Transplant Trivia

The renal module is all wrapped up, but a few nagging thoughts remain. Transplantation in lay media, especially when it comes to kidneys, is seen as a fix-it-all procedure. "Yup, that brand spankin' new kidney there will make it all better. It's like poppin' in a new battery, and you won't need a new one for a 100 years." Just as I used to debunk bad science in movies (as my friends rolled their eyes and munched on the popcorn anyway), I suppose it's time to let the pocket protector ride again and point out bad medicine at the cinema.

One common preconception is at least true. You only need one kidney. Two kidneys filter around 180 L of blood each day, so cutting that in half still isn't too bad considering we only have 5-6 L of blood.

The transplant does not replace the original. It is instead placed somewhere below one of the existing kidneys. Reason? Higher morbidity.

Who does the transplants? A urologist. I was surprised to find this out, especially seeing that urologists usually do small procedures on the urinary tracts.

Who's the best donor? Related or not, a living one. Cadaveric donors, while still good, don't match the 5-year survival rates that the living donor kidneys do.

Transplants can be rejected, in a dazzling variety of ways. From hyperacute rejection which takes minutes--the kidney literally turns black as it's being sawed up, to chronic rejection which takes years. Once rejected, it's back to dialysis for the patient.

The transplant is good for about 10 to 15 years, though the recipient is permanently on a regiment of immunosuppressive drugs.