Pioneering Kidney Transplants

In 1963, Hahnemann University Hospital became one of the first hospitals in the Delaware Valley to perform kidney transplants, and it has remained a leading institution in the region for kidney transplantation for over 40 years.  

Today, the Hahnemann Kidney Transplant Team continues the hospital’s time-honored tradition of providing excellent patient care in this highly specialized and life-giving field.

State-of-the-Art Care

Patients in the Hahnemann University Hospital Kidney Transplant Program receive advanced care from a highly-respected team of specialists offering these advantages:

• An experienced team devoted solely to the care of the transplant patient.
• Extensive experience with high-risk transplant recipients, including patients age 65 and over, highly-sensitized patients, HIV  infected patients, patients with past histories of cancer and patients with Type 1 or Juvenile Type diabetes (these patients may also be recommended for a pancreas transplant).
• Steroid-free transplantation.
• Routine use of modern therapies for preventing rejection. Immunosuppressive drugs  tailored to the individual recipient to help avoid adverse effects.
• Appointments are usually arranged within three weeks of patient’s initial contact with the transplant program.  

Improving the Quality of Life

A successful kidney transplant is designed to offer patients with kidney disease a return to a normal lifestyle. Transplant patients can lead a full life with freedom from dialysis treatment, diet and fluid restrictions, travel limitations and frequent medical care.

The transplant team at Hahnemann University Hospital is committed to providing the benefits of kidney transplantation to all patients interested in exploring this option. Our goal is to assist patients through the evaluation process, get them placed on the national waitlist and then complete transplantation in the shortest possible time.

We take pride in the excellent service we provide.  We will communicate directly with you and you will be able to get a human voice when calling our center.  There is always a member of the transplant team on-call for after hour concerns.

Who is a candidate for a kidney transplant?

Candidates for kidney transplantation are individuals with severe kidney failure related to a number of diseases, including diabetes, hypertension, chronic kidney inflammation, HIV, previous history of cancer, polycystic kidneys and other conditions. A patient’s age and weight are not necessarily deterrents to a successful transplant.  Patients may be considered transplant candidates well before they need dialysis, when they are about to begin dialysis, and after they have started dialysis treatment.

High-Risk Patients

Hahnemann is one of few hospitals in the region with the expertise to handle kidney transplants for high risk patients.  Patients in this category include:

• Highly-Sensitized Patients have a lot of antibodies, which makes it challenging to find a compatible donor.  However, advances in medications that lower antibody levels can make transplantation an option for these patients.
• Patients with Type 1 or Juvenile Type Diabetes who have kidney disease may find that a combined kidney and pancreas transplant is the best alternative to dialysis and insulin therapy. A combined organ transplant, also performed at Hahnemann, provides for independence from daily insulin injections and may prevent further complications due to diabetes.
• Patients Age 65 and Over. Patients age 65 and over are considered to be good candidates and our results confirm positive outcomes for these individuals. Studies have shown that transplantation can lead to a good quality of life and increase in the estimated life expectancy of older patients.
• HIV Patients.  Patients with HIV who are infection-free may be candidates for a transplant.  Some people with HIV develop a disease called IgA nephropathy (Berger’s disease) which causes inflammation and damage to the filtering units of the kidney called glomeruli.  In some cases, the disease progresses to chronic kidney failure.  The prognosis for HIV patients who receive a kidney transplant is very good.

Types of Kidney Transplants

Non-Living (deceased donor) Donation      
This is the most common type of transplant that is performed using organs from individuals who donate at the time of their death.  Technical advances have resulted in very good success rates for transplants from non-living donors.  Kidneys are obtained by the “Gift of Life” Organ Procurement Organization Program that serves Hahnemann University Hospital. Kidneys are allocated according to the amount of time the patient has been waiting for transplant and blood type. The distribution of donor kidneys is very equitable and is guided by Federal policy standards that ensure equal access to needed organs for all patients. The “Gift of Life Program” is very active, allowing for transplantation in the shortest possible time. Because of the increased number of patients with kidney disease who need donor kidneys, the average time to receive a transplant is now approximately three years. At Hahnemann University Hospital, approximately 30 percent of our patients are transplanted within two years.

Living Related Donors (LRD)
Any family member, no matter how distant the genetic relationship, can donate a kidney. There are many advantages to a living familial donor kidney. First, the patient does not have to wait for a kidney. Secondly, living donor kidneys function immediately, allowing for early discharge from the hospital. Third, living donor transplants done between family members are likely to be a better genetic match which lessens the risk of rejection.  As a result, the recipient may need less immunosuppressive therapy. 

Living Unrelated Donors (LUD)
An individual such as a spouse or friend can donate a kidney as an unrelated donor. These kidneys also are very successful and can function almost as well as a kidney from a blood relative.

Altruistic (non-directed) Donors 
In some cases, an individual may donate a kidney to a stranger in need of a transplant.  These donors are known as altruistic or “Good Samaritan” donors.   They donate through a local transplant center or organ procurement organization within a specific region.

All potential living donors first undergo an extensive medical evaluation to ensure that they are in good health and suitable donors. Healthy individuals who donate a kidney appear to have no detrimental effects on their long-term health. Moreover, laparoscopic surgery has made donation less invasive allowing for quicker recovery and return to normal activities.      

Scheduling an Appointment  

To start the process for getting a kidney transplant, you will need to schedule an appointment for evaluation by the Hahnemann Kidney Transplant Team.   

Call the Division of Transplantation at Hahnemann University Hospital.
Phone:   215-762-1147  

Appointments are usually arranged WITHIN THREE WEEKS of your initial phone call or contact with the Hahnemann Kidney Transplant Program.        

The Evaluation Process  

The initial visit to the transplant center consists of meeting with the transplant surgeon, nephrologist, nurse coordinators, social workers and financial consultants. Patients undergo an extensive medical evaluation which involves the following exams and tests:  

• Physical exam
• Chest x-ray
• Complete medical and surgical history
• Electrocardiogram (EKG or ECG). Shows how well the heart is functioning as well as any heart damage.
• Echocardiogram.  Shows any abnormalities in the heart.
• Ultrasound with Doppler examination.  Tests the quality of the iliac vessels which is essential to the success of kidney transplants.
• Blood tests.  Includes testing for blood count, blood and tissue type, blood chemistries, immune system function and certain infectious diseases.
• Blood typing.  Every person is a blood type A, B, AB or O.  The donor’s blood type does not have to be identical to the recipient’s, but it must be compatible.  Compatibility is determined by cross-match testing.
• Pulmonary (lung) function test 
• Renal (kidney) function studies
• Tissue typing.  Performed on white blood cells and used to find a matching kidney.
• Panel Reactive Antibody (PRA).  Measures immune system activity within the body.  PRA is higher when more antibodies are being made.  When a recipient’s immune system measures 0%, a kidney can be acquired more easily.
• Viral testing.  Determines if the patient has been exposed to hepatitis, cytomegalovirus, Epstein-Barr or acquired immune deficiency syndrome (AIDS).
• Mammogram Pap smear.  Cells collected from a woman’s cervix are analyzed for any signs of cancer.
• Dental evaluation.  Patients must have a dental exam before they are listed for transplant.  The dentist must confirm that the patient’s teeth and gums are healthy.  Follow up dental exams must be performed every year until the transplant takes place.
• Other tests.  The Transplant Team may determine that additional tests are needed, depending on your medical condition.  

Many of the required medical tests may be performed locally, if desired, in collaboration with the patient’s primary care physician. Overall medical condition rather than age is the key factor in determining a patient’s suitability for transplantation.        

When a Kidney Becomes Available

When a donor kidney becomes available, the donor must be tested for compatibility with the recipient. Blood type determines the compatibility for kidney transplants. Kidney donors and recipients with compatible blood types are further tested for “tissue-type” compatibility with a test known as CROSS-MATCH.

Cross-Match Testing.  The recipient’s blood serum is mixed with the donor’s blood cells. If the recipient serum does not kill the donor cells, the test indicates that the donor and recipient are “compatible” and the transplant can be performed. A recipient may have to be tested with many potential donors before a match is found and some “tissue-type matches” may be better than others. Age, sex, or race of the donor and recipient are not determining factors in successful cross matching. Once the kidneys are removed from the donor, they are preserved until transplanted.

When a recipient is selected, the organ is sent to the recipient’s transplant center.      

 Preparing for Surgery  

Before surgery, the patient may receive an enema or a laxative to clean out the intestines and prevent constipation after surgery.  An intravenous line will be inserted in the arm or just under the collarbone to give medication and prevent dehydration.  The patient will also receive a sedative to help him or her relax before going to the operating room.

To learn more about Kidney Transplant Surgery, click here.