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Renal transplantation at the Johns Hopkins Comprehensive Transplant Center.
- Source :
-
Clinical transplants [Clin Transpl] 2003, pp. 199-213. - Publication Year :
- 2003
-
Abstract
- A stagnant supply of transplantable organs in the face of a relentless burgeoning of transplant waiting lists has created a crisis. Necessity continues to be the mother of invention and as the crisis has deepened it has served as a crucible for the development of new ways to think about perennial problems. Our program has taken a 2-pronged approach to increasing the organ supply for our patients. First, through innovations like the laparoscopic donor nephrectomy, ABO-incompatible and positive-crossmatch transplantation protocols, unconventional paired kidney exchanges, and the use of altruistic donors we have more than doubled our utilization of live donor organs. At the same time, we have developed algorithms and interrogative techniques to enhance the intelligent use of kidneys from expanded criteria donors for patients who do not have an available live donor. The laparoscopic nephrectomy has proven to be a safe and effective way of removing a significant barrier to live donation. Our results from 100 ABOi, (+)XM, and PKE transplants are similar to national statistics for compatible live donor transplants, suggesting that existing paradigms of compatibility can be safely expanded. These encouraging early outcomes and the savings they transmit to the health care system have allowed us to obtain insurance coverage for the InKTP programs, setting the stage for further expansion of these opportunities to broaden the options for patients with end-stage renal disease.
- Subjects :
- ABO Blood-Group System
Altruism
Antibodies immunology
Antibodies, Monoclonal therapeutic use
Antigens, CD20 immunology
Blood Group Incompatibility
Cytomegalovirus immunology
Desensitization, Immunologic
Graft Rejection drug therapy
Graft Rejection immunology
Histocompatibility Testing
Humans
Immunization
Immunoglobulins therapeutic use
Laparoscopy
Living Donors
Maryland
Nephrectomy methods
Organ Preservation methods
Perfusion
Plasmapheresis
Tissue and Organ Procurement methods
Academic Medical Centers
Kidney Transplantation immunology
Subjects
Details
- Language :
- English
- ISSN :
- 0890-9016
- Database :
- MEDLINE
- Journal :
- Clinical transplants
- Publication Type :
- Academic Journal
- Accession number :
- 15387112