Preparing a child with obstructive sleep apnea for transplantation

All of the expected outcomes have been met for A.W. Intense collaboration among the pulmonary, nutrition, transplant, nephrology teams, and A.W.'s parents have accomplished what at first seemed to be quite difficult. After months of hard work and close monitoring of A.W., he was now at the 90th percentile on the growth curve. The diligence of the dietician and A.W.'s parents provided the intended outcome. A.W. had achieved a manageable weight and could be safely transplanted. The transplant team has decided to quickly taper prednisone until A.W. is completely off of this immunosuppressive after transplantation. A.W. is more cooperative with the nasal cannula at night and it is felt he will cooperate with the CPAP mask during the post-operative period in the hospital. He would need continued evaluation of his obstructive sleep apnea due to the potential of increased weight with immunosuppression medicines. All of A.W.'s blood culture results have been negative and his left tympanic membrane has not drained nor is there evidence of infection. A.W. is finally ready for transplantation. A date was set and A.W. and his living related donor were ready to proceed.