Adults can donate kidneys to children – as Andrew and his niece Sammy prove
THREE-year-old Sammy Ayling was rescued from the brink of death thanks to her doting uncle. The toddler had suffered complications during her birth in 2019 that had starved her kidneys of vital nutrients, causing them to fail. Doctors told her devastated parents, Stacey, 44, and Jim, 46, from Manchester, that she had just a 50 per cent chance of surviving a year.
The kidney damage meant she failed to grow properly and couldn’t eat without vomiting, so had to rely on a tube to deliver nutrients into her stomach. So when her uncle, Andrew Silverman, 36, was confirmed as a suitable match for a transplant, he didn’t hesitate to give his niece the astonishingly generous gift.
‘As soon as she was born we were told her only hope was a kidney transplant,’ says Andrew, who is a company director and has three children of his own. ‘And I asked there and then if I could get myself tested for donation.’
Today, just over a year after their kidney swap, Sammy is healthy and happy. ‘She has this rosy colour in her cheeks,’ says Andrew. ‘As she’s got older, it’s been incredible watching her reach the milestones that the other kids in our family have.
‘As far as I’m concerned, my kidney is where it should be.’
Experts say the story highlights the importance of adult kidney donors, and are urging more people to come forward.
The number of people donating kidneys has reached new lows, dropping a third between 2020 and 2021. About 100 children are currently waiting for a kidney transplant.
IN MOST of these cases it is because a family member can’t donate – usually due to a mismatch of proteins in the blood which would cause the recipient’s immune system to attack the new kidney. Doctors can use a donated organ from a deceased donor, preferably from a child, who will be a like-for-like size match. But few grievdren, ing parents give permission for their child’s organs to be donated after they die. In 2018 – the most recent figures available – just 57 donors of heart, lungs and kidneys were aged 17 or under.
‘The best outcomes usually come from a living donor,’ says Dr Afshin Tavakoli, consultant surgeon in transplantation and renal failure at Manchester Royal Infirmary. ‘And we rely on adults for this, because children cannot donate organs. People assume that if they donate a kidney it will go to an adult of a similar physical size, but that isn’t the case. We simply move things around to make space.’
A 2001 study by researchers from Stanford University found that adult kidney donors in optimum health led to the best outcomes in children receiving the organ, compared with living donors of any other age.
Living with one kidney doesn’t shorten the donor’s lifespan, but they must be closely monitored due to an increased risk of high blood pressure and excess protein in their urine.
Donors and patients must be matched on blood type as well as other proteins that signal to the immune system that the organ is familiar, giving it more chance of being accepted. Sammy had two matched donors – her mother and her uncle. But Stacey was unable to undergo major surgery due to caring responsibilities for Sammy and her two other chilas well as injuries related to Sammy’s traumatic birth.
Andrew says: ‘I have a son who is disabled, and he’s had to have four brain surgeries. The support from my sister was incredible throughout it all, and now it was my turn to return the favour.’
In June last year, both Andrew and Sammy went in for their respective procedures a stone’sthrow from each other – Sammy at the Royal Manchester Children’s Hospital and Andrew at the Royal Infirmary. ‘My kidney was in her body within half an hour,’ says Andrew.
After a month in hospital, Sammy was finally fit to go home. Like all transplant patients, she will have to take daily doses of immunosuppressant drugs for the rest of her life to stop her body rejecting her new kidney.
Andrew, meanwhile, has been left with a 4in scar above his belly button and his fitness level has suffered.
‘I used to get on my exercise bike for half an hour or so a few times a week, and I’d lift pretty heavy weights,’ he says. ‘Now, if I try to do any exercise, I get very tired. But I know it will get better in time.’
As for his unique bond with his niece, he adds: ‘Maybe we’ll talk about it when she’s older, but for now we’re focusing on how she’s doing – and it’s a joy to see her thriving.’