Surgeons at the University of Illinois Medical Center at Chicago are the first to offer robotic kidney transplantation to morbidly obese patients and report fewer complications among this high risk population. They have been able to eliminate wound infections, pulmonary complications, and reduce the length of hospitalization for obese kidney transplant recipients using robotic-assisted surgery. Wound infections lead to increased risk of graft loss in transplant recipients, and obesity is the main risk factor for superficial wound infection.

Researchers report that robotic-assisted kidney transplantation eliminates wound infection (0 percent versus 15 percent in open surgery), pulmonary complications (0 percent versus 9 percent in open surgery) and length of hospitalization is reduced (5 days versus 8.5 days in open surgery). UIC surgeons have transplanted 13 morbidly obese patients since 2009 and report that all were successful, 100 percent patient and graft survival, with no complications. Recently, two renal failure patients each with BMI over 50 underwent successful robotic kidney transplantation during a simultaneous paired exchange, or "swap" transplant, at the medical center.

The development of the program was fraught with ethical concerns, but those behind it felt that organs needed to be obtained sooner outside the hospital before the organ becomes unusable. The major fear is that the first ambulance on the scene will let the patient die while the second "Organ Preservation Unit" lies in wait to take the patient's kidney. In order to overcome that ethical fear, doctors and paramedics at the scene would not be told the organ ambulance is waiting until a supervisor tells them to stop their efforts. In addition, the organ team is to stay out of sight of the first ambulance in order to not influence the resuscitation efforts. Another stipulation is that the dead individual must be registered as an organ donor and his or her family would also have to give consent to harvest the organs. In addition, organs from crime scenes cannot be taken.

Ronald Lee Herrick, who donated a kidney to his dying twin brother 56 years ago in what's recognized as the world's first successful organ transplant, has died of complications following heart surgery. He was 79. Herrick gave a kidney to his twin brother, Richard, at what is now Brigham and Women's Hospital in Boston. The 5 1/2-hour operation on December 23, 1954, kept Herrick's brother alive for eight years and was the first successful organ transplant, according to the United Network for Organ Sharing (UNOS). Lead surgeon Dr. Joseph Murray went on to win a Nobel Prize.

The operation proved that transplants were possible and led to thousands of other successful kidney transplants and ultimately the transplant of other organs. Doctors had tried a handful of transplants worldwide without success up to that point, said Murray, who went on to perform another 18 transplants between identical twins.

In the first paired donation arranged through a national pilot program of the Organ Procurement and Transplantation Network (OPTN), two lucky individuals are experiencing renewed life and health thanks to the generosity of two living kidney donors. Paired donation is helping the transplant community help people who otherwise could not get a living donor transplant. Paired kidney exchange programs have allowed for a significant increase in the number of patients that receive a living kidney transplant, therefore freeing up additional cadaveric kidneys for the 80,000 plus people on the national wait list.

The donors and recipients were paired according to the first computerized match run conducted by the OPTN in October 2010. Each transplant program participating in the pilot program submits detailed medical information on potential living donors and candidates to an affiliated coordinating center, which works directly with UNOS on administrative issues such as enrolling donor/recipient pairs, making logistical arrangements and entering data. The goal of the pilot project is to see whether combining the data of multiple centers and networks will generate successful matches that may not be found through one individual organization. The fact that these transplants occurred from the first match run suggests this will be true. Future match runs will be conducted every four to five weeks with information on potential living donors and candidates supplied by pilot participants.

The longer a child is on a dialysis while awaiting a kidney transplant, the greater the likelihood he or she will experience graft failure and organ rejection following surgery, a new study has found. The findings suggest that, as is the case in adults, whenever possible, children should not be placed on a certain type of dialysis prior to transplantation. Children who face kidney transplant fare best when they receive the organ without undergoing dialysis. The longer the dialysis prior to the operation, the worse is the survival of the kidneys.

Of the transplants studied, 28 percent were pre-emptive, 38 percent involved pre-transplant hemodialysis and 34 percent involved peritoneal dialysis. The study found that for living-donor recipients, pre-transplant hemodialysis adversely affected graft survival. No such effect was seen with pre-transplant peritoneal dialysis. The findings are consistent with the results of studies in adults with kidney disease. It is always best to minimize the time on dialysis prior to kidney transplantation. The study appears in the journal Transplantation.