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Double duty for donor kidneys.

Every week in the United States, about 16,000 people hook up to dialysis machines because their kidneys do not function properly. Only about half of these individuals will get much-needed transplants.

Now, however, physiologists plan to make donated kidneys do double duty by developing a way to divide each organ and transplant each half into a recipient. To investigate this possibility, Dilip 5. Kittur of Johns Hopkins University School of Medicine in Baltimore first studied pigs, whose kidneys anatomically resemble those of humans. In early experiments, he removed and split kidneys, then implanted half a kidney back into each 3-month-old donor pig. The pigs thrived for several years, reaching weights of roughly 400 pounds, he says.

Last year, Kittur's team removed the kidneys from another dozen pigs, implanting half of each kidney into the donor and the other half into a different pig. The researchers found that they could successfully hook up a half kidney in a new pig. But because they did not treat the animals with immunosuppressant drugs, these pigs rejected the transplants. In further work, Kittur says, the researchers hope to use immunosuppressants and assess how well a donated mini-kidney works.

At the same time, Kittur analyzed the anatomy and blood flow of kidneys of deceased humans. Until now, scientists assumed that they couldn't easily divide a kidney because of the arrangement of blood vessels in this organ. But the cadaver studies led Kittur to conclude that he could halve a human kidney if he first altered the connections of two arteries. "It's not too hard to do. It's just the concept that's different" he says.

Other researchers who have evaluated the survival of people who lost all but half a kidney to cancer or some other disease determined that half a kidney can function for at least 10 years. "But they have some amount of damage from having too much work to do," Kittur notes. Also, even small rejection reactions will further impair kidney function. Nonetheless, he thinks the procedure should help relieve shortages of donor organs.
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Title Annotation:methods for transplanting one kidney into two patients explored
Author:Pennisi, Elizabeth
Publication:Science News
Article Type:Brief Article
Date:Apr 17, 1993
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