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Renal and Pancreatic Transplant

Welcome Letter from the Directors

Lloyd Ratner
Lloyd E. Ratner, MD, MPH, FACS
Director, Renal and Pancreatic Transplant
David J. Cohen, MD
David J. Cohen, MD
Medical Director, Renal and Pancreatic Transplant

At the NewYork-Presbyterian Hospital/Columbia University Medical Center Renal and Pancreatic Transplant Program, we are gratified to be able to give patients with end-stage kidney failure and brittle diabetes a new lease on life through transplantation.

Transplantation is a life-altering procedure. Organ recipients require life-long immunosuppressant medications and careful monitoring. Throughout the transplant process, we partner closely with donors and recipients and their referring physicians to enable a seamless continuum of care, while helping patients and their families navigate emotional, financial, and logistical concerns.

As part of a large academic medical center, the NewYork-Presbyterian/Columbia University Renal and Pancreatic Transplant Program calls upon the expertise of a wide range healthcare providers, ensuring that our patients receive the most advanced, multidisciplinary care. Our clinicians help patients with medical issues that present barriers to transplantation, including pregnant women and women with infertility problems, obese patients, and patients at high risk due to advanced age or health conditions.

Kidney (Renal) Transplant

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.

Personal Stories

Transplant Patient Now an Active Mom
Transplant Patient Now an Active Mom. Read the story. Firefighter Is Key to Historic Three-Way Kidney Swap Firefighter Is Key to Historic Three-Way Kidney Swap. Read the story. Kidney transplant recipients Jonathan and Jason Luque with their mother, Mary Grace.
Kidney transplant recipients Jonathan and Jason Lugue with their mother, Mary Grace. Kidney transplant recipient David Garcia with his surgeon, Lloyd E. Ratner, MD
Kidney transplant recipient David Garcia with his surgeon, Lloyd E. Ratner, MD.

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.

Pancreas Transplant

A relatively uncommon procedure, pancreatic transplant is reserved primarily for type 1 diabetics who cannot effectively control their diabetes through diet or insulin injections, or who have end stage kidney failure and require a kidney transplant. Patients with kidney failure may receive pancreatic transplantation, either simultaneously with the kidney or in a separate procedure following kidney transplantation.

Additionally, pancreas transplantation is beneficial for diabetics who no longer develop symptoms when their blood sugar gets too low. Under some circumstances pancreas transplantations may be utilized for type 2 diabetics as well.

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