Can an Organ Be Transplanted More Than Once?

Retransplantation, or reusing previously transplanted organs, is an emerging solution to address the organ shortage crisis. While promising cases of kidney, liver, and heart retransplants have been reported, the procedure carries higher risks due to increased chances of organ rejection and complications caused by previous surgeries. Factors like immunological compatibility, donor and recipient health, and tissue quality are critical for success. Despite challenges, retransplantation could be a viable option, particularly for patients facing long wait times, with careful decision-making and patient involvement.

For patients with failing organs, transplants are often their only hope for survival without reliance on machines. Every year, organ donation saves thousands of lives, with the U.S. setting a record of over 46,000 transplants in 2023. However, despite rising donor numbers, the demand for transplants still exceeds supply—someone is added to the waiting list every eight minutes. In response, medical experts are exploring innovative solutions, including reusing previously transplanted organs.

Although still experimental, “retransplantation of organs is both desirable and feasible,” said Dr. Nima Nassiri, a professor of urology and transplant surgery at UCLA Health, and Atieh Dehghani, a UCLA medical student, in an email interview with *Live Science*. Retransplantation makes optimal use of limited donor resources by extending the lifespan of functioning transplanted tissues that might otherwise be discarded.

Promising results have already been seen, with successful cases of retransplanted kidneys, livers, and hearts documented. However, Dr. Pradeep Kadambi, a kidney transplant expert at the University of Florida College of Medicine – Jacksonville, highlighted that retransplant surgeries carry higher risks than conventional transplants.

All surgeries pose risks such as blood loss, infections, and procedural complications, but transplant surgeries face the added challenge of organ rejection. Dr. Kadambi explained that each person’s unique Human Leukocyte Antigens (HLA) serve as a biological identifier, enabling the immune system to recognize foreign tissues. When an organ is transplanted, the body’s natural defense mechanism often identifies it as foreign and attempts to reject it.

To prevent rejection, transplant recipients are placed on lifelong immunosuppressive medication to weaken the immune response. However, this leaves them more vulnerable to other infections, requiring a delicate balance in treatment.

Immunological compatibility is critical to reducing rejection risk, but retransplanted organs introduce further complications. “These organs may carry additional antigens from previous recipients, increasing the risk of sensitization and rejection,” Dr. Nassiri said.

The success of a retransplant depends not only on immunology but also on the health of the donor, recipient, and the organ itself. Factors like high blood pressure or diabetes in either party can affect outcomes, while previous transplant surgeries may leave physical changes—such as scar tissue or shortened vessels—that complicate the procedure.

Despite these challenges, retransplantation may be the best solution in certain cases, particularly for kidneys, the most commonly transplanted organ. With wait times for a deceased donor kidney ranging from three to five years, retransplantation offers hope to patients facing long delays.

“The risks are higher, but in the right circumstances, it can be successful,” Dr. Kadambi noted. He emphasized that patients must play an active role in deciding whether to pursue retransplantation. Sharing his own experience, he added, “We faced a few unexpected complications, but we overcame them, and the patient had a successful outcome.”