Australia has a world class reputation for successful transplant outcomes, both in terms of survival rates of the recipients and in the number of organs that are able to be transplanted from each donor.
Transplantation has dramatically improved the lives of recipients and enabled them to be active, healthy members of the community. There are significant cost benefits to transplants when compared with the ongoing cost of treatment for people requiring transplants
When families know the donation decision of their family members, they are more likely to agree to their loved one becoming a donor.
Transplant waiting lists
In Australia, organ transplantation waiting lists are kept for each transplantable organ - heart, lungs, kidneys, liver, intestine and pancreas.
A person is put on a transplant waiting list when they have end-stage organ failure, all other treatments have failed and their medical specialist believes they will benefit from a transplant.
Waiting times depend on the availability of suitable donated organs and the allocation of organs through the transplant waiting lists. While this is usually between six months and four years, it can be even longer.
When a person is put on a transplant waiting list they receive support from a transplant coordinator, who keeps them - and their family - informed of developments and timelines.
When a match is found, the transplant coordinator arranges for any necessary tests or scans, and coordinates the surgical team.
Allocation of organs
Organs are allocated to transplant recipients in a fair, equitable process that takes no account of race, religion, gender, social status, disability or age - unless age is relevant to the organ matching criteria.
Waiting lists are managed by different groups according to the organ involved and the state or territory where the recipient is located.
Australia has strict guidelines about the allocation of organs and tissues. The Transplantation Society of Australia and New Zealand (TSANZ) has developed guidelines for organ transplantation, Organ Transplantation from Deceased Donors: Consensus Statement on Eligibility Criteria and Allocation Protocols.
Allocation is a complex process. When an organ (other than kidneys) becomes available for donation, a DonateLife donor coordinator passes the necessary information to transplant units in that state. If there is no suitable recipient, the organ is offered to transplant units in other states and territories on a roster basis that is designed to promote equity.
Criteria used in considering potential organ transplant recipients include:
- how well the organs match the person
- how long the person has been waiting for a transplant
- how urgent the transplant is
- whether the organ can be made available to the person in time.
Organs such as the heart, lungs, liver and pancreas are generally matched to recipients by cross matching blood group and antibodies, size compatibility and urgency. Kidneys are matched by cross matching blood group, antibodies and tissue compatibility through the computerised National Organ Matching Service, administered by the Australian Red Cross Blood Service.
Information and common questions asked about transplantation
Organ and tissue donations can save and significantly improve the lives of many people who are sick or dying. For many people with a serious or critical illness related to organ failure, organ transplantation is the only hope for a healthy life. The following pages will provide some information on the different organs and tissues that can be donated, and the reasons some people need a transplant.
The heart pumps blood around the body, and the blood carries oxygen to all other organs. If the heart cannot pump blood properly, the rest of the body can become sick very quickly. Some people with heart failure, viral infection, or a congenital heart defect, require a heart transplant to survive. Heart transplants are performed when all other forms of medical treatment have failed.
Artificial hearts can be used temporarily until a human heart is available. If the whole heart cannot be transplanted, heart valves can still be donated.
The lungs provide oxygen to the blood and remove carbon dioxide. Lung transplants are often needed by people with cystic fibrosis or emphysema when their lungs cannot provide enough oxygen to their bodies. The two lungs can be transplanted together into one recipient or separated and transplanted as single lungs into two recipients.
Many people believe that smoking will prevent lung donation. However, this is not true. There are tests that can be done in Intensive Care to check how well the lungs work and these results determine suitability for donation.
The main function of the kidneys is to filter waste products from the blood. When the body has taken what it needs from food, wastes are then sent to the blood, filtered by the kidneys, and removed from the body as urine. If the kidneys are damaged or diseased and not able to filter the blood properly, wastes begin to build up in the blood and damage the body.
People with severe kidney failure are put on dialysis, which filters waste products from the blood when the kidneys cannot. However, many of these people will need a kidney transplant to stay alive.
The two kidneys can be transplanted together into one recipient, or separated and transplanted into
The liver is a complex organ with many functions. Its main functions are to maintain a balance of nutrients (e.g. glucose, vitamins and fats), to remove waste products and to regulate blood clotting. People with metabolic liver disease, Hepatitis B or C, and congenital liver defects such as Biliary Atresia can all require liver transplants to stay alive.
The liver is a unique organ as it can regrow. This means that an adult liver can be reduced in size and transplanted into a small child where it can then grow with the child. Alternatively, the liver can be divided and transplanted into two recipients.
The pancreas contains cells called Islets that produce insulin to regulate the body's blood sugar levels. In people with Type-1 Diabetes, the Pancreas produces little or no insulin, and it can be extremely difficult to control blood sugar levels even with insulin injections. At present, the majority of pancreas transplants are performed on people who have Type 1 Diabetes which can also cause kidney failure. For this reason, the pancreas is often transplanted with a kidney from the same donor.
Pancreas islet donation
There are times when it is not possible to transplant the pancreas as a whole organ. However, the insulin-producing islet cells of the pancreas can be transplanted separately as a treatment for diabetes.
Eye tissue donation
Donation of eye tissue can allow transplantation of the cornea and the sclera. The cornea is the clear tissue which covers the coloured part of the eye. It allows light to pass through to the retina, giving sight. Corneal transplants restore sight to people who are partially or completely blind due to corneal damage following a genetic condition, illness or injury. The sclera is the white part that surrounds the eye. Scleral grafts are performed to prevent blindness due to injury or in people who have had cancer removed from their eye.
Donated bone tissue can be grafted to replace bone which has been lost as a result of tumours or through other disease or accidents. It is also used to aid fracture healing, strengthen hip and knee joint replacements, and to repair curvatures of the spine (scoliosis) in children and teenagers. Depending on the type of transplant required over ten people can benefit from a single bone donation.
People who have suffered extensive trauma, infection damaging or destroying the skin, or severe burns can require skin grafts to become healthy again.
When skin is donated, only a thin layer is retrieved, somewhat like the skin that peels in sunburn. It is usually retrieved from the person's back and the back of their legs. On average, skin from three donors is needed for one recipient.
Heart tissue donation
While the heart can be donated as a whole organ, heart tissues can also be donated separately. Donated heart tissues such as heart valves are primarily used to repair congenital defects in young children and babies. The tissue is also used to replace diseased valves in adults.