Dell Children’s Medical Center has performed its first serial prenatal amnioinfusion for fetal renal failure, marking a key milestone in the continued expansion of its Comprehensive Fetal Care Center and establishing it as one of only a few centers in the country with this level of specialized fetal surgery and intervention capabilities. The intervention was directed by Alireza Shamshirsaz, M.D., MHCM, a renowned fetal surgeon who leads Dell Children’s Fetal Care Program through a clinical partnership at Dell Medical School at The University of Texas at Austin.
Designed for pregnancies impacted by critical, life-threatening renal anomalies such as early pregnancy renal anhydramnios (EPRA), this procedure plays a vital role in enabling fetal lung maturation. It offers a potential pathway toward neonatal dialysis, postnatal survival, and eventual pediatric kidney transplantation, offering some families hope where the diagnosis was once considered almost uniformly fatal.
“Advanced fetal interventions and in utero surgeries enable us to treat severe, life-threatening conditions during a key window of fetal development prior to delivery,” said Dr. Shamshirsaz. “By driving clinical innovation and integrating multidisciplinary expertise, we continue to grow our program to offer complex, cutting-edge procedures so that families—whether close to home or from across the country—can receive this specialized fetal care found in only a handful of fetal programs within the U.S.”
Through Dr. Shamshirsaz’s surgical and academic leadership, Dell Children’s is creating groundbreaking discoveries in fetal medicine. Dr. Shamshirsaz co-authored a pivotal August 2026 study in JAMA reporting findings from the national Renal Anhydramnios Fetal Therapy (RAFT) trial. The trial assessed serial prenatal amnioinfusions across 13 leading U.S. fetal centers for pregnancies affected by early pregnancy renal anhydramnios (EPRA), a severe anomaly historically considered 100% fatal at birth owing to profound lung underdevelopment.
The published JAMA findings revealed a 91% live birth rate, and a 65.5% rate of survival to at least 14-days with dialysis access. Sixty-four percent of the children surviving at last follow-up had received a kidney transplant between ages 2 and 5. Offering this emerging therapy at Dell Children’s places the institution among a select group of top fetal care centers nationwide.
“Dell Med faculty like Dr. Shamshirsaz are leaders in their fields, and our partnership with Dell Children’s allows them to apply their clinical and scientific expertise directly to patients,” said George Macones, M.D., chair of the Department of Women’s Health and executive vice dean at Dell Medical School. “Thanks to his work, families facing this once-fatal diagnosis now have access to some of the most advanced fetal care available, right here in Austin.”
Dell Children’s Comprehensive Fetal Care Center brings together maternal-fetal medicine specialists, pediatric surgeons, neonatologists, and specialized care coordinators all under one roof, ensuring that families receive comprehensive diagnostics, advanced interventions, and personalized support in a single, unified location.
