Giving a kidney to her son was the easy part for Shyra Smith.
The bigger challenge was maintaining normalcy and joy for her teenager as he navigated kidney failure, dialysis and an eventual transplant – even if it meant traveling halfway across the country for treatment.
Jaren was 17 when, during a doctor’s appointment, he was told he’d need to be hospitalized and start dialysis immediately.
“He was a junior in high school and he was an athlete … so his whole life completely changed,” Smith says. “My husband and I said we’re going to do whatever we can to keep things as normal as possible for him. We told him, ‘You will not go through this by yourself at all. Whatever I need to do, I will do it so that I can make sure that I'm there by your side this entire journey.’”
She didn’t realize that would ultimately include leaving their Texas home and living in Los Angeles for more than a month.
Born with one kidney
Routine sonogram measurements while Jaren was in utero indicated he might only have one kidney, which was confirmed after he was born. Still, he was a healthy child, always active. The first sign of kidney trouble came when he was about 12½, Smith says, when tests showed a small amount of protein in his urine. His kidney function was monitored regularly, but during that appointment when Jaren was 17, doctors said he would need dialysis immediately. That’s when the family started looking into transplant centers to find the best option for Jaren.
They started close to home in Texas. They visited Mayo Clinic in Minnesota and spoke with experts at Stanford, where they learned about the “tolerance” transplant process, which allows organ recipients to forego the lifetime regimen of anti-rejection drugs typically required to sustain a transplant.
Smith knew she and Jaren had the same blood type, so she offered to give him a kidney. Smith’s husband, Howard, was also evaluated for possible donation, but discovered he and his son had different blood types. Howard’s sister offered her kidney, but she was ineligible. So Smith was the one. She was evaluated and deemed ready.
Meanwhile, Jaren was doing his own research. He found an article about kidney transplant procedures performed through UCLA Health’s tolerance program that had already proved successful in several well-matched sibling pairs. Using the organ donor’s stem cells, the tolerance procedure supports immunosuppression-free kidney transplants and avoids the potential need for a second kidney transplant, as immunosuppressive drugs ultimately lead to kidney damage.
Jaren “did a presentation for my husband and mentioned his reasons why he really wanted to pursue UCLA,” Smith says. “He became an advocate for his health.”
Jaren explained that Jeffrey Veale, MD, who helped pioneer UCLA Health’s tolerance transplant program, was an expert and “it put him at ease,” she says.
A mother’s hesitation
Still, Smith wasn’t so sure about coming all the way to Los Angeles, especially since there was no indication that Jaren would be a candidate for the tolerance procedure. They’d be so far away from their family and community. Plus, Jaren was only 17, and Dr. Veale treats adults. And then there was the expense of it all.
“Immediately I was coming up with every excuse why we probably should not do this,” Smith says.
She said a prayer and asked for guidance, explaining, “I didn’t want to be the one out of all of us to say no and be the negative Nancy.”
Her husband called Dr. Veale to learn more, and after the couple talked to him, everything changed, she says: “Just to see the transition that occurred within my son – I mean, he just lit up.”
Even though Jaren wasn’t a candidate for the tolerance procedure, which is only available to sibling pairs so far, the family felt Dr. Veale and UCLA Health were the right fit.
After nearly a year on dialysis, Jaren turned 18 in December 2023. The following month, the family was in Los Angeles.
Healing together
Smith found a house where her family could stay. Her cousin went along as a caretaker. Later, her mother-in-law and sister-in-law came to help.
On Feb. 28, 2024, Smith and Jaren had their surgeries. They spent the next several weeks recuperating. With their caretakers handling everything, mother and son had plenty of time to rest, relax and “do a lot of self-care.”
“I believe that was a blessing for us, to have it there and experience that,” Smith says. “If we would have done the surgery (in Texas), I wouldn’t have been able to be still.”
The biggest blessing, of course, was seeing the change in Jaren’s health.
“As soon as my kidney got into him, he was fine,” Smith says. “I just watched life come back into my son when we were in California.”
By the time the family returned to Texas, Jaren was shooting hoops in the front yard. After a couple of months, he started lifting weights again. He was able to wrestle with his older brother when he returned from college that summer. When Jaren was finally able to get into the backyard pool again, he and his friends held hands and jumped in together as mom captured the moment on video.
“We got back home from LA and we got back to the life that was paused,” Smith says.
About seven months after the transplant, Jaren started facing immune issues related to the anti-rejection medication.
“That was one reason we looked into the tolerance procedure,” Smith says.
Despite the setback, Jaren is still upbeat, Smith says. The family continues to make periodic trips to Los Angeles for follow-ups with Dr. Veale, whom Jaren calls “Uncle Jeff.”
“Everyone out here knows about Uncle Jeff,” Smith says. “He’s really been a big part of Jaren’s healing as well – a huge part – so we’re very, very grateful.”
For Smith, it feels like a new chapter is beginning.
“We tried to make the best of every moment and kept in mind this is part of this chapter right here,” she says, adding that Jaren kept his spirits – and his grade-point average – up throughout the process.
“He’s probably tired of hearing me say it, but I’m very proud of him – proud to be his mother,” Smith says. “He’s been an inspiration to so many people.”
