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Because the tissues of the donated organ have to match those of the patient. Not all tissue types are compatible with each other, and if they are not, then the body just rejects the donated organ and cannot use it.

Modern pathology testing can go some way towards assessing beforehand if an organ is compatible with the recipient, but there are still occasions when donated organs are rejected for reasons that nobody understands. However, this doesn't necessarily mean that the patient faces death- often the organ will work a bit, not as it should do but for long enough for another donor organ to be found that WILL work.

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