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Children's Health Channel
Reported December 19, 2012

Saving Evan: The New Transplant Procedure--Research Summary

BACKGROUND:   A kidney transplant is surgery to replace your own diseased kidneys with a healthy donor kidney.  Conditions that run in the family will affect the kidneys; for instance, polycystic kidney disease is a disease where normal kidney tissue is replaced with fluid filled sacs.  Glomerular disease is another condition that damages the tiny filtering units in the kidneys called glomeruli.  High blood pressure and diabetes are the top two reasons why adults need kidney transplants.  A person can survive on one healthy kidney; however, if something happens to that kidney, then a kidney transplant is a recommended option. (Source:  kidshealth.org)

There are two types:  living donors and cadaver donors.  A living donor could be a family member, friend, or any person willing to give a kidney to someone who needs it.  A Cadaver donor is someone who recently died.  Typically the key to a successful kidney transplant is having the closest possible blood and tissue matches.  Tests must be performed before hand to determine if two people are a match in order to reduce the chances of the body rejecting the kidney.  Surgery normally takes about three hours where the donor kidney will be placed in the lower abdomen.  Blood vessels from the donor kidney will connect to veins in the blood, and the ureter from the donor will be connected to the bladder.  Blood will flow through the kidney, allowing the kidney to work properly. (Source: webmd.com)

AFTER SURGERY:  Usually the patient will have to stay in the hospital for 7 to 10 days after surgery.  Sometimes it takes longer than expected for the kidney to produce urine.  Some may have to receive dialysis and take medicines, like diuretics, to help the kidney get rid of unwanted salt and water from the body.  All patients after surgery will have to take medicines to suppress the immune system for the rest of their lives.  They are supposed to help the body accept the kidney.  Twenty-five to fifty-five percent of the time, the body will try and reject the new kidney for the first month. (Source: webmd.com)

NEW TECHNOLOGY:  Kidney transplantation has improved survival rates and the quality of life for children and adults with life threatening kidney disease, but transplantation rates are low because of organ availability.  Patients with high levels of antibodies, transplant rates are extremely low.  If the patient does even receive an organ, the rejection rate is still increased.  A recent approach is bringing hope to these types of patients.  The revolutionary process is called hemomodulation desensitization.  It is a two-step process.  The first step is to undergo IVIG, Intravenous immune globulin, which are known to have powerful effects on inflammatory and autoimmune disorders.  IVIG allows antibodies to become isolated from the donated blood and high doses are then infused in the patient, reducing rejection episodes. The next step is for the patient to undergo plasmapheresis (similar to dialysis), a process that filters antibodies from patients’ blood and “desensitizes” them to foreign human tissue.  This whole process is meant to condition the body so they can accept the new kidney.  The process must be performed every day for several weeks before the surgery and several days after the surgery. (Source: hopkinsmedicine.org)

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