What is Transplantation?
Transplantation is the transfer (engraftment) of cells, tissues or organs from one part of the body to another or from a donor to a recipient with the aim of restoring function(s) in the body. There are two types of donors: living donors and deceased donors (cadaveric transplantation). In the latter case, the organ is removed and stored in cold until the operation. Most organs cannot be stored outside the body for longer than 12 hours.
What was an experimental, risky and very limited treatment option fifty years ago is now routine clinical practice in more than 80 countries.
When patients’ kidneys fail, they are offered Renal Replacement Therapy (RRT) which includes: hemodialysis, peritoneal dialysis, and transplantation. Transplantation is considered to be the best option of RRT for the patient both for quality of life and cost-effectiveness. According to World Health Organization, kidney transplantation is by far the most frequently carried out transplantation globally.
Transplantation procedure is performed in a surgery theatre under full anesthesia. A transplanted organ is expected to start working within a few hours. To keep the body of a patient from attacking newly transplanted organ patient is required to take immunosuppressant drugs for the rest of their lives, to minimize the risk of rejection. Hospital recovery for a kidney transplant patient usually takes up to five days. After 8 weeks of recovery at home, if there are no complications, most patients are able to start light activities and get back into their routines.
It is very important for patients with transplanted kidneys to follow certain rules and always be aware of risks associated with transplanted organs:
- Take care of your transplant (keep up with all your scheduled appointments and take your medication as prescribed)
- Limit your exposure to germs
- Avoid prolonged sun exposure
- Watch out for signs of rejection
- Sudden decrease of urine output
Facts and Statistics
The first successful organ transplantation happens to be a kidney transplant performed by Joseph Murray in Boston on 23rd December 1954 between identical twins. This operation gave the start to a new era for patients with ESKD. The number of successfully performed kidney transplants is steadily growing every year.
Report from Global Observatory on Donation and Transplantation for 2015 indicated that there were 84,347 kidney transplants performed worldwide, which is a 5.5% increase from 2014.
Below you can find a global map indicating kidney transplant activities in 2015 (provided by WHO ):
According to data from U.S. Government Information on Organ Donation and Transplantation, there are more than 116 000 patients on the national transplant waiting list as of August 2017. In 2016 there were a total of 41,335 donated organs that came both from deceased and living donors. The number of people on the waiting list continues to grow a lot faster than the number of donors or available transplants. There is a large gap between available organs and the demand for them.
Organ trafficking– any illegal manipulation (trade) with living or deceased persons or their organs for the purpose of monetary benefit for the trafficker. Control over potential donor by means of coercion is illegal and punished by law in most countries.
Transplant commercialism is a policy or practice in which an organ is treated as a commodity, including by being bought or sold or used for material gain.
Travel for transplantation is the movement of organs, donors, recipients or transplant professionals across jurisdictional borders for transplantation purposes. Travel for transplantation becomes transplant tourism if it involves organ trafficking and/or transplant commercialism or if the resources (organs, professionals and transplant centers) devoted to providing transplants to patients from outside a country undermine the country’s ability to provide transplant services for its own population.
World Kidney Day supports The Declaration of Istanbul, which suggests that “organs for transplantation should be equitably allocated within countries or jurisdictions to suitable recipients without regard to gender, ethnicity, religion, or social or financial status”. Yet unethical practices of transplantology, such as organ trafficking, transplant commercialism, and transplant tourism, are, in part, an undesirable consequence of the global shortage of organs for transplantation.
To address the urgent and growing problems of organ sales, transplant tourism and organ trafficking in the context of the global shortage of organs, The Transplantation Society and the International Society of Nephrology adopted a consensus statement on the care of the living kidney donors to ensure the responsibility of communities for living donors and encourage donations.
Both living and deceased donor donations are critical for nations to develop self-sufficiency for organ transplantation.
With the help of The Transplantation Society, World Kidney Day aims to increase awareness and promotion of this life-saving procedure and the donors who make it possible.
World Kidney Day is firmly against organ trafficking or transplant tourism of any kind!
Find out more at:
- The Declaration of Istanbul
- Kidney Transplant – NIH
- Organ Donation Statistics
- Human Organ Transplantation – WHO
- Global Observatory of Donation and Transplantation
- Kidney Transplant – University of California San Francisco
- Article on Transplantation written for WKD 2012