Advances in Pediatric Transplantation

The Pediatric Kidney Transplant Team at NewYork-Presbyterian knows just how important living donors are for the long-term health and well-being of pediatric recipients. As one of the most active living donor programs in the nation and the largest living donor kidney transplant program in the region, NewYork-Presbyterian continues to advance the use of living donor kidney transplants for children. In 2019, we performed more living donor kidney transplants than ever before.

Our program closely collaborates with the National Kidney Registry (NKR) in order to increase access to living donors. In collaboration with NKR, New York-Presbyterian/Weill Cornell Medical Center harnesses the power of social media to develop a unique Microsite Program to help families find potential donors.

The program consists of a customized website that includes living donor education and allows potential donors to register, as well as a personalized story about why the child needs a kidney. The microsites are reviewed and approved by the team at New York-Presbyterian/Weill Cornell and NKR before being published and shared on social media. Families are also given customized business cards to share with others in order to help find a potential donor. Rebecca Craig-Schapiro, MD, PhD, a pediatric kidney transplant surgeon at NewYork-Presbyterian/Weill Cornell, notes that the response from families has been positive and all children who have signed-up for the Microsite Program have been recently transplanted.

The pediatric kidney transplant team at New York-Presbyterian/Columbia University Irving Medical Center is committed to improving outcomes and supporting adolescent kidney transplant recipients as they transition from pediatric to adult care. Adolescence and the transition to adult care can be an extremely difficult period for transplant recipients—a time where medication adherence issues often arise, leaving young patients vulnerable to organ rejection.

“I’ve found that many adolescents and young adults don’t have the basic information and skills they need to manage their medical illness, what’s at stake, and how to prevent losing their kidney transplant and going on to dialysis,” says Hilda Fernandez, MD, Medical Director of the Pediatric Kidney Transplant Program at NewYork-Presbyterian/Columbia. “Our teens have to juggle their chronic medical problems and all the usual demands of being a teenager. They need specialized psychosocial support. Our clinical psychologist works with our solid organ transplant team, increasing the quality of the services we provide, screening for mental health issues, and assisting with counseling and referrals,” adds Dr. Fernandez.

Dr. Fernandez is part of the multidisciplinary group at NewYork-Presbyterian including social work, child psychiatry, clinical psychology, neuropsychology, pharmacy, and pediatric transplant providers from the heart, liver and kidney programs who all collaborated to create a robust Transition Program for young adults. The Solid Organ Transplant Transition Committee meets regularly to discuss issues related transition preparation for patients moving from pediatric- to adult-transplant care. Patients who are eligible for transition preparation must be 16 years of age and older. The Transition Committee also addresses ethical issues in regards to autonomy, guardianship, as well as allograft outcomes, and mental health.

The Columbia Kidney Transplant team transfers care of their young adult patients when they are at least one-year post high school, or when the young adult is prepared medically and mentally to make that transfer to adult services.