One of the true miracles of modern medicine is the ability to transplant an organ from a donor to a recipient. As transplants become more common, we tend to forget how exceedingly difficult the surgery and post-operative care is.
If the patient is a cat, there are some additional issues, including the wishes and resources of the owner, the size of the patient and the availability of a transplant center.
Renal disease is common in cats, sometimes because they are born with it and sometimes because it often comes with advanced age. Cats with advanced renal disease have a very poor chance for long-term survival.
The veterinary school at the University of Pennsylvania in Philadelphia is one of the few places in the country and the world that perform kidney transplants on pet cats. Under the direction of veterinarian Lillian Aronson, 147 feline patients have received a new lease on life over the past 10 years.
The transplant surgery is exacting and complex. At the Penn veterinary school, an entire team of veterinarians and certified veterinary technicians must work in harmony to remove and then transplant a normal kidney. The renal artery and vein are small and, with the urinary drainage outlet (ureter), need to be transected. Highly trained veterinarians use an operating microscope to do the surgery. The new kidney is sewn into the recipient with tiny sutures barely visible without magnification.
After typing and crossmatching the donor and recipient and an intricate surgery, managing the potential rejection requires extraordinary expertise. Donor cats are made available through participating rescue groups, and the donor becomes a companion to the recipient. The majority of cats, nearly 95 percent, have type A blood, making a good match easier. The average transplant recipient is 8 years old; some younger feline patients have congenital cystic kidneys that eventually fail.
The cost of a transplant can approach $15,000. That fee usually covers the screening for both the donor and recipient, surgery for both cats, including the two-week hospital stay for the recipient. Donor cats are able to go to their new home in two days.
The recipient is monitored closely after surgery, and then exams are tapered from daily to weekly, then monthly, and ultimately to just a few visits per year. Immunosuppressive drugs, a combination of prednisolone and cyclosporine, are used to stop transplant rejection.
The success rate is 95 percent initially for cats to survive surgery and go home to join their family and donor cat. Seventy percent of transplanted cats are alive at one year. Possible rejection is monitored by ultrasound and blood testing.
The cats' owners get another companion and get to spend more time with their pet, thanks to the miracle of modern veterinary medicine.
Lawrence Gerson is a veterinarian and founder of the Point Breeze Veterinary Clinic. His biweekly column is intended to educate pet owners. Consultation with a veterinarian is necessary to diagnose and treat individual pets. If you have a question you'd like addressed in Pet Points, email firstname.lastname@example.org. Please include your name and municipality or neighborhood.