PHOTOGRAPH BY ANDREW DOENCH
It’s called CARPEDIEM CRRT for a reason—for those rusty in Latin, it means “seize the day.” It is also a life-saving machine that brings safer dialysis treatments to the tiniest patients at Cincinnati Children’s, and now across the country, thanks to the research and implementation efforts by Stuart Goldstein, M.D., director of the Center for Acute Care Nephrology at Cincinnati Children’s. He was a clinical consultant in developing the new technology—CARPEDIEM: Cardio-Renal Pediatric Dialysis Emergency Machine—in conjunction with Italian physician Claudio Ronco, M.D., who designed the technology in 2014.
“This is the first true advancement in acute dialysis technology in over 20 years,” says Goldstein. “And it is the only device specifically designed for and indicated by the FDA to support children with kidney failure under 8 kilograms in size.” Cincinnati Children’s has three machines and expects to use CARPEDIEM for 10 to 15 patients a year, typically for a treatment course of seven to 14 days.
The family of one of those patients is “eternally grateful” for Goldstein and his team. After trying to conceive for five years, Ashley and Geoff Hart found out they were expecting. But when they headed into Ashley’s 20-week ultrasound, they found out she didn’t have very much—if any—amniotic fluid. Their daughter Selah, now 2, was diagnosed with bilateral multicystic dysplastic kidneys, which meant that she had cysts on her kidneys that started to eat away at the organs’ tissue, so urine wasn’t leaving her kidneys. Their OB/GYN suggested terminating the pregnancy.
A maternal-fetal medicine physician, however, suggested embryo infusions, which would help give Selah time to develop. Fifty-one infusions later, Selah was born just a few weeks early. She would still need dialysis, but “very few medical devices are ever developed or designed specifically for children,” Goldstein says. ICU doctors have made do by modifying larger machines, but those makeshift solutions often aren’t good enough. Luckily for Selah and her family, this option for care existed, provided by what Ashley calls the “incredible, beautiful, amazing, loving team” at Children’s Nephrology.
Today, Selah is on dialysis five times per week, and struggles with occasional seizures. And in November, her family received life-changing news: Selah will be receiving a transplant within months. “Sometimes when there aren’t other options like CARPEDIEM, it’s really sad,” Ashley says. “It’s a miracle that we’re here. I really believe that the clearance CARPEDIEM gave us helped Selah’s neurodevelopment.”
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