Stories about: kidney transplant

Precision medicine for end-stage kidney failure? 40 percent of kids needing transplants have identifiable mutations

People forming a kidney shape - indicating that not all ESRD is alike and that it can have multiple genetic causes

In adults, end-stage renal disease, or ESRD, is most commonly a complication of diabetes or hypertension. In children, teens and young adults, it’s a different picture entirely. New research finds that more than half of people needing a kidney transplant before age 25 have a congenital anomaly of the kidney or urinary tract, and that 40 percent have an identifiable genetic cause of ESRD. Knowing these genetic underpinnings can inform better care for patients with kidney disease, says study leader Friedhelm Hildebrandt, MD, chief of the Division of Nephrology at Boston Children’s Hospital.

Hildebrandt and his colleagues drew on 263 families whose child received a new kidney at Boston Children’s between 2007 and 2017, before the age of 25. In 68 families, the team was able to perform whole-exome sequencing, comparing their DNA with a normal reference sample.

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From math major to transplant pioneer: An interview with William Harmon, MD

William Harmon MD
William Harmon, MD, c. 1996

William Harmon, MD, a pioneer in pediatric dialysis and kidney transplantation, passed away on May 29, 2016 after 45 years at Boston Children’s Hospital. He was 72 years old. Starting as an intern in 1971, the year the hospital performed its first kidney transplant, he worked his way up to Nephrologist-in-Chief, a position he held for 25 years.

Harmon was passionate about caring for children with end-stage renal disease (ESRD), pioneering techniques and devices to adapt hemodialysis to infants and young children. He helped get NIH support for child-specific transplant research and led multiple clinical trials of treatment protocols to help children not only tolerate their transplants, but thrive. He also worked to ensure that government guidelines and legislation on ESRD and kidney transplant gave priority to children.

Harmon was the first chair of the pediatric committee of the United Network for Organ Sharing (UNOS) and the first pediatrician to chair the New England Organ Bank’s Board of Directors. He was passionate about teaching, training more than 65 pediatric nephrology fellows.

Below are lightly edited excerpts from interviews with Harmon, most recently in 2014.

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Giving the immune system a new start, to prevent transplant rejection

Leveling the immune system might let the body rebuild one that’s tolerant of a transplanted kidney. (Photo: Tom Ulrich)

As the science of transplantation has gotten better, the patients whose lives are saved by other people’s organs are living longer and longer. But they’re paying a price—a lifetime of immunosuppressive drugs.  William Harmon, chief of Nephrology at Children’s Hospital Boston, is trying to change that.

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