Feline Kidney Transplants

The Kidney Donor

Qualification

The donor can be selected from other cats in the same household or, as is more common, from an animal shelter. At university facilities donors are often selected from a research colony of cats who have been involved in benign experiments such as nutritional studies. Well established transplant facilities have made the necessary arrangements with local SPCA or Humane Society personnel. The donor is generally between one and three years old, the same relative size as the recipient and must be screened for disease and other health conditions.

Identifying a compatible donor is relatively easy since cats are far more genetically similar than humans with about 99 percent of American domestic shorthairs having the same "A" type blood. The process for verifying a match is to literally mix fresh blood from the recipient and the donor and then look under the microscope for any signs of clotting or incompatibility. There is no need for tissue matching and the donor can be male or female no matter what sex the recipient is. In some cat breeds (especially British Shorthair, Cornish Rex and Devon Rex) the occurrence of type "B" blood is as high as 50 percent and finding a matching donor can be more difficult. Other breeds with significant percentages of Type "B" blood include the Abyssinian, Himalayan, Japanese Bobtail, Persian, Somali and Sphinx breeds. There is a third feline blood type, "AB", but this is extremely rare.

Selection

If the donor is to be selected from a shelter, the transplant staff will visit the shelter and identify one or more potential donors. If there are multiple donor candidates you may select from among them. This is a very important part of the process because this new cat will become a part of your family, whether the transplant procedure is successful or not. Time should be taken to get to know your new adoptee, decide on a name and develop a bond. Focus on the fact that, no matter how the transplant turns out, you will have rescued and provided a home for this new family member. This bonding is essential and will help to overcome any negative or ambiguous feelings if the transplant is not successful.

Preoperative Treatment

Preparation of the donor is essentially the same as for any major surgical procedure. The donor is shaved, primarily on the abdomen and chest. The donor's risk is no more than for any major surgery and because the donor must be young and fit, problems are rare.

Postoperative Treatment and Homecoming

After the surgery, it is generally possible for the donor to go to his new home in just a few days while the recipient normally remains in the hospital longer. This period provides an ideal time to get to know the donor and vice versa. Follow-up care, which is minimal, includes a trip to the local vet to have the stitches or staples removed and a short course of precautionary antibiotics. The life expectancy for the donor is considered to be no less than for cats with both kidneys; the donor is no more subject to renal failure than a normal cat with two kidneys. The remaining kidney in the donor enlarges to provide about 75% of the total function of two kidneys. This is far in excess of the 25-30% threshold required for normal function.

Ethical Considerations

There are lingering ethical questions concerning animal transplants and most center around the donor. Some shelters are bound by general rules that prevent them from cooperating with transplant facilities. The feline kidney transplant program was established with a strict donor adoption requirement and sacrificing the donor for the benefit of the recipient was not an option; both cats were to be treated with equal importance and care. As transplants become available at more facilities, it is important to be certain that the veterinary surgeon you select is qualified, experienced and in tune with your personal feelings on the ethical issues.