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Kidney and Pancreas Transplantation

Clinical Expertise

Kidney Transplantation

Patients with end-stage renal disease on dialysis or with advanced chronic renal failure that is progressing to a point where dialysis is imminent may be candidates for kidney transplantation. Our acute rejection rates are 10 to 15 percent below the national average and our long-term three year graft survival rates exceed the national average-84.5 percent versus the national average of 74 percent. Many factors are responsible for the great success in kidney transplantation that has been achieved by the Cornell-Rogosin multidisciplinary transplant program. These include:

  • Affiliation with the Rogosin Institute and a team of health professionals representing key disciplines that allow patients to receive coordinated care and maximum support before, during and following transplantation
  • Skilled transplant surgeons with years of experience and a high volume of cases
  • A decade of experience with the use of minimally invasive laparoscopic procedures for kidney transplant, which minimizes complications, results in less scarring, decreases length of stay, and allows people return to their normal activities much more quickly
  • Association with the Cornell Immunobiology Core Laboratory enabling us to take advantage of state-of-the-art molecular therapies for transplantation
  • Ability to detect transplant rejection non-invasively using a novel molecular assay
  • Availability of novel immunosuppressant strategies-including steroid avoidance, an immunosuppression withdrawal program, and individualized immune therapy protocols-that minimize a patient's exposure to long term drug therapy and allow patients to achieve the best protection of their organ with the most minimal amount of side affects
  • Access to the newest immune medications allows us to provide state-of-the-art immunotherapy

In addition, we are able to offer patients several options that can allow transplants to go forward. These opportunities represent a unique aspect of our program provides maximum transplant opportunities for our patients. Specific programs include those below.

Laparoscopic donor nephrectomy. To minimize side effects of major surgery and large incisions, we perform kidney removal using minimally invasive techniques. We are one of the nation's leaders and have the longest experience with this special technique.

ABO incompatible transplants. We have the ability to perform transplants between people who do not have the same blood type by using the technology of plasmaphoresis and infusion of an IVIG antibody to pre-treat recipients thereby allowing them to receive a kidney from an incompatible blood type donor.

Desensitization program for cross-match positive patients. Patients who are blood compatible may have cells that are not compatible, which means the recipient will react harshly to the donor cells. While this would have been a contra-indication to proceeding with transplant, we offer a unique program using the technology of plasmaphoresis and infusion of an IVIG antibody that desensitizes the recipients to allow them to receive an organ and proceed with transplant.

Living donor exchange program. This program is designed to increase living donation by pairing ABO blood type incompatible living donor/recipient pairs. All incompatible pairs are stored in a database so that if two suitable pairs come up, we are able to match them and perform two transplants. To further expand living donation opportunities, the Rogosin Institute is enrolled in a similar program offered by the local Organ Donor Network. If no suitable "pair" can be identified within our own institution, patients have the option of also enrolling in a much larger pool from within the region.

Pancreas Transplantation

Our comprehensive diabetes center offers all therapeutic options for treatment of Type 1 diabetes, including whole-organ transplant and islet cell transplant. Whole-organ transplant is performed with open surgery; an islet cell transplant is a minimally invasive procedure that can be performed in a radiology suite. With an islet cell transplant, cells are first isolated in a test tube then injected via a small catheter into the patient. Patients are able to go home the next day or the day after.

The ability to offer both whole-organ transplant and islet cell transplant therapies combined, enables us to function on a comprehensive beta cell replacement program. (The beta cell is the cell in the pancreas that makes insulin.) While transplant cannot reverse all of the damage of diabetes that a patient has endured over his or her lifetime, it will halt the progression of any new secondary destruction from the diabetes. And, most importantly, in patients with Type I diabetes who also have renal failure and need a kidney transplant, obtaining a whole-organ pancreas or an islet cell graft will also protect the newly-transplanted kidney from being destroyed by the diabetes.

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