Transplant Center
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Glossary of Terms
-A-
ABO Blood Type - The classification of human blood into four groups: A, B, AB, and O.
Acute Rejection - The body's attempt to destroy the transplanted organ; usually occurs in the first year after transplant.
Adverse Reaction - An unintended effect from a drug.
Allocation - The process of determining how organs are distributed. Allocation includes the system of policies and guidelines, which ensure that organs and tissues are distributed fairly to those waiting.
Anti-Rejection Drugs (immunosuppressive drugs) - Drugs that are taken to help the body accept the transplanted organ.
Antibody - A protein substance made by the body's immune system in response to a foreign substance, for example a transplanted organ, blood transfusion, virus, or pregnancy. Because the antibodies attack the transplanted organ, transplant patients must take powerful anti-rejection (immunosuppressive) drugs.
Antigen - Any foreign molecule or substance, such as a transplanted organ, that triggers an immune response. This response may be the production of antibodies, which, in turn, try to inactivate or destroy the antigen (transplanted organ).
Ascites - Build-up of fluid in the abdomen, usually associated with liver disease.
Autograft - A graft of skin or other tissue that is taken from the body of the person to be grafted rather than from another person.
Auxiliary Transplant - A type of liver transplant in which the patient's liver remains within the body, while another whole or partial liver is transplanted just beneath or adjacent to the recipient's.
-B-
Biopsy - A tiny piece of tissue from the body is removed (usually with a needle) and examined under a microscope. This procedure is used to diagnose rejection of the transplanted organ.
Blood Vessels - The veins, arteries, and capillaries through which blood flows in the body. Blood vessels can be donated and transplanted.
Brain Death - When the brain has permanently stopped working, as determined by a neurological specialist. Artificial support systems may maintain functions such as heartbeat and respiration for a few days.
-C-
Cadaveric Donation - Cadaveric donors are adults or children who have become critically ill (often due to accident or injury) and do not survive. If the donor is an adult, he/she may have agreed to be an organ donor before becoming ill. Parents or spouses can also agree to donate a relative’s organs. Most transplanted organs come from cadaveric donors
Chronic - Developing slowly and lasting for a long time, possibly the rest of a person's life. For example: chronic kidney failure.
Chronic Rejection - Slow, continuous failure of the transplanted organ.
Cirrhosis - A disease of the liver in which normal, healthy tissue is replaced with nonfunctioning tissue and healthy, functioning liver cells are lost; usually occurs when there is a lack of adequate nutrition, an infection or damage caused by alcohol abuse.
Cold Ischemia Time - The time interval beginning when an organ is cooled with a perfusion solution at the organ procurement surgery and ending when the organ is re-perfused at implantation.
Continuous ambulatory peritoneal dialysis (CAPD) - CAPD is a continuous dialysis procedure, which involves a dialysis solution being emptied into the patient's abdominal cavity. This solution removes waste products from the blood, allowing the patient greater freedom of movement while requiring less time than traditional hemodialysis.
Corticosteroid - A synthetic hormone, which stops the body's normal reaction to infection and foreign tissue, such as a transplanted organ. Prednisone is a corticosteroid.
Crossmatching - A blood test done before the transplant to see if the potential recipient will react to the donor organ. If the crossmatch is "positive," then the donor and patient are incompatible. If the crossmatch is "negative," then the transplant may proceed. Crossmatching is routinely performed for kidney and pancreas transplants.
Cyclosporine - A drug used to prevent rejection of the transplanted organ by suppressing the body's defense system. Considered an immunosuppressant.
-D-
Delayed Function - A condition in which the transplanted organ does not work well right after the transplant. Many kidneys have a delay before they begin to function well. Kidneys can sometimes take as long as three weeks to "wake up." Sometimes a kidney recipient needs dialysis until the kidney starts to work.
Dialysis - A mechanical process which works to correct the balance of fluids and chemicals in your body and to remove wastes from your body when your kidneys are failing.
Division of Transplantation (DoT) - The office of the Federal government whose principal responsibilities include the management of the Organ Procurement and Transplantation Network (OPTN), the Scientific Registry of Transplant Recipients (SRTR) and the National Marrow Donor Program (NMDP) contracts; public education to increase organ/tissue donation; and technical assistance to organ procurement organizations (OPOs).
Donation Service Area (DSA) - A geographic area including one federally designated OPO, one or more transplant centers, and one or more donor hospitals.
Donor - Someone from whom an organ or tissue is removed for transplantation.
Donor Card - A card, usually wallet sized, that indicates your wishes to be an organ donor.
Donor Pool - A group of people eligible to donate an organ.
Donor Registries - Available twenty four hours a day, seven days a week, online registries provide authorized professionals access to a confidential database of registered organ donors, allowing easy and quick confirmation of an individual's consent to organ donation. All registries are completely voluntary and some are affiliated with the local motor vehicle bureau, while others are independently operated or OPO-based.
-E-
En Bloc (or En-Bloc) - Patient receives both kidneys or both lungs from a single donor transplanted en bloc or together.
End Stage Organ Disease - A disease that leads to the permanent failure of an organ and for which the patient requires dialysis or a transplant.
End Stage Renal Disease (ESRD) Program - Part of the Medicare program that provides medical coverage to people with end stage kidney disease or renal failure to help pay for dialysis or transplantation.
-F-
First Person Consent Legislation - Legislation that allows donor designation to be indicated on a driver’s license or an official signed donor document, which gives hospitals legal authority to proceed with organ procurement, even against the wishes of the family. No additional consent form is required.
-G-
Graft - An organ or tissue that is transplanted.
-H-
Hepatic - Having to do with, or referring to, the liver.
Histocompatibility - The examination of human leukocyte antigens (HLA) in a patient, often referred to as "tissue typing" or "genetic matching." Tissue typing is routinely performed for all donors and recipients in kidney and pancreas transplantation to help match the donor with the most suitable recipients. This helps to decrease the likelihood of "rejecting" the transplanted organ.
-I-
Immunosuppression - The artificial suppression of the immune response, usually through drugs, so that the body will not reject a transplanted organ or tissue.
Infection - A condition that occurs when a foreign substance, such as bacteria, enters your body, causing your immune system to fight the intruder. All transplant recipients can get infections more easily because their immune systems are suppressed. It is more difficult for them to recover from infection (such as urinary tract infections, colds and the flu).
Informed Consent - The process of reaching an agreement based on a full disclosure and full understanding of what will take place. Informed consent has components of disclosure, comprehension, competence and voluntary response. Informed consent often refers to the process by which one makes decisions regarding medical procedures including the decision to donate the organs of a loved one.
-K-
Kidneys - A pair of organs that remove wastes from your body through the production of urine. All of the blood in your body passes through the kidneys about 20 times every hour. Kidneys can be donated from living and cadaveric donors and transplanted into patients with kidney failure.
-L-
Living-Related Donor (LRD) - A family member who donates a kidney, part of a lung, liver or pancreas to another family member. Examples: a brother and a sister, or a parent and a child.
Living-Unrelated Donor - A person who is not related by blood, who donates a kidney, part of a lung, liver or pancreas to another person (such as a husband, wife, friend or in-law. In the last few years, stranger-to-stranger living unrelated donations have greatly increased).
Liver - The body’s largest organ. It performs more than 400 functions each to keep the body healthy, including producing bile to help break down fats; storing fats, sugars, iron and vitamins for later use by the body; and making the proteins needed for normal blood clotting. The liver also removes drugs, alcohol, and other substances that may be harmful or toxic to the body. A living donor can give part of their liver, after which the liver will regenerate itself in both the donor and recipient.
Living Donation - Some candidates for kidney or liver transplantation may have a living relative, spouse or close friend who is interested in donating a kidney or part of their liver. This is a living donation. Potential donors are considered if he/she is at least 18 years old, has a blood type compatible with the intended recipient’s blood type. Once a compatible blood type is confirmed, other preliminary tests are performed to see if the donor is medically eligible. If test results indicate that a living donation is appropriate for donor and recipient, pre-surgical testing begins.
-M-
Marginal donor - Donors that are not considered to be "ideal." Factors may include organs from non-heart beating cadaver donors, donor age greater than 55 years, prior infection with Hepatitis B or Hepatitis C and hypertension or diabetes mellitus.
Match - The compatibility between the donor and the recipient. The more appropriate the match, the greater the chance of a successful transplant.
Multiple Listing - Being on the waiting list at more than one transplant center.
-N-
Nephrologist - A specialist who is an expert in the treatment of kidney insufficiency and kidney disease.
Non-Function - A condition in which a transplanted organ fails to "wake up" (work) after being transplanted into a recipient, meaning that the recipient will either have to go on dialysis or undergo another transplant. Non-function is rare (about two percent of all kidney transplants).
-O-
Organ - A part of the body made up of tissues and cells that enable it to perform a particular function. Transplantable organs are the heart, liver, lungs, kidneys, pancreas and intestines
Organ Preservation - Between organ procurement and transplant, organs require special methods of preservation to keep them viable. The length of time that organs and tissues can be kept outside the body varies, depending on the organ, the preservation fluid and the temperature.
Organ Procurement Organization (OPO) - OPOs serve as the integral link between the potential donor and recipient and are accountable for the retrieval, preservation and transportation of organs for transplantation. All OPOs are UNOS members.
-P-
Pancreas - Irregularly shaped gland that lies behind the stomach and secretes pancreatic enzymes into the small intestines to aid in the digestion of proteins, carbohydrates and fats. Islet cells within the pancreas secrete glucagon, which regulates blood sugar levels and insulin, which lowers blood sugar levels. If the pancreas fails, the individual becomes diabetic, and may need to take insulin. The pancreas can be donated and transplanted.
Panel Reactive Antibody (PRA) - 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 more likely the recipient will react against the potential donor(s). The higher the % PRA, the lower the chances of finding a compatible organ. For example, a patient with a PRA of 80% will be incompatible with 80% of potential donors. Kidney patients with a high PRA are given priority on the waiting list.
Peritoneal dialysis - Technique that uses the patient's own body tissues inside of the belly (abdominal cavity) to act as a filter. The intestines lie in the abdominal cavity, the space between the abdominal wall and the spine. A plastic tube called a "dialysis catheter" is placed through the abdominal wall into the abdominal cavity. A special fluid is then flushed into the abdominal cavity and washes around the intestines. The intestinal walls act as a filter between this fluid and the blood stream. By using different types of solutions, waste products and excess water can be removed from the body through this process.
-R-
Recovery (Organ) - The surgical procedure of removing an organ from a donor.
Rejection - Rejection occurs when the body tries to attack a transplanted organ because it reacts to the organ or tissue as a foreign object and produces antibodies to destroy it. Anti-rejection (immunosuppressive) drugs help prevent rejection.
Renal - Having to do with, or referring to, the kidneys.
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 by giving more people the opportunity to donate.
Retransplantation - In the event of organ rejection or transplant failure, some patients need another transplant and return to the waiting list. Reducing the number of retransplants is critical when examining ways to maximize a limited supply of donor organs.
-S-
Status Code - Indicates the degree of medical urgency for patients awaiting heart or liver transplants.
Survival Rates - Survival rates indicate how many patients or grafts (transplanted organs) are alive/functioning at a set time post-transplant. Survival rates are often given at one, three and five years. Policy modifications are never made without examining their impact on transplant survival rates. Survival rates improve with technological and scientific advances. Developing policies that reflect and respond to these advances in transplantation will also improve survival rates.
-T-
Tissue - An organization of a great many similar cells that perform a special function. Examples of tissues that can be transplanted are blood, bones, bone marrow, corneas, heart valves, ligaments, saphenous veins, and tendons.
Tissue Typing - A blood test that helps evaluate how closely the tissues of the donor match those of the recipient.
-U-
Uniform Anatomical Gift Act - The 1968 Uniform Anatomical Gift Act (UAGA) provided the legal foundation upon which human organs and tissues could be donated for transplantation by execution of an anatomical gift authorizing document. Since 1972, all 50 States and the District of Columbia have adopted this Act, or forms of this Act.
UNOS - The United Network for Organ Sharing (UNOS) is a private, non-profit organization. Every transplant center and organ procurement organization in the U.S. is a member of UNOS, as are histocompatibility laboratories, voluntary and professional health organizations, transplant candidates and recipients, donor families and members of the general public. Some of UNOS' duties include maintaining the national organ transplant waiting list, coordinating the matching and distribution of donated organs, and collecting data on transplant recipients, donors and outcomes.
-W-
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 UNOS 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.
-X-
Xenograft - An organ or tissue procured from a different species for transplantation into a human.
Xenotransplantation - Transplantation of an animal organ into a human. Although xenotransplantation is highly experimental, many scientists view it as an eventual solution to the shortage of human organs.
