Kidney Patient Functioning With Donation from 2-Year-Old

Kidney Patient Functioning With Donation from 2-Year-Old

February 10th, 2008 @ 7:46am
by Associated Press

TUCSON, Ariz. (AP) _ It gave this kindly man pause _ that the two kidneys that could heal his body and give him a free and active life would come from such a young child.

But in yet another landmark organ transplant at University Medical Center, William Diehl _ a Willcox grandfather _ was given kidneys donated by a 2-year-old on the morning of Dec. 10.

``It kind of bothered me _ that the organs had to come from a baby,'' he said. ``I had to think about that.''

But the fact is that when transplant surgeons finally figured out that they actually could use these very small organs to save adult lives, it has put a small dent in the horrific shortage of donor kidneys in this country.

Right now, more than 74,000 people are waiting for kidneys. But fewer than a quarter will get one in the coming year.

``These baby-to-adult transplants are not frequently done _ usually at the major transplant centers,'' said Dr. Rainer Gruessner, University Medical Center's new chief of surgery. Gruessner has brought cutting-edge experience as an abdominal transplant surgeon to an effort to rebuild the hospital's transplant program.

``But the issue is so many patients waiting on the kidney list,'' he continued. ``Using these small donors for adults is one way to expand the kidney transplants we can do.''

For a man of 56, a single kidney from a child so small would not do the job. So surgeons instead transplant the child's entire kidney block _ the two kidneys connected by the major blood vessels _ into the adult.

This is known as an ``en-bloc'' kidney transplant _ a technically challenging and somewhat riskier surgery than the far more common transplant with a single adult donor kidney.

Only about 100 en-blocs are done per year in this country, using donors younger than 5. As the surgical techniques have improved _ to deal with hooking very small organs and vessels up to an adult-size body _ several studies have concluded that the operations are getting excellent results and should be done more often.

``In the current era of severe organ-donor shortage, use of en-bloc technique allows for valuable utilization of deceased donor kidneys that might otherwise be discarded,'' states an analysis of this transplant in a 2005 issue of the American Journal of Transplantation.

But chief among the en-bloc risks is a higher threat of a blood clot, which can be triggered by the child donor's very small blood vessels.

``That was the problem that caught my attention,'' said Diehl, who is doing so well post-transplant that he actually made a trip to Willcox a couple months ago.

Since the transplant, he no longer needs dialysis _ that three-times-a-week grind of hooking yourself up to a machine for several hours to do the work of failed kidneys. It's a tedious procedure that leaves patients drained of energy.

Diehl had been on dialysis for a year and a half _ ever since his kidneys failed due to polycystic kidney disease. He probably has had the disease all his life but was not diagnosed until he was nearly 40. He finally lost one kidney to the disease in May 2006, with the other all but dysfunctional.

Diehl, who has four grown daughters and seven grandchildren, is regaining strength and enjoying new freedom to be with his extended family.

``He's a basically healthy man in good shape, and we wanted to go ahead with this when the kidneys became available,'' Gruessner said.

``The whole aim of a kidney transplant is to get patients off dialysis, and we didn't want to wait,'' Gruessner said. ``With the donor shortage, that wait could have lasted many more months.''

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