What is a transplant?
A transplant, or transplantation, is the transfer of living cells, tissues or organs from one person (the donor) to another (the recipient) or from one part of the body to another (e.g. skin grafts) for the purpose of replacing a lost function.
Transplantation can bring enormous benefits to people affected by diseases that would otherwise be irremediable.
What are the prerequisites for a transplant?
Organ transplantation presupposes:
- Find a compatible donor
- Accept the risks of undergoing major surgery
- use powerful immunosuppressive drugs
- facing a possible rejection of the transplanted organ
- overcoming serious complications or even death
What is a tissue transplant?
Tissue transplantation is less well-known than organ transplantation, but there are many types of tissue that are also transplanted to cure various diseases.
The tissues that can be transplanted are:
- Corneas
- Osteotendinous specimens
- skin
- Heart Valves
- Vascular segments
- amniotic membrane
What is a bone marrow transplant?
Bone marrow transplantation consists of the transfusion of progenitor cells taken from the donor's bone marrow in the patient, with the aim of replacing the recipient's diseased cells, forming new healthy cells.
These transplants are indicated in congenital or acquired diseases, such as acute or chronic leukemias, spinal cord disorders, immunodeficiencies, etc. For these patients, the ideal is to find a compatible donor among their immediate relatives, but this situation only occurs in only 30% of cases.
Who can be transplanted?
Patients who, according to a medical report, suffer irreversible damage to one of their organs, without any other type of medical treatment being suitable, may be transplanted. In these types of cases, transplantation is the only possible solution to avoid death or to improve quality of life.
What is the waiting period for transplantation?
The waiting period varies depending on the availability of organs capable of transplantation. For this reason, this process can be time-consuming.
When an organ becomes available, the patient is contacted so that the intervention can take place in a very short period of time, since organs usually do not survive long outside the human body. If the patient is not contactable, he loses his turn to someone else.
What happens after the transplant?
After the transplant, there are frequent follow-up visits.
Although donor-recipient compatibility is tested before a transplant, the prescription of immunosuppressive drugs (which act on the immune system) is mandatory on a permanent basis, except in bone marrow transplants.
What happens in case of rejection?
In cases of rejection, the patient may be offered a new transplant and be put back on the waiting list.
How much does a transplant cost and who pays for it?
The costs of this process are covered by the health system where the patient is inserted. The donated organ is transplanted free of charge, regardless of the social and economic condition of the patient who receives it. All transplant-related therapy is supported by the National Health Service, and the respective hospitals where the transplants are performed.
How do waiting lists work and what are the criteria for organ distribution?
In order to ensure the principles of equality and equity, the criteria are defined taking into account two basic aspects: regional criteria and clinical criteria.
The regional criteria make it possible for organs from donors from a given region to be transplanted in the same region, in order to reduce the ischemia time as much as possible (the maximum time that can elapse between the harvesting of the organ and its transplantation into the recipient).
Clinical criteria determine donor/recipient compatibility and patient severity.
The urgency/emergency of the transplant, taking into account the patient's state of health, is characterized as a preferential criterion over the regional criterion.
The transplant team decides, by consulting the waiting list, which patient is best suited to receive the organ, following clinical criteria, such as blood group compatibility, anthropometric characteristics and severity of the patient.
Legislation
See the decree-law establishing the regime of acts having as their object the donation or harvesting of organs, tissues and cells of human origin, for therapeutic or transplantation purposes, as well as the transplantation interventions themselves.
Source: Portuguese Institute of Blood and Transplantation (IPST)