A little miracle

A little miracle

After battling a deadly E. coli infection, Jacob Silverman is alive, thanks to a kidney transplant

 By Meredith Rutland

Jacob Silverman, 11, received a kidney transplant at Shands at UF in 2009./Photo by Maria Belen Farias

Jennifer Silverman tried the thermometer again, but her little boy’s fever wasn’t going away.

She called the family pediatrician. The next morning, 6-year-old Jacob Silverman was in Joe DiMaggio Children’s Hospital in Hollywood, Fla., fighting for his life.

In what can only be described as a mother’s worst nightmare, Silverman stood by her son’s side as he cried, had strokes and slipped in and out of a coma. As the hours dragged toward dawn, it became clear that the kindergartener’s kidneys had shut down.

But four-and-a-half years later, Jacob, now 11, has a new kidney — his mother’s — and all the prospects of a healthy life after having a kidney transplant at Shands at UF in 2009.

Jennifer Silverman donated her kidney to her son, Jacob, who went into renal failure after battling a deadly E. coli infection./Photo by Maria Belen Farias

“He’s a little miracle,” said Silverman, who lives in Miami. “We’re very fortunate that he’s alive.”

Through the years of dialysis and months of hospitalization, Jacob’s parents did what they could to make him feel like a normal kid. If he was well enough to leave the hospital, their first stop was Toys “R” Us for Yu-Gi-Oh cards and a new box of Legos. Then it was off to Books-A-Million and the Butterfly Rainforest at the Florida Museum of Natural History. Jacob said he couldn’t get enough of the museum.

Jacob had been infected with E. coli 157, the culprit for most E. coli outbreaks across the globe. It can infect anyone, but young children and elderly people are especially at risk, according to the Centers for Disease Control and Prevention. While Jacob didn’t get sick during a national outbreak, the CDC warns that E. coli can be spread at any time of the year through undercooked meats, unwashed vegetables and any contact with animals. Silverman suspects Jacob got sick after eating a piece of broccoli that someone at his elementary school gave him.

The bacteria caused Jacob to develop a potentially fatal illness, hemolytic uremic syndrome. It shut down his kidneys and caused him to be put on dialysis for most of elementary school. When Jacob romped around his living room with his friends, they knew to avoid his shoulder port. His teachers made sure he was ready to leave for his dialysis appointments by 1 p.m. every other day.

“It was kind of hard to do some homework on dialysis,” he said.

He took his toy donkey with him to dialysis to protect him from the machines. He said his donkey won most of the board games they played with volunteers. Jacob said he remembers missing activities he’d been looking forward to — like “reading buddies,” an activity where students pair up and practice reading.

But after bouncing around to hospitals nearly everywhere between Miami to Jacksonville, Silverman contacted Shands at UF in 2008. She was told she’d be a perfect donor for her son, and she started making arrangements.

Vikas Dharnidharka, M.D., chief of the division of nephrology in the College of Medicine department of pediatrics, and Joseph Magliocca, M.D., who recently left UF for Emory University, led Jacob’s transplant team.

“They both were an encyclopedia of knowledge,” Silverman said.

Dharnidharka sees pediatric patients of all ages, from premature babies to 21-year-olds. On average, 13 of his patients receive kidney transplants each year. The division of nephrology in the department of pediatrics cares for children with various forms of kidney failure, and Dharnidharka and other pediatric nephrologists follow up with their patients after transplant surgeons have finished their jobs.

Jacob Silverman, 11, visits his doctor, Dr. Vikas Dharnidharka./Photo by Maria Belen Farias

He said when he met Jacob, he was tired and quiet — but that’s typical of young kids who have to go through dialysis. After Jacob got his new kidney and the years went by, Dharnidharka started to see Jacob’s energetic side. They talked about what superhero Jacob liked that day, and Dharnidharka joked with him about Jacob’s chin-length hair.

“He’s able to do all the usual boy things that he’d want to do,” he said.

Jacob had the surgery in May 2009 and spent a month in the hospital. He had visits from UF football players and friendly therapy dogs.

Once, a Havanese dog came to cheer him up on a particularly difficult day. He ended up getting the same type of dog soon after his surgery. He named it Lucky.

“When that dog came in, I was so happy,” Jacob said.

Now, Jacob is a 4-foot-8-inch preteen ready to tackle middle school next school year. He’s even set on becoming a Gator when he graduates high school.

“I want to study to be a Lego master, a Yu-Gi-Oh card designer, a game designer or a doctor,” he said.

Dharnidharka said Jacob’s battle isn’t over yet. Fifty percent of transplanted kidneys last about 15 years. Some last longer — others less.

But kidneys from live donors typically increase a patient’s chance of survival, compared with ones from deceased donors, according to research done by the Arbor Research Collaboration for Health.

“These are treatments, not cures,” he said. “It’s true that some of our kids that get kidneys early will need a second, maybe even a third.”

But he said Jacob is looking healthy, and he has a sturdy support base to help him along the way — and to drive him across the state for appointments.

“They’ve been a great family,” he said. “Six hours driving both ways is not a small deal, and they haven’t missed an appointment.”

Looking back on the past four years, Silverman said she’s grateful Shands was there for her family.

“We will always be patients of Gainesville, of Shands,” Silverman said.