Another transplant milestone at BWH- BWH Bulletin - For and about the People of Brigham and Women's Hospital
Another transplant milestone at BWH- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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April 7, 2000
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In This Issue:
Another transplant milestone at BWH
Volunteer of the Year
Pike Notes
Great starts at Baby Faire
Reward and Recognition Program
Employee Perks
Forty-six years ago, BWH’s Joseph Murray, MD, performed the first successful human transplant—a kidney transplant between identical twins. Since then, millions of people with end-stage kidney disease have received kidney transplants—either from people who died unexpectedly and donated organs; or from a living person, usually a family member, who was tissue-matched to the patient. With the advent of cyclosporine in 1976, a drug that weakens the recipient’s immune system just enough to prevent rejection, the success of transplant operations soared. New techniques, equipment, and drugs have all contributed to perfecting the procedure for the recipient. However, the fundamentals of procuring a kidney from a living donor for transplantation remain much as they were 20 years ago. In the traditional donor surgery, an incision six to ten inches long is along the patient’s flank, and a rib is removed. While the safety of this operation is well established, the donor actually experiences more pain than the kidney transplant recipient. Donors remain hospitalized for an average of five to seven days, and take two to six weeks to fully recover and return to their regular routines. Recently, new instruments and procedures have begun to change things. Using a laparoscope—a long tube, about seven millmeters wide, with a miniature video camera and flashlight at the tip—and specialized surgical tools, surgeons are now able to perform the procedure through three holes made in the donor’s abdomen. The kidney is then removed through a 2 1/2 inch incision in the lower abdomen. This procedure is often known as “band-aid surgery.” In February, a BWH transplant team lead by transplant surgeon John Powelson, MD, performed BWH’s first laparoscopic donor nephrectomy. Kevin Schofield was one of the first recipients. His own kidneys, which were damaged in utero 28 years ago, had deteriorated so much that he needed a transplant. Kevin’s mother, donated her kidney via an open nephrectomy, but it started showing signs of deterioration about two years later. That’s when his uncle, Peter Schofield, decided to donate a kidney. Peter qualified to have laparoscopic surgery, which Dr. Powelson performed on March 16. “Less than three weeks later, I was able to walk a couple of miles,” says Peter. “At no time was I in excruciating pain, and I’ll be able to return to work within four weeks of the surgery. The difference between my recovery and Kevin’s mother’s recovery is remarkable.” Powelson remarks, “Donors are very special people, who undergo major surgery for someone else’s benefit. In addition, they often have to take six to eight weeks off from work in order to recover. We can now off donors a much less disruptive operation. For example, a recent BWH laparoscopic donor, Mr. Ted Symonowicz, required no pain medication, was discharged home after an overnight stay, and was back to work within one week. Avoiding rib removal, and keeping the incision small and in the lower abdomen, has remarkedly reduced postoperative pain. Laparoscopic donor nephrectomies mean fewer post-op days in the hospital, speedier recovery, and less scarring.” “I feel really good right now,” says Kevin. “What both my mom and Peter have done for me goes beyond words. I hope that as more doctors start doing the laparoscopic surgery, more people will hear about it and hopefully choose to donate.”