Then and now: Kidney transplants
You would never guess by looking at him that Bill
Thompson is a medical marvel: a 55-year-old man with an 82-year-old kidney.
Thompson received the kidney 40 years ago during a
transplant surgery at Children's Memorial Hospital that saved his life and made
medical history. The 1966 procedure was one of the first kidney transplants from
a living, unrelated donor to a child. There is little doubt that without this
pioneering procedure, Thompson would not be here today.
An unprecedented gift
As a boy, Thompson contracted a kidney disease called glomerulo-nephritis. When it led to kidney failure at age 15,
he was rushed by ambulance from Peoria to Children's Memorial and placed on dialysis
. Thompson
needed a new kidney to survive, but none of his relatives was a match. A priest
had already administered last rites when his mother's childhood friend, Verda
Walton, came forward and offered the ultimate gift. Her telegram read, “You have
a kidney. Mine.”
At the time, transplants from living relatives were rare,
and transplants from unrelated donors were nearly unprecedented. The headline
of 1966 news story about Walton reads, “Some call her a kook, but she may have
saved a life.”
Risk pays off
In 1966, the kidney transplantation program at
Children's Memorial was only 2 years old. At
that time, there were no pediatric transplant surgeons, so a
cardiovascular-thoracic surgeon performed the operation, which was
successful. Thompson's chances for
survival into adulthood stood at only 20 percent, while the likelihood of organ
rejection was nearly 70 percent.
Despite the odds, 40 years later, Thompson's kidney continues to function
well, decades beyond the average life span of a transplanted kidney, which is 15
to 20 years. He is the longest known surviving recipient of a kidney from an
unrelated donor, according to University of California at Los Angeles
Immunogenetics Center.
In 1966, Bill Thompson's chances for survival into adulthood stood at 20
percent. Today, children who undergo kidney transplants have 95 percent survival
rate five years after surgery.
A full life
Today, Thompson is a father and grandfather of six living
in Nashville, Tennessee. He has been a professional racecar driver, a pilot and
a senior executive at a medical equipment company. He says that without Walton
and the staff at Children's Memorial, life as he has known it would not have
been possible.
Decades later: remarkable progress
Forty years later in the spring of 2006, a
family from New Lenox, Illinois learned that their 9-year-old son, Brandon,
would need a new kidney to survive polycystic kidney disease
, a progressive, genetic
disorder of the kidneys characterized by multiple cysts (polycystic) in both
kidneys. Although researchers at Children's Memorial and other institutions are
making strides in identifying the causes of diseases like this, the condition
remains serious, even life threatening. Like Thompson, there was no viable
kidney donor in Brandon's family.
When Brandon told his teacher, Patsy Donahue, that he needed a new kidney,
the 25-year-old decided to undergo compatibility testing. She learned that she
was a match. “She walked in with balloons and said that she could give me a
kidney,” Brandon said. Donahue says she was inspired to donate, in part, because
years ago a bone marrow donor saved her father's life.
Hospital continues to lead
Today, children like Brandon receive the highest quality
transplant care because of a $6 million grant from the Siragusa Foundation,
which established the Siragusa Transplantation Center
at Children's Memorial in
1999. This gift transformed pediatric transplant care in Chicago, allowing it to
be more comprehensive through a multi-disciplinary team approach. It is enabling
a range of clinical and research programs to study outcomes and create wellness
programs to help children thrive after their surgery.
Richard A. Cohn, MD , medical director of the kidney
transplant program at Children's Memorial and professor of pediatrics at
Northwestern University's Feinberg School of Medicine, led a multi-disciplinary
team, including nephrologists (kidney specialists), transplant surgeons, nurse
practitioners, social workers and nutritionists, to evaluate Brandon's
preparedness for the surgery.
Unlike Thompson, Brandon had not yet started dialysis;
therefore, his surgery was a “preemptive transplant,” which has a higher success
rate. Approximately one-third of all kidney transplants at Children's Memorial
are preemptive.
In May 2006, Brandon received Donahue's kidney in a
three-hour transplantation surgery performed by Riccardo Superina, MD, surgical director of the Siragusa Transplantation Centerat Children's Memorial.
Superina holds the Robert E. Schneider Chair in Transplantation. Since its
inception, the hospital's pediatric kidney transplant team has completed 490
kidney transplants to date and reports post-transplant survival rates that rank
among the world's best.
Patient experience improves
While little has changed in the surgical techniques
used, the kidney donor's experience has vastly improved. Now a laparoscopic
procedure,
it is far less painful with a shorter recovery time. A kidney donor today, on
average, will spend only 36-48 hours in the
hospital.
“She walked in with balloons and said that she could give me
a kidney,” recalls Brandon.
Advances in medicine have improved the long-term prognosis for kidney
transplant patients. There are more medicines available to Brandon than there
were to Thompson and these newer immuno-suppressive drugs have reduced acute
rejection rates to about 10 percent.
Due to the effectiveness of these anti-rejection
medications, tissue type match is not as important as it once was. To be
considered a match, a kidney donor's blood type must be compatible with the
recipient's blood type, but does not
need be the exact same type. Additionally, the recipient should not
have pre-formed antibodies in the blood directed against donor
antigens.
Shorter waiting time
Another area of progress is the shorter waiting time to
receive a kidney. Typically, a child with a common blood type would wait one to
two years to receive a new kidney, while those with an uncommon blood type
waited an average of three to five years. A federal law passed in 2005 mandates
that the kidney of a deceased donor age 35 or younger must be first offered to a
pediatric recipient. Cohn says typically there are 15 to 20 children on the
waiting list for a kidney at Children's Memorial; presently there are only four.
He says this is a direct result
of the new legislation, which was championed
by the United Network of Organ Sharing and is expected to improve graft survival
rates as well. Today, a child with a kidney transplant has a 95 percent survival
rate five years after surgery.
Brandon's hero
Today, children who undergo kidney transplants have 95
percent survival rate five years after surgery.
Brandon spent one week in the hospital recovering from his transplant
surgery. A few weeks later, he returned to school for a celebration assembly
honoring him and his teacher, who was praised as a “hero” and “angel” in
widespread news coverage – quite a contrast to the perceptions of Thompson's
donor as a “kook” 40 years prior.
High hopes for the future
Brandon dreams of becoming a professional basketball
player and has high hopes for the growth spurt that often occurs after a child
receives a healthy kidney. Cohn and
his team will continue to monitor Brandon's health closely for many years to
come.
“As long as he maintains good kidney function, avoids
rejection episodes and infections, and takes his medicines reliably, Brandon has
an excellent prognosis for a long, healthy life,” says Cohn.
Although much has changed in the realm of pediatric kidney transplantation through
the decades, the generosity of organ donors, the bravery of children and the
expert care at Children's Memorial remain constant.
Children's Memorial Hospital seeks philanthropic funding to enhance its
programs and services. As a proud partner of the Children's Miracle Network
(CMN), all funds raised in the Chicago area through CMN also benefit Children's
Memorial. To find out how your support can help the hospital better serve
children and families, please contact the Children's Memorial Foundation at
773.880.4237 or Foundation@childrensmemorial.org.