Kidney transplant at Westchester Medical Center: Cutting-edge care that transforms lives
Westchester Medical Center’s renowned Kidney Transplant Program has saved and improved thousands of lives since 1989. Every patient benefits from state-of-the-art medical expertise, the finest physicians and equipment, and a focus first and foremost on well-being. Learn more by calling 914.493.1990.
This specialized team’s advanced, precise treatment is conveniently close to home at Westchester Medical Center, the pre-eminent healthcare provider in the Hudson River Valley and flagship of the Westchester Medical Center Health Network (WMCHealth). Each patient receives unique access to all medical treatments in one location and benefits from an important personal touch: the entire team – including a patient coordinator for each transplant patient – is dedicated to ensuring an optimum experience for the patient and family.
The Westchester Medical Center Kidney Transplant Program is the only one in the Hudson Valley. Its outstanding reputation and specialized expertise draw patients from across the greater New York metropolitan area and beyond.
Successful transplant is life-changing – and the start of a lifelong partnership between the patient and transplant team that helps ensure ongoing quality of life. Patients are closely followed by Westchester Medical Center’s team for the first few months after surgery, then less frequently as time progresses. Patients transition back to their referring doctor’s care, but the transplant team sees patients annually, for life.
Kidneys for transplant are secured from donors who are alive (a family member or friend, for example) and deceased. Westchester Medical Center participates in the United Network for Organ Sharing. This national registry equitably identifies deceased donors’ kidneys for possible transplantation and promotes effective, safe care and efficient organ use.
Kidneys remove wastes and excess fluid from blood by producing urine. Transplant is necessary to lengthen and preserve life. It enables most patients to be free from dialysis and have fewer dietary restrictions. Successful transplants also are less expensive, over time, than dialysis.
A kidney transplant is necessary when a patient is diagnosed with end-stage renal (kidney) disease. Causes include diabetes, hypertension (high blood pressure), polycystic kidney disease, lupus and glomerulonephritis. Immunosuppressive therapy before surgery and for the lifespan of the transplanted kidney helps prevent organ rejection.
Four Phases of Transplant
Kidney transplantation is a meticulous multi-phase process that starts well before potential surgery. Please click on each link below to learn more about each step.
Evaluation and Suitability for Transplant
Westchester Medical Center and all transplant centers employ a thorough process to determine if a patient is eligible for a transplant. Just as importantly, they guide patients through this juncture of life with compassion and educational information at every step.
At Westchester Medical Center, the first step is review of a patient’s medical history. Then, patients receive stress tests, echocardiograms and breathing-function analysis. Other examinations may be required as well to screen for cancers as age dictates.
Test data are evaluated by a multidisciplinary team consisting of the nephrologist (kidney doctor), surgeon, transplant coordinator, social worker, nutritionist and financial coordinator. Consultations with specialists in oncology, OB-GYN, pediatrics, cardiology, etc., ensure the thorough consideration of transplant potential for each patient.
The transplant team then determines if the patient meets medical criteria for transplantation. Patients and referring physicians are notified whether the patient will join the national waiting list for a donated organ.
It is an immediate priority for the transplant coordinator to explore the possibility of the patient identifying a suitable living donor – perhaps a family member, friend, co-worker or someone from a place of worship. Patients receiving a transplant from a living donor, compared to a transplant from deceased donor, generally are transplanted much sooner and can expect better outcomes.
Kidney donations from deceased donors, identified through a national registry system, are an option as well.
If a living donor cannot be secured, the patient is added to the national waiting list for a kidney. While awaiting transplant, patients return to Westchester Medical Center's Transplant Center every 12-18 months for re-evaluation. This ensures candidates remain medically suitable for transplant; medical conditions often change over time. Communication among the referring physician, Transplant Center and patient is crucial in ensuring that patients remain healthy for transplantation.
Pre-Transplant Waiting Period
The wait for a donor kidney varies significantly. Availability, medical compatibility and changes in the transplant candidate’s condition are prime determinants of when a transplant may be possible.
Donation from a living donor is a preferred option and can significantly shorten the waiting time for a transplant.
If live kidney donation is not an option, a donation from someone recently deceased is required. Waiting times for a medically suitable kidney can be substantial because of the huge demand.
As the patient awaits a donation, dialysis to clean blood is required to preserve life.
Transplant Surgery
Patients choosing kidney transplant surgery at Westchester Medical Center benefit from a trusted, experienced team of experts on the leading edge of medical advancement.
The patient’s comfort and well-being are priorities throughout the procedure, which lasts a few hours. While the patient is under general anesthesia, the surgeon connects the new kidney with blood vessels at the lower part of the abdomen, near a leg. The new kidney also is connected to the bladder. The original non- or low-functioning kidneys typically are left in place if they are not the cause of complications that may include disease, kidney stones, pain or infection. Doing this minimizes the extent of surgery.
The patient is hospitalized for four to six days; fuller recuperation at home can take up to six weeks.
Post-Operative Care
For the best outcomes, patients must be ready, willing and able to be responsible for their care or have a family member who will do so.
Self-care includes:
- Taking medicines as directed.
- Completing testing and check-ups.
- Attendance at medical appointments.
- Rescheduling missed appointments.
Transplantation patients must take medications to maintain their transplanted organ, prevent infection and treat common medical conditions such as hypertension, diabetes and elevated cholesterol. Following transplantation, dietary changes are likely necessary. A patient also must immediately report fever or illness to a transplant center physician or nurse.
Transplant staff also should be alerted if:
- A patient or family experiences problems obtaining medicines.
- Insurance coverage changes.
- If a patient is prescribed new medication by another physician. This coordination is required to prevent unintended drug interactions with essential transplant-related medication.
Kidneys for transplant are obtained in two ways: A medically suitable donor who is alive – perhaps a friend, family member, colleague or someone from a house of worship – provides the gift of life to a waiting recipient, or a kidney from a deceased donor is identified through a national registry. To register to be an organ donor, please CLICK HERE.
Westchester Medical Center successfully and frequently performs living-donor kidney transplants.
These cutting-edge procedures result in higher long-term success rates of the transplanted kidney; less medication required to prevent the body from rejecting the new organ; and ease in scheduling the transplantation.
The body has two kidneys; only one is required to meet the person’s needs.
A living donor can be:
- From the patient’s immediate family: a parent, sibling or child 18 years or older.
- An extended family member.
- A biologically unrelated person: spouses, adopted or step family members, friends, coworkers, etc.
Living donors are not responsible for costs pertaining to their living donor evaluation, living donor surgery, or post donation care. Those costs are covered by the recipient’s insurance. Living donor candidates must be in physical and emotional good health and have carefully evaluated the decision to donate. A living donor advocate, a volunteer not affiliated with the transplant program, reviews all information with the donor to ensure no coercion to donate is involved, and that the donor has made a fully informed choice to donate.
Then, a medical evaluation determines compatibility with the potential recipient. This analysis also protects the potential donor by identifying any medical concerns. It includes review of the potential living donor’s medical history; a physical; blood and urine tests; cardiovascular tests; cancer screening tests; a CT scan to review the anatomy of the kidneys; and other tests as needed.
After the evaluation is completed, the donor’s evaluation data are presented to an independent panel called the Independent Donor Advocate Team that evaluates if it is medically and psychosocially safe for the donor to participate. If so, the transplant is scheduled.
The donor’s kidney is typically removed using a minimally invasive technique known as laparoscopic living donor nephrectomy. This technique reduces the duration of the surgery and recovery. The donor usually remains in the hospital for one to two days, after which he or she is required to return to the Transplant Center for post-operative follow up one and then two weeks after surgery. Regularly scheduled appointments at 6 months, 1 year and 2 years after donation are scheduled with the Transplant Center. After two years, donors then are monitored by their primary care physician annually for routine health maintenance.
If a potential living donor is medically unsuitable or is incompatible with a transplant candidate, additional donors may be evaluated. Instead of a direct one-to-one connection between a donor and recipient, a larger pool of donors and recipients – in which medical matches have been identified for all – can result in successful donation and transplant for all involved. In cases when a donor is medically suitable for donation, but is incompatible with a transplant candidate, Westchester Medical Center participates in the Kidney Paired Donation (KPD) program, sponsored by UNOS. The KPD program matches incompatible donor-recipient pairs to other pairs that are eligible for a swap (i.e. the donor from one pair donates to the recipient of the other pair, and vice versa). It is also possible to do multi-way swaps including many donor-recipient pairs, called a donor chain. For more information on Kidney Paired Donation, please CLICK HERE.
Westchester Medical Center works closely with each patient to secure a kidney from a deceased donor if a live kidney donor is not an option.
Everyone waiting for a deceased-donor organ is registered on a national waiting list managed by the nonprofit United Network for Organ Sharing. Hyperlink to https://unos.org This national organization determines recipients of deceased-donor kidneys. In addition to medical compatibility, the geographic proximity of the donor and potential recipient is weighed. Kidneys expected to function the longest often are directed to candidates expected to need them the longest.
Deceased donors are usually unrelated to a transplant patient. The donors designated their organs for transplant consideration via a donor card, driver license designation or by registering on a National Donor Registry Family members of the deceased also may approve organ donation. Families also have the choice to direct their loved one’s donation to someone they know who is registered on the national waiting list.
The majority of kidneys transplanted in the United States are from deceased donors, but the demand far exceeds the supply. That means a medically suitable kidney may not be available for a substantial amount of time – potentially years. In addition, kidneys from deceased donors may not function as fully as a kidney from a donor who is alive.
Speed is an essential component in transplantation from a deceased donor. Every medical precaution is taken to sustain the donor’s body functions after brain death so the kidney can be removed. It then is quickly transported, often via a flight, to the recipient’s hospital.