January 16, 2024

Texas Children’s Hospital is excited to unveil our newly renovated Dialysis & Apheresis Center! Last week, the team officially moved into the new space on West Tower 6 and began treating patients.

The revitalized unit is tripled in size from the original, topping out at over 24,000 square feet with 23 patient care stations. The space is inviting with an abundance of natural light, and patients can enjoy the “Under the Sea” theme complete with wall art and fish tanks. It also features a dedicated patient and family support area, including a large waiting room, family lounge, play zone, and quiet space for nourishment and relaxation.

As the top-ranked program grows in volume and service offerings, leaders felt an expansion plan was needed for outpatient dialysis and apheresis to better meet the unique needs of our patients and families.

“The opening of our new Dialysis & Apheresis Center is a transformational event for the renal service, our patients and their families,” said Chief of Renal Services Dr. Michael Braun. “We are grateful to Mr. Wallace and the Board of Trustees for their commitment to the care of children with kidney disease…these facilities have set a new standard for pediatric dialysis and apheresis units in the United States.”

Click the gallery for more photos of the new Dialysis & Apheresis Center. Ranked #1 in Nephrology by U.S. News & World Report, Texas Children’s is home to one of the largest and most comprehensive pediatric renal services in the world. Click here to learn more.

March 30, 2022

What’s the solution for resupplying one of the items that is fundamental for delivering dialysis for our patients when the product is backordered due to supply chain issues caused by COVID? “There’s no one-size-fits-all answer, you have to get creative and think outside of the box if you are going to survive in health care supply chain during COVID,” said Eric Swaim, Director of Strategic Sourcing and Supply Chain Analytics.

According to Swaim, when reordering dialysis acid in January, his team learned our vendor had a COVID outbreak in their Dallas distribution center and would not be able to fulfill our order at that time. Not wanting to accept “no” as an answer, Swaim and his team worked with the vendor to find an alternate solution for restocking our supply of the product in time to avoid any disruptions for our patients receiving dialysis.

The vendor moved fulfillment of the order to an alternate distribution center in Los Lunas, New Mexico, sold the acid in drums instead of the one gallon jugs we normally purchase, and allowed Texas Children’s to pick up the order with our own truck.

To ensure zero issues in picking up and transporting this high priority delivery, the Supply Chain team received updates from the driver every four to five hours during transit from Houston to New Mexico and back to Texas Children’s Renal Center.

“Our clinicians are thankful for the resourcefulness and resilience of our Supply Chain partners,” said Jae Frazier, Director of Renal and Apheresis Services. “Without them, we would have had to make clinical decisions with direct impacts to our patients’ dialysis care and overall health.”

According to Frazier, countless citywide and nationwide dialysis facilities have been affected by a shortage of this critical supply component for life-saving, life-sustaining dialysis care and many centers have had to decrease services provided to dialysis patients. Swaim added that pre-COVID, only five percent of products were on some sort of backorder. Now his team are seeing 30-40 percent on backorder.

Planning ahead in a challenging supply environment

Since this experience, the Supply Chain team has been partnering more closely with the Renal clinical team and with the vendor during weekly calls to monitor supply. Along with this consistent communication, the clinicians are conserving the product, and two more trucks were sent to the same New Mexico distribution center to pick up our allocation of dialysis acid, which provided the Renal Center with over 30 days’ worth of supply.

“This regular communication has allowed us to remain nimble in our approach to managing this critical supply shortage,” said Frazier. “Our conservation efforts, although precipitated by the shortage, will become part of our ongoing commitment to providing cost-effective care.”

The teams’ extra efforts have put Texas Children’s in a good position to survive this backorder through June, and their continued partnership will ensure limited to no disruption for our patients, according to Swaim. One of his main takeaways is that vendors want to help us be successful, but if they say they can’t supply something it’s best to challenge it by asking the tough questions or proposing off the wall solutions in order to get the product you need.

March 23, 2022

With more than 250 patient days of using the Cardio-Renal Pediatric Dialysis Emergency Machine (CARPEDIEM), Texas Children’s is now proud to be the largest CARPEDIEM care center in the world. CARPEDIEM was launched at Texas Children’s in June 2021 to serve our most vulnerable patients in need of continuous kidney support therapy. Since that time it has helped to effectively support several babies with kidney injury.

At a special celebration on Tuesday, February 15 with cake, punch and cheers all around, Director of the Texas Children’s Critical Care Nephrology Program Dr. Ayse Arikan thanked the team for their leadership, care and compassion for our patients. “I am immensely proud to be part of this team,” said Arikan. “This could not have been possible without all of you. As always, when you were asked for your adaptation of a new therapy, everyone went above and beyond expectations.”

“Our labor of love has led Texas Children’s to be the largest CARPEDIEM care center in the world, with four machines on standby for infant kidney support therapy,” said Arikan.

The CARPEDIEM system was originally developed in Europe, and FDA authorization was granted in 2020. CARPEDIEM is designed for use in babies with severe acute kidney injury or fluid overload. It provides continuous renal replacement therapy to patients as small as 2.5 kilograms and up to 10 kilograms.

Texas Children’s is one of seven hospitals to have this technology, and one of five hospitals who have started using it with patients. Until now, children in need of continuous kidney support therapy were using devices designed for older children. CARPEDIEM serves as an appropriate size-based therapy for our most vulnerable babies.

Based on published studies, we know acute kidney injury can affect up to one in three premature infants in the newborn ICU, according to Renal Physician Lead for CARPEDIEM Dr. Catherine Joseph. This occurrence is even more common in babies who are born extremely premature. When kidney injury is more severe and the patient does not respond to medical treatment alone, a device like CARPEDIEM can help support the baby’s kidneys by removing waste products and fluids.

“I am passionate in the care of newborns with kidney disease and invested in ways to improve outcomes for babies affected by kidney problems,” said Joseph. “To have this platform available to help support infants with kidney injury is a dream come true.”

Children born prematurely or admitted to Texas Children’s with critical illness are in the care of our pediatric critical care or neonatology providers in our intensive care units (ICU). “We are only able to deliver this CARPEDIEM technology to the bedside with the collaborative partnerships with our colleagues in the newborn, pediatric and cardiovascular ICUs (NICU, PICU and CVICU),” said Inpatient Chronic Renal Dialysis Staff Nurse Marsha Filipp.

“I am proud to be a part of this team as we reach these important milestones,” added Filipp. “It’s a wonderful feeling knowing we are making a difference and helping give more newborns a chance at life.”

March 17, 2020

 

Texas Children’s Apheresis Program led by Dr. Poyyapakkam Srivaths has reached a milestone with the addition of a new service, photopheresis. Photopheresis is a medical treatment that causes photoactivation of white blood cells by separating them from blood, which are then exposed to a medication called 8-methoxypsoralen followed by UVA irradiation before returning the blood to the patient.

Texas Children’s is currently using this apheresis therapy for bone marrow transplant patients who are experiencing graft-versus-host disease and lung transplant patients who are undergoing organ rejection. Photopheresis is typically used when other treatments have failed.

We are the second institution in Houston to offer photopheresis, and the only program dedicated solely to pediatric patients.

“There was a tremendous multidisciplinary effort to make this happen,” said Dr. Tina Melicoff, medical director of Texas Children’s Lung Transplant team. “We are thrilled to now offer some of our transplant patients with rejection issues another treatment option through photopheresis.”

To be able to offer the service, two photopheresis machines were purchased and a core group of dedicated nurses were trained to operate it. Clinicians expect to treat about five patients a year with each patient receiving about three sessions a week for about 10 weeks. Each session lasts around two hours.

Texas Children’s recently conducted its first photopheresis treatment on a bone marrow transplant patient. The patient is expected to receive additional treatments over the next several months.

“By offering this therapy, we are offering hope to patients who already have been through so much,” said Dr. Robert Krance,” director of Texas Children’s Pediatric Bone Marrow Transplant/Stem Cell Transplant Program. “Photopheresis is a promising therapy for our patients experiencing host-versus-graft and organ rejection.”

Photopheresis is the second new extracorporeal therapy introduced in the past 20 years at Texas Children’s. The last extracorporeal therapy, Molecular Adsorbent Recirculating System, or MARS, was introduced six years ago for liver failure patients.

“MARS helped to transform our liver transplant program,” said Chief of Renal Services Dr. Michael Braun. “I am hopeful photopheresis will have a similar impact for our BMT and lung transplant patients.”

June 3, 2019

Theresa Mottes, pediatric nurse practitioner in Renal Services, was recently elected president of the Nephrology Nursing Certification Commission (NNCC), an organization established in 1987 to develop and implement certification examinations for nephrology nursing. The goal of NNCC is to promote the highest standards of nephrology nursing practice through the development, implementation, coordination, and evaluation of all aspects of the certification and re-certification process.

As part of her introduction in April 2019, Theresa was described as a dedicated leader with more than 25 years of pediatric renal replacement therapy experience and a passionate volunteer advocate for nephrology certification. Theresa also is an adjunct instructor with Baylor College of Medicine.

The NNCC is composed of nine Commissioners: eight with current experience and expertise in nephrology nursing and one public member. Officers of the NNCC include the President, President-Elect, Secretary and Treasurer.

May 9, 2018

From the time Colton Makow was born, he faced an uphill battle. He spent his first 61 days of life in Texas Children’s Hospital’s Neonatal Intensive Care Unit, and while there, was told by doctors that his kidneys were damaged from lack of oxygen and that he one day would need a transplant.

Devastated by the news, Colton’s mother, Julie Makow, knew she would do everything she could to save her son, including giving him one of her kidneys if that’s what it took to keep him alive.

“I always thought, if given the chance, that’s going to be the one thing I can do to make it better,” Julie said. “I knew I was going to be a part of that, and that I would be the first one tested to be a match.”

Julie got her chance to see if she was a viable donor candidate when doctors told her and Colton, then 6 years old, that it was time to make a move toward getting a kidney transplant. After the test, Julie was told she was a perfect match and that she could donate one of her kidneys to her son.

In February, Dr. Christine O’Mahony, surgical director of kidney transplantation at Texas Children’s Hospital, performed the surgery. Texas Children’s performs about 30 kidney transplants a year. When the organ comes from a living donor, it typically lasts longer. For Colton, that means hopefully it will be a long time before he needs another transplant.

“He’ll have to go see the physicians a lot more frequently than he would if he were another kid, he’ll have to get labs, but his life will otherwise be the same,” O’Mahony said. “He can play sports, go to school and be just like everybody else.”

Kirti Bhakta, the transplant coordinator who worked with Colton and Julie, said she has witnessed the selfless sacrifices parents make for their children time and time again.

“It is truly heartwarming,” she said. “So many of our parents will do anything to give their children a better chance at a good life. Their actions are the epitome of unconditional love.”

Dr. Sarah Swartz, medical director of dialysis for Texas Children’s Hospital, also worked with Colton and Julie and said their story is perfect for Mother’s Day.

“Colton now has the chance to live a better life, thanks to his mom,” Swartz said. “What a beautiful reminder to him and others the power of a mother’s love as well as the difference an organ donor can make in someone’s life.”

Click here to learn more about how to become an organ donor and here to read a story by KHOU11 about the Makows.

July 12, 2016

71316Dreileenbrewer175Medical Director of Renal Transplantation Eileen Brewer, MD, recently received an achievement award for her work on the United Network for Organ Sharing (UNOS) Pediatric Transplantation Committee.

Brewer has been a member of the committee since 2009 and was chair of the committee in December 2015 when, after decades of hard work, the UNOS Board passed pediatric bylaws that establish specialized guidelines for surgeon and physician leadership for all hospitals with pediatric transplant programs.

“Dr. Brewer faced many tough questions about the bylaws and handled these questions with the mettle of a seasoned practitioner and diplomat,” said Christopher Wholley, a UNOS policy analyst. “It’s been a pleasure to work with her.”

Dr. John Goss, the medical director of Transplant Services at Texas Children’s Hospital, said Brewer’s work on the Pediatric Transplantation Committee has yielded some great work for the pediatric transplant community.

“This was a huge undertaking and we are very proud of her,” he said.

Brewer is an internationally known expert in pediatric renal diseases, dialysis, transplantation and hypertension. She is past president of the American Society of Pediatric Nephrology, former Council Member of the International Pediatric Nephrology Association and organizer of International Workshops on Hypertension in Children and Adolescents in 2001, 2004 and 2007.

She has been an active clinician and clinical researcher throughout her career, publishing more than 90 journal articles and 30 book chapters. She is frequently invited to speak at scientific meetings and workshops nationally and internationally.