Surgical First Expected To Advance Life-Saving Kidney Transplant Program

August 14, 1998

GAINESVILLE — A 37-year-old Florida man was in good condition and scheduled for discharge today (8/14) at Shands at the University of Florida, three days after UF surgeons performed a first in the Southeast: removal of a kidney from a live donor using a rare technique credited with decreasing the donor’s postoperative recovery time, scarring and pain.

The laparoscopic nephrectomy method of kidney removal is gaining clinical momentum as an alternative to the traditional, open nephrectomy involving a 12-inch, muscle-splitting flank incision and rib removal. The patient’s name is being withheld to protect his privacy.

Dr. Robert C. Newman, UF professor of surgery and urology, performed the minimally invasive surgery, marking another milestone for Shands Transplant Center.

“Our transplant team wants to offer an approach that is best for each individual,” Newman said. “Due to its significant advantages, kidney donors have traveled across the country to find surgeons who perform the laparoscopic nephrectomy because it allows them a quicker return to normal activity and they need less pain medication and have minimal cosmetic concerns.”

Researchers say the laparoscopic technique, pioneered in 1995 at Johns Hopkins Medical Center, revolutionizes kidney donor surgery because it minimally disrupts the abdominal wall while recovering the organ for transplant. The methods for preserving the integrity of the kidney are unchanged, but unlike the open operation, the laparoscopic method involves four, small abdominal incisions for the insertion of the laparoscopic video observation instruments, and only a 3-inch opening to remove the kidney.

Dr. Richard Howard, Shands Transplant Center medical director, said this less painful approach brings advanced technology to Florida to benefit both donors and recipients.

“The laparoscopic approach will probably increase our living donor kidney transplants because donor recovery time is reduced,” Howard said. “It is a better scenario for the donor, who can return to work faster, and the recipient, who feels more comfortable with the donor’s decision.”

The surgical technique requires a team of transplant surgeons with advanced laparoscopic skills.

“Transplantation itself is a multi-disciplinary team process,” Newman said. “Everyone on the team needs to be on board when you introduce a new approach like this.”

Shands Transplant Center — part of the Shands HealthCare network’s flagship teaching hospital — recently was ranked seventh nationally for solid organ transplants and has Florida’s highest kidney transplant survival rate, well above the United Network for Organ Sharing (UNOS) national average. Since the program’s inception in 1966, UF surgeons have performed 2,381 kidney transplants. Based on volume, Shands is nationally ranked fifth for heart transplants, sixth for lung transplants, seventh for liver transplants and 15th for kidney transplants, according to UNOS Scientific Registry data. The Center for Healthcare Industry Performance Studies lists Shands as Florida’s lowest-cost provider for solid organ transplants.

Shands Organ Procurement Organization (OPO) at UF is ranked third nationally out of 63 such centers and it relies on the efforts of all five Florida OPOs. In addition, three other Florida OPOs are ranked in the nation’s top five.