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Less invasive kidney transplant technique spurring donations


In keeping with a national trend, surgeons at Robert Wood Johnson University Hospital say a new, less invasive approach to removing a kidney from a living donor is prompting more people to give one of their kidneys to someone in need of a transplant.

Over the past four years, the number of people donating a kidney at the hospital has doubled, from 14 in 1999 to 28 in 2002.

This is consistent with increases seen at other kidney transplant centers since the introduction several years ago of a surgical procedure called laparoscopic kidney removal, which makes the process much easier on the donor.

"The laparoscopic procedure has many advantages for the person donating a kidney – a smaller incision, a faster recovery time and less blood loss, to name a few. It is clearly responsible for the increase we have seen in the number of donors," said Dr. David A. Laskow, Chief of Kidney Transplantation at Robert Wood Johnson University Hospital and the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School.

(Robert Wood Johnson University Hospital has made arrangements for Dr. Laskow, a living kidney donation recipient and her donor to be available for interviews August 26. Please contact Kristen Walsh John Patella at (732) 937-8521 to arrange.)

Donating a kidney through the traditional "open" method typically required a 10-inch incision, a five-day hospital stay and six to seven weeks of lost work time for recovery.

By contrast, the laparoscopic technique allows the kidney to be removed through a small incision in the abdomen. Two incisions, each less than one inch, are made in the upper abdomen to insert a camera as well as other viewing instruments, followed by a 4-inch incision in the lower abdomen through which the kidney is removed.

This procedure allows donors to return to their normal activities in one-third the time of the traditional approach. There is also less pain, a shorter hospital stay – usually three days – and a faster return to regular food than with the open procedure.

The result is a greater number of people coming forward to donate a kidney.

Statistics from the hospital confirm this. In 1999, the year before introduction of the laparoscopic technique at Robert Wood Johnson University Hospital, the hospital performed 14 living-donor kidney transplants. In 2002, the hospital performed 28 living-donor transplants.

The number of living donors also increased in each of the intervening years at the hospital, rising from 14 in 1999, to 20 in 2000, to 26 in 2001 to 28 in 2002.

Statewide, the number of living donor kidney transplants increased from 123 to 171 from 1999 to 2002. Nationally, the number of living donor kidney transplants increased from 4,884 to 6,611.

Despite the increased numbers of living donors, the majority of kidneys used in transplants come from previously healthy individuals who have died and donated their organs. Such kidneys can perform extremely well, but Dr. Laskow noted that kidneys from living donors are preferable. They tend to last longer – up to six years longer – and function with fewer complications. Many years of medical research also show that donors can function normally with only one kidney and are not at greater risk of developing future health problems, he added.

However, even with the greater number of people coming forward to donate thanks to the laparoscopic technique, the demand for kidneys still far outstrips supply. More than 55,000 people are currently on a waiting list for a kidney nationwide, with approximately 2,300 in New Jersey, according to The United Network for Organ Sharing.

A person waiting for a kidney to become available from someone who has died can remain on the waiting list for three years. By contrast, a person who receives one from a living donor can have a kidney in a matter of weeks.

"When we consider the thousands of people on waiting lists for kidneys around the country, a technique that encourages more people to donate is not just welcome, it’s critical," Dr. Laskow said.

While many kidneys are donated by relatives, a donor does not need to be related; the only requirement for donation is a compatible blood type.

(About Robert Wood Johnson University Hospital: Robert Wood Johnson University Hospital, located in New Brunswick, is a leading academic health center and the principal teaching hospital of the Robert Wood Johnson Medical School within the University of Medicine and Dentistry of New Jersey.)

Kristen Walsh | EurekAlert!
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