Organ Transplant Surgery

In an organ transplant surgery, a living organ is removed from a donor and placed in a recipient whose organ has been destroyed or failed beyond repair. This procedure frequently saves lives. It is currently one of the most efficient ways to treat a variety of illnesses due to advancements in immunosuppressive and surgical methods throughout the years.

A thorough medical examination is performed on the patient by the doctor in order to identify and address any health issues, such as renal and heart illness.

To ascertain whether the patient satisfies the transplant requirements, the transplant team assesses the patient and looks over their medical history. Guidelines for the majority of transplant kinds specify the kind of individual who will benefit from a transplant and can endure the hard procedure.

A patient gets added to a waiting list if the transplant team determines they are a good candidate. The patient's place on the waiting list depends on a number of factors, depending on the type of transplant received. (1)

Definition and Overview

Transplantation of human cells, tissues, or organs saves hundreds of lives and recovers vital functions in the absence of any alternative with similar effectiveness. A surgical operation in which tissue or an organ is transferred from one person (donor) to another (receiver) or from one part of the patient's body to another. 

Transplant surgeons collaborate with massive multidisciplinary teams to provide organ replacement surgery. A kidney transplant, for example, can prolong life, whereas a liver transplant can save it. Additionally, transplant surgeons frequently offer general elective surgery, dialysis access surgery, multiple organ removal, and on-call acute general surgery services. (2)

Procedures

The transfer of organs or tissues from one person (the donor) to another (the recipient) is referred to as transplant surgery.

There are many different types of transplant operations, depending on the organ or tissue being transplanted. Here are a few common examples:

• Liver transplantation

The liver is a complicated organ that makes blood clotting factors and many other essential compounds while also clearing the blood of many toxins and hazardous byproducts. Non-malignant diseases that destroy liver cells and primary liver cancer that affects the major liver cells or bile ducts are the two fatal types of liver disease that can be treated with liver vaccination.

Decades of liver damage can result in longer-term liver failure, commonly known as chronic liver failure. This is most frequently observed in alcoholics who experience liver cirrhosis or liver scarring. Autoimmune, viral, metabolic, oncological, or genetic disorders that result in persistent liver damage are other causes of chronic liver failure.

Candidates for transplants include individuals who have the best chance of surviving surgery and who adhere to conditions like medication, routine checkups, and dietary adjustments like quitting alcohol. Patients are placed on a waiting list, and the recipient's need's urgency is taken into consideration.

• Cardiothoracic transplantation

The majority of heart transplant candidates have advanced heart disease and substantial decompensation. This condition can be brought on by genetic abnormalities, coronary artery disease, and viral infections. Rarely, the heart and lungs can be transplanted together.

During the procedure, the patient's chest is opened, and a heart and lung bypass machine that maintains blood flow throughout the body is connected to the circulatory system. Blood vessels re-connect to the new, healthy heart once it has been implanted.

To recover from the procedure, patients might need to stay in the hospital for up to a month. The risk of sickness can be decreased by practicing good hygiene. To lower the danger of their new heart failing as well, individuals should adjust their lifestyles and get regular immunizations.

• Renal transplantation

A pair of organs located inside the abdominal cavity called the kidneys are necessary for maintaining life. Renal end-stage illness necessitates transplantation. Dialysis is one medical procedure that can be used to filter the patient's blood while waiting for the transplant. The final step is transplant surgery, which can take up to 4 hours.

The new kidney is situated in a different anatomical location from its malfunctioning predecessor—the lower abdomen. The name of this procedure is the heterotopic transplant. Contrarily, the heart and liver are transplanted orthotopically (i.e., in their original anatomical placements). 

Apart from the above, there are many types of transplant surgery. These include 

• kidney transplant, 
• lung transplant, 
• pancreas transplant, 
• intestine transplant, 
• cornea transplant, 
• one marrow transplant, 
• hematopoietic stem cell transplant.

The specific type of transplant surgery recommended for a patient depends on their medical condition, organ/tissue availability, compatibility, and other factors. (3,4)

Candidates

Depending on the type of transplant, there are different qualifying requirements and specific criteria. However, many people need an organ transplant due to 

• a genetic condition such as polycystic kidney disease, cystic fibrosis, or a heart defect,
• infections such as hepatitis, physical injuries to organs, 
• end-stage organ failure, meaning the organs are no longer functioning adequately,
• failure of medical treatments or no longer effective in the management of organ failure,
• damage due to chronic conditions such as diabetes. (5)

Risks and Side Effects

The advantages nearly always outweigh the risks for transplant patients. Without a transplant, the majority of those in need of an organ will die or live much shorter lives. However, transplants are risky procedures, especially because the patients who require them are frequently severely ill. These risks and side effects include

• complications related to the use of anesthesia, including death,
• bleeding or other complications during the procedure,
• post-surgical complications such as infection,
• higher risk of infection and other diseases due to anti-rejection or other transplant-related medications,
• organ rejection,
• organ failure. (6)

Post-Procedure and Follow-up

Post-procedure and follow-up process is a critical part of ensuring the success and long-term viability of the transplanted organ. After transplant surgery, the patient is monitored closely in the hospital's intensive care unit or specialized transplant unit for a period of time. The length of the hospital stay varies depending on the type of transplant and individual circumstances. Following discharge, transplant recipients visit the transplant center regularly for follow-up appointments. To assess organ function, medication levels, and general health during these visits, blood tests, imaging examinations, and other tests are performed.

Recovery

Recovery after transplant surgery can be both physically and mentally demanding. In addition to counseling services, support groups, and access to social workers who can help with the emotional components of the transplant journey, transplant hospitals frequently offer resources for emotional support.

To guarantee the sustained health and functionality of the donated organ, transplant recipients require lifetime monitoring and care. This entails routine follow-up appointments, continuing medication management, and compliance with advised medical and lifestyle recommendations.

Results

To maximize their recovery and long-term outcomes, transplant recipients should keep lines of communication open with their transplant team, report any changes in their health, and actively engage in their own care.