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Use of Living Donors for Renal Homotransplantation

Marchioro, TL and Brittain, RS and Hermann, G and Holmes, J and Waddell, WR and Starzl, TE (1964) Use of Living Donors for Renal Homotransplantation. Archives of Surgery, 88 (4). 711 - 720. ISSN 0004-0010

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Abstract

The procedure is described which is followed at the University of Colorado Medical Center for the selection and evaluation of living donors for renal homotransplantation. Priority is given to volunteers who have a close genetic relationship to the recipient. The aortogram is the single most useful test for determining which kidney to be used. If either organhas a single artery, it can be employed for homografting without fear of encountering anatomic difficulties at the time of its subsequent insertion into the recipient. Twenty-two left and 18 right kidneys have been excised. The donor operation has been a safe one. The only complications have been two pneumothoraces, one atelectasis, one transient peroneal nerve palsy, and two subcutaneous wound infections. Renal hyperplasia of the remaining kidney apparently occurs promptly since the creatinine clearance returns to or toward normal within a few weeks after operation. Interestingly, the same phenomenon is also observed in the homograft in those recipients who have a successful result. The steps in the donor operation are described for both right and left sides. Wide exposure, block removal of the specimen, and meticulous technique are required both to protect the donor from surgical accidents and to insure a homograft of high quality. Homograft cooling is provided eitherby total body hypothermia of the donor or by a method in which intra-arterial infusion of a chilled electrolyte solution isused. The relative future roles of living and cadaveric donors are discussed. The results with parental or sibling donations have been good enough to justify further employment of these sources. In cases in which a genetically unrelated donor must be used, a sounder policy may be to seek cadaveric organs, especially if the recipient falls in an older age group. © 1964 American Medical Association All rights reserved.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Marchioro, TL
Brittain, RS
Hermann, G
Holmes, J
Waddell, WR
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1964
Date Type: Publication
Journal or Publication Title: Archives of Surgery
Volume: 88
Number: 4
Page Range: 711 - 720
DOI or Unique Handle: 10.1001/archsurg.1964.01310220201031
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0004-0010
Other ID: uls-drl:31735062123876, Starzl CV No. 73
Date Deposited: 08 Apr 2010 17:00
Last Modified: 30 Oct 2017 23:56
URI: http://d-scholarship.pitt.edu/id/eprint/3459

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