Our kidney transplant program's mission is to move patients off the transplant list and back to leading healthy, productive lives. To achieve that goal, we develop and employ innovative solutions that provide transplants for more patients. Thanks to new advances developed here, more people than ever have access to a kidney transplant, the most common and successful of all transplant procedures in the United States.
We routinely perform our living donor kidney transplants laparoscopically, with very small incisions, facilitating a more comfortable and faster recovery. Many of our kidney transplant recipients are also candidates for a "mini-incision" transplant operation that uses a 3-4 inch incision. The majority of our patients are able to be on a steroid-free protocol. Without steroids, patients recover quickly and avoid many serious long-term side effects. We are committed to facilitating ease of care for our patients both within and outside our walls. At our special outpatient facility, the Shorin Room in the Milstein Hospital Building, we provide weekend and off-hour attention; our Infusion Center provides infusions and biopsies on an outpatient basis.
Our dedication to kidney transplant patients includes the bigger picture as well: establishing protocols to give as many people as possible access to kidney transplant. Our transplant team has found new ways of expanding the donor pool, increasing the number of kidneys available for transplants, addressing the shortage of healthy organs, and reducing waiting times for organs.
The Renal and Pancreatic Transplantation Program offers patients with advanced kidney disease or kidney failure four transplant alternatives. Notably, kidney transplantation has been shown to result in a longer life expectancy than dialysis.
- Compatible live donor transplants are the gold standard of kidney transplant procedures. Typically, the organ is donated by a relative. An organ from a perfectly-matched sibling donor can function for an average of 35 years, while less perfectly matched donor organs function for 20 years on average. Ninety-seven percent of live donor kidneys are fully functional upon transplantation.
- Paired donor exchanges anonymously match up compatible donors and recipients, when a suitable donor cannot be found through family and friends. While logistically complicated—requiring four transplant teams and operating rooms—the procedure offers the benefits inherent in finding a compatible live donor. Dr. Ratner performed the first donor exchange at NewYork-Presbyterian/Columbia in September 2004.
- Incompatible live donors can be used if a willing compatible donor cannot be found. This can occur if the donor/recipient are either blood-group incompatible or incompatible due to antibodies against the transplant antigens. In order to accept a kidney from an incompatible donor, the recipient's blood must be repeatedly "cleaned" of mismatched antibodies through a process known as plasmapheresis.
- Deceased donor procedures are reserved for those patients who cannot wait for a suitable live donor. Deceased donor kidneys have a 50 to 60 percent chance of being fully functional immediately upon transplantation and have a 50/50 chance of maintaining their function for 10-20 years post-transplant.
Shorter Waiting Times
At NewYork-Presbyterian/Columbia we've created a new strategy to maximize transplant opportunities with our "Top Forty Waiting List." The strategy is designed to assure that our patients are medically, financially and psychologically ready for transplantation, with all their family support systems in place. This way, we decline fewer available kidneys, improve recipient outcomes, and reduce overall waiting times.
The results of this new system show that no donors have been turned down due to the recipient being medically or logistically unavailable. On average, waiting times for deceased donor organs are more than cut in half, from six years to between one and three years.