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Still making history in transplant medicine

Priya Verghese, M.D., is advancing the field by finding new ways to manage infections after a transplant. The trick is to to strike a balance between suppressing the immune system so that the organ isn't rejected, while also keeping infections at bay.

The opportunity to build on a distinguished history and learn from the best drew transplant nephrologist Priya Verghese, M.D., M.P.H., to the University of Minnesota four years ago. The opportunity to improve lives drew her to pediatric nephrology.

When children ill with kidney failure receive a kidney transplant, they “bounce back so quickly,” Verghese says. “It’s amazing to see what they can accomplish.”

At the University of Minnesota, Verghese is grateful to be working with what she calls “a perfect balance of experienced mentors and young, energetic clinicians.” That balance, she says, is critical to good patient care. “You have the enthusiasm of the young tempered by the wisdom of the older doctors.”

Besides her clinical duties at University of Minnesota Amplatz Children’s Hospital, Verghese leads first-of-its-kind research that aims to make kidney transplants safer and more successful.

That was good news for 5-year-old Jackson Fillmore, who became one of her patients last year when an infection caused his kidneys to fail over the course of a single week. Jackson’s parents, Heather and Kerry, took solace in the fact that 98 percent of kids with similar infections bounce back to good health even if they require a few weeks of dialysis.

But, unfortunately, renal failure was not temporary for Jackson, leaving transplantation as his only option. In March he had a kidney transplant, with his dad as the donor.

A hope and an idea

Together, the father and son helped make history: Jackson’s surgery occurred just a month before the University of Minnesota performed its 8,000th kidney transplant — and 50 years after U doctors performed Minnesota’s first solid organ transplant.

The University of Minnesota’s standing as a world-class center for organ transplant innovation began in the early 1960s “as a new way to deal with organ failure,” says Timothy Pruett, M.D., chief of the Medical School’s Division of Transplantation. “It was really just a hope and an idea.”

In the early years, the University made its mark by performing organ transplants for two groups that had been considered impossible candidates for transplantation: children and people with diabetes. It was also the site of the country’s first formal training program for up-and-coming transplant experts; today it’s one of the largest.

“As the field has evolved, so has our program,” says Pruett, who is the John S. Najarian Professor in Transplantation. “We have pushed and refined transplant treatment.” He cites cell-based therapy, steroid-avoidance therapy, and allo-islet cell transplants (in which islet cells from a donor pancreas are infused into a patient with severe diabetes) as just a few of Minnesota’s pioneering advances.

Kerry and Jackson Fillmore enjoy the simplest parts of life, like walking to school together—which seemed like an unlikely possibility just months ago. (Photo: Scott Streble)

New milestones

Today, Verghese is advancing the field by finding new ways to manage infections after a transplant. The trick is to strike a balance between suppressing the immune system so that the organ isn’t rejected, while also keeping infections at bay. As transplants have evolved, infection — not organ rejection — has emerged as the biggest complication, she says, adding that some of those infections can lead to malignancies.

So far, Jackson Fillmore has avoided such complications, and data from his experience will be used to improve treatments for other people for years to come. Meanwhile, his family is thrilled about his latest milestone: With his white cell count back up to acceptable levels, he started first grade with his buddies this fall.

By Kristin Stouffer, a Minneapolis writer who frequently covers health and medical topics

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