Stanford Medicine Children’s Health’s Pediatric Transplant Program Once Again Achieves National Recognition

The SRTR registry, which analyzes data collected by the Organ Procurement and Transplantation Network and other sources, noted the following achievements for Stanford Medicine Children’s Health in 2020:

• No. 1 in the Western United States in organ transplant volume in patients 18 years and younger, and No. 3 nationwide.
• No. 1 in kidney transplant volume and survival outcomes in the United States.
  • Over the past five years, Stanford Medicine Children’s Health has performed more pediatric kidney transplants than any other U.S. program.
  • One-year and three-year survival rates for Stanford Medicine Children’s Health kidney transplant patients are 100 percent.
• No. 1 in the Western United States in pediatric heart transplant volume.
  • The world’s first pediatric heart transplant was performed at Stanford more than 35 years ago. Since that time, the organization has performed more than 440 pediatric heart transplants.

• Stanford Medicine Children’s Health has performed the highest volume of pediatric heart transplants in California for nine straight years.
• In addition to performing 24 heart transplants in 2020, the team implanted 18 ventricular assist devices (VAD), which help extend patients’ lives until they receive a donor heart. Stanford Medicine Children’s Health is one of the highest-volume pediatric VAD programs in the United States.

• Stanford Medicine Children’s Health cares for some of the youngest, smallest, and most acute patients in the country. In 2020, four patients younger than 1 year were transplanted, with the youngest being just 5 months old.

• No. 1 in pediatric liver transplant volume in the Western United States.
  • Stanford Medicine  Children’s Health has performed more than 800 pediatric liver and intestinal transplants since the inception of the program in 1995.
  • The median liver transplant waiting time for Stanford Medicine Children’s Health patients is 2.7 months, compared with the national median of 10.1 months.
• Home to the only pediatric lung transplant program west of Texas.
  • The first pediatric heart-lung transplant was performed at Stanford in 1988, and since then, the organization has performed more than 85 pediatric lung and heart-lung transplants.

“This recognition as a top provider in the nation for pediatric transplantation is a testament to the providers, scientists, and engineers at Stanford whose collaboration continues to advance the field of transplantation,” said Carlos Esquivel, MD, PhD, chief of the Division of Transplantation at Stanford Medicine Children’s Health. “Achieving such high transplant volumes and success rates is especially significant to us at Stanford Medicine Children’s Health because we care for the most complex and acutely ill organ failure patients in the country, including many who have been deemed not suitable for surgery by other centers due to their high risk. Because of our extraordinary clinical breadth and coordination, we are able to provide the best possible care for these patients and their families to ensure great long-term outcomes.”

Stanford experts have performed a total of more than 2,000 pediatric solid organ transplants to date. Patients come from across the United States and even internationally to benefit from the expertise of Stanford Medicine Children’s Health’s pediatric transplant program. In 2020 alone, 20 pediatric transplant patients came from out of state.

In addition to kidney, heart, liver, intestine, and lung transplants, Stanford Medicine Children’s Health is a national leader in combined-organ transplants, in which two or more organs, such as heart-lungs, heart-liver, or kidney-liver, are given to the same patient in a single surgery. In the last five years, Stanford Medicine Children’s Health has performed nine combined liver-kidney transplants, seven heart-liver transplants, three heart-kidney transplants, two liver-intestinal-pancreas transplants, and two heart-lung transplants.

If not for organ donation, transplantation would not be possible. For the last two years, Stanford Medicine Children’s Health has earned the Platinum Award from the Health Resources and Services Administration’s Workplace Partnership for Life Hospital Campaign for its outstanding contributions to raising organ donation awareness in the hospital and surrounding community. Currently, 42 pediatric patients are on the active waiting list for organs at Stanford Medicine Children’s Health.

Pioneering new approaches for pediatric transplantation

Stanford Medicine Children’s Health’s physician-scientists are continuing to advance Stanford Medicine’s history of transplant innovation. This includes a groundbreaking collaboration between the pediatric stem cell transplant and kidney transplant teams to treat Schimke immuno-osseous dysplasia (SIOD), an extremely rare genetic disease that affects multiple systems in the body, including the kidneys and immune system.

The first-of-its-kind treatment is a two-transplant approach—a stem cell transplant, which provides the patient with a new immune system, followed by a kidney transplant from the same donor, usually a parent. Replacing a child’s immune system with a parent’s allows the transplanted kidney to be accepted by the body as if it were native. The risk of rejection that comes with kidney transplants is potentially eliminated—as is the need for long-term immunosuppressant medication.

“By removing the need for medication following transplants, we are removing the toxicities associated with these drugs,” said pediatric hematologist Alice Bertaina, MD, PhD, who leads the stem cell transplant team at Stanford Medicine Children’s Health. “Without medications and long hours of dialysis, quality of life for these children is dramatically improved.”

Dr. Bertaina is the worldwide pioneer in the novel transplant technique that enables a parent to donate both bone marrow and a kidney to his or her child. The transplant method, known as alpha/beta T-cell depleted haploidentical stem cell transplantation, uses stem cells from a partially matched donor—such as a parent—who shares only half of his or her cellular immune markers with the recipient. In the technique, immune fighter cells called alpha/beta T cells are selectively eliminated from the donor’s stem cells before the cells are given to the child. This reduces the risk of graft-versus-host disease, which is otherwise a frequent complication of stem cell transplants.

“My hope is for these patients to live far beyond childhood and become adults with healthy immune systems and functioning transplanted kidneys,” said Dr. Bertaina.

So far, Stanford Medicine Children’s Health has used the double transplant approach to treat three patients with SIOD—including brother and sister Kruz and Paizlee Davenport of Muscle Shoals, Alabama, the first pair of siblings in the United States to both be diagnosed with the condition. All three patients have been successfully transplanted and achieved full donor engraftment, as well as normal kidney function, eliminating the need for anti-rejection medications.

“With the first SIOD patient, this approach was almost an unthinkable idea, and now it’s a reality. We can offer children with this condition a chance at a cure, and that’s very exciting,” Dr. Bertaina said. “We are very optimistic that this unique approach to treating SIOD could be used to treat other rare, genetic diseases in the future and are excited to begin exploring the possibilities.”

To register to be an organ donor, visit organdonor.gov.

Media contact

Kate DeTrempe
media@stanfordchildrens.org
(650) 721-8527