Kidney Transplant: Life-Changing Care for Chronic Disease

Innovations, expanding program benefit patients
first kidney transplant paperwork

By: Eric Klein, MD

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Your kidneys are extraordinary organs. Each is no bigger than a clenched fist, but they purify your body’s entire 1.5-gallon blood supply multiple times a day, straining it through hundreds of thousands of tiny natural filters to extract waste via the urine they manufacture. Your kidneys also regulate your blood pressure, make hormones, and keep your body working properly by controlling its balance of fluids, salts, acids and bases. In short, those two small organs do a big job. They’re like a miniature waterworks and chemical factory in one.

With all those vital roles, it’s easy to see that a malfunctioning kidney can be a life-threatening issue. Chronic kidney disease is a major health problem affecting 26 million American adults. Although inherited conditions are often to blame, the majority of chronic kidney disease cases result from diabetes or damage due to high blood pressure. Because blacks have high rates of both conditions, they’re three times more likely than whites to suffer chronic kidney disease.

Fortunately, for patients whose kidneys fail, dialysis can perform some of the organ’s important functions, including removing harmful waste and excess fluids and helping to control blood pressure. We’re proud at Cleveland Clinic to have played a pioneering role in dialysis development.

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A history of kidney transplant innovations

We’ve also made landmark achievements in the other treatment for end-stage kidney disease – kidney transplants. Cleveland Clinic is home to one of the country’s best and longest-running transplant programs. Our surgeons performed their first kidney transplant from a deceased donor on January 9, 1963, back when gas was 30 cents a gallon and before the Beatles had made their first album. We’ve done more than 4,300 kidney transplants since then, enabling patients to live better, longer lives, free from disease and the burden of dialysis. We’ve helped develop innovative, minimally invasive kidney transplant surgical techniques, and new medications that suppress rejection and keep donor kidneys working.

We’ve worked hard to shorten the amount of time that patients must wait for a kidney transplant. The availability of a matching kidney from a living or deceased donor ultimately determines when the surgery can happen. But we’ve refined and streamlined the evaluation, monitoring and preparation processes for kidney transplant candidates, and our efforts are paying off. Our patients wait an average of 36 months – four months less than the average for Midwest transplant centers, and a year and a half less than the national average.

Our kidney transplant services have expanded well beyond Cleveland, to Cleveland Clinic Florida, and affiliate programs in Charleston, W. Va., Indianapolis, and at Cleveland Clinic-managed Sheikh Khalifa Medical City in Abu Dhabi. Having multiple sites helps patients get the care they need closer to home. Collectively, those programs performed nearly 300 kidney transplants in 2013. The 184 done at our Cleveland main campus made us the busiest program in Ohio for the calendar year.

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Paired donors help expand available organs

We’d like to be even busier, but donor kidneys are in very short supply. Nationally, nearly 100,000 people need a kidney, but less than 17,000 receive transplants each year, and more than 4.500 die while waiting. To help expand the number of available organs, in 2011 Cleveland Clinic began participating in the National Kidney Registry’s paired donor program. Kidney transplant candidates who have a relative or friend willing to donate a kidney but who aren’t a compatible tissue match are pooled with other donor/recipient pairs. The pooling enables matchups – sometimes multiple ones – between compatible donor and recipient pairs, resulting in domino chains of transplants. In 2013, our transplant surgeons took part in the second-largest paired kidney exchange to date, involving 56 donors and recipients and 19 medical centers. We’ve swapped kidneys with institutions as far away as Los Angeles.

The importance of organ donation

Kidney donors, whether living or deceased, are giving an incredible gift. I hope you’ll consider this extraordinarily generous act to help a loved one or a stranger. I promise, it will change someone’s life.

If you’re not convinced, think of Patricia Kunkle, Cleveland Clinic’s longest-surviving kidney transplant recipient. Patricia, who suffered from lupus, received a kidney from her mother in 1968 as a teenager. Patricia’s mother passed away recently, but the kidney she gave her daughter is still going strong at the remarkable age of 92, allowing Patricia to enjoy life with her own children and grandchildren.

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