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Gerald and Jackson Pineda

Kidney donation gives son a normal life

June 2014

by Will Sansom

Before Jackson Pineda was born, doctors told his parents, Gerald and Jennifer, that their sonís kidneys would not last past the age of 10. A prenatal ultrasound showed one enlarged kidney and the other, they believed, would not be strong enough to make up the difference.

To the coupleís amazement, the doctorsí forecast proved accurate almost to the day.

Doctors had removed the enlarged kidney when Jackson was 2 years old, and his remaining kidney functioned at only half of healthy capacity. By age 4, kidney insufficiency prevented Jackson from growing normally, and daily injections of growth hormone became a way of life.

On Nov. 6, 2010, two days short of his 10th birthday, University Transplant Center surgeons removed one of Gerald Pinedaís kidneys and placed it in his sonís body.

"We never gave it a second thought," said Gerald Pineda. For years he had known he was a good match to be a donor for his second-oldest son, whenever the time came.

With the transplant centerís Robert Esterl, M.D., leading the team performing Jacksonís surgery, and Kenneth Washburn, M.D., professor of surgery in the School of Medicine, leading Gerald Pinedaís team, the transplant took three hours. It was a success.

The University Transplant Center, a clinical partnership of the Health Science Center and the University Health System, offers one of the only pediatric kidney transplant programs in the region. The one-year survival rate for University Transplant Center pediatric kidney patients is 100 percent, according to the Scientific Registry of Transplant Recipients. The one-year survival rate of adult kidney recipients, 94.8 percent, surpasses the national average.

The center also has one-year patient survival rates that exceed national rates in two other signature services, with 85.1 percent for lung transplants and 94.1 percent for liver transplants. The team is the only one in San Antonio to offer the option of living-donor liver transplants.

"Iím very happy with where the University Transplant Center is today," said Glenn Halff, M.D., professor of transplant surgery and director of the center. "It has grown into a mature program that continues to refine the quality of care and medical treatment options that we provide."

Living-donor organs enable children and adults to receive transplants sooner, Dr. Halff said. Roughly 30 percent of transplants at University Hospital involve live donors such as Gerald Pineda. Thatís a number the doctors would like to see increase, said Greg Abrahamian, M.D., associate professor of surgery in the Health Science Center's School of Medicine and surgical director of the kidney transplant program.

"We would like to get that up to 50 percent, because the wait time without a living donor is roughly six years in our region," Dr. Abrahamian said. "With living donors, many patients can be transplanted before having to go through dialysis."

That was the case for Jackson.

"He never had to have dialysis because he had a living donor," Jennifer Pineda said. "My husband was willing and able, and spared Jackson from it. We were so fortunate."

And since the majority of kidney donor surgeries are laparoscopic, with only a small incision needed for the donated kidney to be removed, the recovery for Gerald Pineda had resulted in less post-operative pain, a quicker recovery and a shorter time in the hospital.

Both father and son healed well immediately after the transplant, but two months after receiving his new kidney, Jackson was afflicted with a virus infection called BK, which frequently occurs in organ transplant patients and can cause progressive kidneydamage.His nephrologist at the time, Mazen Arar, M.D., medical director of pediatric nephrology with the University Transplant Center, said it was the worst case of BK virus that heíd ever seen, leading to Jacksonís eventual readmission to the hospital with dangerously high blood pressure.

"That was the scariest moment," Gerald Pineda said. "We had this good kidney that we had given himóand we were in danger of losing it."

Thankfully, Jacksonís body responded to treatment. His blood pressure stabilized and his health returned.

Jackson is now 13 and a member of his seventh-grade golf team at San Antonioís Hector Garcia Middle School. He recently shot a nine-over-par 38 on nine holes, leading all players in a middle school tournament. His skills extend to the fine arts, as well. This year he was recognized as one of the stateís best pianists in his age group.

Heís mellow and carefree, his parents said. And father and son have a few other things in common.

"He loves golf, just like me," Gerald Pineda said. "Whether a shot is good or bad, you canít tell whether heís upset."

They donít talk much about Jacksonís rocky first years. Thereís really no need to.

"Heís so normal, you would never know that he had a bad kidney," Gerald Pineda said. "We donít talk about it very much at all. Itís just part of life."

It takes a team

The University Transplant Center is a clinical and academic partnership with transplants performed at University Hospital by physicians from UT Medicine San Antonio, the faculty practice of the School of Medicine at the UT Health Science Center San Antonio.

"We have an exceptionally knowledgeable and skillful faculty," said Glenn Halff, M.D., Dielmann Chair in Transplant Sciences, professor of transplant surgery and director of the center. "The team works in a unique multidisciplinary environment that optimizes patient care."

Surgeons include:

The surgeons collaborate with a team of pediatric nephrologists and hepatologists:

Dr. Halff said the University Transplant Center is successful because of its many partnerships and collaborations.

"Our outcomes are excellent," he said. "For patients who live in this region of Texas, there is no reason to go anywhere else."

An estimated 1,000 South Texans are on the organ recipient wait list. To sign up as an organ donor, go to donatelifetexas.org or call 1-888-336-9633.



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