There are many organ donation and transplantation terms that you will run across during your journey. Some you may have never heard before. Then there are some that are next to impossible to pronounce and have their own separate set of acronyms.

I’ll try to keep this list short and sweet. Hopefully, this will arm you with some of the more common organ donation and transplantation terms.  Then, when your doctors and nurses come you will understand what they are saying better.  It will also eliminate the need to write down words to look up.  Please bear in mind, I am a liver transplant recipient, so these terms may be a tad on the liver-centric side.

 

 

Unfortunate Truth

I discuss death here.  To be the recipient of a transplant, someone must usually die to be a donor (excepting, of course, live donors).  I will speak in this blog often about death and while it can be very uncomfortable, it is a part of life and I will try to discuss death in a factual but respectful way.

Definitions of Organ Donation and Transplantation Terms

A

• Albumin – A blood protein that manages the pressure between the blood vessels and the tissues.  It keeps fluid in the bloodstream so when it gets low, fluid seeps into the tissues. This causes ascites and edema.

• Allocation – The system of rules and guidelines for the distribution of organs.  It ensures everyone has a fair shot medically and ethically.

• Allograft – Transplantation of an organ that comes from another person.

• Antibody – A protein created by a body’s immune system to attack foreign substances (like a transplanted organ).

• Ascites – Excess fluid in the abdomen caused by portal hypertension.

• Antigen – A foreign substance (like a transplanted organ). This sets off a body’s immune system and causes it to attack and try to get rid of it.

B

• Bilirubin/Jaundice – A brown-yellow substance found in bile.  When bilirubin levels in your blood are high, it will result in jaundice (yellowing of the skin, whites of the eyes, and nail beds).

C

• Cadaver – A common word used in the medical community for a type of donor (cadaveric donor vs. live donor).  Please, get in the habit of using the term Deceased Donor.  (See my post about Sensitivity in Transplant Terminology for that)

• Candidate – A person who has been placed on the transplant waiting list.

• Cirrhosis – Excessive fibrosis in liver tissue

• Cold Ischemia Time – When an organ has no blood circulation and is kept cold.  This is the time from organ recovery from the donor until transplant into, and receiving blood supply from, the recipient.  The time for each organ type is different.

• Crossmatching – A blood test done to test the compatibility of a donor organ with a transplant recipient.  Typically performed on kidney and pancreas transplants.

D

• DBD – Donation after Brain Death. The pronunciation of a donor’s brain death.  Three things must happen for brain death pronunciation.  Coma, loss of brain stem reflexes, and apnoea (no respiratory/breathing control). These things cause the brain to become totally and irreversibly non-functional.  When this occurs, a person is legally and clinically dead.

• DCD – Donation after Circulatory (sometimes still called Cardiac) Death. This is when a donor has suffered an irreversible brain injury and their family has decided to withdraw care.  Then, the removal of {{artificial support}} and declaration of death are given in an operating room.  Recovery of the organs occurs only after the declaration of death.  Please understand that transplant doctors are NOT part of the end-of-life care or the declaration of death.  This also does not cause or speed up death.

• Domino Transplant – A less-common procedure where the removal of an organ from one recipient is then transplanted into another recipient.  For example, someone has a disorder that requires a lung transplant. However, they would be better off with both a lung and a heart.  Since the heart still functions, it would be transplanted into another recipient.  Another example would be if someone has a metabolic disorder.  Let’s say that disorder causes non-function of their liver and they need a transplant. However, a person with End-Stage Liver Disease could receive that liver without (or with minimal) issue. 

 

 

• Donor Designation – A document that designates a person’s decision to be an organ, eye, and tissue donor.  A driver’s license or a state donor registry will often show this information.

• Donor Registry – A completely confidential electronic database kept for a single state (or in some cases multiple states). In this database, people can designate their decision to be an organ, eye, and tissue donor at the time of their death.  State motor vehicle offices often accept enrollment. Enrollment is also available online and can be changed by the registrant at any time.  Only authorized organ donation personnel can access this registry to determine if a deceased person decided to be a donor.  The registration information cannot be sold or shared with anyone not involved with the organ donation process (i.e., an EMT can’t access this registration).

E

• Edema – Excess fluid in the legs and feet caused by portal hypertension.

• Esophageal Varices – Enlarged veins in the esophagus caused by portal hypertension.

F

• Fibrosis – Scarring of tissue

H

• HE/Hepatic Encephalopathy – A common occurrence with people with End-Stage Liver Disease. With HE, the liver can no longer filter toxins out of a person’s blood.  Because of this, a high level of toxins in the bloodstream causes a temporary worsening of brain function.  Some signs of HE include forgetfulness, confusion, or change in the wake/sleep cycle. Other signs are mood swings, slurred speech, shaking of hands or arms, or unresponsiveness.

• Hepatitis – Inflammation of the liver.  Some examples include a virus, an autoimmune disease, or drug or alcohol use.

M

• MELD – Model for End-Stage Liver Disease. MELD is a scoring system to determine the severity of a person’s liver disease.

P

• Paracentesis – A procedure where a hollow needle or catheter is inserted in the abdomen to remove excess fluid (ascites).  Typically, the fluid is also checked for infection.

• Portal Hypertension – An increase in pressure in the portal vein caused by a blockage in the blood flow through the liver (such as cirrhosis).

S

• Shunt – A tube used to help fluid flow from one area to another in the body.  Often, this is a wire mesh coil/tube.

• Split-Liver Transplant – The process in which a donor’s liver is split for two recipients. A smaller adult receives the larger portion and a pediatric patient receives the smaller portion.

• SBP – Spontaneous Bacterial Peritonitis is an infection of the excess fluid in the abdomen (ascites).

T

• TIPS – Transjugular Intrahepatic Portosystemic Shunt (thank goodness for acronyms, am I right?).  This is a shunt that allows the flow of blood more readily and relieves portal hypertension.  This can help with complications like edema, esophageal varices, and ascites.