Georgetown End of Week 5

To finish up my transplant module, I watched a real life kidney transplant!

The NP who arranged this joked that we won't be on an elevated balcony, sitting in chairs behind glass, eating chips and looking down on the surgery like on TV. I was actually in the room, wearing scrubs, and right there with the MDs! I was really nervous because everyone was telling me I might get sick or pass out. Actually, it was very interesting and I found out that kidney transplant are the least bloody.

The NP timed it so that we only saw the donated kidney (from the receipient's mother) being attached. The old kidneys were not removed. The donated kidney comes with the artery and vein, the kidney, and the ureter all attached. They have to work very fast as soon as the kidney is removed from the ice bath; at one point they even had to throw some ice into the open abdomen (over the donated kidney) to keep it cold because the surgery was taking a bit longer than anticipated.

First, they clamp and sew the artery and vein onto the existing blood supply. Then, as soon as the sewing is complete, they unclamp and the blood begins to flow through the kidney, bringing it back to life - it got bigger and went from gray to red, very cool! Then, they look for any bleeds/leaks. They sew up any leaks, and burn off some small capillaries which may have bursted and are bleeding. They keep checking with gauze, until it shows clean with no more bleeds. Then, before attaching the ureter (from the donated kidney) to the bladder, they want to test that the kidney is making urine. This part was very fun - the attending squeezed the new kidney, and sure enough urine was squirting out the ureter! Then, they make a small incision in the bladder where the new ureter will connect, and sew it together. Finally, they stitch up the wound.

It was a great experience. I got to see a lot of anatomy and all of the skin and fat layers!