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Basics of Organ Transplantation

Learn about the history, stages, and benefits of liver and kidney transplants. Explore donor operations, kidney transplant outcomes, and facts about pancreas transplants. Understand the impact on donors and recipients.

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Basics of Organ Transplantation

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  1. Basics of Organ Transplantation Lon Eskind, MD Director Liver Transplant, CMC Assoc. Medical Director of LifeShare

  2. CMC Transplant Program History • 1980 Kidney Transplants • 1993 Multi-Organ Program Est. • 1994 1st Liver Transplant • 1995 1st Pancreas & Islet Cell Tx • 2000 1st Pediatric Liver Transplant • 2006Mark Russo, MD • 2010 71 Liver Tx & 141 Kidney Tx (record)

  3. Largest Abdominal Transplant Center in North Carolina 200 Solid Organ Transplants/Year 125 Kidney 70 Liver (4 Pediatric) 5 Kidney / Pancreas CMC’s Transplant Program

  4. Liver Transplantation

  5. The Donor Operation

  6. Stages of a Liver Transplant • GETA • Invasive Monitoring • Back Table Clean Up • Laparotomy • Exploration • Hepatectomy • Veno-Venous Bypass (not in small children)

  7. Stages of a Liver Transplant • Anastomosis • Hepatic Veins • Hepatic Artery • Portal Vein • Recirculation • Hemostasis • Bile Ducts • Drains & Close

  8. Veno-Venous Bypass

  9. Hepatic Vascular Anatomy

  10. Right Lobe Liver Transplant

  11. Kidney Transplant

  12. Benefits of Kidney Transplant • Increased energy, improved appetite • Decreased nausea and itching • No more dialysis and the risks associated with it • Improved survival

  13. USA Kidney Waiting List2013* NationalN. C. Kidney 98,702 1,965 K/P 968 12 *Based on UNOS Data Nov 4, 2013

  14. Kidney Transplants Performed 2012 Deceased Donor 10,868 Living Donor 5,618 Total 16,486

  15. Deceased and Living Donors1996 - 2005 7593 6892

  16. Projected years of life from WL byage group 40 20 0 WL dialysis Transplant Projected years of life 20–39 40–59 60–74 Age group Wolfe RA, et al. N Engl J Med 1999;341:1725–30

  17. KIDNEY TRANSPLANT OUTCOMES 2013 • Live donor • 95% (1yr) • 15 yr median survival • Deceased Donor • 88% (1yr) • 12 yr median survival

  18. Deceased DonorKidney Procurement

  19. Laparoscopic LiveDonor Nephrectomy

  20. Advantages to the donor • Less pain • Smaller incision • Shorter recovery time • Shorter hospital stay

  21. Kidney Transplant vs. Dialysis 5 year mortality: 1995-1999

  22. Pancreas Transplant

  23. Diabetes Facts • Mortality 5-7 times that of general population. • 1 of 6 IDDM patients will die before age 40 • Diabetes is the leading cause of blindness, kidney failure, and non-traumatic amputations. • Even with insulin therapy, there is no guarantee of protection from disabling complications. Diabetic retina Renal failure Diabetic foot

  24. Pancreas

  25. Questions?

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