Pet Kidney Transplant Information in Sunnyvale

UCD School of Veterinary Medicine Renal Transplant Information, 1/97

Workup prior to consideration for surgery:

1. CBC, Chemistry profile, urinalysis, with culture (and sensitivity)

2. Ultrasound of kidneys (and abdomen), and heart (looking for cardiomyopathy). Biopsy or fine needle aspirate of kidneys may be indicated.

3. Blood typing of the recipient (and possible donor, if the client owns possible candidate for donating. Otherwise client MUST adopt the donor animal provided by UCD).

4. Reduce the likely anemia using Epogen alone, or a combination of Epogen and blood transfusion. The goal is a PCV of 30% or more.

Procedure:

1. Cost is about $3500 to $4000 for the usual 2 weeks or so stay at UCD.

2. Post-Op complications include:

a) Seizures- probably secondary to severe post-op hypertension (high blood pressure). This may be due to lack of time for the body to accommodate to a new, functioning kidney. About 20% of the cases will have these seizures, of which half (or 10% of the cases) DIE. UCD is trying hydralyzine post-op to reduce hypertension.

b) Left leg paresis (weakness)- due to reduced blood flow to the left leg after the external iliac artery is used to supply blood to the new donated kidney. This is temporary in the vast majority of cases, as the leg develops collateral circulation very quickly, however in one case the leg had to be amputated.

Post Operative Care:

1. Need to check for rejection on a regular basis, meaning weekly visits to the veterinarian for the first month or two, then monthly visits for the next 2-3 months, then perhaps every 3 months for the first year. The subsequent years will probably require quarterly visits.

2. Each visit will require at least a CBC, urinalysis, creatinine level, and cyclosporin level. The cyclosporin level will require that it be taken in the morning prior to the morning dose of cyclosporin. The blood for cyclosporin testing must be sent to UCD by overnight express, such as Fed Ex.

3. Cyclosporin must be given twice a day for the rest of the recipient’s life. The cost is about $1000 -$1500 per year. Testing as described above costs about $1000 – $2000 the first year, and about $500-$750 per year thereafter.

Survival Times:

A recent retrospective study of 66 cases showed that 47 patients left the hospital alive. Since discharge, 28 of them have died, with an average lifespan of 1 1/2 to 2 years. Eighteen were still alive at the end of the study, with most being over 2 years survival time. One case has lived about 7 years!

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