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A Transplant Transforms a Family

Toddler Receives Kidney During Pandemic

Distant Cousin by Marriage Gives a Kidney to a Toddler and Gets a Lifelong Connection

It was a routine ultrasound, but the results were devastating for Jamie Nash and her husband Andrew. Their baby's kidneys were dilated and his bladder was engorged, which could be signs of severe kidney dysfunction. The couple, who live in Santa Barbara, were told they would need pediatric urology and nephrology specialists as soon as the baby was born. They transferred their care to Cedars-Sinai, where Hudson was born prematurely at 36 weeks.

Dechu Puliyanda, MD, director of Pediatric Nephrology at Cedars-Sinai, said Hudson was born with posterior urethral valves, and while that problem was fixable by surgery, it had caused severely decreased function of the kidneys.

"He continued to have worsening kidney function," said Puliyanda, “and by the time he was 20 months old, we knew he needed a kidney transplant soon or he would end up on dialysis."

Hudson needed to grow before his body could accept an adult kidney transplant, but at home, his family could see his condition worsening. He was not walking at all and was eating only through a feeding tube. "He did not smile as quickly or laugh as quickly," said his mom. “He was losing energy and losing steam fairly quickly."

Because kidneys provided by living donors tend to have long life spans, the Nashes started a social media campaign to find a volunteer donor. But they also searched the old-fashioned way. Nash wrote a letter describing her baby's need for a kidney and included it in the Christmas cards sent by her mom.

The cards were sent to 150 friends and relatives, including a distant cousin in North Carolina. When the cousin's wife, Paige Flotkoetter, read the letter she knew she had to act. "I told Jamie when I read the letter, I felt like it was something I was supposed to do," said Flotkoetter. "Just something about the letter and the situation made me know this is what I was supposed to do."

Flotkoetter turned out to be an excellent match, but just as the families and hospital were proceeding toward a transplant, the country was shut down by COVID-19. It took four months before Flotkoetter and her husband could safely fly to California and the surgery could proceed.

Irene Kim, MD, a liver and kidney transplant surgeon and co-director of Cedar-Sinai’s Comprehensive Transplant Center said the transplant happened just in the nick of time.

"The day of the transplant was a great day," said Kim. "Hudson came to us very sick. He had not yet started dialysis, but his kidney lab numbers suggested he was almost in urgent need of dialysis. After we transplanted Paige's kidney into Hudson, his creatinine, which is how we monitor kidney function, dropped like a stone. It did great. So on the very first day, his labs normalized immediately, and that was really amazing to see."

Hudson is back home in Santa Barbara and his family is thrilled with his progress. He celebrated his second birthday and is walking for the first time.

Flotkoetter said that after a few days she was up and walking around, and now eight weeks later she is back to feeling like herself.

"If I had four kidneys, I'd give two more," said Flotkoetter. "It's a big undertaking, but overall, it's something so minimal to the donor, and the recipient’s life will be changed forever."

Flotkoetter and Nash text every day, and the families, who barely knew each other before, plan to vacation together soon.

"Just seeing him happy and healthy and being a normal 2-year-old is all the thanks I would ever need," said Flotkoetter.

Read more on the Cedars-Sinai Blog: Faces of Cedars-Sinai: Transplant Nurse Coordinator Alexandra Wierzbicki