Organ Transplant Care

Organ transplants occur when a healthy organ is taken from one person — the organ donor — and surgically transplanted into another person whose organ was injured or has failed. Organs that can be transplanted include the kidneys, pancreas, liver, heart, lungs, and small intestine. Most donor organs come from deceased donors, but it is also possible to transplant an organ from a living donor. This is most common in kidney transplant surgery, but living donors can also donate one of the five lobes of their lungs to someone who needs a lung transplant, or a piece of their liver, as it is the only organ that regenerates.

Donor organs are matched to recipients based on medical characteristics, like blood type and the size of the organ needed, as well as factors like geography, how long a person has been on the transplant list, and how sick they are. A deceased donor can save eight lives if all of their eight lifesaving organs (heart, liver, pancreas, intestine, both kidneys, and both lungs), are matched to different recipients.

Of the more than 36,500 organ transplants performed in the United States in 2018, kidney transplant surgery was the most common, and intestine transplants were the least common solid organ transplants.

There are many diseases that can cause a transplantable organ to fail. Cardiomyopathy and coronary heart disease are two of the most common reasons for heart transplants, while diabetes can necessitate a kidney transplant surgery or pancreas transplant. Chronic uncontrolled hypertension and polycystic kidney disease are two other common causes for kidney transplant surgery. People suffering from cystic fibrosis and chronic obstructive pulmonary disease (COPD) may require a lifesaving lung transplant if they are good candidates for the procedure. Intestine transplants account for a small percentage of the total number of solid organ transplants performed each year, but common indications for the procedure include Crohn’s disease, ischemia, and motility disorders. Physical injuries to organs and infections such as hepatitis can also create the need for an organ transplant.

People who need an organ transplant are very ill. Solid organ transplant procedures are a life-saving measure, and many have favorable outcomes. The survival rate for lung transplants after one year is nearly eighty percent, and the average life expectancy of a heart transplant recipient is almost ten years. The effects of an organ transplant are long-lasting, and some people require extended care for a complete recovery, or to manage complications that may arise after the procedure. Organ transplant recipients must make lifelong changes to their healthcare regimen, like taking anti-rejection medication to prevent organ rejection and making dietary and lifestyle modifications to maintain their health and protect their transplanted organ.

Organ Transplant Complications

Organ transplant surgeries save over 35,000 lives in the United States every year, but patients who undergo these complex procedures face potentially life-threatening complications in both the short and long-term. Like any other surgery, an organ transplant presents the possibility for bleeding, infection, and negative reactions to anesthesia. Other risks that are common in any major surgery include pain, hernias, blood clots, wound complications, and, in rare cases, death.

As recovery progresses, the risk of these complications decreases, but others may present, including:

  • Diabetes
  • High cholesterol
  • High blood pressure
  • Gastrointestinal problems
  • Gout
  • Anxiety and depression

What Is the Best Path to Organ Transplant Recovery?

After a successful recovery from an organ transplant, patients are able to enjoy many activities their illnesses prevented prior to surgery. In fact, people often say that they have a new lease on life after kidney transplant or other organ transplant procedures. However, because a solid organ transplant is a major surgery with serious potential complications, long-term acute hospital care and rehabilitation are sometimes necessary to achieve a successful recovery.

The staff at Kindred long-term acute care hospitals have expertise in treating complications that may arise after an organ transplant, including those brought on by underlying chronic conditions. For example, diabetic patients have a high risk of cardiovascular disease after kidney transplant surgery, and they are more likely to experience cardiac or cerebrovascular events post-transplant when compared with non-diabetic transplant recipients. Patients with COPD or pulmonary fibrosis are at risk of developing lung cancer after a lung transplant, and pre-existing bone diseases contribute to post-transplant osteoporosis and fracture risk.

“If you look at organ transplant statistics, you’ll see that the number of transplants performed has increased significantly for six consecutive years,” said Dr. Sean Muldoon, Chief Medical Officer at Kindred. “Each day, about eighty people receive organ transplants, and approximately 110,000 people are waiting on the national transplant list. In most cases, it’s a life-saving surgery, but it’s also one that requires extensive rehabilitation and carries the risk of serious complications. Transplant recipients that require extended recovery time and rehabilitation, and those that suffer complications, need an interdisciplinary team that understand the whole, medically complex picture. That’s what they get at Kindred — a collaborative team that creates customized care plans for organ recipients, so they can achieve a successful recovery and live active, healthy lives.”

Kindred long-term acute care hospitals have a collaborative and integrated approach to organ transplant recovery. Our interdisciplinary team of doctors, nurses, therapists, and other experts work together, as well as with referring hospitals, to support organ transplant recovery by creating customized care plans and treating complications.

Organ transplant treatment plans may include but are not limited to:

  • Treatment in special care units
  • Cardiac monitoring, including telemetry and device monitoring
  • Education regarding specific care plans for patients and family members
  • Medication management, including anti-rejection medication
  • Laboratory monitoring
  • Nutritional assessment and support
  • Rehabilitation, including physical therapy, occupational therapy, and speech therapy
  • Home care education for family and caregivers
  • Financial planning for extended care, if needed

Success Spotlight: Jack's Story

Back Home and Independent Again

John Y., 67, better known as “Jack,” came to Kindred Hospital for continued care following a complicated course of hospitalizations surrounding the double lung transplant he received.

In the year immediately following his lung transplant surgery, Jack was in and out of short-term acute care hospitals. He required significant assistance from his wife for most of his self-care tasks and was only able to walk very short distances with a rolling walker.

Prior to his double lung transplant, Jack was enjoying his retirement as an active and independent senior, able to drive and take care of himself. He came to Kindred Hospital to achieve a more successful lung transplant recovery, with the hope of getting back to his previous quality of life.

Upon admission to Kindred Hospital, Jack was evaluated by our interdisciplinary team of physicians, nurses, specialists, and therapists, who began a treatment program tailored to his medically complex needs. His lung transplant surgery had left him very weak, so he required assistance to roll and sit up in bed, was unable to walk more than ten feet, and could only tolerate five minutes of activity at a time. Jack had to overcome his limited endurance and weakness little by little as his lungs became stronger.

Through his perseverance, and the support of his wife and our clinical and medical teams, Jack was able to achieve a successful lung transplant recovery and return home. At discharge, he was able to get in and out of bed on his own, walk 300 feet with a rolling walker, and tolerate over 45 minutes of activity with minimal rest.

After only two months at Kindred Hospital, Jack was able to return to a life of independence! Less than a week after discharge, Jack’s wife called to report that he was already walking without a walker.

 


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