Multi-Organ Transplant Surgery

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During multi-organ transplant surgery, two or more diseased organs are replaced with healthy donor organs, usually from the same donor. The organs are transplanted during the same surgery, one at a time. Multi-organ transplants are relatively rare -- fewer than 1,400 were performed in the U.S. in 2022. Because the risks of a multi-organ transplant are generally higher than the risks of individual transplants, they require medical expertise and advanced surgical skills that are only available at hospitals like Duke. In 2022, we performed the most multi-organ transplants in the state and were in the top 10 in the nation. 

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    Multi-Organ Transplants Performed at Duke

    • Heart-kidney
    • Heart-liver
    • Heart-lung
    • Lung-kidney
    • Liver-lung
    • Liver-small bowel-pancreas (multivisceral)
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    Before Your Multi-Organ Transplant

    Treatments Overview

    Multi-organ failure may happen when one organ fails and others follow, or multiple organs may fail independently. Sometimes one organ can’t be safely transplanted without another organ being transplanted as well. You may be considered for multi-organ transplant if all other treatments have not improved your condition.



    You will undergo evaluation for each organ being considered for transplant. For instance, if you need a heart-kidney transplant, you will meet with both the heart transplant team and the kidney transplant team for extensive testing. Depending on your health condition, you may have blood tests, X-rays, biopsies, and other tests.

    The Waitlist


    If your transplant teams determine that multi-organ transplant is best for you, your name will be added to the national transplant waitlist for each organ. The lists are managed by the United Network for Organ Sharing (UNOS), which matches available organs with recipients based on factors such as medical need, blood type, and geographic location, with the weakest organ receiving priority. Most multi-organ transplant recipients receive organs from a single donor, since this reduces the risk of rejection.

    Support While You Wait


    A transplant coordinator will guide you through the process. Your coordinator will help educate you, assist with scheduling appointments, and help you stay healthy while you wait for a transplant. You can also access support services such as financial counseling and psychological support.

    Our Locations

    Transplant surgery is performed at Duke University Hospital. Pre- and post-transplant appointments take place at our clinics in Durham.

    Why Choose Duke

    Extensive Experience in Multi-Organ Transplants
    With one of the highest rates of multi-organ transplants in the region and the nation, Duke has the expertise and experience to perform combinations of organ transplants not offered at other hospitals, such as heart-kidney, heart-liver, heart-lung, liver-lung, and liver-small bowel-pancreas.

    Multi-Organ Transplants Performed at Duke by Year
    Source: OPTN

    A Team Approach


    Because multi-organ transplants require a full team of specialists for each organ, careful planning and coordination among medical teams is essential. The transplant teams regularly work together to address the unique needs of patients awaiting multi-organ transplant.

    Less Time on the Waitlist


    We use the latest advances in transplant medicine to expand the pool of available organs, including aggressive organ recovery efforts and innovative organ preservation strategies. These efforts can result in less time spent on organ waitlists.

    Consistently Ranked Among the Nation’s Best Hospitals

    Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

    This page was medically reviewed on 10/14/2022