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Pediatric Kidney Transplant Program: Offering More Than Exceptional Outcomes

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The Pediatric Kidney Transplant Program at the University of Wisconsin Hospital and Clinics offers exceptional outcomes for its patients, and something more.

 

Elizabeth Gerndt-Spaith, UW Health transplant nurse coordinator, elaborates on the program's unique aspects. "We are able to care for patients from childhood through their teen, young-adult and adult years all in the same center."

 

The UW Health pediatric kidney transplant program provides a consistency for the patient and the same transplant surgical team, practices and clinic location, among other aspects. The team strives to provide a familiar and comfortable experience for patients from the time of their initial evaluation through their lifetime of care.

 

"One of the most important aspects of our approach to pediatric kidney transplantation," says Gerndt-Spaith, "is that we can transition our pediatric patients into the adult medical world while maintaining the same coordinator, social worker and nutritionist."

 

This means the patient will stay connected to their transplant team and not get "lost" in the adult medical world.

 

The UW Health pediatric kidney transplant team consists of a pediatric transplant nephrologist, a transplant surgeon dedicated to the performance of pediatric kidney transplants, a pediatric transplant coordinator, a social worker and nutritionist.

 

"The combined experience of our pediatric kidney transplant team gives parents confidence in their selection of the UW Health program for their child's transplant," says Hans Sollinger, MD, surgical director of the program. "It comforts them to know that we do so many pediatric kidney transplants, and with such excellent outcomes."

 

The UW Health pediatric kidney transplant program ranks in the top 20 percent of the programs in the country, based on volume. The majority of kidney transplants performed in children at UW Hospital and Clinics are living donor, with a parent being the most frequent donor. Other relatives or family friends can also donate if necessary.

 

For children needing to receive a kidney transplant from the deceased-donor waiting list, the wait is shorter than most programs in the country. This is due in large part to the high deceased-donor rates in Wisconsin.

 

The chart below illustrates the total number of pediatric kidney transplants done at UW Hospital and Clinics since the program's inception - broken down by transplant type.

 

Type of Transplant Number of Transplants
Deceased Donor Kidney 93 
Live Donor Kidney  200 
Kidney/Liver Combination 
Kidney/Pancreas Combination 
Total Kidney Transplants  296 


Source: UW Hospital and Clinics Transplant database, program inception-11/09

 

The pediatric kidney program is impressive in another important area - outcomes. The team at UW Hospital and Clinics has done exceptional work with live kidney donors for pediatric patients.

 

"We encourage families to explore living donation options," says Dr. Sollinger. "Living donor kidneys have a longer lifetime in general, which is especially important for pediatric patients, since we expect them to live long, healthy and normal lives."

 

The outcomes for living donor transplants at UW Hospital and Clinics are above the national survival rates. The chart below illustrates this success for pediatric living-donor transplant patients.

 
  UW Expected National
1 Month Survival (n=12) 100 97.73 97.73
1 Year Survival (n=12) 100 96.04 96.03
3 Year Survival (n=20) 95 91.95 88.77
 
   Green indicates UW Health performed better than peer group
 
* One graft loss due to recurrent immunologic disease.


The one-year survival rate for living donor transplants is 100 percent, while the national rate is 96.76 percent. At three years, the UW Hospital and Clinics rate also exceeds the national average with a 90 percent survival rate versus 86.57 percent nationally*. For deceased-donor kidney transplant grafts, the survival rates are at 100 percent for one month, one year and three years.

 

"Our transplant program is world-renowned for its innovation and outcomes," says Gendt-Spaith.

 

Gerndt-Spaith attributes these exceptional outcomes to the surgeons, physicians and whole-team approach, which includes parents/families and patients. The pediatric transplant program, headed by Sharon M. Bartosh, MD, includes an exemplary array of physicians, surgeons and staff.

 

In addition to exceptional surgical practices, another unique aspect of the pediatric program is its innovation in medical management.

 

"We are one of only a handful of programs in the country that offers and has significant experience with the use of prednisone-free immunosuppression for children," reports Dr. Bartosh.

 

Because of the significant side effects of prednisone, the majority of our families choose a prednisone-free option, offered at the University of Wisconsin for more than six years.

 

"The level of experience our team has gained using prednisone-free immunosuppression ultimately benefits not only our patients but provides experience for other centers that might be contemplating such unique immunosuppression regimens," Dr. Bartosh adds.

 

The results of the prednisone-free program have been presented both nationally and internationally to disseminate the experience at UW Hospital and Clinics.

 

Gendt-Spaith notes two additional factors that impact the outcomes for pediatric kidney transplant patients: evaluating all potential donors, whether they are related to the patient or not, and educating the families on long-term outcomes.

 

"We are often told how great it is that we treat patients not only as individuals, but as members of the team - which they are - and not as numbers like some facilities."

 

The whole-team approach means that patient education is a vital part of the equation.

 

"We want and expect our patients to join the team in knowing all they need to know about the transplanted kidney, its function, their lab values and medications, so that they feel committed to staying healthy and know how they can contribute to the long-term success of their transplant."

 

Referring providers and patients who have questions about scheduling an appointment for a potential kidney transplant should call (608) 263-9531. At any time you may ask to speak to one of the pre-transplant kidney coordinators or a transplant surgeon.