After being cooped up in the house for most of his life,
Alex Pidkalyuk now spends as much time as he can outside.
TRANSPLANT PROGRAMS
THE DIFFERENCE A DAY MAKES
ALEX PIDKALYUK GOT A KIDNEY AND LIVER TRANSPLANT
SIMULTANEOUSLY
Meet Alex
The transplants
were scheduled
to take 12 hours.
Doctors at
Children’s Colorado
did both in six.
Alex Pidkalyuk lifts up his shirt to show his thick scars: one across the top of his belly, one down
the side, the result of a simultaneous liver and kidney transplant last year. He calls them battle
scars, and he insists he wasn’t afraid.
“He was scared,” says Karina,
his older sister. “The day he had
surgery, then he was scared.”
Alex smiles and shrugs, a baby-faced
14-year-old with hair wet-combed as
neat as only his mother could have
combed it. “I don’t know. I was on
laughing gas the whole time.”
Alex was born with Autosomal
Recessive Polycystic Kidney
Disease (ARPKD), a rare form of the
disease that manifests only when
both parents are carriers, more
aggressive than its more common
genetically dominant counterpart
(see “Doing Our Best,” p. 48). By
the time of the transplant, cysts had
so wrecked his kidneys that they’d
effectively ceased to function. Cysts
involve the liver in about half of
ARPKD cases, and Alex’s liver —
an organ that weighs about three
pounds in healthy adults — had
swollen to a massive 10 pounds.
More than three times its normal
size, it was crushing the rest of
his organs.
“Of all the kids I’ve taken care
of over the years,” says Melissa
Cadnapaphornchai, M.D., Alex’s
pediatric nephrologist at Children’s
Hospital Colorado, “Alex’s liver was
the most impressive.”
“He had a really big, pregnant
stomach,” says his mother, Nataliya.
“He always looked greenish, like
seasick. He slept all the time.”
Doctors always knew Alex had
ARPKD; they expected it. Given
that Nataliya and her husband
Aleksandr both carry the disease,
one in four of their children were
likely to inherit its recessive form.
Three of the couple’s eight children
were born with it. Two of them,
Karina’s older sister and younger
brother, passed away soon after
birth in Ukraine. Alex, their fourth,
was born in the U.S. From birth, it
was understood he’d need a kidney
transplant someday.
“The liver was news,” says Nataliya.
Waiting for a transplant can take
a long time. Alex made due on a
cocktail of medications, some 20
pills two times a day. When a donor
finally did become available, the two
transplants were performed back-toback by Children's Colorado surgeons
Fritz Karrer, M.D., and Michael
Wachs, M.D. The procedure was
schedule