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posted: 7/21/2014 6:33 AM

Can kids who have lost a paired organ play sports?

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It wasn't much of an issue when he was a little guy, but with middle school fast approaching, would the boy's medical past finally catch up with him?

The student was a natural athlete but, in an anatomical quirk of fate, had been born with only one kidney. Protective parents would naturally assume such children need to refrain from competitive sports, but that's not always the case.

Humans thankfully have a number of "paired organs," including ovaries, testicles, kidneys, and eyes. The loss of one of the pair due to injury, disease, malignancy, or congenital absence often leads to increased vigilance in protecting the surviving "solitary" organ.

But, this scenario does not necessarily prohibit a child's participation in sports when the remaining organ is healthy.

The least restrictive condition involving loss of a paired organ is in the case of a solitary ovary. Since the risk of severe sports injury to a female athlete's surviving ovary is considered "minimal," the American Academy of Pediatrics approves participation in all sports without qualification.

This means that for girls with a single ovary there are no restrictions to participation in any of the three categories of sports, including noncontact sports -- such as badminton, golf, running, and swimming; limited-contact sports -- such as fencing, skating, softball, and volleyball; or even contact sports -- such as basketball, cheerleading, lacrosse, and soccer.

For boys with only one testicle -- the second of the pair being absent or undescended (not located in the scrotal sac), the academy also OKs unconditional sports participation, but notes that certain sporting groups may require these athletes to wear a protective cup.

The AAP does not impose restrictions on noncontact sports for children and teens with a solitary kidney.

However, for this group, sports with greater potential for contact or collision -- the limited-contact and full-contact sports -- are granted a more conservative "qualified yes."

A young athlete with only one kidney should participate in these sports only after individual clearance and with the use of protective equipment.

The pediatric group is again restrictive in its recommendations for players who have lost an eye, but still grants a "qualified yes" for their participation in sports.

The academy comments that ASTM-approved eye guards and other protective equipment may allow affected kids to participate in most sports, but only after evaluation and clearance on a case-by-case basis.

This qualified approval also applies to young athletes who are "functionally one-eyed," that is, able to be corrected to less than 20/40 vision in their weaker eye. Children who have had previous eye surgery or suffered a detached retina or serious eye injury also fall into this category of conditional sports approval.

As an important side note, in their article in Pediatric Clinics of North America, physicians Eugene Diokno and Dale Rowe remind both affected and unaffected young athletes that appropriate, well-fitting eye protection is advised for participation in all organized sports.

The authors note that protective eye wear has been shown to decrease the risk of significant sports-related eye injury by at least 90 percent.

• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights

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