And we have a winner!

Kidney Transplantation

It was always going to be transplant.

Transplant, winning the nephron lottery.

Every patient on dialysis, every child of a CKD 5 parent, every mother of an ARPKD baby, all dream about receiving The Call. The phone call that changes their lives. The call that renews life, that restores hope. Some of our most powerful moments in nephrology are related to transplant. Telling a patient that they didn’t need dialysis ever again, after a particularly long delayed graft function. Seeing a patient return to the dialysis unit after receiving a kidney to say “hi” to her dialysis shift friends and everyone ending up with tears rolling down their cheeks.

Patients place all their hopes and dreams on transplant. Doctors and patients can fall into the trap of treating transplant like an escape hatch from the difficult journey through chronic kidney disease and dialysis. However transplant is still an imperfect cure. Transplant is way too rare. With 400,000 people in ESRD, there are less than 20,000 transplants performed a year and that number seems to be depressingly flat. While we have seen dramatic success in improved one year graft survival and knocking out acute rejection, chronic rejection is still pervasive and a problem that needs new answers.

Data from the OPTN/SRTR 2011 Annual Data Report. Graph by eAJKD

We see rays of hope in new drugs, new organ distribution algorithms and even science fiction sounding techniques like printing kidneys and xenotransplantation. It should be an exciting future. Transplantation will not have One Shining Moment.

Here are the final poll results

(1) Medicare ESRD Benefit (17,45%)

(1) HEMO Trial (3.17%)

(1) Captopril (15.87%)

(2) Kidney Transplant (63.49%)

Click here to download the complete bracket