UPMC Video Rounds - Kidney Transplantation

December 10, 2019

 

Sundaram Hariharan, MD, medical director, Transplant Nephrology:

Living donor transplantation is far superior in terms of outcome as opposed to deceased donor or cadaver donor transplantation. There are variety of reasons for that. Living donor transplant organ quality is far superior. It is done in a timely fashion, and the wait time for transplantation is much, much shorter than deceased donor transplantation. Our entire kidney transplant team, they focus on the quality of care than just the quantity of transplants we do.

Our quality of care is done through a strict surveillance protocol which we follow. And the surveillance protocol includes blood chemistry, various viral surveillance, antibody testing and it also includes two surveillance biopsy within the first year after transplant. So, the information derived from all the surveillance, they are very useful for each and every patient so that we can help this patient by identifying problems early after transplant rather than waiting for symptomatic disease to occur. 

Through surveillance biopsy, we are able to identify kidney inflammation and even subclinical rejection early after transplantation. We are able to identify, we are able to quantify and we are in the process of intervention to treatment, which will modify the course and improve the kidney transplant outcome at UPMC. We are embarking on a small study, but it's a very pivotal study cell therapy in kidney transplantation. The goal of the study is to take donor dendritic cell and infuse it to the recipients before transplantation, and we are hoping such an approach will optimize the kidney transplant outcome.

A group of, certain group of patients they don't do well after transplantation. These high risk individuals may benefit by some additional adjuvant therapy at the management, which can improve the outcome. We want to eliminate biopsy and solidify the importance of biomarkers in the, as an ability to identify rejection in kidney transplant recipients. Our eventual goal in organ transplantation is to achieve tolerance. We are hoping through cell therapy, we will be able to reduce immunosuppression and achieve tolerance eventually for all our recipients.

 

Learn more about transplant at UPMC.