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Reuters/Keith Bedford
Transplant surgery can’t work without organ donors.
SUPPLY AND DEMAND

These are the organs transplant patients need the most

Katherine Ellen Foley
By Katherine Ellen Foley

Health and science reporter

When the first kidney transplant was performed in 1954, it changed the field of surgery forever. Instead of dying, thousands of patients with failing organs could receive new, healthy ones.

Organ transplantation, though, has always had a supply problem. Transplanted organs most often come from deceased donors and less than 60% of adults in the US are registered to be organ donors. Of those, fewer than 1% die in a way in which their organs can be safely transplanted into a patient in need. Because there are not enough organs to go around, over 7,000 people in the US die annually while waiting for an organ.

Today, there are more than 114,000 patients waiting for organs in the US. The most in-demand organ, by far, are kidneys, which have a waiting list seven times longer than that for livers, the next most needed organ.

Most donors are deceased, but kidneys and livers can both come from living donors (pancreatic, lung lobe, intestine, and uterus transplants can also come from living donors, but are much more rare). A person only needs one kidney to live, and livers have incredible regenerative capabilities. These donations can usually come from a friend or relative who is a biological match, but sometimes they can come from an altruistic stranger (which is more common in the case of kidneys).

Even so, kidney failure, which is associated with diabetes, is so rampant that there are still not enough donated organs to meet demand, says C. Burcin Taner, a transplant surgeon at the Mayo Clinic’s Jacksonville, Florida location. Although patients with kidney failure can live with the help of dialysis, the process itself is damaging to the body and most patients who have dialysis fare worse than those who receive a new kidney.

Since 1988, the number of transplants has quadrupled. The majority of this increase is due to  improvements in immunosuppressant therapies, which are drugs prevent the host’s body from rejecting a new organ. In recent years, however, there’s been an uptick in organ donation due to the opioid crisis, which as led to a spike in overdose deaths.

 

In the long run, though, transplant surgery will ideally move away from relying on human organs. The field of xenotransplantation, or transplanting organs across species, has made serious strides. Late last year, scientists were able to keep baboons alive for six months after receiving genetically-modified pig hearts. Another group kept pigs alive for two months with lab-grown lungs. Although neither of these developments have been tested in humans yet, the successful work in animals suggests that clinical trials are not far away, and one day there may be a kidney available for everyone who needs one.

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