Tissue Services

Receiving a human tissue transplant

Like all medical treatments, a tissue transplant should only be used when really necessary. The decision to offer a transplant to a patient is made only after careful consideration. In making that decision your (or your child's) doctor will balance the risk of having a transplant against the risk of not having one. Ask your doctor to explain why the transplant is needed, as there may be alternative treatments available.

Why you might need a tissue transplant

A tissue transplant is very different from an organ transplant e.g. a heart, liver or kidney transplant. Tissue is donated for transplant by people when they are alive or after their death. Tissue transplants can be used to treat many conditions. Patients may need a transplant to:

• replace diseased or damaged bone and tendons
• heal severe wounds caused by burns
• replace diseased heart valves or repair a deformity in a child's heart
• replace diseased or damaged corneas

Things to discuss with your doctor

Are alternative treatments available to me?

Some operations cannot be carried out without using a tissue transplant from another person, but it's important to ask about alternative treatments. For example, it is sometimes possible to use tissue from your own body. You should ask your doctor if you actually need a tissue transplant from another person.

Are tissue transplants safe?

Most surgical procedures are routine, but no procedure is completely risk free. There is also a small risk that human tissue donated from another person may carry infections. Because of these risks, we recommend that tissue transplants are only used for treatments that are life saving or where the quality of life will be greatly improved e.g. to restore a patient's mobility. In the United Kingdom, we take many precautions to ensure that tissues are as safe as possible:

• Every tissue donor's health and medical history is carefully checked. Very specific questions are asked to help rule out anyone who may pass on an infection.
• Blood samples from tissue donors are tested for infections which we know can be passed on in blood and tissues.
• Any donated tissue that fails these tests is discarded. These include tests for hepatitis B and C viruses and HIV (the virus that causes AIDS).
• The testing process is checked regularly to make sure that it meets all relevant guidelines.

There is at present no blood test available for variant Creutzfeldt-Jacob Disease (vCJD) and we do not have any treatment for it. Although the risk of transmitting vCJD through a tissue transplant is believed to be very low, it cannot be ruled out.

There have been a very few cases of probable transmission of vCJD by blood transfusion. Tests are being developed, but donated tissues that still contain blood when transplanted, for example certain types of bone, may pose a higher risk than other tissues.

It is very important to discuss all risks fully with your doctor before you give your consent to a tissue transplant. They have a special duty to ensure that you understand all the risks involved. Make sure that you do. Ask about the risks of infection or other disease from the transplanted tissue. If you don’t understand what you are told or if you want to know more, you must say so. It is important to raise any concerns you may have about the operation, no matter how trivial you think they may be.

Making the decision

When you are satisfied that your doctor has fully explained the operation, the alternatives and the risks (including risks specific to transplants from other people), you need to decide whether or not you wish to have the tissue transplant. You must balance the risks of having a tissue transplant from another person against those of any alternative procedure and of not having treatment altogether. Only you can make this decision.

What if I have other worries about my transplant?

You may have other concerns about your operation and transplant that we have not covered. Please tell your doctor about any concerns you may have, no matter how trivial you think they may be.

Other Information

If you are interested in finding out more about tissue transplants and have access to the internet, you might find the following web sites useful:

British Association for Tissue Banking
www.batb.org.uk

UK Blood Transfusion & Tissue Transplantation Services
www.transfusionguidelines.org

National Blood Service
www.blood.co.uk/pages/tissserv.html