UpClose with Elizabeth Dixon, RN, Ph.D.

Organ Transplants: 50 Years of Medical Innovation

The first successful organ transplant, a kidney transplantation, took place in 1954, from one identical twin to the other at Peter Bent Brigham Hospital in Boston. Fifty years later, the science of transplantation has advanced tremendously. Today, in addition to related living donors, patients routinely receive organs from unrelated donors as well as cadavers.

In 2003, 25,458 solid organ transplants were performed. In addition, more than 12,000 unrelated donor stem cell transplants were registered (these are not included in the solid organ category).
The number of transplants performed continues to rise. Advanced surgical procedures, better organ preservation procedures, new immunosuppressant drugs and improved post-transplant care are enabling more types of transplants to be performed and lengthening the life of recipients.

The transplantation of multiple organs at the same time is also becoming more common. At UCLA, the largest multi-organ transplant center in the country, patients are now receiving kidney and pancreas, heart and lung and intestinal transplants.

Currently, more than 87,000 people are on a waiting list for a donated organ. Because of the limited number of donors, about 5,000 people a year will die before a suitable organ becomes available. The increase in demand for organs is expected to grow as more diseases such as cystic fibrosis and diabetes mellitus are treated successfully with organ transplantation. In 2003, the average waiting time for a kidney was more than 1,000 days. The persistent problem of human organ shortages has led to remarkable developments in the field of xenotransplantation, the transplantation of organs or tissues from animals to humans.

The long-term success of organ transplantation varies by the type of organ transplanted, by the number of organs transplanted at the same time, and by the type of disease that may have originally caused the organ to fail. Overall, 5-year survival rates for single organ transplants average around 80%.

It is important to remember that a successful transplantation requires a lifetime of medical care. Typically, a patient will regularly visit the transplant clinic to be sure they remain free of infection and rejection. Follow-up care may include blood tests, radiological studies and biopsies to check for signs of potential problems.

Follow-up visits may involve the transplant physician and the transplant nurse coordinator. They include physical exams, medication management, patient education and psychological support.

Elizabeth Dixon, RN, Ph.D., works in nursing research and education at a leading national medical center.