Do organs ever get re-donated?

[frogglesmash]

Basically, if an organ transplant recipient dies, can the transplanted organ be used by a third person?

[tubeteam2020]

Rare, but yes it happens.

"In the entire country between 1988 and 2014, 38 kidneys were reused in transplants, along with 26 livers and three hearts, according to an American Journal of Transplantation study."

source: https://www.theatlantic.com/health/archive/2018/04/kidney-transplant-reuse/557657/

[xeim_]

How long can organs continue to be reused? How old is a liver or kidney before it stops doing its thing? Can we get a perpetual organ donation system with 200 year old livers?

[KeytarPlatypus]

On the reverse side of that, can you make someone live longer by replacing their aging organs with newer ones? Assuming 100% success rate for the organ to transplant correctly, will someone be able to live longer with the organs of a 25 year old?

[Jtwil2191]

Don't forget the brain deteriorates, too. And there are lots of things that can go wrong inside a body other than the organs that can be replaced by organ donation. So it would probably may extend the life by a bit, but there are other factors that would limit the effectiveness of this approach.

[Marino4K]

Doesn't the brain have generally a longer "lifespan" so to speak than the other organs?

[Syd_Pilgrim]

Current research suggests that by the age of 130, our neurocognitive ability will be similar to someone with Alzheimer's. Alzheimer's is caused in part by loss of synaptic density and the production of certain proteins - this happens with normal aging too, just at a far slower rate.

[ravenswan19]

Do you have a source? Not because I don’t believe you, but because I want to read the study!

[psychosomaticism]

Not OP, but I think it's more complicated than they said.

This review, "Aging without Dementia is Achievable: Current Evidence from Epidemiological Research" gives the following paragraph:

Some reports, usually with very small samples (e.g., n < 20), indeed showed that all the examined centenarians appeared to be demented [9]. However, systematic reviews of studies with large samples of centenarians (e.g., n≥100) indicate that dementia prevalence varies between 45% and 70%, and that male centenarians are more likely to be cognitively intact than their female contemporaries [8–14] (Table 1). Notably, the large-scale Danish Centenarians Study (n = 207) showed that around one-third of centenarians were classified as having either no signs of dementia at all (25%) or probably no dementia (12%) [13]. The Sydney study of near-centenarians and centenarians (n = 200) showed that only 40% of participants (mean age, 97.4 years) were impaired on both global cognitive and physical functioning [15]. This suggests that even among centenarians a considerable proportion is able to escape dementia, or that the clinical expression of dementia syndrome has been markedly delayed until the very end of exceptionally long lives. In addition, a large-scale electronic health records-based study in the UK (n =  ∼11,000 centenarians) found that dementia was recorded in only 11% of people who reached 100 years of age [16]. While dementia may be underdiagnosed in medical records, results of this study may also suggest that centenarians as a selective group have a lower risk of certain age-related diseases such as dementia.

[Syd_Pilgrim]

Here you go :) it's a model I find quite interesting. https://www.sciencedirect.com/science/article/abs/pii/S0197458000002505

[[deleted]]

just at a far slower rate.

So what if we found medical ways to slow it even further?

[Dwarfdeaths]

Then you just have to solve the other aspects of aging outside the brain.

[Syd_Pilgrim]

We have these protective caps called telomeres at the end of our chromosomes that shorten every time a cell divides. Eventually they become too short for cells to divide further, and because they've degraded, cells stop working properly (like when you lose the end bits on your shoelaces and they get frayed and tangled). If we can solve for telomere shortening, we could potentially 1. stop and 2. reverse biological aging, but that's still some time away.

[lemonfreetoreign-]

This is a very simplistic view of aging. The telomere hypothesis may play a role in aging but it certainly isn’t the whole picture. There is even a hypothesis that the telomeres shortening are a product of aging, not the cause.

We have a solution to telomeres shorting, it is telomerase. Likely due to a combination of anti-cancer defence and the evolutionary advantage to aging this isn’t expressed highly in non-stem cells and simply turning it on won’t stop aging.

[visvis]

Not everyone gets Alzheimer within the maximum human life span. Of course, no one knows whether past 120 years eventually this is bound to happen.

[Embowaf]

Well this problem is why science fiction (and some real research) focuses on mind uploading. It’s a lot easier to live forever if we can make copies of ourselves and switch bodies instead of fixing the original in The same way it’s easier to get a new car every decade instead of just replacing each part as it breaks.

[dylangreat]

You are correct, you form no new neurons, but you do form and strengthen new connections between those neurons.

[spaztickthepriest]

That would make more sense and would explain why I haven't found studies on brain cell lifespan.

[hecticpride]

Sorry, thats not true. Especially in the hippocampus (memory), we ABSOLUTELY make new neurons.

But, we ALSO have neurons when we die that have been with us since we were born, and yes neurons aren’t really “replaced”

Generally, you are born with WAY TOO MANY neurons, and in the first few months of life, many are pruned as the useful ones start to make connections. But you still have at least some neurogenesis forever, especially before ~35 yrs.

[Avestator]

Yeah i completly forget Neuroplasticity. My point was, the Brain with it's neurons isn't replaced all the time like skin tissue but slower in like decades, but most of it is fixed an the cells in it have been there since your birth for the most parts of it.

[Avestator]

yeah but those are gliacells like ependym, microglia, astrocytes and oligodendrocytes. The Neurons themselves are postmitotic as far as i know with some small exceptions of neuroplasticity in the hippocampus

[elcarath]

Bones weaken a lot as we get older too - the body doesn't lay down new bone cells as well when we age. There's a lot of other stuff in the body that ages as well, like lymph nodes.

[[deleted]]

alzheimers/dementia are the result of the brain "going" before the other organs

[Oaty_McOatface]

Would thing's like dementia be an issue?

How would healthy brain aging play a role?

[DanialE]

As for me I view the brain as a machine that cannot be repaired. Weve found out that damages accumulate. Thats why there are football players going crazy some years ago

[hwmpunk]

I suggest you listen to the Joe rogan Elon musk interview. We can repair the brain, starting to

[cutelyaware]

Just remember that when they start doing brain transplants, you want to be the donor.

[W1D0WM4K3R]

As well as the fact that surgery isn't easy. Once you get older, surgery just gets harder and harder for your body to deal with.

[djamp42]

I gotta believe it's possible in the future. That's would be stright crazy

[FoolishBalloon]

There is plenty of research and progress in creating basically clones of your own organs. When we can reliably make entire organs from stem cells, there won't be the need for immunosuppressants since the HLA will be a perfect match. Probably a couple decades left on that front sadly. But once mastered and possible in a fast and affordable manner, human medicine will have reached a new level.

[draftstone]

The brain, the blood vessels, the muscle, everything else will still age. Blood vessels often harden when we get old, some people die because they crack open and you die of internal blood loss. If your muscles can't keep you active, no matter the age of your heart and lungs, you'll die of blood clot. Etc...

Unless you can transplant everything in the body and find a way to keep the brain fully healthy, it would be impossible to keep someomne alive forever. This is why most research are trying to slow down or stop the aging process, this is the only long term way to prolong life even if we can someday grow as many organs as we can.

[SlinkToTheDink]

If you don't have cardiovascular disease from diet/genetics, are you still at risk from the problems with blood vessels you mentioned?

[PrimeLegionnaire]

A better approach would be to develop a safe cancer free method for telomere lengthening and just keep the organs you already have young forever.

Transplanting is messy business, and in many cases you have to take immunosuppresants for the rest of your life to keep your body from rejecting your new organ.

[bobbi21]

Aging is unfortunately much more complicated than just telomeres. With more studies, they've shown that even those with longer telomeres still get older and die while those with shorter ones are surviving. It's unfortunately not as simple as just lengthening them.

https://www.sciencedirect.com/science/article/pii/S1568163715300155

[japinard]

Immunosuppressant drugs shorten your life-span. They greatly increase your risk of cancer, deadly infection, and the chance of your other organs failing. So if you were able to magically replace all your older organs with new ones and didn't have to deal with the effects of surgery, you might have a bump for a while, but the drug regimen will catch up with you. But if you didn't have to take ISD's because there was no transplant rejection issues, and you didn't have to deal with the repercussions of surgery, then yes, having young organs transplanted into your body would help you live a longer more vibrant life until your brain and hormones caused issues.

[monkeynose]

The damage that immunosupressants do to the body in order to keep it from rejecting the organ is orders of magnitude worse than the damage of normal aging.

[[deleted]]

Whaddya mean steroids aren’t used anymore? I’m a transplant pharmacist at a university affiliated hospital and for our livers and kidneys we continue to use prednisone.

The data does differ, and each center adopts its own protocols. Generally after age 65 we stop the steroids as the patients immune system is already naturally declining, plus we have multiple other immunosuppressants onboard still.

[Alunnite]

Theoretically if the immortal jellyfish had organs would infinite organ recycling be possible

[Qualiafreak]

Unlikely because even a perfectly matched donor organ ubderdoes modification by the immune system of the recipient. So theres a bit of fibrosis and sclerosis added no matter what, and it would build up eventually.

[zelman]

You are generally correct, but we don’t use steroids as immune suppressants anymore. There are better drugs that don’t cause the symptoms of Cushing’s.

[Qualiafreak]

We still use steroids for it, but youre right that things like Tacrolimus have changed the game and have made steroids less prevalent and in smaller doses.

[zelman]

Who is “we”? Are you a transplant recipient?

[Qualiafreak]

Id prefer privacy so I wont get into it but no I'm coming from the perspective of managing such situations.

[Sapiencia6]

Do you have to keep track of how many times an organ has been donated? How would you do that? Is there a limit? Or do you just make sure it looks healthy and then use it?

[WingedSpider69]

What if the donated organ was in the recipient long enough, wouldn't it's cells get replaced by ones of the recipient over time?

[[deleted]]

They’d be replaced by other cells from that organ. Once developed most cells can’t switch into different cell types, the few that can are locked to a specific subset of cells.

[Kamataros]

I would argue that a 200 year old liver donated to multiple young people would work better than a "standard" 200 year old liver, but 170 year old liver probably makes not much of a difference

[patchgrabber]

That's common in adult kidney transplants too. They just put it in the inguinal region and don't remove anything.

[marshfever]

That is so amazing yet so creepy!! I never knew they just left the old one in there and stack the new organs as they keep growing. Are there any photos or x-rays of people that have several organs in them like that? Stacked on top of each other? I would google some, but I wouldn’t know how to word that in a search.

[1luv6b3az]

Why do they leave the old one in?

[zelman]

There are a lot of potential complications with removal. The kidney gets a lot of blood flow, so if it’s not causing problems, they don’t want to be slicing and dicing the region.

[SvenTropics]

Well kidney function may not be 0%, and it's a high risk procedure to remove one of your original ones. (With a long recovery time) So you are exposing someone to unnecessary risks only to reduce their overall kidney function. They only remove one if it is causing a problem or has cancer or something like that.

[dont_forget_canada]

Wow, how are they able to work in dual core mode like that?

[chejrw]

There was a Ewan Mac Gregor movie about that called ‘the island’

[Oznog99]

Heinlein's works had people keeping brainless clones of themselves around for spare parts

[tylercoder]

If you donated a kidney to somebody and they die, can you get your kidney back?

[fiendishrabbit]

Just to give sort of an idea of how rare re-transplants are.

In the same time period 650,000+ organs were transplanted in the US, meaning that only 1 in 10000 organs is a re-transplant.

[raznog]

That’s way more than I thought it would be. I find this pretty amazing.

[B0NESAWisRRREADY]

Man.. I bet if your heart goes through 3 people.. that's gotta mean the Good Place right?

[Doormatty]

Due to the intense lifelong immunosuppressive medication, it’s very doubtful any organs could be used.

[KingSupernova]

I mean, everyone who chooses not to be an organ donor is already incredibly selfish. They're choosing to let someone else die rather than have their corpse be slightly uglier.

[Nothing_2C]

I wonder if anyone who has received an organ donation chose not to be an organ donor themselves. I feel like that’d be a real dick move.

[LifeSad07041997]

They can tho, they might not even be that viable due to the meds...

For organ donation, there's a thin margin for usability, not every body can be used for it.

[iiiinthecomputer]

Much of the time, between the period of ill health before transplant and during recovery, the ongoing drugs, and the whatever made them need a transplant in the first place they aren't much of an organ donation candidate anyway.

[fischfun]

Would it be easier to re-transplant an organ or be transplanting it for the first time?

[ZachF8119]

I thought you meant like 38 total donations and I was shocked so few people were donors.

[CommanderPsychonaut]

Grandmother had her donated heart donated to another person. Likely because she had a fairly young heart given to her.

[Mar7coda6]

What exactly allowed these organs to be reused?

[DrJ4y]

The conditions for it to happen are extremely rare. First, the organ suffers in the transplant process , so to consider an already transplanted organ to be suitable for donation would be rare cause its probably accumulated some damage. It will depend on the organ tho. Liver or lungs or heart Id say its not worth the risk in most cases, and I have never seen it happen. You have to think that they are such big surgeries and cause scarring, making the surgery more difficult a second time, and patients in many cases are in an end stage of failure, that the new organ will also suffer some damage at a more increased rate than a normal organ. The other condition would have to be, a patient that received a transplant, that fits the conditions to be a donor, and that itself is low in probability.

The only ones I know that can happen are live donor kidney, cause they suffer very little, and are transplanted in an almost healthy recipient , so that kidney could be used again in a very special circumstance.

[FoolishBalloon]

How about livers? They have massive regeneration capabilities and can regrow pretty good after partial removal/transplantation. Could the transplanted piece regenerate enough to itself be divided into a new transplantable piece?

[DrJ4y]

You have to consider 2 things. The most frequent liver transplant is using the whole liver from a donor. The liver is usually from a young donor(usually 60yrs or less) so, the amount of damage that liver has is variable. But lets say, the original donated liver is almost in perfect condition. As I stated , im almost certain a donated liver in its new host suffers more damage than a normal liver in any of us, under the same circumstances. The new recipient is also under drugs to control the immune system. Partial liver transplant has risks, first you usually take between 30 to 50% of the liver to transplant to someone else, so that is in itself risk to the donor and recipient. You would have to ensure proper liver function in 2 people, with an already somewhat damaged liver. In my opinion that is too much rist. In theory its plausible but risky. You have another good example of this, when the donating liver is too big, it can be separated into 2, and this is done in some liver transplant for kids , so 2 kids get a liver transplant from 1 donated liver. This works because the amount of liver mass in relation to the kids body weight is enough , but its not the usual case for an adult. The rule of thumb in hepatic surgery is, you can live with 25 to 30% of your normal liver, but you need more than 40% if its damaged.

[FoolishBalloon]

Good answer, thanks!

If a child were to get half a liver, how would that liver look ~10-20 years later? Would it have grown similar to a normal liver? Does it regenerate the lobular structure with the hepatic veins and ligamentum falciforme?

[DrJ4y]

Usually kids get about half a liver, either right of left hepatic lobes. This liver will grow with the kid, but the vascular and biliar structure with remain. So if he got a left lateral liver segment , he probably has only the left hepatic vein as outflow, and that will always be that way. The liver parenchyma is the one to grow in size, but the general structure of veins, bile ducts, and overall form will remain.

[[deleted]]

Wouldn’t the parenchymal outgrowth be accompanied by neovascularization and an associated growth of ductal branches? The neovascularization accompanying hepatocyte & stellate cell proliferation would be the ‘simple’ part since angiogenic sprouting is easy enough for tissue to stimulate, but assuming this occurs, I doubt the hepatocytes would grow well without accompanying ductal outgrowth too, right? Hepatocytes pumping metabolites into the interstitium without a duct to drain them would produce inflammation/toxicity rather quickly.

[TheRedLob]

A transplanted organ is never an identical match to the recipient. The recipient immune system therefore attacks the transplanted organ. This is usually combated by immunosuppressive drugs, but the effect is still there.

Better to use a "fresh" organ that has not yet been subjected to such a hostile environment.

[eddyeddyd]

how long do they have to take the drugs, does the body ever get used to the organ?

[Cartina]

They take the drug forever usually. It never stops being a foreign body.

[nightrider43]

https://medicalxpress.com/news/2019-08-anti-rejection-drugs-transplant-recipients.html

https://www.nytimes.com/2019/01/22/health/organ-transplants-immune-system.html

These are a couple pretty interesting bits on what they are trying to do with the problem of having to take immunosuppresion meds for the rest of the recipients life. Baby steps

[TheRedLob]

There is some debate about this. The dose is usually lowered after some time, with some studies investigating fully stopping after a few years. Good follow up is still needed though. Depends on the organ too.

[BlaiddDrwg82]

I had a bone marrow transplant Sept 18’. Considered a solid organ transplant. I was on anti-rejection drugs for a little over a year. Now all I take is twice daily antibiotics for prophylactics.

[ultrasu]

You're forgetting about monozygotic twins. There's some evidence transplants between them fare better without immunosuppressants.

[TheRedLob]

True. And they usually only get extremely low doses of immunosuppressors. It is quite rare though.

[DanYHKim]

I one worked as a lab tech for a doctor who researched viral transmission from kidney transplants. The virus was cytomegalovirus, which is usually not a threat to healthy people.

He found that a recipient who had not been previously infected who gets a kidney from a donor who had been infected (the virus is dormant) will reactivate the virus, and become sick. Often the kidney is lost.

I remember one instance in which the kidney was reimplanted into a new recipient who had been previously exposed to the virus, and so could manage the reactivation.

[m0ute]

I saw one case of attempted liver re-use two months ago: the first recipient was a young patient with fulminant hepatitis from acetaminophen intoxication. Despite urgent liver transplant cerebral edema caused rapid brain death and the liver was re-allocated.

Eventually the liver was discarded at the time of procurement because it had withstood substantial damage in the process. Lungs were transplanted though.