First Teen In Florida To Be Part Of Three-Way Paired Kidney Exchange

At 13 years old, Emma Garcia de Paredes celebrated the gift of life, after receiving a second kidney transplant. In January 2015, Emma became the first child in Florida to be part of a three-way paired kidney exchange transplant at the Miami Transplant Institute at the University of Miami/Jackson Memorial Medical Center.

Emma was born with a congenital condition called ureteropelvic junction (UPJ) obstruction, a blockage at the point where the kidney attaches to tubes which carry urine to the bladder, blocking the flow of urine from the kidney. This condition caused problems with her kidney function, and at just one month of age, Emma had to undergo dialysis.

“We learned very early on that Emma would need a kidney transplant,” said Maria Garcia de Paredes, Emma’s mother. “I immediately knew I wanted to donate my kidney to my daughter, but since she was so little, we had to wait a couple of years.”

In July 2004, when Emma was almost three years old, she received her first kidney transplant. After the first transplant, Emma managed to live a normal life, going to school and playing with her friends.

But in 2012, Emma came down with the flu and pneumonia, and with an already compromised immune system, she had to receive a blood transfusion. Her body then developed antibodies, and she started rejecting her kidney. She immediately was put on dialysis again, and learned she would need a second kidney transplant.

Finding a perfect match for Emma proved to be a challenge the second time around because Emma has a highly sensitized immune system that would attack the transplanted kidney. Emma’s father, Carlos Garcia de Paredes, wanted to donate his kidney, but he wasn’t a match. In December 2014, a family friend offered to donate her kidney. She, too, was not a match.

“At that point, we were losing hope and prayed for a miracle,” said Emma’s mother.

Emma was also feeling high anxiety from waiting for a donor. “It was very difficult for her,” said her mother.  “I got her to accept that things take time, and she eventually overcame her state of anxiety and depression.”

But a miracle finally came occurred when Giselle Guerra, MD, medical director of the Living Donor Kidney Program at the Miami Transplant Institute, and Jayanthi Chandar, MD, pediatric nephrologist at Holtz Children’s Hospital, informed the family that they had found a perfect match for Emma through the Paired Kidney Exchange Program.

The Paired Kidney Exchange Program allows a living donor, who is incompatible with the intended recipient, to be swapped with another living donor who is also incompatible with their intended recipient. A more compatible match between a recipient and donor increases the chances of a well-functioning and longer-lasting kidney. In the interest of protecting the health of both the patients and donors, extensive medical and psychological screenings take place first. Nationally, very few centers offer this unique initiative, which requires extreme diligence and coordination, and the Miami Transplant Institute is the only one in South Florida to do so.

Emma’s father would be able to help his daughter, by donating his kidney to someone else – and in turn, Emma would receive a compatible kidney from another donor, who was a perfect match. During these procedures, three families – each comprised of one potential donor and one recipient – found a match in one of the other families.

On January 7, a team of transplant surgeons, nurses, and other medical staff occupied six operating rooms at Jackson Memorial Hospital, simultaneously performing these three lifesaving transplants. Each procedure was a success.

Emma is now recovering at home.

“We are so happy,” her mother said. “We feel so blessed.”

Maria and Carlos have met Emma’s donor and frequently talk on the phone and exchange text messages. Emma is now looking forward to enjoying the summer with her best friends.

“We went bathing suit shopping recently, and I’m looking forward to swimming in the ocean, and also going to carnivals,” said Emma, a seventh grader, who enjoys reading, baking, and dreams of becoming an actress.

For now, Emma is looking forward to meeting her donor: “I’m speechless. I wouldn’t know what to say to him, I mostly want to thank him.”