Allograft – An organ or tissue transplanted from one individual to another of the same species, i.e. human to human.
Antibody – A protein made by the body’s immune system in response to a foreign substance, for example a previous transplant, blood transfusion or pregnancy. Because antibodies attack the transplanted organ transplant patients must take powerful immunosuppressive drugs.
Antigen – A foreign molecule or substance, such as a transplant, that triggers an immune response. This response may be the production of antibodies.
Aplastic Anemia – A defect in which the bone marrow is depleted of blood-cell-forming tissue, generally due to exposure to radiation or toxic chemicals. In some cases the etiology is unknown.
Artificial Heart – A mechanical device implanted in and/or attached to the recipient that assumes the function of pumping blood through the circulatory system.
Autograft Tissue – or bone transplanted from one site on an individual’s body to another site.
Brain Death – When the brain has permanently stopped working, as determined by the attending physician and appropriate consultants. Donor organs can only be taken from persons declared brain dead.
Cadaveric Donor – Donors who have been declared dead. Donor families consent to have the organs removed.
Clone – One or a group of genetically identical cells, organisms, or plants derived by vegetative reproduction from a single parent.
Coalition on Donation – A non-profit alliance of health and science professionals, patients, voluntary and transplant organizations. The Coalition serves to increase national public awareness of the critical organ shortage, thus creating a greater willingness and commitment to organ and tissue donation.
Compliance – The act of following orders and adhering to rules and policies, i.e. taking one’s medications post-transplant.
Cornea – The thin transparent membrane in the front part of the eye: it protects the inner tissues of the eye.
Cross Match – A test for patient antibodies against donor antigens. A positive cross-match shows that the donor and patient are incompatible. A negative cross-match means there is no reaction between donor and patient; the transplant may proceed.
Cyclosporine – An improved immunosuppressive drug used following organ transplantation.
Cystic Fibrosis – An inherited disease that causes abnormalities in gland secretions, including sweat and saliva, and a thick mucus that can block parts of the lungs, pancreas, sweat glands, and digestive system; eventually it destroys the lungs.
Diabetes Mellitus – A disease characterized by the body’s inability to produce the amount of insulin required to metabolize sugar; although predisposition to the disease is genetically determined, other factors such as stress and obesity may contribute to its onset.
Dialysis – Used in cases of kidney failure, a procedure for removing waste products from the blood by filtering the blood through a mechanical membrane.
Donor – The person who donates the organ.
Durable Power – A document in which individuals may designate who should make Of Attorney medical decisions for them when they are unable to speak for themselves.
End Stage – Also known as chronic kidney failure; a condition for which renal disease (ESRD) patients need dialysis or a transplant.
Graft – See allograft.
Graft Survival – A graft (i.e., an organ) that is functional at a certain point post transplant.
Harvest – To remove the organ from the donor. Many consider this an insensitive term. Alternatives include recover, procure or retrieve.
Heart Lung Machine – A device used to replace the functions of the heart and lung during surgery.
Heterograft – Transplants between members of different species, see xenograft.
Heterotopic Tissue – Transfer of tissue to an anatomically abnormal site, i.e. transplantation of the kidney into the iliac fossa of the recipient.
Histocompatibility – Antigens Molecules found on all nucleated cells in the body that characterize each individual as unique. These antigens are inherited from one’s parents. Human leukocyte antigens determine the compatibility of tissues for transplantation from one individual to another.
HLA System Human Leukocyte Antigens – There are three major genetically controlled groups HLA-A, HLA-B and HLA-DR. In transplantation, the HLA tissue types of the donor and recipient are important in matching.
Immune response – The body’s defense against foreign objects or organisms, such as bacteria, viruses or transplanted organs or tissue. The immune system is composed of various types of white blood cells, including phagocytes, which consume bacteria and lymphocytes, which produce antibodies.
Immunosuppression – The artificial suppression of the immune response, usually through drugs, so that the body will not reject a transplanted organ or tissue. Drugs commonly used to suppress the immune system after transplant include prednisone, azathioprine (Imuran), cyclosporine, OKT3 and ALG.
Informed Consent – A process of reaching an agreement based on full disclosure. Informed consent has components of disclosure, comprehension, competence and voluntary response. Informed consent often refers to the process by which one decides to donate the organs of a loved one.
Lens -The part of the eye that allows the sight to be focused.
Leukemia – Cancer of the blood-forming organs; causes the bone marrow to produce deformed cells.
Leukocyte – A white blood cell used by the body to destroy invading bacteria.
Lymph Node – One of a number of small swellings found at intervals along the lymphatic system.
Lymphocyte – A variety of white blood cells involved in immunity; includes B-lymphocytes and T-lymphocytes.
Lymphoma – Any malignant tumor of the lymph nodes, excluding Hodgkin’s disease; victims suffer weight loss, fever and sweating.
Living Donors – Living donors consent to have an organ or piece of an organ they can live without removed. Living related donors are blood relatives of the recipients, and living unrelated donors (including spouses) are not blood relatives.
Monoclonal Antibody – A laboratory-made antibody that is used to slow the rejection of a transplanted organ while leaving the rest of the person’s immune system intact; its usefulness usually lasts 10 days.
Neoral – New formulation of cyclosporine based on microemulsion technology.
NOTA – The National Organ Transplant Act, passed by Congress in 1984, outlawed the sale of human organs and initiated the development of a national system for organ sharing and a scientific registry to collect and report transplant data.
Organ Preservation – Between procurement from a donor and transplant, organs require special methods of preservation. The length of time that organs and tissues can be kept outside the body vary, depending on the organ, the preservation fluid and the temperature.
Organ Preservation
- Heart 4-6 hours
- Liver 12-18 hours
- Kidney 48 hours
- Heart-lung 4-6 hours
- Lung 2-4 hours
- Pancreas 12-18 hours
Organ Procurement – OPO serves as the integral link between the potential donor and Organization (OPO) recipient and are accountable for the retrieval, preservation and transportation of organs for transplantation. As a resource to the communities they serve, they are proactive and continually engaged in public education on the critical need for organ donation. Currently, there are 69 OPOs around the country. All are UNOS members.
Orthotopic Tissue – Organ graft transferred to an anatomically normal recipient site.
PRA Panel Reactive Antibody – The percentage of cells from a panel of donors with which a potential recipient’s blood serum reacts. The more antibodies in the recipient’s blood, the higher the PRA. The higher the PRA, the less chance of getting a good cross-match. Patients with a high PRA have priority on the waiting list.
Presensitization – Prior exposure to donor antigens by means of blood transfusion, prior transplantation or pregnancy.
Recipient – The person who acquires a new organ.
Rejection – When the body tries to get rid of a transplanted organ or tissue by making antibodies. Anti-rejection or immunosuppressive medications combat rejection.
Remote – Removing an organ from a patient in one hospital and transporting it, (on Procurement ice) to another hospital for transplantation.
Re-transplantation – Due to organ rejection or transplant failure, some patients return to the waiting list. Reducing the number of re-transplants is a critical concern when examining ways to maximize a limited supply of donor organs.
Required Request – Hospitals must tell the families of suitable donors that their loved one’s organs and tissues can be used for transplant. This law is expected to increase the number of donated organs and tissues for transplantation.
Sandimmune – A brand name of cyclosporine.
Sensitization Potential – recipients are “sensitized” if there are antibodies in their blood, usually because of pregnancy, blood transfusions or previous rejection of an organ transplant. Sensitization is measured by PRA. Highly sensitized patients are more likely to reject an organ transplant than de-sensitized patients.
Solid Organ – Solid organ transplants include the heart, lung, liver, kidney, pancreas Transplants and intestine.
Status – Indicates degree of medical urgency for patients awaiting transplants.
Survival Rates – Survival rates indicate the percentage of patients or grafts (transplanted organs) that are still alive/functioning at a certain point post transplant. Survival rates are often given at one-, three-, and five-year increments. Policy modifications are never made without examining their impact on transplant survival rates. Survival rates improve with technological and scientific advancements.
Syngenic Graft – Graft between identical twins.
Tacrilimus – Substance found in a soil sample at the foot of Mt. Tsukuba outside Tokyo, Japan. It possesses a powerful suppressive effect on interleukin-2 production, and is now marketed by Fujisawa as Prograf; an agent used for immunosuppressive therapy.
Tissue Transplants – Tissue transplants include cornea, skin, bone and bone marrow.
Tissue Typing – The examination of human leukocyte antigens (HLA) in a patient. Tissue typing is done for all donors and recipients in kidney transplantation to help match the donor and recipient.
US Scientific – A database of post transplant information. Follow-up data on every Registry of transplant are used to track transplant center performance, transplant Transplant Recipients success rates and medical issues impacting transplant recipients. UNOS facilitates the collection, tracking and reporting of transplant recipient and donor data.
Waiting List – After evaluation by the transplant physician, a patient is added to the national waiting list by the transplant center. Lists are specific to both geographic area and organ type: heart, lung, kidney, liver, pancreas, intestine, heart-lung, kidney-pancreas. Each time a donor organ becomes available, the computer generates a list of potential recipients based on factors that include genetic similarity, organ size, medical urgency and time on the waiting list. Through this process, a “new” list is generated each time an organ becomes available that best “matches” a waiting patient to a donated organ.
Xenograft – An organ or tissue procured from a different species for transplantation into a human (see heterograft).
Xenotransplantation – Transplantation of genetically modified organs of laboratory animals into humans. Although xenotransplantation is highly experimental, many scientists view it as an eventual solution to the critical shortage of human organs.