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Transplant procedures for different organs

HEART TRANSPLANT PROCEDURE

Heart transplants have been perfected over many years. The following is an example of what will happen:

When an organ that meets the requirements is located, the patient will be called to the hospital where he/she is registered by the transplant coordinator. The transplant doctors will check the donor organ while the patient is being evaluated and he/she will be started on appropriate medications in preparation for transplantation.

If the donated organ is suitable, the patient will then be taken to the operating room, and anesthetized, and one of the transplant surgeons will begin the process of preparing the chest cavity for removal of the patient’s heart.

The surgeon will begin by exposing the chest cavity through a cut in the ribcage. The surgeon will then open the pericardium (a membrane that covers the entire heart) to remove the diseased heart. The back part of the patient’s left atrium will be left in place, but the rest of the heart will be removed.

The new healthy heart will be carefully trimmed and sewn to fit the remaining parts of the old heart. This transplant method is called an “Orthotopic procedure”. This is the most common method used to transplant hearts.

The patient is given medications both before and during the operation to prevent the body from rejecting the new heart. After the surgery, the patient will be taken to a special unit and hospital floor for recovery. The patient remains in the hospital until the doctors are sure that he/she is ready to go home. How long the patient stays in the hospital will depend on the following factors:

➢ Patient’s overall health.
➢ How well the new heart is working.
➢ Patient’s ability to learn to take care of the newly transplanted heart.

LIVER TRANSPLANT PROCEDURE

A liver transplant is a surgery that involves replacing a diseased liver with a healthy one from another person. The whole liver may be transplanted, or just part of it.

In most cases, the healthy liver will come from an organ donor who has just died.

Sometimes healthy living persons will donate a part of their liver to a patient whose liver is diseased. A living donor is generally a family member or it may be someone who is not related to the patient but whose blood type is a good match.

People who donate part of their liver can live perfectly healthy lives with the liver that is left.

The liver is the only organ in the body that can replace lost or injured tissue (which means it can regenerate). The donor’s liver will soon grow back to normal size after surgery. The part that the patient receives as a new liver will also grow to normal size within a few weeks.

KIDNEY TRANSPLANT PROCEDURE

The patient (recipient) is put on appropriate medication before and during surgery. Thereafter he/she will be put “under” using general anesthesia and will remain asleep for the duration of the surgery. Once asleep, the transplant surgeon will make an incision on the lower abdomen just above the groin.

The donor kidney (if it is a deceased donor) will be placed in the lower abdomen. The donor kidney’s blood vessels will then be connected to the recipient’s iliac artery and vein. The surgeons will then connect the ureter to the bladder. A small drain may be inserted into the abdomen to drain any excess fluid that may have accumulated during the operation.

In the case of a living donation, the living donor will also undergo surgery under general anesthesia to remove the healthy kidney. Which kidney has to be removed is pre-decided by the transplant surgeons. Once the kidney is removed, it will be cleaned and prepared for transplantation into the recipient’s lower abdomen. Then the same surgical procedure mentioned above is followed.

Living donations have better outcomes because the waiting time between kidney retrieval and transplantation is very short resulting in better kidney health as opposed to deceased kidney transplantation where the waiting time between retrieval and transplantation can sometimes exceed 6 hours.

The recipient is then carefully and closely monitored post-surgery to ensure that the newly transplanted kidney is not rejected. The length of hospital stay depends on the recipient’s overall health and how his/her body is adapting to the new kidney.

Live donors also have to stay in the hospital post-surgery until the doctors decide that they have recovered well to resume normal activities.

SKIN TRANSPLANT PROCEDURE

A person can donate skin after his/her death. Skin can be donated within 6 hours from the time of death.

Anyone can donate skin irrespective of sex & blood group. The minimum age of the donor should be 18 years but there is no upper age limit; even a 100-year-old person can donate his/her skin and it will be used for treatment.

The whole procedure takes only about 30 – 45 minutes.

A Skin Bank Team – consisting of one doctor, two nurses, and an attendant will come to the donor’s home, hospital, or morgue, wherever the donor is kept. They don’t need to shift the donor to the operating room, hospital, or ambulance.

A special instrument called DERMATOME harvests the skin. It is a battery-operated instrument made exclusively for skin harvesting only.

Skin is harvested from both the legs, both the thighs, and the back. There are a total of 8 layers of skin; only the 1/8th layer i.e. the uppermost layer of the skin is harvested.

There is no bleeding from the site where skin is harvested from and there is no disfigurement to the body also. After the procedure, the parts from where the skin is harvested are bandaged properly.

After the skin is harvested, it will be evaluated, processed, screened at the skin bank, and then supplied to the Burns Department for transplanting onto burn patients.

Skin is preserved in 85% glycerol solution. It is stored between 4 to 8 degrees Celsius and it can be stored for 5 years.

No payment has to be made to the Skin Donation Team since selling and buying organs is illegal as per Indian law.

Anyone’s skin can be transplanted on anyone, there is no blood matching, no color matching, and no age matching required. Once all the blood reports are negative, the donor skin can be transplanted freely.


EYE DONATION PROCEDURE

o Eyes can be donated only after death

o Eyes must be removed within 4 – 6 hours after death

o Eyes can be removed by a registered medical practitioner only

o The eye bank team will visit the home of the deceased or the hospital to remove the eyes

o Eye removal does not delay the funeral since the entire procedure takes 20-30 minutes only

o A small quantity of blood will be drawn from the donor to rule out communicable diseases

o Eye retrieval does not cause disfigurement

o The identities of both the donor and the recipient are kept confidential

The whole eye of the donor is never transplanted, only the cornea is transplanted. However, the rest of the eye is used for research and education purposes.

A person who is blind due to retinal or optic nerve disease can donate his eyes provided the cornea of the donor is clear.


Things to do after death

• Close the eyelids of the deceased and switch off the fan

• Raise the head of the deceased slightly by placing a pillow underneath

• Contact the nearest eye bank as quickly as possible (National Eye Bank – 011-26593060/26589461)

• Give the correct address and telephone number to enable the eye bank team to locate the place easily

• Death certificate of the deceased to be kept ready


Eye donation can be done only with the written consent of the next of kin in the presence of two witnesses.