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Living donation
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The dramatic shortage of organs from brain-dead donors in Switzerland, forces surgeons to look for alternative ways to help seriously ill patients.
Donation of organs (or partial organs) from a living donor has become increasingly important during the last ten years. A stable, emotional relationship or a relation by blood is required between the donor and
recipient. Research projects (e.g. regeneration of the liver) and the introduction of new, innovative techniques are the basis for the clinical application of transplantations of organs from living donors.
Living donation of liver
The first liver transplantation from a living donor in Zurich took place in December 2000. Using this new technique, the right half of the liver of a living donor is removed (Fig. 1) and transplanted into the patient (Fig. 2). Due to the good regeneration ability of the liver, the two halves of the liver in the donor and in the patient receiving the liver reach their original size within two months.
To date, 7 livers from living donors have been transplanted in Zurich. As living donation is carried out only after s strict selection process, a total of 11 patients had to be evaluated before 7 suitable donors could be found. All donors recovered without complications and on average left the hospital 12 days after the operation. No donor required blood transfusions and all went back to their normal routine.
Thanks to living donations, patients were able to receive a liver after minimal waiting time. This is especially important for patients, who cannot wait for the organ of a dead donor because of their critical condition. Additionally, the liver transplantation from a living donor can be carried out at the optimal time point and under planned conditions. Living donation of liver is applied world wide and offers a true chance of recovering for patients, who might otherwise wait for a donor organ in vain.
Due to the shortage of donor organs, the importance of living persons donation of kidney increases: roughly one third of the transplanted kidneys at the USZ today come from living donors. For a patient, this is often the only possibility to avoid years of waiting for a suitable organ. The results of living donations in terms of patient survival worldwide is noticeable better than the results of cadaveric transplantation, which is due to the good health of the donor and the optimal conditions during transplantation. The safety and the well-being of the donor is considered absolute priority. Removal of the kidney with a new technique, the minimal invasion kidney removal, has introduced a new era of living donation and offers clear benefits for the donor (Fig. 1 –7 and Video-Clip). Using a camera, the designated kidney can be prepared in the CO2-filled stomach of the patient and is finally removed through an 8 cm-long cut. An increasing number of scientific publications shows the great interest in this new, attractive method (Fig. Z).
Since May 2000, minimal invasive kidney removal from living donors has been the technique of choice at the USZ. The indication is identical to the previously used method of open kidney removal. Results from scientific studies and experience from the 50 performed surgeries by the author show that this technique is safe. Warm ischemia (non-cooled kidney without blood supply) during the removal of the kidney is on average 120 seconds, which is not longer than what is necessary during an open kidney removal. Postoperative function of the kidney is excellent and patients clearly suffer from less pain than after an open kidney removal. On average, the donor stays in the hospital for 5 days, retaining only three small 1 cm-long and one 8 cm-long scars. Especially the short recovery time is impressive. It could be shown that thanks to these advantages minimal invasive kidney removal leads to an increased willingness to donate. This could also be seen at the USZ, as living person donations almost trebled in the last two years.
Author: M. Weber, M. Selzner, N. Demartines und Z. Kadry
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A day in the life of |
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The account of Cornelia Seitz, who this summer, donated her left kidney to her brother.
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Clinical Research |
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A long-term study shows that the survival rate of patients receiving kidneys that were taken in circulatory arrest is almost identical to that of patients receiving kidneys from brain-dead donors who had a functioning circulation.
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History |
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When did the first organ transplantation take place? Who were the main characters contributing to the development of transplantation medicine? Learn more in this article!
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