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Frequently Asked Questions

Below are answers to frequently asked questions. You may have some of the same questions whether you are newly diagnosed or recovering from transplant surgery. As always, be sure to ask your transplant team any questions you have.

Select the type of organ transplant to see questions and answers that may be relevant to you.

Heart
Liver
Kidney

Before Your Heart
Transplant Surgery
During Your Heart
Transplant Surgery
After Your Heart
Transplant Surgery

Why do I need a heart transplant?

Heart transplants may be necessary when illness or injury leads to heart failure and other treatment options have failed.

What diseases or conditions may lead to the need for a heart transplant?

Although there are many potential causes of end-stage heart failure, the 2 most common conditions are coronary artery disease and cardiomyopathy.

What are the symptoms of heart disease?

Some common symptoms of heart disease are:

  • Shortness of breath
  • Increased heart rate or irregular heartbeat
  • Chest pain
  • Numbness or pain in your legs, feet, calves, or thighs
  • Tiredness, fatigue
  • Nausea or vomiting
  • Persistent coughing or wheezing
  • Swelling in different parts of the body

If you are experiencing any of these symptoms, you should contact your doctor.

How is heart disease diagnosed?

  • Blood tests
  • Chest radiograph (x-ray of the cardiac systems)
  • Cardiac catheterization (a catheter is introduced through an incision in a large vein and threaded to the heart)
  • Echocardiogram (ultrasound showing movements of the heart)
  • Electrocardiogram (a recording of the heart's electric impulse activity)
  • Doppler (technique used to evaluate blood flow within the heart)
  • Ejection fraction (measurement of the percentage of blood leaving the heart each time it contracts)
  • Stress test (a test that measures the function of the heart, usually during physical stress, but sometimes with specific drugs)

If a specific type of heart disease is diagnosed, your doctor will decide which treatment is right for you.

What are antibodies and how do they affect my status on the waiting list?

Your immune system produces certain kinds of proteins called antibodies that help protect your body from germs. After someone is exposed to a germ and creates antibodies against it, the person is immune to the specific disease caused by the germ. The antibodies created are then ready and waiting to destroy the germ if it tries to invade the body again.

The body can also create antibodies against the tissues of other human beings, such as those from blood transfusions or an organ transplant. The antibodies that the body can create after these sensitizing events may react with the tissue type of the heart donor, which means that you would not be able to receive a heart from that donor. The antibodies in your blood would attack and damage the heart immediately after transplantation. This is called "hyperacute rejection," which usually results in loss of the transplanted heart.

A panel reactive antibody (PRA) test, or "crossmatching," is performed before the transplant. A positive crossmatch means that the transplant should not be done because of the high risk of rejection. A negative crossmatch indicates that it is okay to proceed with the heart transplant.

In certain situations, plasmapheresis may be used to remove antibodies from the blood. This involves circulating part of a person's blood through a machine.

How is waiting list status determined?

The status of a person awaiting a heart transplant is determined by factors such as severity of disease and time on the waiting list. When a donor heart becomes available, people who are a match are identified, and the heart is offered to the recipient who has the most urgent need for the heart, based on his or her current health status.

How is heart transplantation done?

A healthy heart is usually obtained from a donor who is brain-dead but has been kept on life support.

Following arrival at the hospital and necessary surgical preparations, the transplant team performs a transplantation.

Typically, during a transplantation procedure:

  • The recipient will first receive general anesthesia
  • While the surgeon works on the heart, a heart-lung bypass machine will supply the body with blood and oxygen
  • The diseased heart will be removed and the donor heart will be put into place
  • The new heart should start beating after blood flow is restored

Does the size of the donated heart matter?

Organ size (which can be affected by gender and weight of donor) is important in matching a donor heart with a recipient. It is important that the donor heart will fit into your chest without pressing against or interfering with other organs and structures in the area.

What are the possible complications of a heart transplant?

It is important to remember that a heart transplant is a serious surgery and there are risks. Talk to your transplant team about what you can expect and make sure your concerns are addressed. You may experience some complications after your procedure. Complications after any type of surgical procedure are common.

One of the more common complications of transplantation is rejection. However, rejection episodes are less common today and can usually be managed. Knowing the signs of rejection and getting treatment early can help prevent a more serious rejection episode. Infection is another potential problem following a heart transplant. Symptoms that may signal a problem may include:

  • Fever over 100°F (38°C)
  • Pain or swelling at the transplant site
  • Flu-like symptoms (eg, chills, nausea, cough, and body aches and pains)
  • Coughing, wheezing, or shortness of breath
  • Retaining fluids or having sudden weight gain
  • Change in heart rate

What can I expect after a heart transplant?

Your doctor may perform frequent biopsies after your heart transplant, which will likely become less frequent as time passes after the transplant. You will be given a new medication regimen that may include immunosuppressant, anti-bacterial, anti-viral, and anti-fungal medicines.

After you are released from the hospital, you will likely be closely monitored. You will probably be receiving a high dose of immunosuppression, which increases your risk of infection. Therefore, it is often recommended that you avoid large crowds for the first few months. Several months after your surgery, depending on your recovery and your doctor's instructions, you can generally expect to return to a healthy, active lifestyle.

Will my new heart act the same way as my old one?

Your heart will probably react differently to physical activity after transplant. This is because the nerves that connected your original heart to your nervous system were cut during the transplant surgery. Because these nerves will likely not fully heal, your heart cannot respond immediately to exercise or sudden movement. It does react, but not nearly as fast. It may take some time to get used to how your new heart responds.

Will I need to monitor my vital signs after surgery?

As part of your post-transplant care, you may need to weigh yourself daily. Rapid weight gain can be a sign that your heart is not pumping efficiently. If you have unexpected weight gain, call your doctor.

Your transplant team may also instruct you to take your temperature a few times a day. A fever can be one of the first signs of infection. You may also be asked to measure your blood pressure to check if your heart is pumping blood through your body efficiently.

Make certain that you have a scale, thermometer, and blood pressure cuff at home. These items may be given to you by your transplant coordinator.

When can I exercise after my surgery?

In the days immediately after your heart transplant, you can expect to be tired. Transplantation is major surgery. However, you should begin to feel better and stronger each day and you may be encouraged to resume physical activity, including work.

Exercise according to your transplant team's instructions. Your transplant team can help you plan a proper exercise program.

What medications may I need to take after a heart transplant?

Your doctor will prescribe different medicines to slow down your body's immune system and make your body less likely to reject your transplanted heart. This process is called immunosuppression.

Even with immunosuppression, rejection can occur. If you experience a rejection episode, your doctor may decide to treat it with different or additional medications.

Sometimes medicines such as anti-infective (used to prevent or treat infections) or anti-ulcer (used to treat digestive problems) medicines may be prescribed. Other medicines not discussed here may also be prescribed.

Always ask your transplant team any questions you might have about the medicines your doctor has prescribed.

One of your responsibilities after a heart transplant is keeping your organ, and yourself, healthy. Taking your medications as prescribed is important to your health.

Because some medicines may produce unwanted side effects, it is important that you ask questions and talk freely with your transplant team about how you are feeling.

Why do I need a liver transplant?

Liver transplants are necessary when illness or injury leads to organ failure and standard medical and surgical therapies have failed.

What diseases or conditions may lead to the need for a liver transplant?

Cirrhosis is one condition that may lead to liver transplantation. Cirrhosis is the end result of chronic (long-term) liver disease, which causes scarring of the liver and poor liver function. There are different causes of cirrhosis, such as:

  • Primary biliary cirrhosis

    Primary biliary cirrhosis destroys the bile ducts in the liver. When bile ducts are destroyed, the liver can no longer release bile. Bile is required for the breakdown and digestion of fats.

  • Alcoholic cirrhosis

    Alcoholic cirrhosis is the widespread death of liver cells caused by long-term alcohol use.

  • Hepatitis

    Hepatitis is an inflammation of the liver often caused by hepatitis A, B, or C.

  • Other common causes of liver disease:

    • Sclerosing cholangitis—scarring and narrowing of the bile ducts
    • Wilson's disease—high levels of copper accumulate in the liver and other organs
    • Hemochromatosis—an inherited disease in which the body is overwhelmed with iron
    • Liver cancer

What are the symptoms of liver disease?

Some common symptoms associated with chronic liver disease are listed below.

People with liver disease may experience one or more symptoms, such as:

  • Nausea, vomiting, and loss of appetite
  • Diarrhea
  • Weight loss
  • Fatigue, weakness, and muscle loss
  • Yellow discoloration of the skin and whites of the eyes (jaundice)
  • Buildup of fluid in the abdomen
  • Pain on the right side of the abdomen

If you are experiencing any of these symptoms, you should contact your doctor.

How is liver disease diagnosed?

Tests such as imaging tests and liver function tests can check for liver damage and help diagnose liver disease.

What are antibodies and how do they affect my status on the waiting list?

Your immune system produces certain kinds of proteins called antibodies that help protect your body from germs. After someone is exposed to an infectious agent and creates antibodies against it, the person is immune to the specific disease caused by the germ. The antibodies created are then ready and waiting to destroy the germ if it tries to invade the body again.

The body can also create antibodies against the tissues of other human beings, such as those from blood transfusions or an organ transplant. The antibodies that the body can create after these sensitizing events may react with the tissue type of the liver donor, which means that you would not be able to receive a liver from that donor. The antibodies in your blood would attack and damage the liver immediately after transplantation. This is called "hyperacute rejection" which usually results in loss of the transplanted liver.

A panel reactive antibody (PRA) test, or "crossmatching," is performed before the transplant. A positive crossmatch means that the transplant should not be done because of the high risk of rejection. A negative crossmatch indicates that it is okay to proceed with the liver transplant.

In certain situations, plasmapheresis may be used to remove antibodies from the blood. Like hemodialysis, plasmapheresis involves circulating part of a person's blood through a machine.

How is waiting list status determined?

The status of a person awaiting a transplant organ is determined by factors such as severity of disease (as determined by your Model for End-Stage Liver Disease [MELD] or Pediatric End-Stage Liver Disease [PELD] score). When a donor liver becomes available, the person for whom that liver is a match is identified. The liver may be offered to the recipient who has the most urgent need for the liver, based on his or her current health status.

What is the difference between a living liver donor and a deceased donor organ donation?

Deceased donor liver donation is the donation of a liver from someone who has died. Living donor donation is when a portion of a liver is donated by someone who is living.

For some people, living donation is a possibility. You can learn about it in greater detail in our Sharing Life brochure.

The benefits of living donation include:

  • The organ may be from a younger, healthy person who has had medical testing
  • Surgery may be planned when the recipient's medical status is stable
  • The time the transplanted organ is without a blood supply may be shorter

How is a living liver transplant donor chosen?

A potential living donor for liver transplant must undergo a thorough medical evaluation similar to the one the recipient goes through. The doctor will select a donor who matches the recipient in regard to A/B/O blood type and human leukocyte antigen (HLA) compatibility. After the surgery, the donor should visit the doctor for follow-up testing.

If a transplant through a living liver donor is not possible, the recipient will be placed on the waiting list for a deceased donor liver.

To learn more about living donation, download the Sharing Life brochure and speak with your transplant team.

What is the risk of living liver donation to the donor?

Liver transplantation is major surgery. As with any surgery, there is potential for complications such as infection. Your doctor can provide more information about the specific risks for the recipient and donor.

To learn more about living donation, download the Sharing Life brochure and speak with your transplant team.

How is liver transplantation done?

  • The recipient will receive anesthesia to make him or her sleep
  • Once the recipient is asleep and the preparation is done, the surgeon will begin the operation to remove the diseased liver
  • The blood vessels will be sewn together, and the bile duct of the donor liver will be sewn to the bile duct of the recipient
  • After surgery, the recipient is taken directly to the intensive care unit, where the staff will monitor his or her vital signs very closely

Does the size of the liver matter?

Organ size is important in matching a donor liver with a recipient. For a living donation, the doctor will evaluate the size of the liver to ensure there is enough liver for the donor and recipient.

What are the possible complications of a liver transplant?

It is important to remember that transplantation is a serious surgery and there are risks. Talk to your transplant team about what you can expect and make sure your questions and concerns are addressed. You may experience some complications after your procedure. Complications after any type of surgical procedure are common.

One of the more common complications of transplantation is rejection. However, rejection episodes are less common today and can usually be managed. Knowing the signs of rejection and getting treatment early can help prevent a more serious rejection episode. Infection is another potential problem following a liver transplant. Symptoms that may signal a problem may include:

  • Fever over 100°F (38°C)
  • Pain or swelling at the transplant site
  • Flu-like symptoms (eg, chills, nausea, cough, and body aches and pains)
  • Shortness of breath
  • Weight loss
  • Yellow skin color
  • Bleeding easily

What can I expect after my liver transplant?

The period immediately after liver transplant surgery is a very important time. Your transplant team will monitor you very closely. As your condition begins to improve, they will likely teach you and your family about medicines, diet, and other important issues.

What medications will I need to take after my liver transplant?

Your doctor will prescribe different medicines to slow down your body's immune system and make your body less likely to reject your transplanted liver. This process is called immunosuppression.

Even with immunosuppression, rejection can occur. If you experience a rejection episode, your doctor may decide to treat it with different or additional medications, or adjust the dose of the medicines you are already taking.

Sometimes medicines such as anti-infective (used to prevent or treat infections) or anti-ulcer (used to treat digestive problems) medicines may be prescribed. Other medicines not discussed here may also be prescribed.

Always ask your transplant team any questions you might have about the medicines your doctor has prescribed for you.

One of your responsibilities after a liver transplant is keeping your organ, and yourself, healthy. Taking your medications as prescribed is important to your health.

Because some medicines may produce unwanted side effects, it is important that you ask questions and talk freely with your transplant team about how you are feeling.

Will I need to monitor my vital signs after surgery?

You may need to monitor your vital signs on a regular basis at home. Although it can vary, you may need to check your temperature, weight, blood pressure, and pulse. Talk to your transplant team about the vital signs you may need to monitor, as well as additional questions you have or instruction you need.

When can I exercise after my surgery?

In the days immediately after your liver transplant, you can expect to be tired. Transplantation is major surgery. However, you should begin to feel better and stronger each day, and you may be encouraged to resume physical activities, including work.

Exercise according to your transplant team's instructions. Your transplant team can help you plan a proper exercise program.

Why do I need a kidney transplant?

When illness or injury leads to kidney failure, the 2 main treatment options are dialysis or a kidney transplant.

What diseases or conditions may lead to the need for a kidney transplant?

Adults

The most common conditions that may lead to kidney failure in adults are complications of diabetes (high blood sugar), hypertension (high blood pressure), and glomerulonephritis (inflammation of the glomerulus of the kidney). Other disorders and abnormalities can also lead to kidney disease in adults such as systemic lupus erythematosus or polycystic kidney disease. However, there are several others.

Children

Causes of kidney disease in children and adults are generally very different. Children often have a higher rate of inherited (congenital) disease such as polycystic kidney disease.

What are the symptoms of kidney disease?

Kidneys are bean shaped and located near the middle of the back. Their job is to filter and remove waste products from the body and make chemicals (hormones) that keep the bones strong and the blood healthy.

When the kidneys cannot remove waste, symptoms may develop such as:

  • Nausea and vomiting
  • Loss of appetite
  • Headaches
  • Weight loss
  • Itching, dry skin
  • Numbness or swelling of hands and feet
  • Fatigue
  • Problems thinking or concentrating
  • Shortness of breath
  • Excessive thirst
  • Breath odor
  • Sleep problems
  • Easy bruising or blood in stool
  • Muscle twitching or cramps
  • Bone pain
  • Abnormally dark or light skin

If you are having any of these symptoms, you should contact your doctor.

How is kidney disease diagnosed?

Tests for kidney disease include:

  • Glomerular filtration rate (GFR): a common blood test to check for chronic kidney disease. It tells how well your kidneys are filtering
  • Creatinine blood and urine tests: check the levels of creatinine, a waste product that your kidneys remove from your blood
  • Albumin urine test: checks for albumin, a protein that can pass into the urine if the kidneys are damaged
  • Imaging tests, such as an ultrasound: provide pictures of the kidneys that help the doctor see the size and shape of the kidneys, and check for anything unusual
  • Kidney biopsy: a procedure that involves taking a small piece of kidney tissue for examination with a microscope to check for the cause of kidney disease and the extent of damage

What are antibodies and how do they affect my status on the waiting list?

Your immune system produces certain kinds of proteins called antibodies that help protect your body from germs. After someone is exposed to a germ and creates antibodies against it, the person is immune to the specific disease caused by the germ. The antibodies created are then ready and waiting to destroy the germ if it tries to invade the body again.

The body can also create antibodies against the tissues of other human beings, such as those from blood transfusions or an organ transplant. The antibodies that the body can create after these sensitizing events may react with the tissue type of a kidney donor, which means that you would not be able to receive a kidney from that donor. The antibodies in your blood would attack and damage the kidney immediately after transplantation. This is called "hyperacute rejection," which usually results in loss of the transplanted kidney.

A panel reactive antibody (PRA) test, or "crossmatching," is performed before the transplant. A positive crossmatch means that the transplant should not be done because of the high risk of rejection. A negative crossmatch indicates that it is okay to proceed with the kidney transplant.

In certain situations, plasmapheresis may be used to remove antibodies from the blood. Like hemodialysis, plasmapheresis involves circulating part of a person's blood through a machine.

How is waiting list status determined?

The status of a person waiting for a kidney transplant is determined by such factors as severity of disease and time on the waiting list. When a donor kidney becomes available, the people for whom that kidney is a match are identified, and the organ is offered to the recipient who has the most urgent need for the kidney, based on his or her current health status.

What is the difference between a living kidney donor and a deceased donor organ donation?

Deceased donor kidney donation is when a kidney is donated from someone who has died. Living donor donation is when a kidney is donated by someone who is living.

For some people, living donation is a possibility. You can learn about it in greater detail in our Sharing Life brochure.

The benefits of living donation include:

  • The organ may be from a younger, healthy person who has had medical testing
  • Surgery may be planned when the recipient's medical status is stable
  • The time the transplanted organ is without a blood supply may be shorter

How is a living kidney transplant donor chosen?

A potential living donor for kidney transplant must undergo a thorough medical evaluation similar to the one the recipient goes through. The doctor will select a donor who matches the recipient in regard to A/B/O blood type and human leukocyte antigen (HLA) compatibility. After the surgery, the donor should visit the doctor for follow-up testing.

If a transplant through a living kidney donor is not possible, the recipient will be placed on the waiting list for a deceased donor kidney.

To learn more about living donation, download the Sharing Life brochure and speak with your transplant team.

What is the risk of living kidney donation to the donor?

The risks to kidney donors are low; however, kidney transplantation is major surgery. As with any surgery, there is potential for complications such as infection. Your doctor can provide more information on the specific risks of kidney donation for the donor and any potential problems associated with having only 1 kidney.

To learn more about living donors, download the Sharing Life brochure and speak with your transplant team.

Will my kidney need to be removed before transplant?

In most cases, your old kidneys will not be removed. However, if you have a kidney disease that causes ongoing problems, then your transplant team may consider removing your kidneys.

How is kidney transplantation done?

Regardless of whether the kidney is from a living or deceased donor, kidney transplant surgery involves general anesthesia and treatment with anti-rejection drugs.

  • A small cut is typically made in the lower left side of the abdomen, and the kidney is placed into the space
  • The patient's own kidneys are left in place unless the kidney(s) cause medical problems
  • The blood vessels of the donor kidney are sewn to the recipient's blood vessels
  • Then the surgeon connects the ureter to the bladder and closes the cut

What are the possible complications of a kidney transplant?

It is important to remember that a kidney transplant is a serious surgery and there are risks. Talk to your transplant team about what you can expect and make sure your questions and concerns are addressed. You may experience some complications after your procedure. Complications after any type of surgical procedure are common.

One of the more common complications of transplantation is rejection. However, rejection episodes are less common today and can usually be managed. Knowing the signs of rejection and getting treatment early can help prevent a more serious rejection episode. Infection is another potential problem following a kidney transplant. Symptoms that may signal a problem may include:

  • Fever over 100°F (38°C)
  • Pain or swelling at the transplant site
  • Flu-like symptoms (eg, chills, nausea, cough, and body aches and pains)
  • Shortness of breath
  • Weight loss
  • Urinating less often

What can I expect after my kidney transplant?

Your new kidney should start working as soon as your blood flows through it, but sometimes the new kidney doesn't start working right away. This is called delayed graft function.

After the transplant, you will probably be monitored in the intensive care unit for several hours and then moved to a transplant unit. Most transplant recipients will return to a normal lifestyle when they have recovered and their doctor has determined that it is appropriate for them to resume daily activities.

It is important to note that even though you no longer have to go to dialysis several times each week, initially your days will now be scheduled with doctor's appointments, taking medicines, and following your doctor's instructions.

What medications will I need to take after my kidney transplant?

Your doctor will probably prescribe different medicines to slow down your body's immune system and make your body less likely to reject your transplanted kidney. This process is called immunosuppression.

Even with immunosuppression, rejection can occur. If you experience a rejection episode, your doctor may decide to treat it with different or added medicines.

Sometimes medicines such as anti-infective (used to prevent or treat infections) or anti-ulcer (used to treat digestive problems) medicines may be prescribed. Other medicines that are not discussed here may also be prescribed.

Always ask your transplant team any questions you might have about the medicines your doctor has prescribed.

One of your responsibilities after a kidney transplant is keeping your kidney, and yourself, healthy. Taking your medications as prescribed is important to your health.

Because some medicines may produce unwanted side effects, it is important that you ask questions and talk freely with your transplant team about how you are feeling.

Will I need to monitor my vital signs after surgery?

You may need to monitor your vital signs on a regular basis at home. Although it can vary, you may need to check your temperature, weight, blood pressure, and pulse. Talk to your transplant team about the vital signs you will need to monitor, as well as additional questions you have or instructions you need.

Make certain that you have a scale, thermometer, and blood pressure cuff at home. These items may be given to you by your transplant coordinator.

When can I exercise after my surgery?

In the days immediately after your kidney transplant, you can expect to be tired. Transplantation is major surgery. However, you should begin to feel better and stronger each day, and you may be encouraged to resume physical activity, including work.

Exercise according to your transplant team's instructions. Your transplant team can help you plan a proper exercise program.