The procedure has evolved in ways few could have imagined at the time of the first
successful kidney transplant in 1954. At that time, immunosuppressant drugs were
not yet available, and transplants were performed only between identical twins in order to prevent organ rejection. The advent of immunosuppressant
medications in the 1960s broadened the scope of donation to include deceased donors, and increased the number of organs available for
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1969. The three thousandth was performed on April 6, 2010
To celebrate this milestone, over 600 kidney transplant patients, donors and their
families reunited with their medical teams on April 21, 2010 at NewYork-Presbyterian
Hospital/ColumbiaUniversity Medical Center (NYPH/CUMC). The occasion, the
Circle for Life: Renal 3000 event, was a huge success, a heartfelt celebration of a
second chance at life. The reunion made national news, being featured on more
than 50 CBS affiliate stations across the country.
Columbia's Kidney Transplantation Program Directors Lloyd E. Ratner, MD,
Mark A. Hardy, MD, and David J. Cohen, MD
Yet as the practice of kidney transplantation increased, so did demand for donor organs, as well as for better approaches to preventing organ rejection.
Determined to meet these challenges, the transplant team at Columbia has pioneered a continuous stream of innovations in surgical techniques, organ donation,
and medical therapies over the past four decades.
Extended criteria protocols: To meet the shortage of donor organs, the program has implemented new protocols for using extended criteria organs that may
not meet the usual criteria for transplantation, but are healthy enough for a successful transplant. Organs in this category include those from donors who are
older, have hypertension or diabetes, or who at the time of their death suffered mild kidney injury. The use of extended criteria kidneys allows more people to
receive kidney transplants than ever and is proving highly successful, especially among older recipients and those doing poorly on hemodialysis.
Donor swaps: Paired donor exchanges anonymously match up compatible donors and recipients when a suitable donor cannot be found through family and
friends. While logistically complicated (a two-way swap requires four transplant teams and four operating rooms; a three-way swap requires six teams and six
operating rooms, and so on), the procedure dramatically improves opportunities for patients to find a compatible donor. Building on the success and popularity
of the two-way swap, the program now performs swaps among up to six patients, events requiring twelve simultaneous operations.
Kidney swaps enable patients to be transplanted far earlier than if they had to wait on the organ wait list (for a deceased donor), sparing many from dialysis. In
conjunction with an aggressive approach to managing the organ waiting list, kidney swaps have reduced the waiting time for deceased donor organs by an
average of four years at NewYork-Presbyterian/Columbia — reducing the number of patient deaths while on the waiting list and significantly improving
outcomes after transplantation.
Laparoscopic donor operations: the use of laparoscopy and minimally invasive techniques rather than open surgery facilitates a more comfortable and faster
recovery for kidney donors. Many transplant recipients are also able to receive donor kidneys through a three or four inch 'mini-incision.'
Steroid avoidance protocol: In a highly successful protocol in place since 2001, molecular therapies provide highly personalized immunosuppressant therapy
that can reduce or eliminate use of steroids after transplantation in more than 90% of patients at NewYork-Presbyterian/Columbia.