Kidney Transplantation Deceased Donor
Patients with advanced kidney failure who do not have the option of a living donor transplant join the waiting list for a deceased donor. The majority of kidneys transplanted in the United States are from deceased donors. Unfortunately, over 60,000 Americans are currently on the waiting list for a deceased donor kidney, with many waiting up to seven years to receive an organ.
Kidneys from deceased donors have a 50/50 chance of maintaining their function for 10-20 years post-transplant. In contrast, a live donor kidney has a 50/50 chance of functioning over 20 years, while a kidney from a perfectly matched sibling donor last for 35 years on average. In addition, 50-60% of deceased donor kidneys are fully functional immediately upon transplantation, versus 97% of live donor organs.
In light of these and other health advantages associated with live donor transplants, the surgeons at NewYork-Presbyterian Hospital/Columbia University Medical Center (NewYork-Presbyterian/Columbia) try to exhaust all live donor alternatives, including paired kidney exchanges and incompatible donors, before relying upon a deceased donor. In 2003, approximately 25% of the kidneys transplanted at NewYork-Presbyterian/Columbia were from deceased donors. However, currently approximately 50% of our kidney transplants are from deceased donors.
Once a compatible organ has been identified and obtained, the surgeon places the kidney on one side of the recipient's front lower abdomen, using an 4-10 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.