When people talk about organ transplants they have visions of sick people on a long list waiting for just the right match. For veterinary technician Gerianne Holzman, CVT, talk of organ transplants means patients of the feline persuasion and no waiting list. Gerianne is the feline kidney transplant coordinator at the University of Wisconsin’s School of Veterinary Medicine Teaching Hospital. Gerianne graduated as a veterinary technician 26 years ago and is amazed at the advances veterinary medicine has made during her career. She would have never guessed that she would be coordinating kidney transplants for feline patients!
In her role, Gerianne takes calls from referring veterinarians and clients who want information about the transplant process. Clients may choose to have a kidney transplant performed on their cat if all other forms of treatment for renal failure have been exhausted. She helps them determine if the cat is a good candidate for a kidney transplant and confers with the transplant surgeon. The day the cat comes to the university for evaluation, Gerianne identifies three potential donors so that their blood type can be cross matched. “Cats in the U.S. generally have Type A blood, so blood typing is generally not a problem. However, the donor and recipient still should have no reactions between their bloods. Cats from Europe, i.e. British Shorthairs, tend to have Type B blood making it difficult to find a donor in the U.S.”
We know that many times human organs are donated when someone dies, but what about the feline donors? Sometimes the donors live with the recipient cat, however, many come from a disease free closed cat colony. The recipient’s owner is required to adopt the donor cat after the transplant. The donor cat gets to go home after only 1-2 weeks of hospitalization. When the donor and recipient are matched Gerianne notifies the transplant team and schedules the surgery.
The transplant patient arrives at the hospital several days before the surgery and undergoes a full pre-operative work up including blood tests and cultures to ensure that the recipient is as healthy as possible. The morning of the surgery, the donor’s kidney is harvested in a procedure that takes about two hours. Usually, the left kidney is taken because it has a longer vein which makes it easier for the surgeon to implant. The kidney is kept in a cold storage solution developed by the transplant surgeon as it waits for the recipient surgery to begin. After a short break for the surgery team, the recipient heads into the operating room. Using an operating microscope, the new kidney is connected to the blood supply and bladder. The two native kidneys usually remain in place. The transplant procedure lasts about four hours.
Like human patients, recovery can take time, so “the recipients will spend 1 " 2 weeks in critical care for monitoring.” After that they are housed in the surgery ward where Gerianne cares for them for the next couple weeks, until they are discharged. Gerianne says that the patient goes home after “…cyclosporine, an anti-rejection drug, reaches appropriate blood levels and stabilizes.”
The recipient will not need any special diet, but will be on medications for their lifetime. Like humans, cats too sometimes reject the transplanted kidney, especially if the anti-rejection drugs are stopped. The cats may also suffer from “…acute rejection episodes” that are treated with intravenous fluids and steroids. This therapy will get them back to normal kidney function.
At the University of Wisconsin’s School of Veterinary Medicine Teaching Hospital, their success rate is 85% with about six transplants per year performed. Each time, Gerianne is rewarded “…knowing that [she has]played a small part in helping these very sick cats return to a normal healthy life.”
Additional information is available at: http://www.vetmed.wisc.edu/dss/mcanulty/felinekidneytransplant
