Kidney Transplants
The diseases that most often create a need for kidney transplantation are glomerulonephritis (inflammation of the kidneys), diabetes, hypertension and cystic fibrosis leading to kidney failure. People with these diseases who have failing kidneys have to undergo regular treatment with an artificial kidney (haemodialysis). However, dialysis can only replace about 5% of the function of two healthy kidneys, and for many people their quality of life on dialysis is very poor. Additionally, life expectancy is lower for people on dialysis than for the normal population.
Kidney transplantation is the best treatment possible for kidney failure. It can improve quality of life dramatically and increases life expectancy.
One year after transplantation of a kidney from a living donor around 90% of transplants are still functioning well. After five years over 60% are still healthy and overcome any need for dialysis.
In some people who have severe insulin-dependent diabetes, the donor's pancreas may be transplanted at the same time as the kidney transplant. This helps to stop the diabetes from damaging the new kidney.
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Liver Transplant
For people with serious liver disease, transplantation can sometimes be the only effective treatment available. The most common diseases which cause a need for liver transplantation are cirrhosis, some types of chronic hepatitis, acute liver failure, or inflammation of the bile ducts that lead into the liver (primary sclerosing cholangitis).
Fortunately, waiting lists for liver transplants are shorter than for kidneys. At one year, around 80% of liver transplants are working well. This falls to 60-65% after five years.
Transplant surgeons have also developed other techniques to provide new liver tissue, including splitting a donor liver in half to transplant into two recipients, or taking part of a parent's liver and transplanting it to their child. Living donation of liver tissue is now also becoming an option for adult recipients.
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Heart & Heart/Lung Transplants
Coronary heart disease is one of the major causes of early death today. Heart transplantation is an effective option: 85% of heart transplants are still working well after a year, and almost 70% after five years. However, because there is only a limited supply of donor hearts, many people who could potentially benefit from heart transplantation are not placed on the waiting list.
Combined heart/lung transplants are less common, and are usually carried out in people who have cystic fibrosis. Additionally, a small number of lung-only transplants are undertaken for patients with chronic lung disorders.
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Other Types Of Transplant?
For certain people with insulin-dependent diabetes a pancreas transplant may improve their production of insulin and reduce the risk of diabetic complications. This may be undertaken in conjunction with a simultaneous kidney transplant from the same donor, since kidney damage is a frequent complication of diabetes.
As transplantation develops, other procedures are also being developed. A number of centres now perform small bowel transplants to replace damaged sections of gut in people with severe Crohn's disease or cancer, for example. Multiple transplants combining several organs have also been carried out occasionally.
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