Kidney Transplant Program at Columbia University Medical Center in New York City

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Kidney Transplantation: New and Better Options for Patients and Donors

Lloyd E. Ratner, MD
Director, Renal and Pancreatic Transplantation
Department of Surgery
Columbia University Medical Center
In affiliation with NewYork-Presbyterian Hospital
Phone: 800.227.2762

Those with advanced kidney disease or kidney failure find their lives transformed by kidney transplant, which has become the most common and successful organ transplant.

Obtaining a suitable donor organ can be one of the greatest challenges for a transplant candidate. Some are fortunate enough to receive a kidney from a relative or friend. Others must join the national waiting list, which can mean enduring theirkidney disease for several years longer.

The good news regarding live kidney donation is that availability of minimally invasive laparoscopic techniques for removing a kidney from a live donor (also known as harvesting the kidney) has greatly improved the safety and comfort of this procedure. This in turn increases the number of individuals willing to be donors. Laparoscopic techniques also permit some individuals who would not have been considered good candidates for an open procedure, such as older individuals, to donate an organ. Laparoscopic kidney harvesting has rapidly been adapted as a standard of care worldwide because of its considerable advantages.

Our team employs all available strategies to maximize transplant opportunities and reduce waiting times, including:

Use of "extended criteria" organs, from donors who are older or whose health or a mild kidney injury might otherwise prevent their donating. Extended criteria organs help transplant centers meet the needs of those too sick to wait for a kidney;
"Kidney swaps" enable two or more patients whose donors are blood-group or antigen incompatible to swap donors in order to receive a compatible organ. By agreeing to exchange recipients—giving the kidney to an unknown, but compatible individual—the donors provide healthy kidneys where previously no transplant would have been possible;
Plasmapheresis, cleaning the recipient's bloodstream of mismatched antibodies to prevent rejection of the transplanted organ.

Recent statistics show that 17,000 Americans undergo a kidney transplant yearly. Our goal is to increase this number every year by offering the widest range of options to individuals facing end-stage kidney disease.

Quality of Life Interventions from the Columbia University Department of Surgery