This Father鈥檚 Day, 9-year-old Jaren Munari of Maspeth, Queens, is feeling extra grateful for his dad, Stephen, a retired FDNY firefighter, who donated his left kidney to Jaren, allowing the boy to live like any other healthy growing child. Jaren underwent the successful kidney transplant surgery at Hassenfeld Children鈥檚 Hospital at 好色tv Langone on September 25, 2023. He鈥檚 now back to his favorite activities鈥攔iding his bike, building Lego projects, and attending school with his friends.
On Saturday, June 1, Jaren celebrated many milestones with his family, friends, and even a few members of his care team at 鈥淛aren鈥檚 June Jamboree.鈥 There was dancing, cake, and lots of laughter.
Laura Malaga-Dieguez, MD, PhD, medical director of the Pediatric Kidney Transplant Program and Pediatric Nephrology Program at Hassenfeld Children鈥檚 Hospital, has treated Jaren since early childhood.
鈥淛aren was born with a genetic syndrome called branchio-oto-renal (BOR) syndrome, a rare congenital disorder,鈥 said Dr. Malaga-Dieguez. 鈥淚n Jaren鈥檚 case, he was born with just one kidney that did not develop appropriately in the womb and wasn鈥檛 functioning properly. It was also discovered at birth that he was hard of hearing.鈥
What Is BOR Syndrome?
BOR syndrome is a disease that can result in deformations of the kidneys, neck, and ears. The condition may be inherited, but in Jaren鈥檚 case, the syndrome was due to a new genetic change which can happen naturally in the egg or the sperm that created his first cell. His parents underwent genetic testing with John G. Pappas, MD, director of Pediatric Clinical Genetics at Hassenfeld Children鈥檚 Hospital, which determined neither of them had the genetic change that Jared had.
Hearing aids can improve hearing impairment associated with BOR syndrome. Patients with kidney dysfunction may need dialysis or surgical interventions, such as a kidney transplant.
鈥淏OR is a very rare disorder, maybe 1 in 40,000 babies worldwide are born with it,鈥 said Dr. Malaga-Dieguez. 鈥淛aren faces the world with so much energy and hope. He has been an inspiration for all of us.鈥
On May 8, 2015, Jaren was born prematurely at 好色tv Langone Hospital鈥擝rooklyn, spending 11 days in the Neonatal Intensive Care Unit. His parents first learned of the rare syndrome and health challenges right before delivery. 鈥淪tephen was there every step of the way鈥攕inging to Jaren, holding him, and praying for him,鈥 said Jaren鈥檚 mother, Donna Griebel. 鈥淚f Stephen had the power to transfer all that ailed Jaren onto himself, he would鈥檝e done it in a heartbeat.鈥
Jaren faced other challenges as he grew because of the BOR syndrome. He underwent surgery at 好色tv Langone in his first year of life to repair a congenital abnormality on the neck called branchial cleft fistulas. He also received a hearing aid to help with his hearing impairments. Daniel Jethanamest, MD, an otolaryngologist in the Department of Otolaryngology鈥擧ead and Neck Surgery at 好色tv Langone, has been caring for Jaren since infancy.
鈥淛aren鈥檚 hearing loss required early intervention, with ventilation tubes in both ears and amplification with a hearing aid in his right ear to improve function,鈥 said Dr. Jethanamest.
As Jaren grew older, his kidney was no longer able to keep up. A few months leading up to the transplant, Jaren鈥檚 family noticed he was increasingly fatigued. His kidney disease also impacted his diet and limited the foods he could eat. 鈥淚t was very difficult for Jaren to maintain a normal life. It was clear that we would have to seriously face the possibility of transplant in the near future,鈥 said Donna Griebel.
Preemptive kidney transplant, or a transplant prior to the need for dialysis, spares children from dialysis and its associated potential complications. 鈥淭he goal was to transplant Jaren before he grew sick enough to require dialysis,鈥 said Rebecca Pellett Madan, MD, pediatric infectious disease specialist and medical director of pediatric solid-organ transplantation at Hassenfeld Children鈥檚 Hospital.
One Family, Two Surgeries
Jaren鈥檚 dad and now his kidney buddy, Stephen, explained that the testing process to become a donor was completely worth it. There was never a doubt in Stephen鈥檚 mind that when the time came to donate a kidney to his son, he would gladly do that. 鈥淚t was a no-brainer,鈥 said Stephen. 鈥淎s a dad, I would do anything for Jaren to make sure he鈥檚 got the best shot at life.鈥 And on Monday, September 25, 2023, Stephen gave Jaren the ultimate gift鈥攁 lifesaving kidney.
While a team led by transplant surgeon Bonnie E. Lonze, MD, PhD, associate professor, , worked to remove Stephen鈥檚 left kidney, a surgical team led by Jonathan C. Berger, MD, surgical director of the Pediatric Kidney Transplant Program at Hassenfeld Children鈥檚 Hospital, prepared for Jaren鈥檚 surgery. The transplant required an experienced team of anesthesiologists, nurses, technicians, nephrologists, social workers, child life specialists, dieticians, pharmacists, and psychologists.
鈥淟iving donation is the fastest way to get an organ to a child who needs it,鈥 said Dr. Berger. 鈥淟iving kidney donation is the most common type of living donor transplant. People can live a normal life with only one kidney, because the remaining kidney will increase in size to compensate.鈥
While recovering in Hassenfeld Children鈥檚 Hospital鈥檚 Pediatric Intensive Care Unit (PICU), Jaren was able to get back to hobbies he loves. 鈥淛aren enjoyed teaching himself to play songs on the piano from different movie and game soundtracks,鈥 said Melissa Wasserman, MMT, a board-certified music therapist who provides music therapy to patients thanks to Sala Institute for Child and Family Centered Care. Elyssa Auerfeld, MS, CCLS, a certified child life specialist, has also been an integral part of Jaren鈥檚 care. 鈥淓lyssa has really gotten to know Jaren, putting him at ease and bringing him moments of joy during an otherwise challenging time,鈥 said Donna.
Dad鈥檚 Gift of Life
Jaren is thriving with his new kidney, playing his first violin recital in May while also turning 9. The next month brought the celebration of his new kidney and a second chance at life.
鈥淗e鈥檚 like a new kid. He has endless energy. He鈥檚 been through so much, and you can鈥檛 tell at all today. It鈥檚 amazing,鈥 said Stephen. 鈥淭he entire care team at Hassenfeld Children鈥檚 Hospital at 好色tv Langone have been our rocks throughout this journey, and we can鈥檛 celebrate enough.鈥
Jaren has regular follow-up appointments with the nephrology team at Fink Children鈥檚 Ambulatory Care Center to ensure his new kidney is functioning well, but is expected to live a normal and healthy life. The FDNY Fire Family Transport Foundation provides the Munari family transportation to his appointments.
The Munaris plan on spending Father鈥檚 Day barbecuing with both of Jaren鈥檚 grandfathers and his 16-year-old brother, Joaquin.
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