The Kidney Transplant Program at USC University Hospital is dedicated to providing comprehensive perioperative care to patients with chronic renal disease, including end-stage renal disease.

Our team consists of physician and surgeon specialists and nurse coordinators whose purpose is the efficient pre-transplant evaluation and management and a smooth transition into the transplant phase. Following kidney transplantion, care will be coordinated by the USC nurse transplant coordinator and depends on consistent communication between the transplant physicians, the patient, and the referring doctor.

Within the scope of our program exist the necessary services to provide comprehensive evaluation and management of patients before and after the transplant event. The kidney transplant procedure is performed at the USC University Hospital. The USC University Hospital, opened in 1991, is a modern 284-bed hospital on the USC Health Sciences Campus near downtown Los Angeles.

The Kidney Transplant Program is one component of the full-service Multi-Organ Transplantation Program at the University of Southern California School of Medicine.

Additionally, all of our transplant programs are members of the United Network of Organ Sharing (UNOS), which is the central agency in the United States which is responsible for equitable allocation of organs. These affiliations provide our patients with the best opportunities to receive new organs.

Since the first kidney transplant was performed at USC University Hospital in October 1991, more than 250 have been done afterwards, with an average 92% patient survival rate and 87% graft survival rate at three years post-transplant -- statistics well above the UNOS national averages.

Full Scope of Services
Expanded surgical techniques, improved anti-rejection protocols, and high-quality patient care characterize the USC program and are critical factors in our current success in kidney transplantation. Candidates for kidney transplantation are individuals with chronic kidney failure related to:

• diabetes
• hypertension
• glomerulonephritis (chronic kidney inflammation with failure).
• polycystic kidneys
• other kidney diseases

Patients have convenient access to a range of comprehensive services, including:

• A Full-Service Dialysis Center - Located on the USC medical campus next to the University Hospital, the dialysis center is a new facility that offers dialysis in a comfortable environment.

• Access Management - Physicians, nurse specialists, and ancillary personnel have the capability of establishing reliable dialysis access including fistulas, grafts, and peritoneal catheters. In addition, we have the surgical and interventional radiologic skills to troubleshoot and manage difficult access problems, including clotted access, graft revision, and catheter infections.

• Cadaveric Transplantation - Cadaver organs are acquired based on criteria set forth by UNOS. Working with One Legacy, the USC team is able to implant allocated organs within 24 hours.

• Living Donor Transplantation - Live donor transplantation has become increasingly common, due in large part to the success of the procedure and the shortage of cadaveric organs. Living donation allows the immediate transplantation of kidneys into recipients so operations can be scheduled electively once a suitable living donor has been identified. This avoids the long waiting times encountered with cadaveric donation. The USC University Hospital program has earned an outstanding reputation for its living donor program and now offers a new minimally invasive approach to living donor nephrectomy (see laparoscopic kidney removal below).

• Followup Care - Our physicians are practiced in the use of the latest immunosuppressive drugs, including a new class of specific antibodies to some of the cellular receptors responsible for rejection. These FDA-approved drugs have reduced the frequency of rejection episodes by about 40 percent.

Laparoscopic Kidney Removal
One of the newest and most advanced procedures offered by the USC Kidney Transplant Program is laparoscopic kidney removal from living donors. In this minimally invasive approach, four or more small incisions are made in the abdominal wall. Video equipment and instruments are inserted through these punctures to visualize, dissect, clip, and staple. Once the kidney is freed from its attachments, it is extracted from the abdomen through a 3-inch supra-pubic or peri-umbilical incision, and cooled. It is then prepared for immediate implantation into the recipient, following the donor surgery.

This minimally invasive procedure results in less pain, a reduction in hospitalization from five days to one or two days and a return to normal activity in about a week for the donor.

Family Involvement
Kidney transplantation is a family affair, especially if the recipient is receiving a kidney donation from a living relative. For this reason, family members are intricately involved in the care process, including decision making and follow-up lifestyle changes. The USC transplant coordinators help kidney patients and their families communicate and learn about what is happening. They are available 24 hours a day to answer emergency questions. They also serve as liaisons among patients, referring physicians, and the USC kidney transplant team. Through their commitment and dedication, patients and family members experience a true continuity of care from admission into the program through post-transplant follow-up.

A Dedication to Education
The Kidney Transplant Program at USC University Hospital is dedicated to both patient and physician education. We provide continuing medical education for outside physicians and dialysis center staff by providing conferences on topics related to pre-transplant and post-transplant management issues, maintain a web site for patient and physician access (kidneytransplant.org), host a monthly transplant support group for abdominal organ transplant candidates and recipients (to be announced), and a yearly physician symposium to discuss cutting-edge issues in kidney transplantation.

Patient Education
The complexity of kidney transplantation requires intensive education for patients, living donors (if applicable), and family members. The program has produced brochures in English and Spanish regarding all aspects of the transplant process. In addition, recipients and donors receive extensive one-on-one instruction and education by members of the multidisciplinary transplant team. A patient support group for transplant patients is also held on a regular basis, helping recipients find strength and encouragement through the experiences of others.

Physician Education
Members of the Kidney Transplant Program are regularly invited to local and national meetings to discuss the latest advances in the field of end-stage renal disease and kidney transplantation. They also speak to local groups of physicians and hold Grand Rounds across the Southland. In addition, our physicians are available for telephone consultations and invite colleagues to call with questions about complex cases.

For More Information
There are several ways to obtain more information about this program or to make a referral:

• Visit our contact information page, or phone Kidney Transplant Program Administrator Brad Selby at (323) 442-5908.

• Call 1-800-USC-CARE and ask for information about the Kidney Transplant Program.

• Visit our Patient's Guide to Kidney Transplant Surgery Web Site.

USC Kidney Transplant Program
1510 San Pablo Street, Suite 200, Los Angeles CA 90033-4612
Phone: (323) 442-5908     Fax: (323) 442-5721
E-mail: usckidney@surgery.hsc.usc.edu