Kidney transplantation is when a donor kidney is transplanted in a patient with end-stage renal disease, regardless of the cause of the disorder. Conditions and disorders that can cause end-stage renal disease include diabetes, malignant hypertension, infections, genetic causes such as polycystic kidney disease and autoimmune conditions such as systemic lupus erythematosus.
Kidney transplantation can be classified as living-donor or deceased-donor, and this will depend on the source of the organ. Living-donor kidney transplants can then be further classified into genetically related or non-related transplants, depending on whether there’s a biological relationship between the recipient and the donor.
There are situations though which contraindicate kidney transplantation and these include pulmonary and cardiac insufficiency, liver disease, incurable terminal infections and some types of cancer. Patients diagnosed with mental health disorders or who struggle with substance abuse may also be excluded from receiving donor kidneys. Factors which can increase the risk of post-surgical complications include severe obesity and the use of tobacco products.
Xpertdox: Top 5 list
The top hospital centers that perform kidney transplants are located in the Northeastern and Southeastern parts of the United States, with one being located on the West coast. These are world-class hospitals that offer comprehensive services and may be known to many patients already. We shall mention these centers as well as some of the best doctors who specialize in kidney transplantations.
New York-Presbyterian Hospital, New York, NY: New York-Presbyterian/Columbia University Medical Center and New York-Presbyterian/Weill Cornell Medical Center have kidney transplant programs that are the oldest in the area and the biggest in the United States. Specialists at both these centers perform more than 450 kidney transplantations annually. The transplant specialists at the Weill Cornell center collaborate with physicians at the Rogosin Institute, an independent non-profit research and management center in New York City, which is one of the best rated comprehensive kidney centers in the United States. A multidisciplinary team approach is incorporated at both of the kidney transplant programs, and they include specialists such as urologists, nephrologists, pathologists, social workers, financial coordinators, and apheresis unit and blood bank specialists. The renal surgeons at these two centers perform living-donor transplantations whenever possible so that patients receive their new kidney before their heath worsens and they need to start on dialysis. Patients who have other complex medical conditions receive coordinated and comprehensive medical and surgical care such as those with; diabetes and end-stage renal disease (they may receive pancreatic transplantation in a separate procedure or together with a kidney transplant), advanced hepatic or heart disease (who may receive combined liver-kidney or heart kidney transplantation), skin cancer and other skin diseases (where these patients are managed by dermatologists who specialize in managing transplant patients with diseases). New York-Presbyterian Hospital's two transplant programs are among the few facilities in the world where incompatible kidney transplantation is performed, which is done when a compatible live donor is not available. This requires the latest immunologic management protocols to prevent organ rejection from occurring, and the long-term survival among these incompatible recipients is similar to that for compatible transplants recipients. Some of the top rates specialists at these centers include Dr Lloyd E Ratner, Dr Sandip Kapur, Dr Jim Kim, Dr Pedro R Sandoval and Dr Anthony C Watkins.
Jackson Memorial Hospital, Miami, FL: The Miami Transplant Institute is situated at Jackson Memorial Hospital and has existed for the last 45 years, making it one of the biggest and most comprehensive transplant programs in the United States. This center is the only one in Southern Florida where every type of organ transplant can be performed, making it a very popular choice for patients locally, nationally and worldwide. Together with the resources available and the clinical researches performed at the University of Miami Health System, and the care offered by Jackson Memorial Hospital (which happens to be the biggest teaching hospital in the United States), makes the Miami Transplant Institute one of the most impressive medical facilities in the world. This institute performs up to 300 kidney transplants annually, which is more than any other facility in Florida, and it persistently ranks as one of the top three transplant center nationally. The center provides more than a third of renal transplants from living-donors, and this includes individuals who are part of the Paired Kidney Exchange Program, which in a one-of-a-kind initiative in the region which pairs listed living-donors with recipients when family members don’t match. Some of the top rated specialists at the Miami Transplant Institute include Dr Gaetano Ciancio, Dr George W Burke, Dr Linda J Chen, Dr Michael J Goldstein and Dr Rodrigo M Vianna.
University of Maryland Medical Center, Baltimore, MD: The University of Maryland Medical Center has the biggest renal transplant program in Maryland. The center manages a large number of kidney transplants for many patients, and they therefore have an extensive living kidney donation program which includes a kidney exchange scenario where individuals offer a kidney even if they are not compatible with their chosen recipient. Patients are assessed individually to determine whether a kidney transplant is the correct course of treatment. The evaluation process at the University of Maryland Medical Center includes offering a flexible schedule for the patient to accommodate their dialysis schedule, if on dialysis, completing laboratory investigations and consulting with the multidisciplinary care team in a single day (the aim is to complete the evaluation within 4 hours as compared to 12 hours at other centers), meeting with the surgical team who will perform the transplant, and meeting up with the social worker who will assist the patient and their family members address any complex personal, financial and social issues that may arise. If the patient is approved for the kidney transplant, then they will be ready to receive organ offers around 30 days after the initial evaluation. In some cases, donor/recipient pairs from evaluation to transplant may occur within 14 days. Some of the top rated specialists at the center include Dr Jonathan S Bromberg Dr jonathan s bromberg Dr jonathan s bromberg, Dr Eugene J Schweitzer, Dr Rolf N Barth, Dr Stephen T Bartlett and Dr David B Leeser..
The Johns Hopkins Hospital, Baltimore, MD: The Johns Hopkins Comprehensive Transplant Center offers complete and collaborative patient care to make sure that the best possible outcomes are achieved for the patient. Patients will initial meet several members of the multidisciplinary team when being assessed to determine whether they will be eligible for kidney transplantation. The kidney transplant program at Johns Hopkins specializes in living-donor organ donation, but they do cater for deceased organ donors. Kidney transplants can last for around 4 hours and the patients tend to stay in hospital for around seven days if the procedure is uneventful. Kidney transplant patients are then followed up on an outpatient basis to monitor their health. Some of the top rated specialists at the Johns Hopkins Transplant Centre include Dr Robert A Montgomery, Dr Niraj M Desai, Dr Bonnie E Lonze, Dr Dorry Segev and Dr Benjamin Philosophe.
UCSF Medical Center, San Francisco, CA: The UCSF Connie Frank Transplant Center provides medical services for patients before and after kidney transplantation. The kidney transplant program was established in 1964 and is considered as a major transplant center for the American West coast. Specialists at the transplant center assess more than 1,000 patients annually as potential transplant recipients, and they perform more than 300 transplants a year. In 2015, the surgeons at the Connie Frank Transplant Center performed more kidney and kidney/pancreas transplants than any other facility in the United States. Some of the top rated specialists at this center include Dr Chris E Freise, Dr Peter G Stock, Dr Sang M Kang, Dr Ryutaro Hirose and Dr Andrew M Posselt.