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Basics of Organ Transplantation

Basics of Organ Transplantation. Lon Eskind, MD Director Liver Transplant, CMC Assoc. Medical Director of LifeShare. CMC Transplant Program History. 1980 Kidney Transplants 1993 Multi-Organ Program Est. 1994 1 st Liver Transplant 1995 1 st Pancreas & Islet Cell Tx

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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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