Comprehensive Transplant Center background

Background Information:
The Johns Hopkins Comprehensive Transplant Center (CTC)

The Johns Hopkins Comprehensive Transplant Center is one the world’s leading transplant centers.  The activities of its nearly 200 transplant employees reflect the hospital’s original goal: to become the model for patient care, medical education and research.

When it was founded in 1996, the CTC integrated the resources of the hospital’s pre-existing transplant programs within one center to bring a modern, collaborative treatment program to transplant patients.  Today, the CTC manages over 4,000 solid organ adult and pediatric patients needing pre- or post- liver, lung, heart, kidney or pancreas transplant care.

Over the past decades, the transplant specialists at Johns Hopkins have introduced a number of breakthrough surgical and patient care techniques to the transplant field.  While transplant techniques have evolved tremendously since the first kidney transplant five decades ago, today, transplant patients on the national (deceased donor) waiting list are faced with a critical organ shortage.  At the same time that national and local organizations are working to increase the number of people who donate organs after death, transplant specialists are working to make it easier for living people to donate their kidneys. 

Hopkins’ recent contributions to the live donor transplant field include the “minimally invasive laparoscopic surgery” and the “Incompatible Kidney Transplant Program (InKTP)”:

Minimally Invasive Laparoscopic Surgery
The first major breakthrough for potential kidney donors occurred in 1995, when former Hopkins surgeon Lloyd Ratner, M.D., Hopkins surgeon Robert Montgomery, M.D., D.Phil,and Hopkins urologist Louis Kavoussi, M.D., developed the minimally invasive laparoscopic nephrectomy.  Unlike the older method that removed the kidney through a large incision, the laparoscopic nephrectomy uses only small incisions.

The results make it easier for people to donate kidneys to transplant candidates.  Prior to the development of the laparoscopic procedure, donors required lengthy hospital stays to recover from large incisions, which were more susceptible to complications.  Now, living donors who undergo laparoscopic nephrectomies require about three days in the hospital, and most are back to their normal activities within two to four weeks.  Today, that technique has become the standard procedure in over 100 countries and on six continents.

The Incompatible Kidney Transplant Program 
When the Incompatible Kidney Transplant Program was introduced by Hopkins in 1998, it significantly expanded the living donation opportunities.  About 30 percent of the patients among the 66,000 people on the national kidney waiting list have sensitivities or incompatibilities against most organ donors.  While this 30 percent may have living donors who are willing to provide healthy kidneys to them, these same transplant recipients have biological incompatibilities to their donors that make them unable to receive their donor’s gift.

The options available through Hopkins’ InKTP program allows patients to be medically treated for their incompatibilities or to enter into a “a kidney paired donation pool” so that they can be matched up with other incompatible pairs to produce compatible transplants.  Transplant surgeons have been successfully transplanting patients through kidney paired donation since 2001.  In July 2003, Hopkins was the first transplant center in the world to perform a three-way kidney exchange.  On March 2 – 3, 2005, faculty from Johns Hopkins and several other transplant centers convened a consensus conference with the goal of designing a national kidney paired donation program that has since been considered by the United Network for Organ Sharing, the government oversight agent for transplant centers.  In May 2005, Johns Hopkins transplant specialists performed the world’s first “domino” three-way kidney transplant involving an altruistic, non-directed donor.