Cat Kidney Transplant – The Health of Both the Recipient and Donor Matters

Kidney disease in cats is very common. Sometimes it can be managed well with relatively simple treatments like fluid therapy, dietary changes, and medication. At other times, these therapies don’t provide enough relief from the symptoms of kidney disease, or they stop working after a period of time. When this happens, it’s the end of the road for most cats, but for a lucky few, a kidney transplant might be a reasonable option.

To be a good candidate for kidney transplantation, a cat should not have any other significant health problems other than the kidney disease—no cancer, immune disorder, active infectious disease, chronic metabolic disease, etc. When looking at the potential costs and benefits of an aggressive form of treatment like organ transplantation, younger cats generally make better candidates than do extremely old cats.

The cost of a kidney transplant is prohibitive for most owners. The University of Georgia’s (UGA) College of Veterinary Medicine puts it this way:

Without serious complications, the estimated cost of a renal transplant is $12,000 to $15,000, including the donor and recipient. These costs are subject to change and serious complications do occur in some cats, resulting in increased cost….

Owners generally spend around $1,000 per year for medication and testing after the transplantation.

And did you notice that mention of “donor and recipient"? If you are considering a kidney transplant for your cat and all goes well, you’ll actually be going home with two cats instead of one, because as UGA says:

Donor cats “give” one of their kidneys in exchange for a permanent and loving home. All donor cats must be adopted by the recipient’s family. Clients assume financial and legal responsibility for the donor prior to the transplantation.

Before considering a kidney transplant, most owners are understandably concerned about the prognosis for their cat with kidney disease. Studies at several veterinary schools around the country that perform kidney transplants show that around 80% of cats survive for at least six months after surgery, with approximately 65% still being alive three years later. Most of the cats that do well after kidney transplant actually die of something other than kidney disease.

But the long term health of the donor cat is equally important. After all, we’re putting them through surgery and taking away at least half of their kidney function, right? Would it really be ethical to do so if we were essentially trading one cat’s wellbeing for another? Recent research has examined how kidney transplantation affects the health of the donor cat.

The study looked at the medical records of 141 cats that donated a kidney and found the following:

• No cats died or were euthanized around the time of surgery.
• Two cats suffered complications during surgery.
• Seventeen cats suffered complications after surgery.
• For the 99 cats who had long-term follow-up (3 months to 15 years), three cats developed chronic kidney disease, two had an episode of acute kidney injury, and one developed bladder inflammation. Nine cats had died by the time the study was performed—two from chronic renal failure and four from a blocked ureter (the tube that carries urine from the kidney to the bladder).

The authors concluded:

Most cats (84%) for which follow-up information was available had no associated long-term effects [of donating a kidney]. However, a small subset (7%) developed renal insufficiency or died of urinary tract disease.

What do you think of those odds?

References

Feline Renal Transplantation Program. University of Georgia College of Veterinary Medicine. Accessed 2/11/2016.

Perioperative morbidity and long-term outcome of unilateral nephrectomy in feline kidney donors: 141 cases (1998-2013). Wormser C, Aronson LR. J Am Vet Med Assoc. 2016 Feb 1;248(3):275-81.