Organ transplants

The first face transplantation in Finland and the Nordic countries was performed in Töölö Hospital in 2016. It was the 35th face transplantation in the world.

A face transplantation is an extremely complex and demanding procedure. It is a last resort in cases where the patient's face is so badly destroyed that no other treatment method is possible. During the surgery, facial tissue from a brain-dead donor is used to replace the facial tissue of the recipient.

The face transplant team in HUS began its work in 2011. Over 30 physicians from various specialties (plastic surgery, maxillofacial surgery, ENT, transplantation surgery, cardiac and thoracic surgery, anesthesiology, infectious diseases, immunology, radiology, psychiatry, skin and rejection pathology) in addition to more than 20 other experts participated in the project. Members of the face transplant team have travelled abroad for transplantation training.

At HUS, we perform all lung transplantations and combined heart-lung transplantations in Finland. We performed the first heart-lung transplantation in 1988 and the first lung transplantation in 1990. We perform 20 to 30 lung transplantations per year. The numbers have increased in recent years.

Lung transplantation can be used to treat nearly all life-threatening, end-stage pulmonary diseases except lung cancer.  Heart-lung transplantations have mainly been replaced by lung transplantations combined with corrective heart surgery.

The most common reasons for lung transplantation are scarring in the lungs–or pulmonary fibrosis, chronic obstructive pulmonary disease, pulmonary vascular disease, and severe purulent pulmonary infections, such as cystic fibrosis.

The preconditions for lung transplantation are good co-operation and commitment to permanent medication and follow-ups. In accordance with international schedules, the transplantation examinations should be conducted already when the disease is stable, so that there is enough time to find a suitable transplant.

Finland’s first hand transplantation was performed at HUS Meilahti Bridge Hospital in 2024. Hand transplantation is a very demanding procedure, and it consists of three separate surgeries: detaching the hand from the donor, preparatory surgery of the recipient, and attaching the transplant. During the attachment, the bones and blood vessels are connected first. Then, the tendons, nerves, and other structures are attached. There are dozens of different structures that need to be attached. 

Before the transplantation, the patient undergoes extensive examinations to find out if they are suitable for the operation. After the surgery, the patient still needs to undergo rehabilitation, which will last over a year. They will also have several follow-ups in the hospital to monitor function and sense of touch in the transplant, as well as the overall health of the patient. 

Prosthetic arms have developed tremendously in recent decades, but lack of sensation, clumsiness, and reliability still pose challenges. Hand or arm transplantations are usually performed on patients who do not have functioning hands. Hand transplantations are not life-saving procedures, but the aim is to significantly improve the patient's quality of life.

Read more about the Finland’s first hand transplantation

On average, we perform 50 to 60 liver transplantations per year. Our results in liver transplantations are among the best in the world. About 95% of liver transplant recipients are alive one year after the transplantation, and 80% are alive ten years after the transplantation.

The indication for liver transplantation is a chronic, end-stage liver disease or a sudden hepatic insufficiency. Liver transplantation may also be possible in selected cases of early-stage hepatocellular cancer.

The cause of chronic liver disease is almost always cirrhosis. To receive a liver transplant, patients with alcoholic cirrhosis must commit to complete and permanent abstinence from alcohol as soon as they are diagnosed, and they must prove that they can live without alcohol.

The majority of liver transplant recipients lead normal lives. Some patients develop severe complications during the first few weeks after transplantation, which prolongs their recovery and treatment. About a third of recipients undergo transplant rejection during the early stage. This is treated with increased immunosuppressive medication.

 Read more about liver surgery here 

We conduct approximately 250 kidney transplantations every year. The kidneys used can be from living or brain-dead donors.

Our renal transplantation results are among the best in the world. In the transplantations performed in the 2000s, over 95% of the transplants were functional over a year later, and more than 70% are expected to function 10 years later. According to the current estimates, more than half of transplants will function 20 years after the transplantation.

The most typical reasons for renal transplantation are glomerulonephritis, cystic kidney disease, and type 1 diabetes. In about 10% of cases, the reason for an advanced kidney failure that progresses without any symptoms remains unknown.

The most significant reasons that prevent kidney transplantation are poor condition of the heart, circulation, or the nervous system. Other contraindications include chronic infectious diseases and malignant tumours.

Dialysis treatment can be stopped after a successful kidney transplantation. The recipient may lead a fairly normal life, even work in a physically demanding profession, and exercise. Immunosuppressive medication is necessary for the rest of the patient's life, but the doses can usually be decreased as years go by.

Globally, more than 2500 intestinal transplantations have been performed and majority of the recipients have been children. At HUS, we began performing intestinal transplantations in 2009. All intestinal transplantations in Finland are performed at HUS. The prognosis for intestinal transplantations has improved significantly in recent years: more than 60% of transplants are functional five years later.

The most common diseases requiring intestinal transplantation are short-bowel syndrome, intestinal motility disorder, and rare intestinal mucosal diseases and tumors.

Intestinal transplantation is considered when, in addition to failure of bowel function, there are serious complications associated with parenteral nutrition. However, only a small number of short-bowel syndrome patients are treated with intestinal transplantation. They may also be treated with bowel lengthening surgery.

Since a suitable donor must be at least 20% lighter in weight than the recipient, the waiting list for transplants is long for children.

Heart transplantation is the last treatment option in a life-threatening cardiac insufficiency when other treatment methods no longer suffice. Most heart transplantations are performed due to dilated cardiomyopathy or permanent damage to the cardiac muscle caused by coronary artery disease.

All heart transplantations in Finland are performed at HUS. We have been performing heart transplantations since 1985. On average, we perform 16–20 heart transplantations per year. Children's transplantations are performed in New Children's Hospital.

Better prevention of cardiac diseases as well as improved medicines, technological solutions and cardiac surgery techniques have postponed the occurrence of severe cardiac insufficiency to older age groups. In fact, coronary artery disease as the cause of severe cardiac insufficiency has decreased, and nowadays the most common reason for heart transplantation in Europe is cardiomyopathy.

We performed the first simultaneous kidney and pancreas (SKP) transplantation at HUS in 2010. Since then, SKP transplantations have become an established part of our work. The results of our simultaneous kidney and pancreas transplantations are good. One year after the transplantation, 97% of recipients are alive and 94% of the transplants are functional. 

Currently, we can perform SKP transplantations to patients with type 1 diabetes and renal insufficiency, and who are assessed to endure the strenuous and risky procedure.

Type 1 diabetes occurs when the insulin producing cells in the pancreas stop working. Since insulin is produced in the pancreas, a pancreas transplantation can return the patient’s insulin production to normal. The primary aim in pancreas transplantation is to normalize the patient’s glucose metabolism and slow down the development of later complications caused by diabetes.

Simultaneous kidney and pancreas transplantation is only suitable for a small number of patients suffering from type 1 diabetes and renal insufficiency. Preferably, the patients should be under the age of 60 and their body mass index should not exceed 30 kg/m2. In addition to regular examinations before a renal transplantation, it is essential to perform thorough cardiac examinations before the decision to operate is be made.

Pancreas transplantation is the only way to get rid of insulin therapy for several years.