Transplant data show that more and more people receive transplants every year and that many people with transplants are living longer after receiving their organ(s) than ever before.
There are many people at the transplant center who work to make a transplant successful. Each person on the "transplant team" is an expert in a different area of transplantation. The transplant team includes all or some of the following professionals:
- Clinical transplant coordinators have responsibility for the patient's evaluation, treatment, and follow-up care.
- Transplant physicians are doctors who manage the patient's medical care, tests, and medications. He or she does not perform surgery. The transplant physician works closely with the transplant coordinator to coordinate the patient's care until transplanted, and in some centers, provides follow-up care to the recipient.
- Transplant surgeons perform the transplant surgery and may provide the follow-up care for the recipient. The transplant surgeon has special training to perform transplants.
- Financial coordinators have detailed knowledge of financial matters and hospital billing. The financial coordinator works with other members of the transplant team, insurers, and administrative personnel to coordinate and clarify the financial aspects of the patient's care before, during, and after the transplant.
- Social workers help the patient and their family understand and cope with a variety of issues associated with a patient's illness and/or the various side-effects of the transplant itself. In some cases, the social worker may perform some of the financial coordinator duties as well.
Waiting times vary widely for many reasons. The shortage of organs causes most patients to wait for a transplant. The amount of time a patient waits does not show how well a transplant center or OPO is doing its job. Each patient's situation is different. Some patients are more ill than others when they are put on the transplant waiting list. Some patients get sick more quickly than other patients, or respond differently to treatments. Patients may have medical conditions that make it harder to find a good match for them.
How long a patient waits depends on many factors. These can include:
- blood type (some are rarer than others)
- tissue type
- height and weight of transplant candidate
- size of donated organ
- medical urgency
- time on the waiting list
- the distance between the donor's hospital and the potential donor organ
- how many donors there are in the local area over a period of time and
- the transplant center's criteria for accepting organ offers
Depending on the kind of organ needed, some factors are more important than others.
Potential recipients often contact the OPTN to ask if they are on the National Patient Waiting list. Unfortunately, the OPTN cannot provide this information. A patient's presence and status on the waiting list should be discussed with the patient's transplant team.
- The transplant program must notify patients in writing within ten business days of registration that the patient has been placed on the national transplant waiting list (including the date the patient was listed), or
- The transplant program must notify the patient in writing ten days after completion of the evaluation that the patient will not be placed on the patient waiting list.
- Once listed, if the patient is removed from the waiting list for any reason other than transplantation or death, the transplant program must notify the patient in writing within ten business days that the patient has been removed from the list.
This policy is intended to improve communication between transplant centers and their patients and to help patients better understand the listing and transplant process.
As an informed participant, it is important that transplant candidates know their treatment options. Some patients choose to list at hospitals in different parts of the country, change hospitals, and transfer their waiting time to a different center or receive a transplant from a living donor.
- Multiple Listing: Sometimes patients choose to register for a transplant at more than one hospital. When a patient lists at a transplant hospital, they are generally considered for organs from a donor in that local area first. If a patient is put on the list at more than one transplant hospital, they will be considered for donor organs that become available in more than one local area.
National transplant policy allows a patient to register for a transplant at more than one transplant hospital. However, each hospital may have its own rules for allowing its patients to be on the list at another hospital. Patients should ask each hospital whether it allows its patients to list at more than one transplant hospital. Being listed in more than one area does not guarantee an organ will become available faster than for patients registered at only one transplant hospital. Generally, each transplant center will require the patient to go through a separate evaluation, even if the patient is already listed at another hospital.
- Transferring Waiting Time: Patients may switch to a different transplant hospital and transfer their waiting time to that hospital. Waiting time from the original center is added to the time collected at the new hospital.
The transplant teams at the first hospital and the new hospital will be responsible for coordinating the exchange of information and notifying UNOS of the transfer of waiting time. Patients should ask each hospital if transferred waiting time will be accepted.
- Variability among Transplant Centers: Hospitals can vary widely in the number of transplants they perform and the characteristics of the donor and recipient pool. Organ procurement organizations can vary widely in the number and types of donors they receive each year.
- Living Donation: In addition to deceased organ donation, patients may also receive organs from living donors. In 2007, more than 6,300 living donor transplants were performed. With more than 100,000 people currently waiting for a transplant in the U.S., the need for donor organs is far greater than the supply. Living donation offers an alternative for individuals awaiting transplantation.
The first successful living donor transplant was performed between identical twins in 1954. Since that time, hundreds of patients have received successful transplants from living donors. Parents, children, brothers, sisters, and other relatives are eligible to donate organs to family members. Unrelated donors (for example, spouses, or close friends) may also donate their organs if they are a match for the candidate and the transplant hospital approves.
As scientists learn more about transplantation, new ways are developed to help recipients and their new organs survive longer. Almost every year since 1988, the number of patients that survived at least one year after their transplant has increased. A large amount of data is available to help patients make informed healthcare choices about transplantation. The OPTN and SRTR provide data to assist patients in choosing a transplant hospital. The federal government's Web site, www.organdonor.gov, is an excellent source of donation information as well as the UNOS Patient Services' toll free number (888) 894-6361, which patients can call to request a general or organ-specific information packet.