Transplantation

Foundation-wide, the Mayo Clinic Kidney Transplant Programs constitute the largest renal transplant practice in the USA. The Kidney Transplant Program at Mayo Rochester is the largest living donor program in the country. The number of kidney/pancreas transplants in Rochester has increased from 87 in 1995 to 252 kidneys and 23 pancreas in 2003. Innovative programs have been developed to address the issue of limited organ supply. These include clinical protocols for ABO Blood Group incompatible and positive crossmatch kidney transplantation and for an expanded living donor pool. Other initiatives are focused on the two main factors that limit the long-term success of renal transplantation, chronic allograft nephropathy and premature cardiovascular mortality. The pancreas transplant program at Mayo Rochester is also among the largest in the nation with an emphasis on pancreas after kidney transplantation or solitary pancreas transplantation for selective patients. As an extension of the pancreas transplant program, this section is actively involved in the islet transplant initiative in Rochester. The islet isolation facility has been completed and extensive pre-clinical studies have been successful. An FDA IND, required for all clinical transplant programs in the U.S., will be submitted early in 2005 with plans for the first clinical islet transplantation to occur shortly thereafter. Looking further towards the future, approaches pioneered by the Transplantation Biology Program are the genetic engineering of compatible organs (organogenesis) and the use of genetically-engineered animal organs (xenotransplantation).

• Optimal immunosuppressive regimens in Kidney and Kidney-Pancreas transplantation, including transplant of organs to individuals at high risk of rejection because they are ABO-incompatible or have positive cross matches with the potential donor
• Mechanisms of immune tolerance
• The Division of Nephrology plays an important and active role in the Mayo Clinic Transplant Center, a unique resource that fully integrates medicine and surgery in a collegial, collaborative effort.