REPLACING A FAULTY KIDNEY

The patient's kidneys were infected, inflamed, and all but useless. For a time, he had been kept alive by drugs and a strict diet limiting his intake of fluids and salt. But that was only temporary treatment. His doctors calculated that he had about eight weeks to live.

What he needed was a new kidney; doctors at Boston's Peter Bent Brigham Hospital who have pioneered with transplanted kidneys since 1950, decided to try and give him one. First they needed a healthy volunteer to donate a kidney. They found one--a woman. Then they got down to one of the most hazardous tasks of modern surgery, that of transplanting a living organ from donor to host.

They attacked a basic transplant problem. Donated tissue usually is assaulted by antibodies in the host, resulting in a transplant that does not "take." So the male host was given drugs (azathiopurine and azaserine) that experiments had shown to be the most effective in interfering with transplant rejection.

In one operating room, surgeons made an incision in the woman donor. Removing her kidney, they placed it in a basin and carried it to an operating room next door, where another team was removing the male host's right kidney.

The donated kidney arrived right on schedule after a "bed" had been prepared for it at an unnatural site in the host's lower abdomen near the hipbone. Working quickly, the surgeons sutured vein, artery and ureter of the kidney to the host's blood vessels and ureter. After clamps were removed, blood began to course through the kidney. But it will be months before the doctors will know for sure whether the transplant was a success.

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