The sad reality of organ transplantation is the demand for healthy organs far exceeds the supply of organs from deceased organ donors. However, with the option of the living donor kidney transplantation, patients can now receive an organ from a family member, friend, or a kind stranger, without waiting on long UNOS organ list.
NewYork-Presbyterian is a leader in living donor kidney transplant. Our programs at Weill Cornell Medical Center and Columbia University Medical Center were founded in 1963 and 1970, respectively. Over the years, our transplant teams have revolutionized the kidney donation operation — perfecting the minimal-access kidney donation procedure (laparoscopic nephrectomy), which leaves only a small three-inch incision mark. We have also pioneered in offering transplantation for incompatible donors and recipients.
Is Living Donor Kidney Transplant Right for You?
The ultimate goal of any transplant surgery is to improve the quality of life and longevity of the organ recipient. Deceased-donor and living donor kidney transplant both offer recipients a chance at a longer life that is unencumbered by the need for dialysis, which puts you at an increased risk for infection. However, living donor transplantation has many benefits that deceased donor transplant does not, including:
- Better survival rates. On a national level, long- and short-term survival rates for living donor kidney transplants are higher than that of deceased-donor transplant. At NewYork-Presbyterian, our living donor transplant patients exceed the national average at the one-month, one-year, and three-year post-transplant review periods.
- Shorter waiting time. Patients with a designated living donor can bypass the United Network for Organ Sharing (UNOS) waiting list for organs, which is an average five to seven years in New York State. By shortening your waiting time for an organ, our doctors can prevent potential complications, further health deterioration, and possibly death.
- Immediate kidney function. Studies have shown that patients who undergo deceased-donor kidney transplant are more likely to have delayed kidney function (a “sleepy kidney”) than those who undergo living donor transplant. This delayed kidney function means patients may need to continue dialysis for several weeks after the surgery.
As with all transplantation surgeries, there are risks involved, including organ rejection. Our doctors will explain your potential risks and allay your concerns.
Types of Living Donor Transplant
Living donor kidney transplant gives people suffering from chronic kidney disease or renal failure an opportunity to receive a functioning kidney from a family member, friend, or in some cases, a stranger. In addition to the usual compatible living donor kidney transplant, we perform:
- Paired donor exchanges or “swaps”. If you have a medically suitable and willing living kidney donor who is immunologically incompatible with, doctors at NYP are still very often able to find you a compatible living kidney donor. Since 2004, NewYork-Presbyterian’s kidney transplant teams have performed paired donor transplants, in which an incompatible donor and recipient is paired with another recipient and donor, who are also incompatible with each other but compatible with the other patient's living donor. In 2012, the kidney transplant teams at NewYork-Presbyterian participated in an unprecedented 60-person kidney swap , which connected 30 renal failure patients with 30 donors at more than ten transplant centers around the country.
- Incompatible transplant. NewYork-Presbyterian is one of the few institutions to offer "incompatible" kidney transplants for recipients who have anti-donor antibodies and are therefore more likely to reject a donor kidney. This method requires techniques and medications to reduce antibody levels in the recipients' blood to enable successful transplantation. Our research has shown that long-term kidney transplant survival among incompatible recipients is better than waiting on the list for a compatible deceased donor kidney.
The Living Donor Transplant Process
At NewYork-Presbyterian, we have been performing living donor kidney transplantation for more than 50 years. Our team of exceptionally trained nephrologists, transplant surgeons, intensive care nurses, and other medical staff, can help guide patients and their families through the process of identifying a donor, planning and performing the surgery, and aftercare.
Some key points of the living donor/recipient process to consider include:
- Pre-operative testing. To make sure your potential donor is compatible and fit to undergo this task, we perform a series of tests, such as a general physical exam, urine tests, blood tests, blood and tissue typing (compatibility testing), routine cancer screening, kidney function testing, and psychological examinations.
- Donor operation. Living donors undergo surgery in a separate operating suite from the recipient. In the past 50 years, we have made significant advancements in surgical technique, which allows donors to recovery faster with smaller incisions. Our surgeons can perform laparoscopic (minimally invasive) surgery to remove the donated kidney, which leaves one to four small incision marks.
- Recipient operation. Kidney transplantation takes about two to four hours. In most cases, we place the new kidney into the body and do not remove the damaged kidneys. Damaged kidneys are removed if they are prone to infections or cause other complications.
- Post-transplant period. After the surgery, we closely monitor the recipient to ensure the kidney is functioning, and the body is not rejecting the organ. We also place the patient on anti-rejection medication.