When a kid needs a kidney — again

When a child suffers from kidney failure, he or she is placed on the transplant list to locate a suitable donor organ. Family and friends often step forward to be tested as living donors, to speed up that search.

But sometimes — especially if they've had an earlier transplant that failed after a few years — finding a match becomes a lot harder.

Meet Jack Buller, age 9; Diego Smith, 15; and Angelica Cantu, 18. All have had a kidney transplant at some point in their young lives that later failed. To survive, all are undergoing dialysis treatment — an artificial process that helps filter toxins from the blood until another donor kidney can be found.

That could be a long wait — while these children become sicker and sicker. They are known as “sensitized,” or high-PRA (panel-reactive antibodies), patients because their previous transplanted kidneys exposed them to foreign proteins that they developed antibodies against.

Sensitized patients have a higher risk of rejection. The hope is to find an organ for which they have no pre-existing antibodies. A larger donor pool would make that search less difficult.

"Children on dialysis spend four hours a day, three to four times per week, connected to a hemodialysis machine," said Dr. Mazen Arar, medical director of the Pediatric Dialysis Program at University Health System and professor of pediatrics at UT Health San Antonio. "They need to follow a restricted diet and limited fluid intake.  Their quality of life isn’t great.  Dialysis offers them enough kidney function to survive, but it’s just a tool until they get the definitive treatment for kidney failure, which is a kidney transplant."

Jack, Diego, Angelica and their families took part in a news conference at University Hospital on Monday to share their own stories and ask the community to register  as an organ donor at donatelifetexas.org, or consider becoming a living donor. More information about becoming an altruistic donor can be found at  mattswish.com.

Diego underwent a kidney transplant at age 2. After a decade the kidney failed and he's been coming to University Hospital's pediatric dialysis unit three times a week while waiting for another matching donor kidney to surface, said his father, William Smith.

"After 10 years — even though we took care of him, made sure he had his medication and all that — he rejected the kidney," Mr. Smith said. "Monday, Wednesday and Friday...I drive him here at 6 a.m. and (his mother) picks him up at 10 or 11, whenever he's done, to go back to school. He gets probably 2-1/2 days of school a week."

Carlos Cantu, Angelica's father, said the Laredo teen has been on peritoneal dialysis at home since her transplanted kidney failed in 2015.

"If somebody out there can donate and help her to have a normal life, to help any patient here, it would be great," said Mr. Cantu, who has another daughter who also received a kidney transplant.

Jack, who suffers from congenital bilateral ureteropelvic junction obstructions, received his first kidney transplant in 2011. He, too, has been getting peritoneal dialysis at home while on the transplant list. Asked what he hopes to do when he gets his new kidney, he said: "go swimming."

Of the 11,689 people of all ages awaiting a kidney in Texas, 81 are children.

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