collaboration and teamwork she’s proud exists at Rady Children’s. “We are proud of the multiple organ system transplantations we’re able to do at Rady Children’s,” she says. “We can do hearts and kidneys, and we’re getting our liver program up and running. If kids need a single organ, it’s here for them. Now, if they need more than one, it’s also here—all thanks to the ability of our teams to work together. This takes precise management and excellent communication to pull off—and we have that at Rady Children’s.” Looking to the Future Excellence in management and communication is evidenced by a milestone achieved earlier this year: Rady Children’s first dual organ transplant. Surgeons saved the life of 13-year-old Nehemiah “Nemo” Maldonado by performing heart and kidney transplants over two consecutive days (see the story on page 24). Both Dr. Ingulli and Dr. Nigro are optimistic that the success of these surgeries will lead to more happy outcomes for young transplant patients in the future. “This gives us lots of options,” Dr. Ingulli says. “Before, there were kids we maybe couldn’t accept for transplantation: They couldn’t survive with just a new heart—they needed a heart and a kidney, and we couldn’t do it. Now that we can, it opens up the possibility of us providing lifesaving surgery to more kids. This really shook us up and tested our thinking. That makes us better physicians. It makes us a better kidney program and a better heart program.” Dr. Nigro agrees: “What does this imply for us? Number one, it shows that we’ve demonstrated the ability to do combined transplantation, which may be necessary for more kids in the future. The most important thing is that through our transplant program, we’ve been able to take care of patients who are very ill, get them through surgery and get them home.”
The Rady Children’s Kidney Transplant Program
In addition to its comprehensive heart transplant program, Rady Children’s is also a leading destination for kidney transplants. In 2001, UC San Diego brought its established pediatric abdominal transplant program to Rady Children’s to help provide patients with specialized pediatric services. Since that time, the team at Rady Children’s has performed more than 100 kidney transplants and maintained outcomes well above the national average. The Kidney Transplant Program is part of the Division of Nephrology, which provides comprehensive care to all patients with kidney disease, ranging from general kidney problems to dialysis and transplant. The division is routinely recognized as one of the best in the country by U.S. News & World Report. Under the direction of Elizabeth Ingulli, MD, a pediatric kidney transplant specialist, the program has seen exceptional growth. In the first four months of 2022 alone, the team performed eight transplants—a number that Dr. Ingulli says demonstrates the “exploding” need for transplantation. “While there is some backlog from COVID, the main factor for this growth is that there’s more illness, more severity of illness and more kids surviving with a level of kidney function,” she explains. “There are more children born with some level of kidney function who still need a new organ sooner rather than later. Treatments have allowed for survival of illnesses that haven’t been survivable before. There’s more and more need from that point of view. Our growth is related to these factors, plus the fact that other centers are seeing our success, so our referrals have increased and so has our need for donor organs.” This is a trend Dr. Ingulli expects to continue—and a need she and her team aim to fulfill, thanks to the
ELIZABETH INGULLI, MD Pediatric Kidney Transplant Specialist
18 HEALTHY KIDS MAGAZINE SUMMER 2022
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