Compatible Living Donor Kidney Transplant
The first successful live donor kidney transplant was performed in 1954. The donor and recipient were identical twins. Since then, our understanding of donor compatibility and the development of immunosuppressant medications have greatly advanced living donor procedures. Today, approximately 75% of people who receive a kidney transplant from a living donor maintain their kidney function for 10 to 20 years.
Living donor programs allow a relative or a compatible unrelated donor (such as a spouse or friend) to donate a kidney. Siblings have a 25% chance of being an "exact match" for a living donor and a 50% chance of being a "half-match." Donor compatibility is established through blood tests that look for matching blood types and antigens. The overall health of the potential donor is also of critical importance. (To learn more about becoming a donor, please click here.)
Kidneys from perfectly matched sibling donors on average can function for over 35 years. Live donor procedures of all types, however, offer better outcomes than deceased donor procedures:
- Live donor recipients spend less time waiting for a donor organ. The wait for a deceased donor kidney in New York averages five to seven years.
- Immediately upon transplantation, 97% of live donor kidneys are fully functional, versus 50-60% of deceased donor kidneys.
- Live donor recipients face less risk of organ rejection.
The success of the living donor program has helped to make renal transplantation one of the most common and successful types of organ transplantation. NewYork-Presbyterian Hospital/Columbia University Medical Center (NewYork-Presbyterian/Columbia) began performing live donor kidney transplants in 1970 and expanded its program in 1986 to encompass non-related donors. Today, NewYork-Presbyterian/Columbia has the most active living-donor service in New York.
Once the surgeon has obtained the donor kidney, he or she makes a 4-10 inch incision to place the kidney on one side of the recipient's front lower abdomen. Some patients may be candidates for a new minimal access kidney transplant procedure. The procedure, which we developed at Columbia, uses a single three-inch incision. The novel placement of the kidneys—versus its natural position at the back of the body—allows the surgeon to more easily connect the kidney to the bladder. To ensure an adequate blood supply, the surgeon also attaches the kidney to an artery and vein that lead to the legs. In most cases, the patient's own kidneys are not removed, thereby avoiding unnecessary additional surgery.
The transplant operation typically lasts from 2½-5 hours. The patient stays in the hospital for as little as three days and spends approximately six weeks recuperating at home. All organ transplant recipients, including kidney recipients, need to take daily immunosuppressant medications.