Pediatric Transplantation at UW Health

MADISON - Eleven-month-old Brayden Welhoefer landed on the national organ donor list last August, after an initial diagnosis of biliary atresia, the main cause of liver failure among newborns and children. He waits for the same reason many children with liver disease wait - he's not yet sick enough to rocket to the top of the waiting list, yet not well enough to function normally.

Most children with Brayden's condition begin deteriorating at or around a year of age. It's at that point, his parents hope, that a donor will become available to him.

"It's difficult, to say the least," says Brayden's mother, Brenda Welhoefer, of her family's situation. "The waiting, having no control over this. The day-to-day is difficult, although, after all these months, it's almost normal. It's our version of normal."

When the time comes, Brayden will be in experienced hands at the University of Wisconsin Hospital and Clinics. UW Health's Transplant Program has performed more than 400 pediatric organ transplants since 1988, including liver, kidney, pancreas and multi-organ. UW Health pediatric liver transplantation surgeons have performed more than twice as many pediatric liver transplants as any other program in the state.

Niloo Edwards, MD, Tony D'Allesandro, MD, and Hans Sollinger, MD of the UW Health transplant team

Niloo Edwards, MD, Tony D'Alessandro, MD, and Hans Sollinger, MD of the UW Health transplant team

UW Health Pediatric Transplant Results Among the Best in the Nation
Their results are among the best in the nation. According to January 2008 data released by the United Network of Organ Sharing (UNOS), UW Health's one-month and one-year survival rates for pediatric liver transplant patients were at 100 percent, surpassing the national average by as much as 10 percent.

Some of the organs involved in these transplants come from living donors, because the liver is the only organ that can be resected and regenerated, says Tony D'Alessandro, MD, the director of the pediatric liver transplant program at UW Health. Living donor transplants involving adult donors are slightly less successful that those involving pediatric donors.

It used to be that pediatric patients with biliary atresia had only one treatment option - the Kasai procedure, in which physicians create an opening for bile to drain from the liver.

"These children used to die before the advent of liver transplant," says Dr. D'Alessandro. "Now, they can have a normal lifespan and quality of life."
The Need for Pediatric Donor Organs

But only if enough donor organs can be found to help them. One of the things that puzzles transplant surgeons - and everyone working in transplant - is that awareness of the need for pediatric organs often lags behind awareness of the need for adult organs.

"Children are one of the most satisfactory groups to help," says Dr. D'Alessandro. "And when they become aware, people are very sympathetic to a child's needs."

UW Organ and Tissue Donation works tirelessly to educate the public about the need for donor organs. Meanwhile, families like the Welhoefers wait.

"We're at that point where we want to move forward," says Brenda Welhoefer. "We feel like Brayden's ready for a transplant, and we're ready as parents for him to do that."

Learn More About Organ Donation and the UW Health Pediatric Transplant Program
Date published: 4/28/2008