Organ transplant

An organ transplant is the transplantation of a whole or partial organ from one body to another, for the purpose of replacing the recipient's damaged or failing organ with a working one from the donor. Organ donors can be living, or deceased (previously referred to as cadaveric).

Types of Donor

Living

In living donors, the donor remains alive and donates a renewable tissue, cell, or fluid (e.g. blood, skin); or donates an organ or part of an organ in which the remaining organ can regenerate or take on the workload of the rest of the organ (primarily single kidney donation, partial donation of liver, small bowel, or pancreas).

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Living-Related

Living related donors donate to family members or friends in whom they have an emotional investment. The risk of surgery is offset by the psychological benefit of not losing someone related to them, or not seeing them suffer the ill effects of waiting on a list.

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"Good Samaritan"

"Good Samaritan" or "altruistic" donation is living donation to someone not well-known to the donor. Some people choose to do this out of a need to donate. Some donate to the next person on the list; others use some method of choosing a recipient based on criteria important to them. Web sites are being developed that facilitate such donation.

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Compensated

Each year, hundreds of impoverished people sell their kidneys to later be used in illegal transplants. The size and scope of this current problem has yet to be fully understood or realized. The National Organ Transplant Act of 1984 made illegal any profit from organ donation in the United States; careful regulation by the OPTN has probably eliminated organ sales in the United States. Recent development of web sites such as *MatchingDonors.com and personal advertisements for organs among listed candidates has raised the possibility of selling organs once again, as well as sparking significant ethical debates over directed donation, "good-Samaritan" donation, and the current U.S. organ allocation policy. Recently, two books have been published that advocate using markets to increase the supply of organs available for transplantation. The first is by Mark Cherry, *Kidney for Sale By Owner* (Georgetown University Press, 2005). The second is by James Stacey Taylor, *Stakes and Kidneys: Why markets in human body parts are morally imperative* (Ashgate Press, 2005.)

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Deceased (formerly cadaveric)

Deceased donors are donors who have been declared brain-dead and whose organs are kept alive by ventilators or other mechanical mechanisms until they can be excised for transplantation. Apart from brain-stem dead donors, who have formed the majority of deceased donors for the last twenty years, there is increasing use of non-heart beating donors to increase the potential pool of donors as demand for transplants continues to grow. These organs have inferior outcomes to organs from a brain-dead donor; however given the scarcity of suitable organs and the number of people who die waiting, any potentially suitable organ must be considered.

Related Topics:
Brain-stem dead - Non-heart beating donors

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Allocated

The overwhelming majority of deceased-donor organs in the United States are allocated by federal contract to the Organ Procurement and Transplantation Network (OPTN), held since it was created by the Organ Transplant Act of 1984 by the United Network for Organ Sharing. This allocates organs based on the method considered most fair by the scientific leadership in the field. For kidneys, for instance, that is by waiting time; for livers, it is by MELD (Model of End-Stage Liver Disease), an emprical score based on lab values indicative of the sickness of the patient from liver disease.

Related Topics:
Organ Procurement and Transplantation Network - Organ Transplant Act of 1984 - United Network for Organ Sharing

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Directed

Experiencing somewhat increased popularity, but still very rare, is directed or targeted donation, in which the family of a deceased donor (often honoring the wishes of the deceased) requests an organ be given to a specific person. If medically suitable, the allocation system is subverted, and the organ is given to that person.

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