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Supplement to “Gifts of Life”

You might think of transplants as something like changing out car parts, but it’s not usually that simple. Transplanting is part science and part art, and finding the right match is the most challenging part.

Colleen Wilson, director of the transplant program at Jewish Hospital Transplant Center in Louisville, says patients are placed on the national transplant list (one for each major organ, liver, kidney, pancreas, lung, and heart) by a committee that examines the patient’s case. The most requested transplant is kidney, Wilson says. Some 600 people sought transplants last year through Jewish, which operates its center in partnership with the University of Louisville.

The national transplant list is matched against potential donors. Emphasis is placed on keeping organs close to the deceased person, for the practical reason of transporting the organs. But sometimes, as in Emilie Hester’s case in the main story on organ donation, a person who isn’t in the same state may get an organ if it’s a better match. This is particularly true with kidneys, according to Jenny Miller Jones, director of education for Kentucky Organ Donor Affiliates. In Emilie Hester’s story, all of her organs except a kidney stayed in Kentucky.

Here’s why: kidneys have six antigens that can match. If all six match but the person is out of state, they are more likely to get that kidney than someone who is nearer but only has five antigens that match the donated kidney, because the survival rate is much higher with a total match. Having all six antigens match, Jones says, “is like getting one of your own kidneys back.” Also, kidneys are more transportable than most other organs.
Wilson explained that helping to ensure survival is a key to matching donated organs to recipients.

“It is a big commitment for someone to get a transplant, and we have to be sure that they are healthy enough in all areas that, once they get the transplant, they will have a beneficial result from that,” Wilson says. “We also want a good outcome for the donor family who has given this wonderful gift.”

Overall, organ transplants have become increasingly successful, making more transplants possible and upping the odds of survival for recipients. Dr. Rick Bentley, head of the transplant program at Jewish Hospital in Louisville, says the biggest changes have been advances in surgical techniques in liver transplants that allow for easier transplantation and changes in immunosuppressant drugs, which have to be taken by the organ recipient to keep them from rejecting the new organ. “We have more at our demand,” Bentley says. “Our bag of tools is greater.”

To read the Kentucky Living October 2005 feature that goes along with this supplement, click here: Gifts of Life

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