We have performed more pediatric kidney transplants with the best outcomes than any other U.S. center
When Hazel Cunanan, a home health nurse, got the call that her 15-year-old son, Markus, needed a kidney transplant, she broke down. It was simply too much. The family had already endured a kidney transplant for their eldest daughter, Danica.
“I sat with my patient and I cried and cried,” Hazel says. “But it ended up being much easier the second time around. We knew what to expect, we were stronger. And we already had a community at the hospital and at home to help us.”
Danica had a kidney transplant nine years ago at the Stanford Medicine Children’s Health Pediatric Transplant Center when she was 10 years old. The family felt great relief and gratitude to have the same transplant surgeon—Amy Gallo, MD—to perform Markus’s transplant.
“We really hoped it would be Dr. Gallo again. Her bedside manner is amazing. She really knows how to speak to my children, putting us all at ease. She didn’t have to promise us anything; we just knew it was going to be OK. I can’t thank her enough,” Hazel says.
The family of six from Brentwood, California, is extremely close—partly because their children share some of the same health challenges, like Danica and Markus, but mostly because they truly appreciate each other and enjoy spending time together.
“After Danica got sick, the idea that another one of our kids might also need a kidney transplant was like a burning flame in the back of my mind,” says dad Roel Cunanan.
The family had health checkups and blood tests, but during the pandemic they weren’t as regular. It was Hazel who noticed that her son was struggling.
“I suggested that we be safe and have him tested,” Hazel says. “Sure enough, his kidney function was out of whack, and we had to go to the emergency department right away.”
Going to Hawaii despite kidney failure
Before learning that he had kidney failure, Markus had asked if the family could go to Hawaii in March for his birthday. The parents agreed, and the trip was planned. Yet he was diagnosed with kidney failure just a few weeks before the trip.
“Markus was so excited about the trip. He loves the beach and he loves to swim,” Hazel says.
A part of his care at Stanford Children’s was receiving dialysis—via a machine that does the job of the kidneys—for several hours each day. Despite being strong, Markus couldn’t help but cry one day while getting dialysis over missing the trip. Paul Grimm, MD, nephrologist with Pediatric Kidney Transplant, and Cynthia Wong, MD, director of Pediatric Dialysis, said they would find a way to make the trip happen.
“The two said no matter what, they would get us to Hawaii. They bent over backwards so we wouldn’t have to cancel our trip,” Roel says. “Because of their efforts, Markus realized his disease wasn’t going to stop him from doing anything.”
Nurses and social workers worked day in and day out to arrange for his dialysis to continue in Hawaii near where they were staying. When they got it approved, everyone celebrated with a birthday party for Markus at the dialysis center.
“We do whatever we can to convince these kids that having a kidney transplant won’t stop them from living their lives. If we have the means to make a wish come true, we do it,” Dr. Gallo says.
The couple says everyone at the hospital is like one big family, with people who have known them for years throughout both kidney transplants. Every Tuesday, Hazel brought in Filipino bread to the dialysis team as a small token of appreciation for everything they did.
Receiving a kidney transplant
After an eight-month wait for a donor kidney, Markus received transplant surgery. It came at just the right time, as dialysis, despite being lifesaving, can take its toll on the body and the spirit.
The transplant went as expected, and the stress of Markus’s immediate recovery was eased by something that tapped into his love for video games—virtual reality (VR) equipment with interactive bedside projector-based games, provided by the Stanford Children’s CHARIOT program.
“I came in to check on Markus after the surgery, and he was flying through New York City. There can be so much anxiety with surgery, so it was fun to see VR take him somewhere different. He asked for it again and again,” Dr. Gallo says.
Faith Collins, from the CHARIOT program, helped Markus forget his pain and begin sitting up after surgery. VR also helped doctors and nurses take out drains and draw blood, which eased his fear of needles. After less than a week, Markus was out of the hospital, recovering and getting back to normal life.
“Everyone was so wonderful, and they were really there for us. The nurses even cared for our kids while we went on a much-needed date,” Hazel says. “We are not rich people, but we felt like we were VIPs receiving concierge care.”
About the Pediatric Kidney Transplant Program
The Pediatric Kidney Transplant Program at Stanford Children’s has performed more pediatric kidney transplants with the best outcomes than any other U.S. center. The program’s one-year and three-year success rates are 100%, which are unsurpassed despite caring for children with the toughest challenges.
“Our kidney transplant team is one big passionate family with a very inquisitive nature. We work together really closely, and we are comfortable pushing each other to think outside the box and do our very best for every child,” says Lynn Maestretti, MPH, MMS, a physician assistant in transplant surgery.
Dr. Gallo agrees, remarking how thrilling it is to get a call at 2:00 a.m. to learn that a kidney has been located for a child in her care: “It doesn’t feel like work. It feels great, and that feeling resonates throughout our entire team. We are excited to care for kids who need kidney transplants, and we fold their families into our care.”
A large, comprehensive care team walks children and families through all aspects of care, including helping families cope with the emotions that kidney transplant brings and the logistics of needing to stay near the hospital. After discharge, patients can be seen closer to home at outreach clinics in four Western states.
Sister helping brother with his recovery
Markus and Danica bonded over the experience of kidney failure and kidney transplant. Even though Danica was a senior in high school preparing for her upcoming freshman year at the Academy of Art University in San Francisco, she made time to support Markus.
“She would FaceTime him when he was in the hospital and tell him it would be OK,” Hazel says. “When he got home, they would take each other’s blood pressure, and she showed him how to set alarms on his phone for his meds.”
Roel remembers them comparing war stories about their experiences. Danica was a safe haven for Markus to discuss his worries about having a transplanted kidney.
“It was so fun to have his sister call and hear her say, you got this. Markus saw that it didn’t stop Danica, so he believed her,” Dr. Gallo says. “There is so much love in that family.”
Looking forward to their next family adventure
Now that Markus is healed and doing well, the family is dreaming of their next big adventure.
“When we have time off and no one is sick, we like to go places together, like the beach, or camping in the foothills and fishing,” Roel says.
Today, Markus’s labs show healthy kidney function. He’s back to feeling positive and enjoying life.
“All of his labs are looking great, and there are no signs of rejection,” says Stephanie Choy, CPNP-PC, who coordinated seamless care for Markus during his hospital stay and recovery, as part of a team of nurse practitioners and physician assistants who are specially trained in kidney transplant care.
“He did it! He is back to his normal self, saying he wants to be in tech and do this and that. He’s thriving in school, and his health is really good,” Hazel remarks.
The family wanted to share their story to give others who are facing a kidney transplant hope. Roel knows that hearing the news is like being thrown in the deep end, and he wants to bring families peace. Hazel wants families to know they are not alone.
“We were lucky to receive care at Stanford Children’s. They are like family to us. They offer a whole community of help. I want families to know there are people there to help you,” she says.
Transplants start with generous kidney donors. In honor of Donate Life month, we thank those who have donated a kidney to save a life, including Markus’s anonymous donor and Danica’s Uncle “Bapa” Rick. You can save lives.
Learn more about our Pediatric Kidney Transplant services at kidneytransplant.stanfordchildrens.org.
