NN&I - August 2010

Transplant Update 24 Nephrology News & Issues August 2010Subscribe to our free eNewsletter at www.nephronline.comSurgeons study safety of a new technique for kidney extractionSurgeons at The Methodist Hospital in Houston are studying whether remov-ing a donated kidney from a woman through her vagina is less invasive and can help to reduce scarring. The technique is called natural ori -fice translumenal endoscopic surgery (NOTES), in which surgeons use a natural opening in the body to mini -mize pain and scarring. According to the United Network for Organ Sharing (UNOS), more than 60% of living kidney donors are female. "Our current technique of laparo -scopic, minimally invasive kidney removal reduces side effects caused by open surgery," said Brian Dunkin, MD, a surgeon at The Methodist Hospital and lead researcher on the study. "However, even with a minimally invasive tech-nique, the incision is large enough to cause the pain, hernias, and wound infections seen with open surgery." Currently, kidney donors undergo a laparoscopic operation during which the surgeon prepares the kidney for An assemblyman from suburban New York is hoping his constituents will agree to donate their organs upon their deathunless they inform the state otherwise. Richard Brodsky is motivated by his daughter, a two-time kidney trans-plant, to increase organ donation in his state. His proposal would require that people automatically be added to the state donor registry, unless they opt out when they get a driver's license or state identification card. Other states, including Delaware and Pennsylvania, have made similar proposals, but none have passed in the legislature. "What I've said to anybody, wheth-removal by working through three \274-inch incisions. However, when it comes time to remove the kidney, a larger three- to four-inch incision must be made for the extraction. The larger incision is the source for most of the pain and scarring. Removing the kidney transvaginally where there are relatively few pain fiberscould result in a nearly painless operation with no extraction scar, said Dunkin, who is also medical director of MITIE, the Methodist Institute for Technology, Innovation and Education at Methodist. Dunkin and co-investigator Rohan Joseph, MD, will conduct a micro-biological analysis of the cervix and vagina of patients undergoing laparo -scopic transvaginal hysterectomy. A sterile mock kidney will be placed in the patient's abdomen and extracted transvaginally at the end of the hyster -ectomy procedure. They will conduct a microbiological analysis of the mock kidney after the procedure as well. Nephrologist Levey offers gift of lifeAndrew Levey, a Tufts University nephrologist active in the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative efforts, has donated a kidney through a paired exchange program to help his wife battle kidney failure. The editor of NKF's American Journal of Kidney Diseases donated a kidney as part of a three-pair "kid- ney swap" so that his wife, oncolo-gist Dr. Roberta Falke, could receive a kidney. Falke, like her father and two of her siblings, suffers from poly-cystic kidney disease. She developed symptoms related to PKDenlarging kidney and liver cysts, and advanced kidney diseaseover the past three years. "Since donating my kidney, I can tell people exactly what to expect every day post-transplant," noted Levey after the surgery. "I always tended to be close to my patients, but now our connection is so much more direct. They feel like I'm one of them. I have done something that they hope their family members will do or already have done, and they know how impor -tant it is to them. They really feel in a way like I'm part of their families," says Levey. New York legislator pushing for opt-in policyer they like it or they don't like it, [is that] we can't sustain the current sys-tem," said Brodsky, a Democrat from Greenburgh in New York's Westchester County, in an interview with USA Today. He and other advocates of the pre-sumed consent donor system believe it could help increase organ and tissue donations. Daughter Julianne "Willie" Brodsky, received her second trans-plant four years ago and has become an advocate for changing the system. A survey by the New York Alliance for Donation found 67% of state resi-dents strongly support organ and tissue donation, yet 13% of the state's residents 18 and older are on the Donate Life Registry, which allows individuals to give their legal consent to be an organ or tissue donor, USA Today reported. Nationally, 37% of adults 18 and older are desig- nated donors, according to a report card published in April by Donate Life America based on an online survey of 5,100 adults. Transplant_NNI_0810_3TK.indd 24 7/16/10 1:40:40 PM