Fourteen year old Essa Lashkari has had kidney problems since he was born. He was born with only one kidney which had not formed properly. When he was five years old, this kidney began to fail and he had a kidney transplant in the Philippines. However, after 8 years, Essas kidney function continued to decline and he required kidney replacement therapy with haemodialysis, which he had never had previously. After a recommendation from their local health office in Dubai, Essas family agreed to take Essa for treatment at the world-class Great Ormond Street Hospital (GOSH) in London, UK.

Essa spent a year being treated at GOSH and seven months on dialysis before he was able to have a second transplant under the care of his consultant at GOSH, Dr Stephen Marks, Consultant Paediatric Nephrologist. Dr Marks and his team decided that Essa needed another kidney transplant, and Essas mother was proposed as a donor. Unfortunately, Essa had a high level of human leukocyte antigen (HLA) antibodies, meaning that the likelihood of Essas body rejecting the new kidney would be very high.

Essa required antibody removal so that he was able to receive his mothers kidney. This was the first HLA incompatible kidney transplant in a child performed in the UK. Dr Marks explains. Dr Marks described the procedure to Essas parents who agreed for Essas mother to donate her kidney for the transplantation.

Collaborating with transplant surgeons at Guys Hospital in London and Kings College London, Essa underwent his kidney transplant with antibody removal, whereby his HLA antibodies were removed prior to transplant using a blood filtering process known as plasmapheresis. This meant that Essa could receive his mothers kidney without his body rejecting it. This is the first time that an HLA incompatible kidney transplant has been performed in the UK on a child. Historically, children with HLA antibodies would not be able to receive kidneys from living donors and would be on the waiting list for deceased donor kidney transplants for many years. Dr Marks noted.

Essas recovery has gone well and he has returned to Dubai. Since the operation, Essa has been absolutely fine. He has been out and about with friends. He has a normal life. says his father Ahmad. The family return to GOSH on a regular basis for follow up appointments with Dr Marks. Essas father Ahmed described his familys stay at the hospital The medical staff have been very good with meI think of Great Ormond Street Hospital as my hospital and Dr Marks as my doctor. Im not going anywhere else.

The procedure was life-saving for Essa and an important moment in the future treatment of children needing kidney transplants.
Dr Stephen D Marks was a medical student in Scotland and came to GOSH 18 years ago. He has led the kidney transplant team for over a decade and continues to be involved in international immunosuppressive drug studies for children who are kidney transplant recipients. He has been the chair of the NHS Blood and Transplant Paediatric Kidney Advisory Group since 2011.

I have looked after patients from when they were babies. I love seeing how we are able to improve the quality of life for our patients on dialysis after they receive a good functioning kidney transplant. It is an honour and a privilege to look after children and their families for many years, and see them throughout their childhood growing up into young adults for the future. If you came to my kidney transplant clinic, you would see a group of healthy children who can lead lives to the full.

Great Ormond Street Hospital in London is recognised as one of the few truly world-class hospitals for children. As a global leader, GOSH has top clinical and research experts working every day to find new and better ways to treat children. While breakthroughs and medical expertise are essential to the treatment of patients, GOSH also places great emphasis on the support and care provided for children by nurturing an open and supportive atmosphere, ensuring that parents and patients are well informed and closely involved in the treatment process. Children receive the highest standards of care and attention from the expert team of medical and support staff during their stay at GOSH, and are always treated with respect, trust, concern and openness.