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Transplant Glossary

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Acute rejection
The body's attempt to destroy the transplanted organ. Usually occurs in the first year after transplant.

Administrative fee
An amount of money charged by an organization that is handling your fundraising money.

Adverse reaction
An unintended effect from a drug.

Advocacy organization
A group that helps someone get what they need or want; promotes a certain point of view, pleads the case of another.

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Allocation
The system of ensuring that organs and tissues are distributed fairly to patients in need of a transplant.

Allograft
An organ or tissue that is transplanted from one person to another of the same species: i.e. human to human. Example: a transplanted kidney.

Antibody
A protein substance made by the body's immune system in response to a foreign substance; for example a previous transplanted organ, blood transfusion, virus or pregnancy. Because the antibodies attack the transplanted organ, transplant patients must take powerful antirejection drugs.

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Antigen
A foreign substance, such as a transplanted organ, that triggers the body to try to destroy it. This response may be the production of antibodies, which try to destroy the antigen (transplanted organ).

Anti-rejection drugs (immunosuppressive drugs)
Drugs that are taken to help the body accept the transplanted organ.

Arteriogram
An X-ray of an artery after a dye has been injected.

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Ascites
Build-up of fluid in the abdomen, usually associated with liver disease.

Beneficiary
The person who receives the benefits of an insurance policy.

Benefits
Paid-for services of an insurance policy.

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Biopsy
A tiny piece of tissue from the body is removed (usually with a needle) and examined under a microscope. This test is done to diagnose rejection of the transplanted organ.

Blood vessels
The veins, arteries and capillaries through which blood flows. Blood vessels can be donated and transplanted.

Brain death
When the brain has permanently stopped working, as determined by the physician. Artificial support systems (machines) may maintain functions such as heartbeat and breathing for a few days, but not permanently. Donor organs are usually taken from people who have been declared "brain dead."

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Cadaver
A dead body.

Cadaveric
Refers to things about or relating to a dead body.

Cadaveric donor
A person who has been declared "brain dead" and whose family has offered one or more organs or tissues to be used for transplantation.

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Candidate
A person who is waiting for a transplant.

Cardiac
Having to do with, or referring to, the heart.

Center of excellence
An insurance term for a medical center that will negotiate a discounted price even if that center is not part of the insurance's company's PPO network.

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Charitable organization
A group that does not charge a fee for its services.

Chronic
Developing slowly and lasting for a long time, or the rest of the patient's life. Example: kidney failure.

Chronic rejection
Slow failure of the transplanted organ.

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Cirrhosis
A disease of the liver in which normal, healthy tissue is replaced with nonfunctioning tissue, and healthy, functioning liver cells are lost; usually occurs when there is a lack of adequate nutrition, infection, or damage caused by alcohol abuse.

Coalition on Donation
A nonprofit alliance of health and science professionals, transplant patients and voluntary health and transplant organizations. The Coalition works to increase public awareness of the critical organ shortage and create a greater willingness and commitment to organ and tissue donation.

Coinsurance
A percentage of money that you must pay toward a service that your insurance will pay. A very typical amount is 20 percent; you pay 20 percent of the doctor's bill and your insurance pays the
other 80 percent.

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Co-payment (co-pay)
A flat fee that a person pays for health care services in addition to what the insurance company pays. Example - a 10 dollar "co-payment" each time you visit your doctor.

Corticosteroid
A synthetic hormone which stops your body's normal reaction to infection and foreign tissue, such as a transplanted organ. Prednisone is a corticosteroid.

Coverage date
The day that your insurance benefits begin.

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Covered benefit
A service or supply that an insurance company will provide payment toward.

Covered service
See covered benefit.

Criteria (medical criteria)
A set of standards or conditions that must be met.

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Critical care unit
See "intensive care unit."

Crossmatching
A blood test done before the transplant to see if the potential recipient will react to the donor organ. If the crossmatch is 'positive,' then the donor and patient are incompatible. If the crossmatch is 'negative,' then the transplant may proceed. Crossmatching is routinely performed for kidney and pancreas transplants.

Cyclosporine
A drug used to prevent rejection of the transplanted organ by suppressing the body's defense system.

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Deductible
A fixed amount of money you must pay for covered health care expenses before the insurance company starts to pay. This is usually a yearly amount, such as $250, $500, $1000 or more.

Delayed function
A condition in which the transplanted organ does not work well right after the transplant. Many kidneys have a delay before they begin to function well. Kidneys can sometimes take as long as three weeks to "wake up." Sometimes a kidney recipient needs dialysis until the kidney starts to work.

Department of Health and Human Services (DHHS)
Department of the federal government responsible for health-related programs and issues. Formally called HEW (the Department of Health, Education and Welfare).

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Dependents
People who also receive insurance benefits on your policy. Example: spouse and children.

Depilatory
A cream or spray put on the skin to dissolve and remove excess hair.

Dialysis
A mechanical process which works to correct the balance of fluids and chemicals in your body and remove wastes from your body when your kidneys are failing. (See hemodialysis and peritoneal dialysis).

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Diastolic
The bottom number in your blood pressure (80 in a blood pressure of 120/80). Measures the heart muscle at rest, when it is filling up with blood.

Disability (disabled)
An injury or illness that keeps you from working. Some disability insurance policies pay benefits if you are unable to work at your regular type of job. Others only pay if you cannot do any type of gainful work at all.

Disability Determination Service
A state agency that will review your eligibility for vocational rehabilitation.

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Disability insurance
Provides you with an income if illness or injury prevents you from being able to work for an extended period of time.

Division of Transplantation (DOT)
The office of the federal government whose principal responsibilities include the management of the Organ Procurement and Transplantation Network (OPTN), the Scientific Registry of Transplant Recipients (SRTR), and the National Marrow Donor Program (NMDN) contracts, public education to increase organ/tissue donation and technical assistance to organ procurement organizations (OPOs).

Donor
Someone from whom an organ or tissue is used for transplantation.

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Donor card
A card that states your wishes to be an organ donor. Usually wallet sized.

Durable Power of Attorney
A legal document in which you may name someone to make medical decisions for you when you are unable to speak for yourself.

Edema
Swelling caused when your body retains too much fluid (water weight).

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End stage organ disease
A disease that leads to the permanent failure or an organ.

End-Stage Renal Disease/chronic kidney failure (ESRD)
A condition in which the kidneys no longer function and for which the patient needs dialysis or a transplant.

End Stage Renal Disease (ESRD) Program
Part of the Medicare program that provides people with end stage kidney disease or renal failure with medical coverage to help pay for dialysis or transplantation.

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Evidence of insurability
Proof that you are healthy enough for a particular insurance company to provide you with insurance.

Exclusion
Medical services that are not paid by an insurance policy.

Experimental
New treatments, procedures or drugs that are being tested. Insurance companies do not usually pay for anything that is considered experimental.

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Federally mandated
Required by federal law.

Foreign body
An organ or tissue that does not normally belong where it is, such as a transplanted organ. Your body normally tries to attack foreign bodies.

Foundation
A fund that pays for the permanent maintenance of an institution.

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Fulminant
Happening very quickly. Example: fulminant liver failure.

Fungus
A parasitic plant that cannot make its own food and is dependent on other life forms.

Gender
The particular sex of an individual; male or female.

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Genetic
Referring to heredity, birth or origin.

Genetic matching
See tissue typing.

Gingival hypertrophy
Enlargement of the gums. It can be controlled by good oral hygiene and regular dental checkups.

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Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate. A measurement of kidney function, used to determine the severity of kidney disease.

Graft
A transplanted organ or tissue.

Graft survival
The percentage of patients who have functioning transplanted organs (grafts). They are usually given in one, three and five-year time periods.

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Grant
An amount of money given as a gift, usually for a specific use.

Group health plan
See group insurance.

Group insurance
Typically offered through employers, although unions, professional associations and other organizations also offer group insurance. Much, if not all of the premium is usually paid by the employer.

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Harvest
The act of surgically removing an organ or tissue for transplantation; now referred to as "recover" rather than "harvest."

Health and Human Services (HHS)
See DHHS.

Health Maintenance Organization (HMO)
An insurance plan where you or your employer pay a fixed monthly fee for services, regardless of the level of care. Typically, you must see your primary physician and then be referred to a specialist.

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Hemodialysis
A treatment for kidney failure where the patient's blood is passed through a machine to remove excess fluid and wastes. The procedure usually takes about 3-4 hours per session and is usually done about 3 times per week.

Hemorrhage
A rapid loss of a large amount of blood; excessive bleeding.

Hepatic
Having to do with, or referring to, the liver.

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Hepatitis
Inflammation of the liver; can lead to liver failure.

High blood pressure (hypertension)
When the force of the blood pushing against the walls of the blood vessels is higher than normal because the blood vessels have either become less able to stretch or have gotten smaller. High blood pressure causes the heart to pump harder to move blood through the body. High blood pressure can cause kidney failure if not treated.

Hirsutism
An excessive increase in hair growth in a female. It is a common side effect of some drugs and can be controlled with waxing, hair removal creams or shaving.

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HLA System
There are three major genetically controlled groups: HLA-A, HLA-B and HLA-DR In transplantation, the HLA tissue types of the donor and recipient are important in determining whether the transplant will be accepted or rejected. This testing is routinely performed on kidneys and pancreases only.

Human immunodeficiency virus (HIV)
A virus destroys cells in the immune system, which makes it difficult for the body to fight off toxins, or poisons, and diseases. HIV is the virus that causes AIDS.

Human leukocyte antigens (HLA)
Molecule found on cells in the body that characterize each person as unique. These antigens are inherited from your parents. In donor-recipient matching, HLA determines whether an organ from one individual will be accepted by another.

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Hypertension
See high blood pressure.

Immune response
The body's natural defense against foreign objects or organisms, such as bacteria, viruses or transplanted organs or tissue.

Immune system
The organs, tissues, cells and cell products in your body that work to find and neutralize foreign substances, including bacteria, viruses and transplanted organs.

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Immunosuppression
The artificial suppression of the immune response, usually through drugs, so that the body will not reject a transplanted organ or tissue. Drugs commonly used to suppress the immune system after transplant include prednisone, azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), OKT3 and ALG, mycophenolate mofetil (CellCept) and tacrolimus (Prograf, FK506). New drugs keep improving the success of transplantation.

Immunosuppressive
Relating to the weakening or reducing of your immune system's responses to foreign material; immunosuppressive drugs reduce your immune system's ability to fight a transplanted organ.

Infection
A condition that occurs when a foreign substance, such as bacteria, enters your body, causing your immune system to fight the intruder; all transplant recipients can get infections more easily because their immune systems are suppressed. It is more difficult for them to recover from infection (such as urinary tract infections, colds and the flu).

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Inflammation
The swelling, heat and redness your body produces when it has an injury.

Informed consent
The process of reaching an agreement based on a full understanding of what will take place. Informed consent has components of disclosure, comprehension, competence and voluntary response.

Inpatient treatment
When you are treated in the hospital with an overnight stay.

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Insurance benefits
Services paid by an insurance company.

Intensive care unit (ICU)
A unit in the hospital that has highly technical and sophisticated monitoring devices and equipment. The staff is specially trained and educated.

Intravenous (IV)
Within a vein or veins; usually refers to medication or fluids that are infused into a vein through a plastic catheter inserted into the vein.

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Investigational
A drug or procedure that is not yet approved for marketing. Insurance companies normally do not pay for investigational drugs or procedures.

Kidneys
A pair of organs that remove wastes from your body through the production of urine. All of the blood in your body passes through the kidneys about 20 times every hour. Kidneys can be donated by living and cadaveric donors and transplanted.

Legislation
A group of laws and regulations.

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Leukocyte
A white blood cell.

Lifetime cap
See lifetime maximum.

Lifetime maximum
The total amount of money your insurance company will pay out for your covered expenses during your lifetime. Typical amounts are $150,000, up to 5 million dollars. Most insurance plans have a maximum amount. Once you have reached your lifetime maximum, you will no longer have insurance benefits. It is very important for you to be aware of how your insurance dollars are being spent.

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Liver
The largest gland in your body, made up of a spongy mass of wedge-shaped lobes. The liver secretes bile, which aids in digestion, helps process proteins, carbohydrates, and fats, and stores substances like vitamins. It also removes wastes from the blood. The liver can be donated and transplanted. A living donor can give part of their liver.

Living-related donor (LRD)
A family member who donates a kidney, part of a lung, liver or pancreas to another family member. Example: a brother and a sister, or a parent and a child.

Living-unrelated donor
A person who is not related by blood, who donates a kidney, part of a lung or pancreas to another person (such as a husband and wife).

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Mail-order pharmacy
A pharmacy that operates in another area. You call the pharmacy to reorder your medicines and they ship them to you by mail, UPS or Federal Express, usually monthly or every 3 months. These pharmacies are often less expensive and many have staff who are very knowledgeable about anti-rejection drugs.

Managed care
A term used to describe insurance programs that try to control health costs by limiting unnecessary treatment. Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Point-Of-Service (POS) plans and utilization review are all forms of managed care.

Match
The compatibility between the donor and the recipient. The more closely they match, the greater the chance that the transplant will be successful.

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Medicaid
A partnership between the federal government and individual states to share the cost of providing medical coverage for recipients of welfare programs and allows states to provide the same coverage to low income workers not eligible for welfare. Programs vary greatly from state to state.

Medically necessary
A specific health care service or supply which your insurance company has determined is required for your medical treatment and is also the most efficient and economical way to provide that service or supply. An example would be doing a minor surgical procedure in the doctor's office instead of keeping you in the hospital overnight, or renting a piece of medical equipment instead of buying it.

Medicare
The program of the federal government that provides hospital and medical insurance, through social security taxes, to people age 65 and over and those who have permanent kidney failure and certain people with disabilities.

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Medigap policy (MedSupp, Medicare supplementary)
Private insurance that helps cover some of the gaps in Medicare coverage.

Mortality
Death (mortality rate = death rate).

Multiple listing
Being on the waiting list at more than one transplant center.

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Noncompliance
Failure to follow the instructions of your medical team, such as not taking your medicines properly or not showing up for clinic appointments. Noncompliance can easily lead to the loss of your new organ.

Non-function
A condition in which a transplanted kidney fails to "wake up" (work) after being transplanted into the recipient, meaning that the recipient will either have to go on dialysis or have another transplant; non-function is rare (about 2 percent of all kidney transplants). If you get a kidney from a cadaver donor and the kidney never works, you get to "keep your place" on the waiting list.

National Organ Transplant Act (NOTA)
Passed by Congress in 1984, outlawed the sale of human organs and initiated the development of a national system for organ sharing and a scientific registry to collect and report transplant data.

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OPO local area
Each OPO provides its organ procurement services to the transplant programs in its area. An OPO's local service area can include a portion of a city, a portion of a state or an entire state. When an organ becomes available, the list of potential recipients is generated from the OPO's local service area. If a patient match is not made in that local area, a wider, regional list of patients waiting is generated.

Organ
A part of the body made up of tissues and cells that enable it to perform a particular function. Transplantable organs are the heart, liver, lungs, kidneys, pancreas and intestines.

Organ donation
To give an organ, such as your kidney, to someone in need of that organ; or to decide that after you die, your family has permission to give your healthy organs to people who need them.

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Organ preservation
Donated organs require special methods of preservation to keep them viable between procurement and transplantation. Without preservation, the organ will deteriorate. The length of time organs and tissues can be kept outside the body vary depending on the organ, the preservation fluid and the temperature.

Organ procurement
The removal or retrieval of organs and tissues for transplantation.

Organ Procurement and Transplantation Network (OPTN)
A function supervised by the Department of Transplantation (DOT), which maintains the national computerized list of patients waiting for organ transplants and a 24-hour computerized organ placement center to match donor organs to recipients in a fair and efficient manner; this function is performed by UNOS.

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Organ Procurement Organization (OPO)
OPOs serve as the vital link between the donor and recipient and are responsible for the identification of donors, and the retrieval, preservation and transportation of organs for transplantation. They are also involved in data follow-up regarding cadaveric organ donors. As a resource to the community they serve, they engage in public education on the critical need for organ donation. Currently, there are 69 OPOs around the country. All are UNOS members.

Out-of-pocket expenses
The portion of health costs that must be paid by the insured person per year, including deductibles, co-payments and co-insurance. After this amount is paid, the insurance company pays benefits at 100 percent.

Outpatient care (ambulatory care)
Medical testing or treatment that is done without an overnight hospital stay. Can be done in a hospital setting or a doctor's office.

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Pancreas
A long, irregularly shaped gland that lies behind the stomach and secretes pancreatic juice into the lower end of the stomach that aids in the digestion of proteins, carbohydrates and fats. If the pancreas fails, the individual becomes diabetic, and may need to take insulin. The pancreas can be donated and transplanted.

Panel reactive antibody (PRA)
The percentage of cells from a panel of donors with which a potential recipient's blood serum reacts. The more antibodies in the recipient's blood, the more likely the recipient will react against the potential donor. The higher the PRA, the less chance of receiving an organ that will not be rejected. A patient with a PRA of 80 percent means that they will reject 80 percent of donor kidneys. Patients with a high PRA have priority on the waiting list.

Pool
A group of people.

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Potential recipient
A person who is waiting for a transplant.

Pre-authorization (pre-certification)
The process of notifying and getting approval from your insurance company before you proceed with an elective (non-emergency) medical procedure. If your insurance plan requires pre-certification and you do not obtain it, your share of the cost will be higher.

Pre-existing condition
Any disease, illness, sickness or condition which was diagnosed or treated by a provider within 12 months before your the start date of your insurance coverage. Also, anything that caused symptoms in those 12 months that would cause most people to seek medical care.

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Preferred Provider Organization (PPO)
A group of hospitals or physicians who have made a contract with a particular insurance company to provide care to their members, usually at a discounted charge. If you have a PPO type insurance plan, your share of the cost is usually lower if you use one of these designated providers.

Premium
Amount paid to an insurance company for providing medical or disability coverage under a contract.

Private health plan
An insurance policy bought by an individual, not through an employer.

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Procurement
The act of recovering a donated organ or tissue.

Pulmonary
Having to do with, or referring to, the lungs.

Race
For UNOS purposes: Alaskan Native, American Indian, Asian, Black or African American, Native Hawaiian, Pacific Islander, and White.

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Recipient
A person who has already received a transplant.

Recovery (organ)
The surgical procedure of taking an organ from a donor.

Rejection
Rejection occurs when the body tries to destroy a transplanted organ or tissue because it sees the organ or tissue as a foreign object and produces antibodies to destroy it. Anti-rejection (immunosuppressive) drugs help prevent rejection.

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Renal
Having to do with, or referring to, the kidneys.

Required request
Hospitals must tell the families of suitable donors that their loved one's organs and tissues can be used for transplant. This law is expected to increase the number of donated organs and tissues for transplantation by giving more people the opportunity to donate.

Retransplantation
Due to rejection or failure of a transplanted organ, some patients receive another transplant after having returned to the waiting list.

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Retrieval
The surgical procedure of taking an organ from a donor.

Risk pools
A state-created, nonprofit association that does not require tax dollars for its operational purposes. The risk pools are a temporary stopping place for individuals who are denied health insurance for medical reasons. Risk pools often help individuals who, because of their physical condition, are unable to purchase health insurance at any price.

Scientific Registry of Transplant Recipients (SRTR)
UNOS maintains the SRTR which includes information on recipients of kidney, heart, liver, heart-lung, lung and pancreas transplant since October 1, 1987. The Registry also tracks all transplant patients from the time of transplant through hospital discharge, and then annually, until graft failure or death.

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Second opinion
A medical opinion provided by a second physician or medical expert, when one physician provides a diagnosis or recommends surgery to an individual.

Sensitized
When a potential recipient has antibodies in their blood, usually because of pregnancy, blood transfusions or previous rejection of an organ transplant. Sensitization is measured by panel reactive antibody (PRA). Highly sensitized patients are less likely to match with a suitable donor and more likely to reject an organ than unsensitized patients.

Side effect
An unintended reaction to a drug.

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Social Security Administration
A federal government program, best known for its retirement benefits. The Social Security Administration also administers disability benefits. Your salary and the number of years you have been covered under this program determine how much you can receive in monthly payments.

Spend down
For disabled people who have higher incomes, but cannot pay their medical bills. Under this program, a person pays a part of their monthly medical expenses (the spend down), then Medicaid will pay the rest. Eligibility is determined on a case-by-case basis.

Status
A code number used to indicate the degree of medical urgency for patients awaiting heart or liver transplants. Example: Status 1, Status 2, Status 3.

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Steroids
Naturally occurring substances found in your body which include hormones that help control important functions in your body; synthetic or man-made steroids can be used to suppress your immune system.

Supplemental policy (Medigap policy)
Offered by private insurance companies, not the government. These policies are designed to pay for some of the costs that Medicare does not cover. These policies have limited coverage for medicine costs.

Survival rates
Survival rates indicate what percentage of patients are alive or grafts (organs) are still functioning after a certain amount of time. Survival rates are used in developing UNOS policy. Because survival rates improve with technological and scientific advances, developing policies that reflect and respond to these advances will also improve survival rates.

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Systolic
The top number in your blood pressure (the 120 in a BP of 120/80) Measures the force of contraction of the heart muscle as blood is pumped out of the heart chamber.

Termination of benefits
Health insurance benefits will stop when the individual has reached the lifetime maximum amount, or when the individual is no longer eligible for the plan due to non-payment of premiums or having left or lost a job. Also see COBRA.

Thoracic
Referring to the heart, lungs and chest.

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Tissue
An organization of a great many similar cells that perform a special function. Examples of tissues that can be transplanted are blood, bones, bone marrow, corneas, heart valves, ligaments, saphenous veins, and tendons.

Tissue typing
A blood test done to evaluate how closely the tissues of the donor match those of the recipient (done before the transplant). Done on all kidney transplant donors and recipients to help match the donor to the most suitable recipient.

Transplant, transplantation
To transfer a section of tissue or complete organ from its original position to a new position. For instance, transferring a healthy organ from one person's body to the body of a person in need of that organ.

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U.S. Scientific Registry of Transplant Recipients (SRTR)
A database of post-transplant information. Follow-up data on every transplant are used to track transplant center performance, transplant success rates and medical issues impacting transplant recipients. Under contract with the Health Resources and Services Administration (HRSA), UNOS facilitates the collection, tracking and reporting of transplant recipient and donor data.

UNOS United Network for Organ Sharing.

Usual and customary (U&C) fee
The fee that providers of similar training and experience charge for a service in a particular geographical area. If your provider charges more than the U&C fee, your insurance might only pay up to the U&C amount and you might be responsible for the rest of the fee.

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Varices (esophageal)
Enlarged and swollen veins at the bottom of the esophagus, near the stomach. A common condition caused by increased pressure in the liver. These veins can ulcerate and bleed.

Vascular
Referring to blood vessels and circulation.

Ventilator
A machine that "breathes" for a patient when the patient's body is not able to breathe on its own.

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Virus
A group of tiny organisms capable of growing and copying themselves while living within cells
of the body.

Waiting list/waiting pool
After evaluation by the transplant physician, a patient is added to the national waiting list by the transplant center. Lists are specific to both geographic area and organ type: heart, lung, kidney, liver, pancreas, intestine, heart-lung, kidney-pancreas. Each time a donor organ becomes available, the UNOS computer generates a list of potential recipients based on factors that include genetic similarity, blood type, organ size, medical urgency and time on the waiting list. Through this process, a "new" list is generated each time an organ becomes available that best matches a patient to a donated organ.

Waiting period
A period of time when you are not covered by insurance for a particular problem, such as a pre-existing condition.

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Xenograft
An organ or tissue procured from an animal for transplantation into a human.

Xenotransplantation
Transplantation of an animal organ into a human. Although xenotransplantation is highly experimental, many scientists view it as an eventual solution to the shortage of human organs.

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