for a deceased organ donor. It takes on average between two and seven years to obtain a kidney from a deceased donor, although several factors influence this period. Sensitized patients (meaning they have antibodies against common cell markers) will likely have to wait longer. While on the waiting list, patients should notify their transplant coordinator about any changes to medication, new allergies, or new support contacts. Patients on the transplant waiting list should keep their cell phones on them 24/7 and be able to travel to the transplant center quickly.
How does matching with a donor work?
The United Network for Organ Sharing (UNOS) matches the top donor kidney with the top patient on the waiting list. Then, UNOS contacts the patient’s transplant center, which contacts the patient. Before the surgery occurs, the patient will undergo a final test to determine whether they have antibodies against the potential kidney. In some cases, this prevents the surgery from occurring. Alternatively, if a donor kidney comes from far away, surgeons may deem it unfit for transplant. However, if this occurs, the patient should not be too concerned: they remain at the top of the list and are likely to receive another kidney soon.
What does kidney transplant surgery entail?
Kidney transplant surgery generally takes between two and four hours. First, a nurse will conduct a brief check-up on the patient, after which the patient will receive an IV. Then, anesthesiology professionals will administer medication that will put the patient to sleep. Following the surgery, patients will be taken to a recovery room for between two and six hours while medical staff monitor their vitals.
Health and recovery post-transplant
Risk of rejection
Following a kidney transplant, recipients should pay close attention to their weight, temperature, blood pressure, urine output, and heart rate. Abnormalities in any of these could indicate potential organ rejection.
Organ rejection refers to the immune system’s response when it identifies a transplanted organ as foreign and attacks it. This reaction occurs because the body’s immune system is designed to recognize and defend against foreign substances, including organs from another person. Organ rejection can be acute, happening shortly after transplantation, or chronic, developing over time. To prevent rejection, transplant recipients can take immunosuppressive medications that lower the immune response and help the transplanted organ function properly without being attacked by the body’s immune system. However, these medications can lead to other health risks.
General health information
Patients who have undergone kidney transplantation may be at higher risk of infection, but they can engage in healthy practices to reduce this likelihood. Transplant recipients should wash their hands regularly, consider wearing a mask in public, and maintain distance from sick people. Kidney transplant recipients may experience other medical complications such as increased blood pressure, new or worsened diabetes, high cholesterol, increased risk of heart attack and/or stroke, and psychological issues. Patients should consistently discuss with their doctors about side effects they are experiencing.
Aside from physical health symptoms, it is common for transplant patients to develop anxiety or depression following their surgery. Patients who do not notice an improvement in their quality of life as quickly as expected may be especially prone to these conditions. Another common mental health concern post-transplant is a fixation on the “numbers:” data from lab and clinical visits.
The American Transplant Foundation offers the 1+1=LIFE Mentorship Program to help patients struggling with mental health throughout the transplant process. We provide free support to transplant recipients, caregivers, living donors, and those on the transplant waiting list by pairing them with an experienced mentor. Mentors have undergone the transplant process and can answer questions, provide guidance, and engage in conversation to help their mentees.
FAQs and other resources
Have more questions about kidney transplants? Visit our Kidney Transplant FAQ Page.
For more information about living donation, check out our Living Donation Toolkit.
Review our Free Transplant Patient and Living Donor Checklists.
Liver Transplant
What is a liver transplant?
A liver transplant is a surgical procedure where a diseased or damaged liver is replaced with a healthy liver from a donor. It is typically performed in patients with end-stage liver disease or acute liver failure that cannot be treated effectively through other means. The transplant aims to restore normal liver function, improve quality of life, and prolong survival. It’s a complex procedure requiring careful matching of donor and recipient, and lifelong medical management to prevent rejection of the new liver.
Who might need a liver transplant?
A person may need a liver transplant if they are experiencing liver failure, primary liver cancer, or chronic liver diseases. People generally only undergo liver transplantation if nothing else is working, as the procedure is relatively high-risk, and securing a liver donor can be difficult.
There are two types of liver failure: acute and chronic. Acute liver failure is damage to a liver that was previously healthy, and it may arise from infection or poisoning. Acute liver failure usually must be treated within a few days, or it can become fatal.
Chronic liver failure is the final stage of progressive liver disease. Patients with chronic liver failure experience cirrhosis, or the replacement of healthy liver tissue with scar tissue that can cause the liver to break down. People with chronic liver failure can live for months or even years before obtaining a transplant, however, a longer wait generally brings more complications.
How does liver transplant evaluation and referral work?
The liver transplant process begins with referral from a doctor to a transplant center. Candidates for liver transplant can find a transplant center near them by contacting their doctor or consulting the Scientific Registry of Transplant Recipients website.
To qualify for a liver transplant, a person must fulfill the following requirements:
- Present clinical signs of liver failure/primary liver cancer
- Be able to recover from a potential surgery
- Show that they are not at risk for future drug/alcohol abuse.
A healthcare team will evaluate the person to determine if they meet the requirements, in which case they can enter the waiting list.
What is the waitlist process like?
Patients approved for liver transplants are placed on the liver transplant waiting list. A patient can be on the waiting list for between a few days to several years, depending on their location, blood type, and specific circumstances. Those with acute liver failure will go to the top of the list as they are in critical condition and require immediate care.
People with chronic liver disease will be scored using the MELD (Model for End-Stage Liver Disease) or PELD (Pediatric End-Stage Liver Disease) system. Using patients’ blood tests, the system determines a score based on bilirubin, prothrombin time, creatinine (used for adults), and albumin (used for children). Patients with liver cancer are scored on tumor size and wait time. There are also “exception points,” which take into consideration other conditions that may complicate a patient’s circumstances.
While on the waiting list, patients should notify their transplant coordinator about any changes to medication, new allergies, or new support contacts. Patients on the transplant waiting list should keep their cellphone on them 24/7 and be able to travel to the transplant center quickly, as livers can only stay viable for eight to nine hours.
How does matching with a donor work?
The United Network for Organ Sharing (UNOS) matches the top donor liver with the top patient on the waiting list through a computerized program. This program considers the person’s body size, blood type, and location—in most cases, the patient must match all three categories. Sometimes, two patients can receive a transplant from the same liver. This is because most adults require just one lobe or hemisphere of the liver, as it can regenerate. In addition, children usually need only 20% of the liver during transplant.
To be viable for transplant, a liver must be fully functional, meaning its tissue has not yet died. Therefore, the liver must come from a body that still has active blood flow. Healthcare officials will always evaluate a liver closely before matching it to the recipient.
Another option is to find a living donor. While doing so may be difficult, liver transplant recipients who have used a living donor are more likely to recover effectively. This process requires ensuring compatibility between the donor and recipient’s blood type and body size.
What does liver transplant surgery entail?
Liver surgery or Hepatectomy is a challenging procedure, in part because it involves blood transfusions. One main function of the liver is blood clotting in response to excessive bleeding. As a result, patients undergoing liver transplantation may bleed a lot and need blood transfusions. The surgical process takes between six and 12 hours on average, and patients must remain in the hospital for several weeks following their procedure.
Patients undergoing liver surgery will first be anesthetized and given several IVs that include:
- An IV to deliver fluids and medication
- An IV to monitor blood pressure and take blood samples
- A “breathing tube” attached to a ventilator that mechanically expands the lungs to ensure the patient continues breathing
- Tubes in the abdomen to drain fluid and blood from around the liver
- A nasogastric tube, which drains stomach secretion
- A catheter in the bladder to drain urine
After this, surgery will begin. A doctor will first cut along the abdomen to access the liver. Next, they will separate the liver and clamp any connected blood vessels and bile ducts. Lastly, they will attach the new liver and re-connect those vessels and ducts before sending the patient to the Intensive Care Unit.
Before a patient moves to the hospital’s recovery unit, they will be monitored closely to ensure the operation has been successful. For several days, healthcare workers will check the patient’s vitals and note any signs of potential complications. After this time, the patient will relocate to the recovery ward, where they will stay for a few more weeks.
Risks During Surgery
Liver transplant surgery is generally fairly successful, with a 75% average five-year survival rate. However, the surgery presents some risks, including blood clots, hemorrhage, bile duct injury, and liver failure.
Health and recovery post-transplant
Risk of rejection
Organ rejection refers to the immune system’s response when it identifies a transplanted organ as foreign and attacks it. This reaction occurs because the body’s immune system is designed to recognize and defend against foreign substances, including organs from another person. Organ rejection can be acute, happening shortly after transplantation, or chronic, developing over time. To prevent rejection, transplant recipients can take immunosuppressive medications that lower the immune response and help the transplanted organ function properly without being attacked by the body’s immune system. However, these medications can lead to other health risks.
Acute organ rejection occurs in 25-50 percent of all liver transplants within the first year; the highest risk period within this timeframe is the first four to six weeks. Early signs of acute organ rejection include high levels of liver enzymes, which can be confirmed through a biopsy. An additional five percent of liver transplant patients experience chronic rejection that does not improve through medication and can eventually result in liver failure.
General health information
Patients who have undergone liver transplantation may be at higher risk of infection, but they can engage in healthy practices to reduce this likelihood. Transplant recipients should wash their hands regularly, consider wearing a mask in public, and maintain distance from sick people.
Aside from physical health symptoms, it is common for transplant patients to develop anxiety or depression following their surgery. Patients who do not notice an improvement in their quality of life as quickly as expected may be especially prone to these conditions. Another common mental health concern post-transplant is a fixation on the “numbers:” data from lab and clinical visits.
The American Transplant Foundation offers the 1+1=LIFE Mentorship Program to help patients struggling with mental health throughout the transplant process. We provide free support to transplant recipients, caregivers, living donors, and those on the transplant waiting list by pairing them with an experienced mentor. Mentors have undergone the transplant process and can answer questions, provide guidance, and engage in conversation to help their mentees.
FAQs and other resources
Have more questions about liver transplants? Visit our Liver Transplant FAQ Page.
For more information about living donation, check out our Living Donation Toolkit.
Review our Free Transplant Patient and Living Donor Checklists.
Heart Transplant
What is a heart transplant?
A heart transplant is a procedure that replaces a patient’s diseased heart with a healthy one that comes from an organ donor. It is typically considered for patients with severe heart failure or heart conditions that cannot be effectively treated with medication or other therapies. The procedure involves removing the recipient’s damaged heart and connecting the donor heart, including the major blood vessels. While it can significantly improve the quality of life and survival rates for eligible patients, it requires lifelong medical management and careful monitoring to prevent rejection of the donor’s heart by the recipient’s immune system.
Who might need a heart transplant?
A person experiencing heart failure that cannot be treated with other methods may need a heart transplant. Heart failure is when weakness or damage to the heart prevents it from properly pumping blood. Conditions that may lead to heart failure include heart attack, viral infection of the heart, high blood pressure, heart valve disease, and congenital heart defects. Patients should consult their doctors to determine if they might be a candidate for a heart transplant.
How does heart transplant evaluation and referral work?
The heart transplant process begins with referral from a doctor to a transplant center. Candidates for heart transplant can find a transplant center near them by contacting their doctor or consulting the Scientific Registry of Transplant Recipients website.
The transplant center will then evaluate a patient to determine if they would be a strong candidate for heart transplants. The medical team may perform several tests, including but not limited to: blood type and antibody tests, cancer screenings, DEXA scans, imaging tests (X-rays, ultrasounds, and CT scans), pulmonary function tests, EKG, heart catheterization, and more. A patient’s specific tests depend on their case.
If the transplant center approves a patient for heart transplant, they will move onto the heart transplant waiting list.
What is the waitlist process like?
Patients approved for heart transplants are placed on the heart transplant waiting list. A patient can be on the waiting list for between a few days to several years, depending on their circumstances. This time range depends on the patient’s location, level of illness, blood type, availability of donor hearts, and other factors. Patients who are sensitized (meaning they have antibodies against common cell markers) will likely have to wait longer. While on the waiting list, patients should notify their transplant coordinator about any changes to medication, new allergies, or new support contacts. Patients on the transplant waiting list should keep their cellphone on them 24/7 and be able to travel to the transplant center quickly—most hearts must be transplanted within four hours after removal from the donor.
How does matching with a donor work?
The United Network for Organ Sharing (UNOS) matches the top donor heart with the top patient on the waiting list through a computerized program. For heart transplant candidates, UNOS considers medical urgency, distance from donor hospital, body size, and pediatric status.
What does heart transplant surgery entail?
Heart transplant surgery takes between four and 12 hours. First, medical staff attach an IV to the patient that provides fluids and medications. They also insert catheters to monitor the patient’s vitals and administer anesthesia. During the surgery, a ventilator and cardiopulmonary bypass machine allow the patient to continue to breathe and pump blood, respectively. The procedure entails separating a patient’s sternum, removing their diseased heart, inserting a donor heart, and ensuring that the blood vessels of the new heart are properly connected. Finally, doctors may insert wires that attach to a pacemaker and help pace the new heart. After surgery, a heart transplant recipient may remain in the hospital for one to two weeks to make sure they recover properly.
Health and recovery post-transplant
Risk of rejection
After receiving a heart transplant, patients should monitor their health closely and inform their doctor if they experience any of the following: fever, chills, redness/swelling around the incision or catheter sites, increase in pain around the incision site, difficulty breathing, fatigue, or low blood pressure. These symptoms may indicate that the patient’s body is rejecting the new heart.
Organ rejection refers to the immune system’s response when it identifies a transplanted organ as foreign and attacks it. This reaction occurs because the body’s immune system is designed to recognize and defend against foreign substances, including organs from another person. Organ rejection can be acute, happening shortly after transplantation, or chronic, developing over time. To prevent rejection, transplant recipients can take immunosuppressive medications that lower the immune response and help the transplanted organ function properly without being attacked by the body’s immune system. However, these medications can lead to other health risks.
General health information
Patients who have undergone heart transplantation may be at higher risk of infection, but they can engage in healthy practices to reduce this likelihood. Transplant recipients should wash their hands regularly, consider wearing a mask in public, and maintain distance from sick people. Heart transplant recipients may experience other medical complications and are at especially high risk of developing yeast infections, herpes, and respiratory viruses. Patients should consistently discuss with their doctors any side effects or symptoms they are experiencing.
Aside from physical health symptoms, it is common for transplant patients to develop anxiety or depression following their surgery. Patients who do not notice an improvement in their quality of life as quickly as expected may be especially prone to these conditions. Another common mental health concern post-transplant is a fixation on the “numbers:” data from lab and clinical visits.
The American Transplant Foundation offers the 1+1=LIFE Mentorship Program to help patients struggling with mental health throughout the transplant process. We provide free support to transplant recipients, caregivers, living donors, and those on the transplant waiting list by pairing them with an experienced mentor. Mentors have undergone the transplant process and can answer questions, provide guidance, and engage in conversation to help their mentees.
FAQs and other resources
Have more questions about heart transplants? Visit our Heart Transplant FAQ Page.
Lung Transplant
What is a lung transplant?
A lung transplant is a surgery that replaces one or both damaged lungs with a healthy lung or lungs from a donor. Patients who undergo this procedure often have late-stage lung disease that cannot be cured using other methods. Lung transplant recipients have a five-year survival rate of roughly 50-60% because the lungs are relatively fragile.
How does lung transplant evaluation work?
Candidates for lung transplants can find a transplant center near them by contacting their doctor or consulting the Scientific Registry of Transplant Recipients website.
The transplant center will then evaluate patients to determine if they are potential transplant candidates. This could involve several tests, including blood tests, a perfusion/ventilation scan (evaluates the blood supply to your lungs and the ability for air to ventilate through them), pulmonary function tests, imaging tests (such as X-rays and CT scans), an endurance test, an echocardiogram and electrocardiogram (to evaluate heart function), and more. The tests a patient receives depend on their condition.
In addition to these tests, a potential lung transplant recipient may work with a dietician, finance coordinator, pulmonologist, pharmacist, and other experts throughout their evaluation.
What is the waitlist process like?
After a patient is approved for a transplant, they may either find a living donor or get on the waiting list for a deceased organ donor. On average, it takes two years for a single lung transplant and three to four years for two lungs. Patients who are sensitized (meaning they have antibodies against common cell markers) will likely have to wait longer. While on the waiting list, patients should notify their transplant coordinator about any changes to medication, new allergies, or new support contacts. Patients on the transplant waiting list should keep their cell phones on them 24/7 and be able to travel to the transplant center quickly.
How does matching with a donor work?
The United Network for Organ Sharing (UNOS) matches the top donor lung with the top patient on the waiting list. Then, UNOS contacts the patient’s transplant center, which contacts the patient. For lung transplant patients, UNOS considers predicted survival benefit, medical urgency, geographical distance, and pediatric status.
What does lung transplant surgery entail?
A lung transplant surgery usually takes between six and eight hours, during which physicians replace a damaged lung or lungs with donor lung(s). After removing the diseased lung, a surgeon will connect the donor long at three locations: the main bronchus, lung artery, and lung veins.
During the procedure, medical staff may place the patient on a ventilator and insert plastic tubes into the neck, arms, and bladder. The tubes will provide the patient with necessary fluids and medications and allow for drainage. Doctors may also redirect the patient’s blood flow via bypass or an “ECMO” machine.
Immediately following surgery, a patient must stay in the intensive care unit (ICU) for one to two weeks (or longer). During this period, medical staff will monitor the patient’s vital signs, take blood samples, and provide medication. When the patient is ready, they will move to a different hospital unit to continue recovery.
Health and recovery post-transplant
Risk of rejection
Following a lung transplant, recipients should pay close attention to their temperature, breath, and heart rate. Patients should also monitor their incision site, watching for any leakage, redness, swelling, bleeding, or pain. Any abnormalities could indicate potential organ rejection.
Organ rejection refers to the immune system’s response when it identifies a transplanted organ as foreign and attacks it. This reaction occurs because the body’s immune system is designed to recognize and defend against foreign substances, including organs from another person. Organ rejection can be acute, happening shortly after transplantation, or chronic, developing over time. To prevent rejection, transplant recipients can take immunosuppressive medications that lower the immune response and help the transplanted organ function properly without being attacked by the body’s immune system. However, these medications can lead to other health risks.
General health information
Patients who have undergone lung transplantation may be at higher risk of infection, but they can engage in healthy practices to reduce this likelihood. Transplant recipients should wash their hands regularly, consider wearing a mask in public, and maintain distance from sick people.
Lung transplant recipients may experience other medical complications such as narrowing of the lung transplant airway, increased risk of some cancers and stroke, recurrent lung disease, heart problems, and psychological issues. Patients should consistently discuss with their doctors about any side effects they are experiencing.
Aside from physical health symptoms, it is common for transplant patients to develop anxiety or depression following their surgery. Patients who do not notice an improvement in their quality of life as quickly as expected may be especially prone to these conditions. Another common mental health concern post-transplant is a fixation on the “numbers:” data from lab and clinical visits.
The American Transplant Foundation offers the 1+1=LIFE Mentorship Program to help patients struggling with mental health throughout the transplant process. We provide free support to transplant recipients, caregivers, living donors, and those on the transplant waiting list by pairing them with an experienced mentor. Mentors have undergone the transplant process and can answer questions, provide guidance, and engage in conversation to help their mentees.
FAQs and other resources
Have more questions about lung transplants? Visit our Lung Transplant FAQ Page.
For more information about living donation, check out our Living Donation Toolkit.
