Transplantationsverfügbarkeit

Transplantation is the surgical transfer of an organ, tissue, or cellular material from a donor to a recipient to replace a diseased or missing function. It encompasses solid organ transplants such as the kidney, liver, heart, lung, pancreas, and intestine; tissue transplants like cornea, bone, cartilage, skin, and heart valves; and hematopoietic stem cell transplantation used for certain blood and immune disorders.

Donors may be living or deceased. Living donors commonly provide kidneys or portions of liver, pancreas, or lung, while deceased donors supply the majority of solid organs. Thorough evaluation assesses medical suitability, compatibility, and risk for both donor and recipient.

Organ allocation is coordinated by regional or national networks that assign available organs based on blood type compatibility, immune compatibility when possible, medical urgency, organ size, and time spent on the waiting list. Recipients undergo pre-transplant evaluation and, if selected, a surgical procedure followed by intensive postoperative care.

Immunosuppression is essential to prevent rejection and is tailored to the type of transplant. Regimens typically combine calcineurin inhibitors (for example tacrolimus or cyclosporine), antimetabolites (such as mycophenolate), and corticosteroids, with adjustments to balance rejection risk and infection or other side effects. Rejection can be hyperacute, acute, or chronic, and ongoing monitoring is required.

Outcomes vary by organ and donor type but have improved markedly with advances in surgical technique, organ preservation, and immunosuppressive therapy. Transplantation often offers longer survival and better quality of life compared with ongoing organ failure, though it carries risks of infection, malignancy, cardiovascular disease, and complications related to surgery.

Ethical and policy considerations include organ shortage, consent, allocation fairness, and the safety of living donors, governed by regulatory frameworks and organ procurement organizations.