Fifty years of kidney transplants

Published in the Asbury Park Press 12/21/04

By Michael Riley

Staff Writer

When your kidneys go, you are in real trouble. End-stage renal disease claims the lives of nearly 60,000 Americans each year, making the condition the ninth leading cause of death in the United States.

Photo: Courtesy Jersey Shore University Medical Center Dr. Patrick Buddle (right) , Wall, chief of rehabilitative medicine at Jersey Shore University Medical Center, Neptune, two years ago donated a kidney to colleague Dr. Anand Swaroop (left), Ocean Township, an orthopedic surgeon affiliated with the hospital. In this 50th year of kidney transplantation, their story shows how successful the procedure can be.

Unless treated, kidney failure can mean death in as little as few days as the blood fills with toxins and fluid.

And dialysis, while a life-saving procedure that filters the blood, is only a stop-gap measure.

"The goal should be transplantation," says Dr. John DePalma, a board certified nephrologist affiliated with Ocean Medical Center in Brick and director of dialysis services for Meridian.

"Dialysis puts the patient in a chronic inflammatory state," he says.

What offers the best chance for long-term survival, he adds, is a kidney transplant.

"Transplant patients live longer and fare better," DePalma says.

Fifty years ago, Dr. Joseph E. Murray performed the world's first successful solid organ transplant at Peter Bent Brigham Hospital in Boston. On Dec. 23, 1954, he transplanted a kidney from Ronald Herrick into his identical twin, Richard Herrick. Murray was a recipient of the 1990 Nobel Prize in medicine for his work in cell and organ transplantation.

"He is a genius," says Dr. David Laskow, transplant surgeon and chief of the Kidney and Pancreas program at Robert Wood Johnson University Hospital/UMDNJ. "The operation was so well designed that it has changed very little. It has stood the test of time."

The past half century has brought some improvements and technological advances, according to DePalma.

The development of better immunosupressant drugs lowers the rate of tissue rejection, according to DePalma, and laparoscopic techniques have improved the operation for the kidney donor, says Laskow.

Two doctors affiliated with Jersey Shore Medical Center in Neptune are testimony to the power of modern transplant techniques to save lives and to change them.

It was two years ago that Dr. Patrick Buddle, Wall, chief of rehabilitative medicine at Jersey Shore University Medical Center, donated a kidney to Dr. Anand Swaroop, Ocean Township, an orthopedic surgeon affiliated with that hospital. "He's a good friend," says Buddle. "It wasn't a tough decision."

It is both a personal and professional friendship that extends back nearly 20 years. Their specialties and, therefore, their patients often intertwined.

Swaroop was admitted to Jersey Shore in the summer of 2000, and discovered rather quickly that both his kidneys had shut down.

He started dialysis and was put on the kidney transplant waiting list.

There are broadly two types of donors -- living and deceased.

One day, Buddle asked Swaroop his blood type. They were both B positive. Swaroop initially was unsure about whether to accept the offer of his friend and colleague's kidney.

But on Dec. 19, 2002, the operation took place at the St. Barnabas Health Care System Renal Transplant Center in Livingston.

The operation took approximately eight hours and Buddle was back to work on a limited schedule within eight days. Swaroop returned to work in April 2003.

"Patrick is my angel," he has said.

The world could use a lot more angels.

Today, there are more than 82,000 Americans registered with the United Network for Organ Sharing on transplant waiting lists, according to The Sharing Network, the New Jersey Organ and Tissue Donation Services.

Every year, an estimated 6,000 people die while waiting for organ transplants. In 2001, there were 24,076 organ transplants performed in the United States, and more than 6,447 of those were living donor transplants, according to the Organ Procurement and Transplantation Network.

The most frequent type of living organ donation is kidney transplants. For the donor, there is little risk of living with one kidney, since the remaining kidney can do the work of both kidneys.

Since the transplant nearly two years ago, Buddle has become an ardent proponent of organ donation and a supporter of The Sharing Network.

The need may become only more pressing.

Diabetes and hypertension account for 75 percent of end-stage renal disease and both conditions are on the rise.

Additionally, says Laskow, the best medical opinion is moving to the idea of preventative kidney transplants.

"People should be on the transplant list when their kidneys reach a level of functioning at 20 percent. That can buy a year or two. But the average waiting period on the transplant list is four years." he says.

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This article posted January 6, 2005.