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Piedro's Exchange

4th-level transmutation (ritual)

Casting Time: 10 minute

Range: 5 feet

Components: V, S, M (a prosthetic organ, worth at least 50gp, which replaces the same type of organ)

Duration: Instantaneous

You target a creature within range that is missing or has a failing internal organ (such as a heart, lung, liver, or eye). You must have line of sight to the location where the replacement is to be implanted, and a crafted organ in hand or suspended in magical stasis. The target must be either conscious and still, or under the effect of Piedro's Anesthesia or a similar spell that renders the body inert.

Over the course of the casting, you force the replacement organ into the creature's body, anchoring it to nerves, vessels, and structure. Upon completion, the new organ fully replaces the missing one, restoring its biological or magical function.

The recipient regains full function of the replaced organ, though the material may react differently under stress or magical detection. The organ is immune to disease and resistant to magical decay, but cannot be repaired by any spell that restores hit points, since the object counts as a construct.

This spell cannot replace a soul, brain, or heart unless cast with material components worth at least 1,000 gp and GM approval.

The GM decides what qualifies as an organ for this spell's purpose. Generally, this includes distinct internal structures (like heart, eye, kidney), but not broad tissue systems like skin or veins unless explicitly allowed.

Class/Race Requirement: Artificer, Cleric, Wizard