As a young trainee decades ago, Dr. Mikel Prieto, a transplant surgeon at Mayo Clinic, said the one-year success rate for a donor organ could be as low as 25%. Now most short-term success rates for organ transplants are in the 80s or 90s, he said.
Although there are still issues of equity and access, organ transplantation has become safer and more routine due to major developments in the field.
Take kidneys for example.
“Most people don’t realize how successful kidney transplantation is,” Prieto said. “If you come for a kidney transplant, the chances that you will go home with a working transplant is in the range of 98% to 99%.”
Advancements in technology and medicine have allowed for organs from older donors and organs from donors with hepatitis C or HIV to be used with methods to control diseases after the transplant, said Diane Brockmeier, president and CEO of Mid-America Transplant. Currently, donors who test positive for COVID-19 are being evaluated for transplantation.
Additionally, physicians have made steady improvements in understanding the immune system and finding new drugs to prevent organ rejection or fight common infections that patients have when they are immunosuppressed, Prieto said.
“The most important thing in transplantation is safety,” said Dr. Manuel Rodriguez-Davalos, director of liver transplantation at Intermountain Healthcare’s Primary Children’s Hospital. “We want to make sure that all we’re doing for our patients is going to have the right results and be able to change their lives.”
Quality improvement in this area has the potential for great impact. From 2015 to 2020, the annual number of organ transplants increased from 30,974 to 39,036, according to the Organ Procurement and Transplantation Network. In 2021, largely due to stalled non-COVID-19 related procedures, transplants fell to 31,363.
The global organ transplantation market is expected to climb to more than $27 billion by 2027, at a compound annual growth rate of 9.5%, according to a 2020 Precedence Research report. In 2019, the market was valued at $13.1 billion worldwide.
This predicted growth is driven largely by the rising demand for transplantation to treat organ failure and for tissue transplantation products as well as other needs from biotechnology companies.
Of all the innovations in transplantation in recent years, experts said a few stick out as the most crucial breakthroughs.
The timely transportation of organs is a major challenge in transplantation, since many organs are simply too far away from the patient’s location to arrive at their destination in a viable condition.
To avoid losing organs due to timing, machine perfusion was invented to preserve donor organs long enough to be transplanted, said Rodriguez-Davalos, who’s also medical director for living donor liver transplantation at Intermountain Medical Center.
With this technique, organs are stored at a set temperature and a machine keeps blood flowing at a continuous pace throughout the organ. The machines allow organs to be preserved anywhere from 12 hours to 72 hours for delivery, he said.