Many people now require organ transplantation these days which can be attributed to improving medical science which allows patients to maintain as normal a life as possible until a transplant is available. As a consequence of this, the amount of organs available from dead organ donors has become insufficient. However, medical science has also provided a way to carry out organ transplants using organs from living donors.
Accordingly, whereas in the past the risks of transplanting an organ applied only to the recipient since the donor was deceased, now the living donor is also at risk. The risks of organ transplantation are numerous and some of them are discussed below as they apply to both organ donors and recipients.
Risks to the Recipient
A lot of people are already familiar with the possible risks of organ transplantation to the recipient. They include:
Before an organ transplant is carried out, all possible investigations are done to ensure that the donor organ is as near a match as possible to the recipient. Despite all of these precautions, the recipient’s body usually recognizes the transplant as foreign and attacks it. This is called transplant rejection. The recipient will have to take suppressant medication for life to prevent rejection and this leads to even more complications.
Graft Versus Host Disease
In graft versus host disease (GVHD), the transplanted organ rejects the recipient’s body and begins to attack it. This is in contrast to what happens in transplant rejection mentioned above. It occurs when the transplant contains immune cells capable of attacking the recipient and if the recipient’s immune system is too weak to fight off the transplant’s immune cells.
The transplanted organ may fail to work for any reason such as due to transplant rejection and graft versus host disease mentioned above. This puts the patient back on the transplant waiting-list.
Any surgical procedure is risky and an organ transplant surgery is even more so. Potential complications include pain, infection of the wound, hemorrhage and death.
Recurrence of Earlier Problem
The transplanted organ may also become a victim of the problem or disease process that caused the recipient’s own organ to fail. For example, a liver transplant may be needed where a tumor in another part of the body has metastasized to the liver of a patient. If that tumor is inoperable or incurable, it can still send metastasis to the new organ.
Immune Suppression from Anti-Rejection Drugs
To prevent the occurrence of transplant rejection or graft versus host disease, the organ recipient has to take immunosuppressive medication. This medication prevents the recipient’s immune system from attacking the organ. However, this also prevents the immune system from fighting off any diseases and infections. It may lead to development of some types of cancer, diabetes, heart problems, osteoporosis and opportunistic infections.
Risks to the Living Donor
Surgical Complications and Death
As mentioned above under the surgical risks to the recipient, the surgical procedure for organ transplants has plenty of risks. It may lead to the death of the donor.
Specific Complications from Organ Donation (1)
Other than the complications which can arise during/after surgery already mentioned above, there are particular risks for specific transplants. These complications are usually long-term and some of them include:
– Short bowel syndrome, weight loss and diarrhea in intestinal transplant donors.
– Bile leakage, portal vein thrombosis and renal failure in liver transplant donors.
– Hypertension, proteinuria (protein-loss in urine) and renal failure in kidney transplant donors.
Organ donation is an altruistic act but it is an unnecessary surgical procedure for the organ donor who is apparently healthy. Thus, there are often psychological risks which could arise such as feelings of regret. There may be depression and anxiety due to the concerns about the surgery. A situation may also arise where donors are put under pressure to donate to family members or they may be made to feel guilty for not donating to a relative. (2)
Financial and Insurance Problems
The organ recipient’s insurance covers all medical expenses related to the donation including those of the donor. However, it does not cover other expenses such as the donor’s loss of income during the procedure. Consequently, a donor may be in financial straits afterward especially if he or she does not have disability insurance. (3)
Organ donors may be denied insurance because insurance companies can categorize donors as having a pre-existing condition. They can also be subjected to higher insurance premiums. (4)
1. Transplant Living: Organ Donation and Transplantation Information for Patients
2. NHS Choices: Organ Donation – Risks
3. The Costs of Organ Donation
4. Organ donors run risk of being denied health insurance – Los Angeles Timeshttp://articles.latimes.com/2009/jul/15/business/fi-lazarus15