Getting a Transplant
The road to preparing for and getting a transplant, as well as post-transplant life is a long, challenging but ultimately rewarding one. You may feel excited, nervous and a little uncertain about the process. At NUCOT, our team of doctors, nurses, and allied healthcare staff are here to guide you along your transplant journey.
As a transplant patient, arming yourself with knowledge is the first step to managing your expectations, clearing up doubts and empowering yourself with the information to enable better self-care.
If you are at the end-stage of organ failure and a candidate for organ transplant, your doctor will refer you to a transplant coordinator. He or she works together with the transplant team to evaluate your suitability for a transplant. This means assessing if you are well enough to undergo major surgery, the extent of your disease and whether you are suitable for transplantation.
Understanding the Risks
As with any major surgery, there are risks involved. These risks as well as the benefits of a transplantation will be explained to you. This will help you make an informed decision. As a patient, you have the right to accept or decline a transplant. Your decision will be respected.
Should you accept to go ahead with a transplant, you will be placed on the relevant organ transplant waiting list. This is where you wait for a suitable organ from a deceased donor to be available.
The Waiting List
Each time a donor organ becomes available, it will be matched to the blood group, weight and urgency of the patients on the waiting list. The best-matched patient will receive the organ.
The wait can be a difficult and long one. It is normal to feel worried and uncertain. There may be some false alarms, for instance, if the donor organ is not ideal for transplant or if you happen to be ill that day. Our transplant team will be there to offer support in this challenging time.
Be sure to keep your contact details updated so that you can be readily contacted when an organ becomes available.
Prepare for a Transplant
In the time leading up to a transplant, the NUCOT team will work to ensure that you are in the best of health, both physically and emotionally.
You will also need to undergo a range of tests and screenings. These will help doctors ensure a better match and also identify any risks.
- Blood type: Your blood type should be compatible, even if it is not the same as, the organ donor.
Recipient blood group
| Compatible donor blood group
| Incompatible donor blood group
|
O
| O
| A,
B, AB
|
A
| A,
O
| B, AB
|
B
| B,
O
| A, AB
|
AB
| A,
B, AB, O
| Nil
|
- A cross-match blood test: This checks how your antibodies react to the donor’s and determines how high the chance of rejection is.
- Antibody screening: The panel-reactive antibody (PRA) test measures your antibodies against other people’s. If you have a wide range of antibodies against others, there is a higher risk of organ rejection, even if the cross-match shows a good match.
- Tissue type test: This is a blood test for your genetic makeup. The more of genetic markers you share with the organ donor, the more likely your body will accept the donor organ.
- A mental health assessment: In living donor transplants, both the donor and organ recipient will need to be assessed for any psychological issues.
This pre-transplant assessment is aimed at ensuring the best chances for a successful organ transplant. The more matches there are, the more likely your body will accept the new organ. As a donor, you may also need to undergo x-rays, scans and other screenings as determined by your doctor.
The Transplant Operation
When an organ becomes available for transplant, and doctors determine it is the best match for you, you will be contacted to head down to the hospital. There is a chance that even when a donor organ is found, the organ may become unsuitable during the retrieval process. In the event that you have an infection (a flu, cough or fever), you will also not be a suitable candidate for transplant. Should the donor organ be a suitable match to you, an operation time will be set and a series of tests – ECG, blood tests and x-rays, will be done before the operation.
In cases of living donor transplant (e.g., liver or kidney), the donor and recipient will be scheduled for the operation on the same day. The donor will start his/her operation first to retrieve the donated organ and the recipient will start the operation slightly later to receive the donor organ.
The transplant operation is a major procedure and your medical team will need to monitor you closely while it happens. While you are under general anaesthesia, a number of drips and devices will be put in.
- Central venous catheter (CVC or ‘central line’) to receive medication and retrieve blood for tests
- Intravenous (IV) line to receive saline or medication
- Endo-tracheal tube (ETT) to help you breathe during the operation
- Nasogastric tube to drain stomach secretions
- Urinary catheter to drain urine
- Drainage tubes to drain away fluid and blood from the operation site
Life After a Transplant
Preventing organ rejection
There will also be some challenges. The biggest will be to prevent organ rejection. Since the donated organ is not your own, you body’s natural response is to attack it. To prevent the immune system from attacking your transplanted organ, you will need to take anti-rejection medications called immunosuppressants. Often that is a cocktail of a few different drugs. These medications prevent your immune system from attacking or rejecting the new organ. Typically, you must take these medicines for life.
You may also be given other medications. These may help the anti-rejection drugs perform better or control their side effects. If you have other medical conditions, you may need to take medicines for these as well.
Taking care of your transplanted organ:
- You may need to go for frequent blood tests and check-ups in the first year of your transplant. These appointments and blood tests may be tapered down over time depending on the health of your transplanted organ.
- You need to take your immunosuppressants and medications as prescribed.
- Take more precautions against falling ill. Your weakened immune system (to prevent rejection) will mean you may be more susceptible to infections. Practice good hygiene at all times and stay away from people who are ill with an infectious disease (cold, flu, fever, etc.)
- Monitor your health. Be aware of how you feel and do self-monitoring if required. This includes checking your weight, temperature, blood pressure and pulse daily. If you are diabetic, monitor your blood sugar.
- Practice good dental hygiene and make regular appointments to see your dentist.
- Live a healthy lifestyle: exercise regularly, eat a balanced diet, manage stress and get adequate sleep