I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Medical Breakthroughs => Topic started by: justagirl2325 on March 10, 2018, 08:12:06 AM

Title: New advances in kidney transplant
Post by: justagirl2325 on March 10, 2018, 08:12:06 AM

Iolaire posted something in a different thread that live donor kidney are better than deceased donors which is what all the research says.  I thought I would share this article from the doctors that operated on me and my husband last year. They are working to make deceased donor kidneys work just as good as live donors.

http://www.uhn.ca/corporate/News/PressReleases/Pages/Device_keeps_donor_kidneys_healthy_outside_the_body_until_transplant.aspx

Title: Re: New advances in kidney transplant
Post by: Michelle2016 on March 12, 2018, 08:42:58 PM

Wonderful news.

Title: Re: New advances in kidney transplant
Post by: Simon Dog on March 13, 2018, 08:22:52 AM

My surgeon mentioned that cadaver kidneys often arrive on a perfusion pump.  Did not get a full explanation as to the criteria for doing so.

Title: Re: New advances in kidney transplant
Post by: iolaire on March 13, 2018, 08:43:25 AM

Both the study and the perfusion pump sound good.  I thought that kidneys are generally transported on ice.

This study showed ice transport was not so bad:
https://www.hopkinsmedicine.org/news/media/releases/shipping_kidneys_for_transplant_is_safe_johns_hopkins_research_finds

At the same time, doctors had concerns about shipping kidneys. They worried that extending a kidney’s cold ischemic time — the time the donor organ was kept outside the body — would take away some of the benefits of getting a kidney from a live donor, Segev says.
So Hopkins researchers studied whether the length of time the kidney was kept viable on ice had any harmful effects on long-term graft survival. Their research found none.

I think the not quite as good deceased donors kidneys is those which are "Donation After Cardiac Death (DCD)"
http://www.ucdmc.ucdavis.edu/transplant/nonlivingdonors/nonliving_after_cardiac.html
Organs recovered from a donor after cardiac death have some degree of oxygen deprivation during the time after the heart stops beating. This may make kidneys from this type of donor "slow to start".

versus "Standard Criteria Donors (SCD) "
http://www.ucdmc.ucdavis.edu/transplant/nonlivingdonors/nonliving_std_criteria.html
The standard criteria donor (SCD) is a donor who is under 50 years of age and suffered brain death from any number of causes. This would include donors under the age of 50 who suffer from traumatic injuries or other medical problems such as a stroke.

So a "brain dead donor" would still have the blood circulating and the lungs working which is better than the "donation after cardiac death" donor whose kidney looses blood flow prior to harvesting the organ.  Thus the brain dead donor kidneys function better.

FYI this is a good story on the ethics of DCD:
http://www.nejm.org/doi/full/10.1056/NEJMp078066

Title: Re: New advances in kidney transplant
Post by: Simon Dog on March 13, 2018, 03:40:37 PM

A pilot friend loves driving transplant organs since it gets him a no-wait landing slot and gate.