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Organ donation is a social welfare act through which living or deceased donors can donate their organs to people who are in need of those organs due to illness. Only healthy organs and tissues from the donor are transplanted into the receiver. Organs that can be donated by deceased people include internal organs such as kidneys, liver, heart, pancreas, intestines, and lungs; bone and bone marrow; skin; and cornea. According to the US National Institutes of Health (NIH), organs donated by one donor can help save over 50 people.
However, living donors cannot donate most organs. Kidneys are the most commonly donated organs by living donors.
On the occasion of World Organ Donation Day, ABP Live spoke to Dr Dinesh Balakrishnan, Clinical Professor, GI Surgery & Centre for Organ Transplantation, Amrita Hospital, Kochi; and Dr Sujit Chatterjee, CEO, Dr L H Hiranandani Hospital, Mumbai, and asked them if living donors can donate organs such liver, lung, pancreas or heart, and what the scientific procedure of the transplant is.
Which organs can living donors donate?
Kidney, liver and pancreas transplant are the only kinds of organ donation possible from living donors, the experts said. Lung and heart transplants from living donors are currently not feasible. However, research is underway to check possibilities of transplanting parts of lungs, heart and pancreas from living donors.
“Living donors can donate certain organs through surgical procedures that involve removing a portion of the organ while leaving enough behind for the donor’s own health. The most common organs for living donation are the kidney and liver. It is only after medical evaluations, including tests to ensure they are healthy and have compatible blood and tissue types with the recipient, that the organs can be transplanted,” Dr Balakrishnan said.
He explained that in the case of kidney donation, the donor’s other kidney compensates for the loss, and they can usually live a normal, healthy life with one kidney. In the case of liver donation, a portion of the organ is cut for donation, because the liver has the ability to regenerate. “The donor’s liver will regain its original size and function within a few months after donor surgery.”
Not only the liver, but parts of the pancreas can also be donated for transplantation to a person with diabetes, Dr Chatterjee said. “These strategies require rigorous clinical evaluation to ensure that the donor’s health is not affected”.
Explaining the scientific procedure behind organ donation, Dr Balakrishnan said: “Organ donation begins by identifying suitable donors, assessing their medical histories, and surgically procuring the organs with precision. These organs are then meticulously preserved to maintain their functionality during transportation to the transplant centre. Proficient surgeons conduct the transplantation, inserting the donated organ into the recipient’s body. After the transplant, recipients undergo thorough follow-up care, including medication to prevent organ rejection and ongoing monitoring to ensure sustained success.”
Which is better – living donor transplant or deceased donor transplant?
In the West, deceased donors are the most common source of kidney transplantation. Deceased donors, also known as cadaveric donors, are individuals who have suffered irreversible brain damage to the point of brain death, Dr Balakrishnan said. Meanwhile, in India, living donor kidney transplantation is more common than deceased donor kidney transplantation.
Living donor donation is more advantageous than deceased donor donation. One reason is better tissue matching, which allows for reduced chances of rejection, and better graft survival. Also, since the organ is transplanted soon after it is removed from the living donor, the removed organ is kept without blood supply for a shorter period of time, resulting in better outcomes.
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“There are some advantages attributed to living donor donation, such as better tissue matching. Living donor transplants often allow for better tissue matching between the donor and recipient, which can lead to reduced chances of rejection and better graft survival. Another factor that contributes to better outcomes is that the organ is typically transplanted soon after it is removed from the donor, leading to a shorter time the organ is kept without blood supply. There is shorter ischemia time, or in other words, the organ remains without blood supply for a shorter duration. This can contribute to better outcomes,” Dr Balakrishnan said.
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Once a suitable donor is identified, planning and scheduling can be done in advance. This allows the recipient to receive a new organ before their condition worsens significantly, Dr Balakrishnan said. “Organs from living donors are often healthier and come from individuals who have undergone thorough medical evaluations. This can contribute to better organ function post transplant.”
In countries with organ shortages, the benefits of organ transplants from living donors are clearer than in other regions. This is true for organs like kidneys and parts of the liver.
Most importantly, living donor transplants eliminate the need for patients to wait for their turn on the deceased donor waiting list. In this way, living donor transplants provide quicker access to life-saving organs.
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How successful are organ transplants? How long do organ recipients live?
A large number of factors determine the success of organ transplantation. These include the health of the donor and recipient, compatibility between the donor and recipient, surgical expertise, and post-transplant care, the experts said.
It is difficult to predict the typical lifespan of the organ recipient because this depends on the health status and medical history of the recipient, elements such as pre-existing medical conditions, age, overall health, and the presence of other diseases.
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“Different organs have distinct rates of success and potential complications, contributing to variations in the success of transplantation and the potential for long-term survival among kidneys, hearts, lungs, livers, and pancreases,” Dr Balakrishnan said.
Organ recipients are administered with immunosuppressive medications to prevent graft rejection. However, these medications are risky because they weaken the immune system, and increase the chances of contracting an infection.
“Immunosuppressive medications used to prevent organ rejection carry their own set of risks, including rejection, complications, and an increased likelihood of infection. Consequently, there is a wide statistical variability in post-transplant lifespans,” Dr Balakrishnan said.
According to the UK National Health Service (NHS), a kidney transplant from a living donor lasts for 20 to 25 years, while that from a deceased donor lasts 15 to 20 years.
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Kidney transplants exhibit the highest survival rates among organ transplants, followed by heart and liver transplants, Dr Balakrishnan said.
Dr Chatterjee explained that after a successful transplant, the lifestyle of the recipient plays a major role in determining how long they survive. “Organ transplantation is a practice that combines medical understanding, technology and compassion, and is constantly evolving to improve patients’ lives.”
Check ABP Live’s stories explaining the science behind various health phenomena, and the articles appearing in the weekly health column here.
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