Information Brochures

Transplant recipient Pooh (left) with donor Winnie (Surgery April 2000)

Currently, the success rate for canine renal transplantation is about 40%. To date our longest survivor has been 8 years following transplant. Our current longest living survivor was transplanted in 2001. The main cause of death is no longer rejection, but other problems associated with renal failure in the canine patient. For this reason we recommend that renal transplantation be performed for dogs as soon after diagnosis of renal failure as possible. We do not recommend waiting until all medical options have been exhausted. Renal transplantation is never performed on an emergency basis or as a last ditch effort to save the animal. Dogs that have ingested ethylene glycol (antifreeze) generally require a period of stabilization prior to transplantation. All candidates for transplantation must be in stable medical condition.

Costs
The cost (barring major complications) for renal transplantation in dogs is $11,000-13,000. If an animal requires dialysis prior to transplant this could add $3,000-4,000 dollars to the estimate. A deposit of $13,000 dollars will be required prior to transplantation. Immunosuppression may average from $150 dollars (small breeds) to $2,000 dollars (giant breeds) a month depending on the size of the dog and individual dose requirements.

There are certain criteria that potential renal transplant candidates must fulfill prior to being considered for transplantation. In general, although each case will be given individual consideration, all candidates must be free of any systemic diseases other than renal failure. Dogs with urinary tract infections may be considered if they are treated and have 2 subsequent negative urine cultures and pass a cyclosporine challenge. Please see the list of test results and findings that would preclude transplantation below.

The following tests should be performed with your regular veterinarian prior to contacting UC-Davis to set up an appointment. We require the results of all tests be faxed to us for assessment.

1. complete blood count
2. serum biochemistry profile
3. urinalysis
4. urine culture and sensitivity
5. urine protein:creatinine ratio
6. heartworm antigen test
7. toxoplasmosis titer (IgG and IgM)
8. thyroid (T4) test
9. echocardiogram
10. thoracic radiographs
11. abdominal ultrasound
12. coagulation panel
13. antithrombin III and fibrinogen levels
14. blood pressure
15. fecal exam

Test results or physical exam findings that would preclude transplantation include:

1. cardiac disease that produces significant hemodynamic compromise
2. urinary tract infection (see qualifications above)
3. inflammatory bowel disease
4. heartworm disease
5. neoplasia
6. diabetes or cushings disease
7. poor body condition
8. fractious temperament

You will be required to obtain a suitable donor dog for transplantation. The donor is at no greater risk for developing kidney problems than a dog with 2 kidneys and there are minimal risks associated with the surgery. Please see the donor requirements listed below for more information.

The donor animal should be < 6 years of age and free of any systemic illness. The donor should be of a similar size and body weight or slightly bigger than the recipient. The donor does not have to be the same breed as the recipient, but it is preferable to use donors of the same breed.
Screening tests for the donor include the following:

1. complete blood count
2. serum biochemistry profile
3. urinalysis
4. urine culture and sensitivity
5. heartworm antigen
6. toxoplasmosis titers (IgG and IgM)
7. intravenous pyelogram
8. blood type and blood cross-match compatible to the recipient

Please fed-ex the following samples from the recipient and each donor to:

Midwest Animal Blood Services Inc.
4983 Bird Drive
Stockbridge, MI 49285

Toll Free: 877-517-MABS
Office (517) 851-8244
Fax (517) 851-7762

The lab will perform the required tests to determine the histocompatibility of the recipient and donor pair. The cost per donor/recipient pair will be billed to you. Contact Midwest Animal Blood Services Inc. for detailed instructions.

Transplant recipients will require immunosuppressive medications in pill form for the rest of their lives. Most medications are given every 12 hours. Routine cyclosporine assays, complete blood counts, and serum chemistry panels will be necessary weekly for the first month and then decreasing in frequency as the patient stabilizes. These tests are not included in the estimate and are usually performed by your referring veterinarian. It will be very important that you have access to a 24-hour emergency hospital and a referring veterinarian who is willing and able to help with managing a renal transplant recipient when the animal returns home.

Major complications that can occur after transplantation include acute rejection of the kidney, infections, and complications with drug therapy including, hepatotoxicity, bone marrow suppression, gastrointestinal problems, and neoplasia. These complications may require immediate and aggressive emergency treatment and can be fatal. The recipient is usually in the hospital for 10-14 days following transplant, barring no major complications. The donor may be discharged 2 days after surgery.

To make an appointment or if you have further questions, please contact:
Small Animal Admissions at (530) 752-1393 and ask for the Renal Transplant Coordinator. Please address faxes ATTN: Renal Transplant Coordinator and fax to (530) 752-9620.