-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. BACK
TO THE TOP -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. BACK
TO THE TOP -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. BACK
TO THE TOP -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. BACK
TO THE TOP -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. BACK
TO THE TOP -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. BACK
TO THE TOP -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. BACK
TO THE TOP -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. BACK
TO THE TOP -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. BACK
TO THE TOP Definitions courtesy of UNOS.
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