The kidney came from his grandfather
A boy from Greece born with a kidney defect now has a greater chance of a full and healthy life because of a new kidney donated by his Baltimore grandfather. Eleven-year old Dimitris Attiti's urinary tract did not form properly in the womb. It is a condition known as posterior urethral valves.
"It is a rare, and potentially devastating abnormality," says kidney specialist Susan Mendley, M.D., director of pediatric nephrology at the University of Maryland Hospital for Children and assistant professor of pediatrics and medicine at the University of Maryland School of Medicine. She adds, "Over time, a patient's kidney function may decline to the point of kidney failure, which is what happened to Dimitris."
"As he got bigger, he experienced progressive kidney failure," says Alan Farney, M.D., Dimitris' transplant surgeon at the University of Maryland Medical Center, who is also an assistant professor of surgery and pediatrics at the University of Maryland School of Medicine.
Dimitris was born in the United States but has spent most of his life in Greece, his father's homeland. He was seen by doctors in Athens, but this winter when his condition worsened, he traveled back to his mother's native Baltimore to undergo care at the University of Maryland Hospital for Children. "He had advanced renal failure," says Dr. Mendley. A transplant was inevitable and he needed dialysis for a month and a half while he and his grandfather prepared for the surgery.
Right now there are close to 49,000 people in the United States waiting for a kidney transplant. Dimitris was lucky that he didn't have to wait. When his grandfather, Paris Pearce, learned a transplant was needed, he offered one of his kidneys. "He said if he were a match, he would give Dimitris a kidney," recounts the boy's mother, Tamara Attiti.
Neither of Dimitris' parents had the same blood type as their son, but his healthy and fit 58-year old grandfather did, making him a good match as the donor. Transplanting a kidney from an adult to a child is often very successful. Children's bodies adapt to an adult-sized kidney.
Dimitris and his grandfather underwent a living donor kidney transplant in late April at the University of Maryland Medical Center, which has the largest kidney transplant program in the United States. The Medical Center also has performed more of the less invasive laparoscopic procedures for removal of a kidney from living donors, called laparoscopic nephrectomy, than any other hospital in the world. In the five years that doctors have been using this method, more than 650 of these laparoscopic removals have been completed at the University of Maryland Medical Center.
Using a laparoscope, surgeons make a small incision near the navel, as well as four small holes in which they can insert instruments. The laparoscope has a miniature camera which enables surgeons to watch what they are doing on a video screen. When the kidney is disconnected, the instruments are used to wrap it in a plastic bag and slide it out through the two and a half-inch incision. This procedure was used to remove Mr. Pearce's kidney. Since laparoscopic kidney removal is less invasive, Mr. Pearce was able to leave the hospital in just two days.
"Children have more living donor transplants than adults because they often have family members, like parents and siblings, and in this case a grandparent, who are willing to give an organ," says Dr. Mendley. According to the United States Renal Data System, in 1998 there were 409 living donor kidney transplants for people under the age of 20, as compared to 337 cadaver kidney transplants in that same age group. The living donor transplant is often less complicated; there is less chance of rejection and there is immediate function of the organ.
"Dimitris now has a functioning kidney, however, he must take anti-rejection medication for the rest of his life," says Dr. Farney. Transplant recipients must take the drugs to prevent their immune system from destroying the new kidney. But Dimitris doesn't mind. For the next few months, he will come to the University of Maryland Hospital for Children twice a week for blood tests, but according to his mom, "He has a different life. He's happy to be able to eat foods he couldn't have before because of his kidney condition." Dr. Farney recalls the first forbidden food Dimitris wanted after his transplant was chocolate.
"The transplant is not a cure for Dimitris, but it is the best possible treatment," says Dr. Mendley. A kidney from a living donor lasts an average of 10 to 12 years, so Dimitris could potentially need several more kidney transplants during his lifetime.
In the past three years, surgeons at the University of Maryland Medical Center have performed nearly 20 pediatric transplants. "Treating a child is especially rewarding. You can have a great impact on their life," adds Farney.
"I am grateful for what my father has done for my son, and the wonderful care he has received at the University of Maryland Hospital for Children," says Dimitris' mother. "He is now a happy and healthy boy."
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