Renal 3000
Jada Fabrizio
Renal Program Directors Lloyd E. Ratner, MD, Mark A. Hardy, MD, and David J. Cohen, MD.
The first kidney transplant at Columbia University Medical Center was performed in 1969. The three thousandth was performed on April 6, 2010.
To celebrate this milestone, over 600 kidney transplant patients, donors and their families reunited with their medical teams on April 21, 2010 at NewYork-Presbyterian Hospital/ColumbiaUniversity Medical Center (NYPH/CUMC). The occasion, the Circle for Life: Renal 3000 event, was a huge success, a heartfelt celebration of a second chance at life. The reunion made national news, being featured on more than 50 CBS affiliate stations across the country.
The procedure has evolved in ways few could have imagined at the time of the first successful kidney transplant in 1954. At that time, immunosuppressant drugs were not yet available, and transplants were performed only between identical twins in order to prevent organ rejection. The advent of immunosuppressant medications in the 1960s broadened the scope of donation to include deceased donors, and increased the number of organs available for transplantation.
Yet as the practice of kidney transplantation increased, so did demand for donor organs, as well as for better approaches to preventing organ rejection. Determined to meet these challenges, the transplant team at Columbia has pioneered a continuous stream of innovations in surgical techniques, organ donation, and medical therapies over the past four decades.
Extended criteria protocols: To meet the shortage of donor organs, the program has implemented new protocols for using extended criteria organs that may not meet the usual criteria for transplantation, but are healthy enough for a successful transplant. Organs in this category include those from donors who are older, have hypertension or diabetes, or who at the time of their death suffered mild kidney injury. The use of extended criteria kidneys allows more people to receive kidney transplants than ever and is proving highly successful, especially among older recipients and those doing poorly on hemodialysis.
Donor swaps: Paired donor exchanges anonymously match up compatible donors and recipients when a suitable donor cannot be found through family and friends. While logistically complicated (a two-way swap requires four transplant teams and four operating rooms; a three-way swap requires six teams and six operating rooms, and so on), the procedure dramatically improves opportunities for patients to find a compatible donor. Building on the success and popularity of the two-way swap, the program now performs swaps among up to six patients, events requiring twelve simultaneous operations.
Kidney swaps enable patients to be transplanted far earlier than if they had to wait on the organ wait list (for a deceased donor), sparing many from dialysis. In conjunction with an aggressive approach to managing the organ waiting list, kidney swaps have reduced the waiting time for deceased donor organs by an average of four years at NewYork-Presbyterian/Columbia — reducing the number of patient deaths while on the waiting list and significantly improving outcomes after transplantation.
Laparoscopic donor operations: the use of laparoscopy and minimally invasive techniques rather than open surgery facilitates a more comfortable and faster recovery for kidney donors. Many transplant recipients are also able to receive donor kidneys through a three or four inch 'mini-incision.'
Steroid avoidance protocol: In a highly successful protocol in place since 2001, molecular therapies provide highly personalized immunosuppressant therapy that can reduce or eliminate use of steroids after transplantation in more than 90% of patients at NewYork-Presbyterian/Columbia.
Read more about kidney transplantation at NYP/Columbia.
View photos from Renal 3000 on the Department of Surgery's blog.
Jada Fabrizio
Kidney Transplantation Milestones at NewYork-Presbyterian Hospital/Columbia
1969Columbia's first kidney transplant is performed under the auspices of Columbia-Presbyterian's Department of Surgery at Delafield Hospital.
1970
Columbia-Presbyterian performs its first transplant of a kidney donated by a living relative.
1980's
Groundbreaking research at Columbia leads to life-saving immunosuppressant drugs Sandimmune®, OKT3®, and Atgam®.
1986
The Columbia team performs the first combined kidney and heart transplant in the New York region.
Columbia launches the Living-Unrelated Donor Program, allowing husbands and wives to donate a kidney to their spouses.
1988
Columbia organizes the first international symposium to investigate cross-species transplantation.
1993
Dr. Lloyd E. Ratner (at Columbia University since 2004) performs the first dual kidney transplant, in which two adult kidneys are transplanted into a single recipient, improving outcomes for patients implanted with kidneys from older donors and increasing access to transplantation.
1994
Columbia's Living-Unrelated Donor Program is expanded to include friends and unrelated loved ones.
Columbia's immunogenics laboratory develops ways to detect organ rejection earlier.
1995
Columbia sets new guidelines for the use of immunosuppressants in connection with organ transplantation. Dr. Lloyd E. Ratner performs the first laparoscopic removal of a kidney for live kidney donation.
1996
The Columbia team performs its 1,000th kidney transplant, at which time it is able to offer all donors minimally invasive kidney removal.
1997-98
The Kidney Transplant Program is a key participant in a multicenter trial to establish safety of discontinuing steroid therapy after transplantation, leading to Columbia's steroid-free surgery program for patients with compatible donors.
2004
Dr. Ratner, who performed the world's first kidney swap at Johns Hopkins in 2001, brings this technique to Columbia, which becomes the first medical center in the New York region to perform a kidney exchange.
2006
Columbia becomes the second institution in the U.S.–and the first in the New York region–to successfully complete a three-way kidney swap.