For first-time parents, JoAnna and Kris Palinchak, having twin girls was a dream come true. But three months after delivering healthy twin girls, the new parents noticed that one of their daughters, Ella, was developing differently than her sister, Lacy.

Ella had developed jaundice, a liver condition that causes yellowing of a newborn baby’s skin and eyes. She required immediate medical attention and was taken to a hospital near their home in Naples. Doctors there conducted exploratory surgery and performed a liver biopsy.

Initially, doctors suspected Ella had biliary atresia, a rare and genetic life-threatening disease that affects the bile ducts in the liver of infants. The Palinchaks turned to a trusted gastrointestinal doctor who advised them to have Ella evaluated by the Miami Transplant Institute (MTI), an affiliation between Jackson Health System and UHealth – University of Miami Health System.

Due to their global expertise in complex cases, the medical team at MTI discovered that Ella’s jaundice had manifested into Alagille syndrome, a condition in which bile builds up in the liver because there are too few bile ducts to drain it.

“Alagille syndrome is a rare genetic condition in early childhood in which many organs may be involved, including the liver, heart, brain, kidneys, bones, eyes, and face,” said Tamir Miloh, MD, medical director of MTI’s pediatric transplant hepatology unit. “Ella had developed progressive jaundice, intractable itching, poor sleeping patterns, and stunted growth.”

While normally non-threatening, her condition was causing early-onset liver failure. Though there is currently no cure for the condition, there are ongoing studies at some children’s hospitals on early diagnosis and new innovative medical interventions aimed at improving outcomes and quality of life in these children. Holtz Children’s Hospital at the University of Miami/Jackson Memorial Medical Center is among the hospitals with experience treating children with Ella’s condition.

After meeting with doctors at the Miami Transplant Institute and Holtz Children’s, Ella’s parents were told the best treatment for their daughter would be a liver transplant.

Although the family was scared after receiving the news, they had confidence in Ella’s medical team and quickly bonded with them — especially Kati Garcia, her assigned nurse and transplant coordinator, who had been with the family every step of the way.

“We were afraid, but Kati was very helpful in helping us understand everything that was happening,” Ella’s mom said.

On December 16, 2016 -one day before her first birthday – Ella was listed on the national transplant waiting list.

The Palinkchaks remained hopeful, but the developmental delays of their baby girl began to discourage them. While Lacy began walking at nine months, it took Ella 24 months.

The loving parents would spend the next two years traveling between their home in Naples and Holtz Children’s.

“She was followed by a transplant and heart teams to optimize her nutritional status while we waited for an appropriate donor,” said Dr. Miloh. “Before safely undergoing transplant surgery, she needed intense nutrition support including fat-soluble vitamins and targeted therapy for severe debilitating itching associated with Alagille.”

On March 8, 2018, Ella’s parents were notified that a donor liver was found for their daughter. They quickly packed their bags and drove to Miami.

As the medical team prepared Ella for transplant surgery, the peaceful look on her face gave the worried parents a sense of security that everything was going to be fine. The following morning, Ella underwent a successful liver transplant led by Akin Tekin, MD, UHealth’s liver, intestinal and multivisceral surgeon, and a multidisciplinary pediatric team at Holtz Children’s.

The surgery was a success. And when the Palinchaks got to see their daughter in the pediatric intensive care unit, they were met with an unexpected surprise: Ella’s nurses had brushed and styled her hair.

“We were in the right place, with the right people,” her mother said. “Within two weeks, Ella was discharged, and ever since then, our baby girl started thriving.”

To honor the donor family, a garden with beautiful flowers was planted on the Palinchaks front lawn For Ella and other children who are battling this condition, the Palinchak family hosts an annual fundraiser in their community to raise awareness of Alagille syndrome.

“The family’s selfless act of organ donation during a moment of sadness forever changed our family,” said JoAnna Palinchak. “We have cried sorrowful tears for them and prayed for them. When our daughter is old enough to understand the path of her life, we hope that the ‘person’ at the center of her story can be identified as her lifesaving superhero.”

Now age 5, Ella visits MTI twice a year for check-ups. She’s happy, healthy, and loves spending time with her twin sister.

“Her beautiful scars tell an amazing story that we will never forget,” JoAnna said. “No words are enough to show appreciation and gratitude for all that was done to change Ella’s life. Every single day of her life is better because of the medical team at MTI.”

While 28-year-old Keyondra Smart knew at a young age that she suffered from sickle cell disease (SCD), she didn’t fully understand the effects of the illness until four years ago when she was hospitalized at Jackson Memorial Hospital with acute chest syndrome and double pneumonia, which occurs when the infection affects both lungs.

Sickle cell disease is a group of hereditary red blood cell disorders that causes the cells that carry oxygen around the body to become hard, sticky, and c-shaped like a sickle. The cells tend to die early, leading to a shortage of oxygenated blood cells. The disease can also put a patient at a higher risk of developing infections.

The Center for Disease Control estimates that more than 100,000 Americans suffer from SCD, and 1 in 13 Black or African American babies is born with sickle cell trait.

After a month’s stay at Jackson Memorial, Keyondra fell into a deep depression. She had to relearn how to walk and was struggling with the reality of living with the effects of SCD.

“I was on my deathbed and in the intensive care unit for two weeks,” Smart said. “I had never experienced so much pain before. I was mentally, physically, and emotionally exhausted.”

Slowly, Smart came to terms with the disease and began learning about ways to manage her ongoing pain and symptoms.

She returned to school and was determined to graduate despite days when she did not feel well following her treatment.

A few years passed, and as Smart’s life seemed to be getting better, the COVID-19 pandemic hit.

“My anxiety came back because I was so scared of the virus,” she said. “I already have a weak immune system, and this was something I could die from.”

Sickle Cell and COVID

Thomas Harrington, MD, and Maya Bloomberg, MSN, APRN, are the adult sickle cell providers in the Division of Hematology/Oncology at Jackson Memorial. They explained that patients living with sickle cell are at a greater risk of contracting COVID-19. SCD patients who get sick with the virus experience higher rates of hospitalizations and complications, along with worsening sickle cell pain.

Additionally, studies performed before COVID vaccinations were available and the spread of the Delta variant also showed racial disparities in terms of life expectancy due to the virus.

“While life expectancy dropped for all groups, it has been worse for the Black community,” Bloomberg said. “Overall life expectancy dropped by one year for Caucasians and two years for the Black population.”

One study published via PLOS ONE showed that the difference in life expectancy was due in large part to increased exposure at work and access to personal protective equipment.

COVID-19 Vaccine

Faced with the discouraging disparities and risks to patients with sickle cell, Dr. Harrington and Bloomberg are encouraging their patients and the community to get vaccinated.

“You need to put the relative risks in perspective,” Bloomberg said. “The COVID-19 virus is very unpredictable, especially the latest Delta variant. People assume that only older people with health conditions are getting sick and dying, but more and more we’re seeing younger people in the hospital with severe COVID cases.”

If people are worried about the vaccine or have concerns, she encourages them to turn to speak with their doctor.

Keyondra chose to get vaccinated after speaking with Dr. Harrington, who is one of the few experts in sickle cell care in South Florida.

“I know people are scared because there’s a lot of information out there, and they might think it’s a setup, but you should talk to your doctor about any concerns you might have,” Smart said. “I highly recommend other SCD patients get vaccinated, too. We’re already fighting one disease. Who wants to fight two?”

For more than three decades, Cassandra Hirsh has owned Scully’s Tavern, a popular Kendall restaurant.

As Cassandra was getting ready to leave her house and head to work one day last September, the 68-year-old fell down the stairs and suffered a catastrophic injury.

“It happened in the blink of an eye,” she said. “I can’t remember how I fell. I was standing at the top step, and then suddenly, I was on the ground in unimaginable pain.”

Home alone, she laid on the floor, drifting in and out of consciousness, unable to call for help or move to reach for a phone.

It wasn’t until six hours later that her husband, Chris, returned home from the restaurant, where he had been smoking ribs for the week ahead.

He discovered a horrific scene: Cassandra laying on the ground, immobile, in a pool of her own blood. Chris frantically called 911.

Fire rescue carefully lifted Cassandra onto a stretcher. Her nose was broken and her face was covered in bruises. They rushed her to Ryder Trauma Center at Jackson South Medical Center.

A CT scan confirmed that Cassandra had a broken neck and an incomplete spinal cord injury. She was assessed by Ian Cote, MD, a UHealth – University of Miami Health System neurosurgeon who specializes in spine surgery at Ryder Trauma at Jackson South.

“She was in a lot of pain, incredibly weak, and couldn’t move either one of her hands or her right leg,” Dr. Cote said.

To alleviate the pressure of her spinal cord, Dr. Cote performed a complex cervical fusion surgery. This type of traumatic injury is rare, and if her medical team had not acted as expeditiously as they did, Cassandra risked permanent paralysis.

“When Cassandra came to the trauma unit, she had incomplete paralysis in her upper and lower extremities,” Dr. Cote said. “But the surgery went great, and her body responded well to the procedure.”

Following the successful surgery, Cassandra required physical rehabilitation to help her get back on her feet. She chose Christine E. Lynn Rehabilitation Center for The Miami Project to Cure Paralysis at UHealth/Jackson Memorial for its state-of-the-art facility, expert medical team, and commitment to including family in the patient’s rehabilitation and recovery process.

During her six weeks at Lynn Rehabilitation Center, Cassandra underwent intense physical and occupational therapies to relearn how to use the right side of her body. In occupational therapy, her therapists incorporated her love for calligraphy into her daily exercises as a way to work on fine motor skills in her right hand, while her physical therapy focused on helping her regain strength in her right leg.

“Cassandra had a positive attitude and was driven to get better,” said Oliver Acosta, MD, a physical medicine and rehabilitation physician who cared for her. “Our goal at inpatient rehab was to build her back up to help her regain a sense of independence.”

She was discharged just before Christmas and was able to spend the holidays at home with her family.

After completing her outpatient physical and occupational therapy at Lynn Rehabilitation Center, Cassandra was thrilled with how much progress she made. She has regained most of the function in her right hand and is still working on regaining all of the strength in her right leg.

Most importantly, she’s been able to go back to work and continuing managing her restaurant.

“I’m so thankful for the staff at Jackson South and at Lynn Rehab,” Cassandra said. “All of my doctors and nurses were phenomenal throughout my recovery process. I wouldn’t have progressed as quickly as I did if I didn’t have an incredible surgeon and if I wasn’t receiving great care at Lynn Rehab.”

Patients at Jackson Memorial Hospital’s Miami Transplant Institute first in nation to receive custom-made hospital gowns

For more than two decades, Miami fashion designer René Ruiz has designed glamorous gowns that have been worn by celebrities and well-known public figures at red carpet events, galas, and runway shows. Each gown Ruiz makes is designed with the individual in mind with touches inspired by Miami’s rich culture that have been represented in the fashion industry worldwide.

A few years ago, Ruiz began dedicating more time to philanthropy, giving back to the community that has helped grow his brand RENÉ BY RR.

Developing Recovery Gowns for Miami Transplant Institute

That concept was later solidified following an encounter at a local charity event where he met Matthew Pinzur, chief marketing officer at Jackson Health System. The two discussed a collaboration that would allow Ruiz to use his fashion insight to create gowns of a different kind: custom-made hospital gowns for transplant patients recovering from complex surgeries.

Over the course of several months, Ruiz met with representatives from the Miami Transplant Institute (MTI), Jackson leadership, transplant nurses, and post-transplant patients. He learned about their experiences and listened to their recommendations on what it would take to transform a standard hospital gown into a more practical, comfortable gown for this patient population. Among the suggestions was adding snaps and slits in appropriate locations, allowing easier access for the medical teams to check surgical incisions and equipment, such as drains and heart monitors.

Implementation at the Miami Transplant Institute

Ruiz took all of these suggestions to the drawing board and started designing. He researched fabrics that would be comfortable and easily laundered. The result: a denim-blue hospital gown with convenient button snaps and slits. The Miami Transplant Institute team welcomed the change, as did patients of all ages, saying the custom gowns – emblazoned with a JH for Jackson Health inside of Rene Ruiz’s signature red heart icon – are more comfortable and dignified than the standard hospital gown.

Impact and Future for Miami Transplant Institute

“When I witnessed the first patient wearing my design, it was an amazing moment – one of the highlights of my life,” said Ruiz. “It’s been an amazing project for me, this is so fulfilling. What could be better?”

To date, more than 4,000 gowns have been delivered to Jackson Memorial. For now, the gowns are being used exclusively for Miami Transplant Institute’s post-transplant patients.

Renowned fashion designer Rene Ruiz supports Jackson Health System’s mission through philanthropy. To find out how you can also become a supporter on projects like these at Jackson, contact the Jackson Health Foundation today at 305-585-GIVE (4483).

In August 2017, Karen Hunter-Jackson and her son were turning into the driveway of their home in Miami Gardens, when a speeding motorcycle crashed into them. The motorcycle’s gas tank exploded, sending flames running under Hunter-Jackson’s car.

“The first thing that came to my mind was ‘Stop, Drop and Roll,’” remembers Hunter-Jackson. “This is was the lesson I learned in grade school.”

She and son ran through the fire to escape the burning car. She was wearing shorts and sandals and suffered burns up to 30 percent of her body. Her son was not hurt. The driver of the motorcycle was killed on impact.

Hunter-Jackson was immediately rushed to the Miami Burn Center, where she was treated for burns on both legs and her right arm. She underwent a series of skin grafts to her legs and arm, and was released from the hospital two months later.

“In the months I spent at the Miami Burn Center, I became family with most of the doctors, nurses, techs, rehab and occupational therapists,” said Hunter-Jackson. “I couldn’t have asked for a better experience under those circumstances.”

Hunter-Jackson, who underwent physical therapy to learn how to walk again, is also an active member of the Burn Survivor Support Group at the Miami Burn Center.

She’s currently undergoing laser treatments at the Miami Burn Center, which will help minimize her scars, and improve her flexibility.

Hunter-Jackson expressed her gratitude during Burn Safety Festival at Jackson Memorial Hospital.

The Miami Burn Center in collaboration with City of Miami Fire Rescue and Miami-Dade Fire Rescue hosted the festival to raise awareness and educate the public about burn safety and prevention. The Burn Center is one of the leading, most comprehensive burn treatment centers in the nation, treating hundreds of patients – from babies to adults – each year.

“As good as the team is at taking care of burn injuries, the best thing, of course, is to prevent it from happening at all,” said Louis Pizano, medical director at Miami Burn Center

According to the American Burn Association (ABA), every year more than 450,000 serious burn injuries occur in the United States that require medical treatment.

Gerard Daphnis and Jermaine Chambers were top recruits in the University of Miami’s football program; they forged a strong friendship on the field, one that has withstood the test of time.

When Daphnis needed a lifesaving kidney transplant, Chambers secretly got tested to see if he was a compatible donor. Just days before Christmas 2018, he shared the results with Daphnis in a handwritten card: “I’m your guy – see you on January 10. #CanesForLife.”

“It took a few minutes for it to click,” Daphnis said. “Once it did, it was very emotional. For the first time in a long time, I felt like there was hope, a chance that I was going to be okay.”

The successful transplant surgery at Jackson Memorial Hospital was performed by Gaetano Ciancio, MD, MBA, FACS, the Miami Transplant Institute’s chief medical officer and director of the kidney and kidney-pancreas transplant programs, Mahmoud Morsi, MD, CPHQ, abdominal transplant surgeon, along with a multidisciplinary team.

“Everyone at Jackson, at the Miami Transplant Institute – they’re awesome,” said Chambers. “They all worked together to make this whole thing possible; they helped me save my friend’s life.”

The pair first met in 1992, soon after being recruited by UM. Chambers, a wide receiver from Homestead Senior High and Daphnis, a tight end from Miami Norland Senior High, were already making headlines in Sports Illustrated during their freshman year of college. They became fast friends as they both looked to make their mark on the football field and the world.

But shortly after graduation, Daphnis was diagnosed with diabetes. For several years, no one knew just how much his health had deteriorated. He subsequently started dialysis.

“It all started when I stepped on a nail while pouring a new driveway at my house,” recalls Daphnis. “I went to the ER, got a tetanus shot and went on my way. I thought I was okay.”

The injury led to several fractures and a serious infection that would not go away. He underwent two surgeries and a series of painful debridements – the medical removal of the dead and damaged tissue to save the healthy tissue remaining in his foot.

But the father of five was hit with even more bad news.

His foot was not getting better and one of the antibiotics he had been prescribed had further compromised his already damaged kidneys.

“My kidneys were functioning at about 60 percent before that,” recalls Daphnis. “Now they were down to 11 percent.”

Barely able to get around and in near-constant pain, Daphnis was retaining fluid. He ballooned to 410 pounds.

“I felt like a cross between Frankenstein and the Michelin man,” he said. “I had difficulty walking and difficulty breathing.”

His health issues led to his foot being amputated. Five-hour sessions of dialysis – three times a week – were keeping him alive. Doctors determined his best chance at survival was a kidney transplant.

That is when Daphnis learned about the Living Donor Kidney Program at the Miami Transplant Institute, an affiliation between Jackson Health System and UHealth – University of Miami Health System, the second largest transplant center in the United States.

After undergoing testing, his wife Harriett had been deemed a potential match. But she was later rejected as a donor. Months later, a friend also offered to be a donor, but was also determined not to be a viable match.

“That really took a lot out of me,” Daphnis said. “It was a tough pill to swallow.”

Around the same time, Chambers reached out to Harriett and expressed interest in being the donor. As he went through the necessary testing, they decided not to tell Daphnis.

“We didn’t want to get his hopes up and disappoint him,” said Chambers. “He’d already been through so much.”

But Chambers turned out to be the perfect match.

Today, Chambers, 45, and Daphnis, 44, are both healthy and have become advocates for organ donation.

During April’s National Donate Life Month, both Daphnis and Chambers were speakers at the annual Miami Transplant Institute reunion event at Jackson Memorial Hospital, where transplant survivors share their stories of how transplantation has impacted their lives in the hopes of promoting the importance of becoming an organ donor.

Nearly 200 attendees, including former patients, doctors, and transplant staff, attended the dinner.

“They’re the best doctors in the world,” chimed in Daphnis. “And Jermaine is my hero, even if he doesn’t like me to say that.”

By Alana J. Arnold, MD, MBA
Medical Director of Pediatric Emergency Medicine at Jackson North Medical Center
Affiliated Assistant Professor, Dept. of Pediatrics
UM Miller School of Medicine

Summer is here! Kids are out of school. It’s time to start having fun! While summer means more time outdoors swimming, bike riding, and visiting playgrounds, it’s also a time for parents and caregivers to be extra alert. Outdoor play, hot weather, and water activities present potential threats to you and your child. Your family can help avoid a trip to the emergency room this summer by following these simple safety tips.

Staying Safe While Biking

• Bike riding is exercise and fun all rolled into one, but ultimately, safety is most important.
• Be sure to use headlights, taillights, and reflectors when you and your family ride at night.
• Prevent head injuries by wearing a helmet, every single time. Remember, it’s the law!
• Follow all traffic rules by paying close attention to traffic signals, signs, and street or sidewalk markings.
• Ride single file. Don’t ride side by side on the road with your family. This behavior is dangerous and could result in injury.

Swimming Safety

• Swimming is fun. But remember that kids, whether in or out of the water, need to be supervised at all times, even if they know how to swim.
• An adult should be designated to supervise the kids and have EYES on the children, at all times
• Only use FDA-approved floating devices for all toddlers and children
• If you and your family are swimming in public areas, be sure to obey all rules and posted signs.
• Don’t swim during a thunderstorm or lightning storm.
• Only swim in pools and at beaches protected by an on-duty lifeguard.

Staying Safe in the Sun

• The sun is strongest between the hours of 11:00 a.m. and 3:00 p.m. Do your best to stay out of direct sunlight during those hours.
• For children over six months of age, use sunscreen with an SPF of 15 or higher.
• Always apply sunscreen at least 30-45 minutes before going outside. Then reapply it every two hours.
• Be sure to use sunscreen even if it’s cloudy or you’re in a shaded area.
• Remember that babies less than six months of age should not be exposed to the sun.

Bug Bite Safety

• Use a safe insect repellant with ingredients that include DEET, citronella, and soybean oil.
• Avoid areas where bugs and flies congregate, such as gardens with flowers.
• Avoid getting insect repellent into your eyes and mouth. Spray repellent on your hands first and then carefully rub it on your skin.
• The worst time for bugs is in the early morning and early evening. Stay indoors or wear long-sleeved, light-colored shirts during those times.

Staying Safe Around Fireworks

• Talk to your child about how to stay safe around fireworks and go over the potential dangers.
• Children should NEVER play with fireworks. Only adults should be responsible for lighting them.
• Be sure to keep sparklers away from your family’s clothing, face, and hair.
• Don’t point or throw fireworks at anyone, ever. Remember to keep fireworks away from your home, brush, and leaves.

A lifesaving liver transplant gives 16-month-old Danilia a second chance at life.

When Danilia “Amor” Aquino was born prematurely at 26 weeks in Orlando on August 26, 2019, she was showing early signs of liver disease. Two months later – at the start of the COVID-19 pandemic – she was diagnosed with biliary atresia, a rare, genetic, life-threatening liver disease that only appears in infants.

The medical team at Danilia’s local hospital performed the Kasai procedure – considered one of the most effective treatments of this disease – in which any problematic bile ducts outside the liver are removed, and the small intestine is attached to the liver. Unfortunately, the procedure was unsuccessful.

Danilia began to have complications and was intubated for 54 days. Her parents turned to their trusted gastrointestinal (GI) doctor in Orlando who advised the family to have Danilia evaluated for a transplant at the Miami Transplant Institute (MTI), a joint program between Jackson Health System and UHealth – the University of Miami Health System.

“None of our children have had any medical conditions,” said Danilia’s mother, Jennifer Cotto. “On top of the stresses of our sick newborn, the pandemic had just begun, and her father and I were getting married February 2020.”

At the beginning of 2020, the family met with Jennifer Garcia, MD, the Miami Transplant Institute’s medical director of pediatric transplant services. Danilia’s parents instantly connected with Dr. Garcia and the medical team, who had experience with these complex cases at MTI, the largest transplant center in the nation for the second year in a row, and among the top six for pediatric liver transplants.

“Danilia was extremely small (8.8 pounds) and undernourished as a result of not only her liver disease but her prematurity and bowel complications following her Kasai,” said Dr. Garcia. “She needed Total Parenteral Nutrition (TPN) – a procedure where fluids are given intravenously to provide her with the nutrients her body would need, in hopes that this would increase her chances for transplant candidacy.”

The family returned home with their newborn daughter just nine days before their wedding – a meaningful moment for them that they were able to share as a family.

Shortly after, Danilia experienced aggressive gastrointestinal bleed, common in patients of biliary atresia and liver failure. Danilia and her father were immediately airlifted to the pediatric intensive care unit (PICU) at Holtz Children’s Hospital at the University of Miami/Jackson Memorial Medical Center. Once she arrived, Asumthia Jeyapalan, DO, a University of Miami Health System pediatric critical care physician at Holtz Children’s, would join a multidisciplinary medical team to care for her. The team included doctors, nurses, and respiratory therapists from transplant, intensive care, infection control, ear, nose and throat, nephrology, and neurosurgery.

“With COVID-19, we were facing many restrictions, and we were worried what would happen if a transplant patient would get the virus. There were so many unknowns,” said Dr. Jeyapalan. “Are we going to find a donor? From the ICU perspective, we needed to make sure she was going to tolerate transplant surgery.”

At Holtz Children’s, the approach is to practice family-centered care, which allowed the family to develop strong relationships with the medical team caring for their daughter. They also were an integral part of Danilia’s recovery, working closely with support departments in the hospital, including Child Life and Music Therapy.

“I think our entire team would agree that Danilia has shown incredible resilience and strength through the many life-threatening medical hurdles she has faced,” said Amanda Alladin, MD, a University of Miami Health System pediatric critical care physician in the Holtz Children’s PICU. “Her parents have been steadfastly at her side and have been true members of Danilia’s interdisciplinary team and we have tremendous respect and admiration for them as a family.”

During Danilia’s time in the intensive care unit at Holtz Children’s, her mother and father rotated shifts to always have a parent with her. In the span of a few short weeks, she faced infections, septic episodes, intubation, was on an oscillator, and needed dialysis for her kidneys – all situations that limited her chances of transplantation.

Eventually, she was listed on the national transplant list in April 2020.

But shortly after, she became extremely ill. Her chance of survival was less than 72 hours.

“That was difficult to hear,” recalls her father. “I spent the whole night holding her, as I cried, not knowing if she was going to make it.”

On June 16, just when her family began to lose hope, Danilia’s parents received the lifesaving call that a liver was available for their daughter.

“The nurse on shift and I hugged and cried. It was so amazing,” said her mother. “She was prepared for surgery, but we knew she was so sick going into transplant, that there was a chance she wouldn’t survive.”

She was in multi-organ failure before the transplant: her intestines were not working. Still, the MTI team took a chance on her.

Her liver transplant took place the next day, led by UHealth transplant surgeons Rodrigo Vianna, MD, PhD, director, Miami Transplant Institute and chief of liver, intestinal, and multivisceral transplant; Akin Tekin, MD, UHealth’s liver, intestinal and multivisceral surgeon; and Gennaro Selvaggi, MD, FACS, UHealth transplant surgeon.

After the 12-hour surgery, Danilia’s kidneys began to fail. Her family was devastated at the thought of another transplant.

Upon further evaluation, her medical team switched Danilia off her dialysis machine to a smaller machine meant for babies of her size. Though recovery was slow, Danilia got taken off dialysis 12 days before Christmas. The family considered this a “Christmas miracle.”

The recovery was slow, but Danilia’s kidneys began to function perfectly, she began breathing on her own, her nutrition improved, and her neurological development continued to maintain itself.

After 10 long months in the hospital, Danilia was finally ready to go home.

“She’s a miracle who has had to overcome many medical hurdles in her young life,” said
Jayanthi Chandar, MD, UHealth pediatric kidney transplant physician. “Seeing her go home is so heart-warming. Kudos to the parents whose optimism and perseverance played a big role in Danilia’s recovery.”

Upon discharge, 16-month-old Danilia received receive a special surprise visit from Mickey and Minnie Mouse outside of Holtz Children’s – signaling her return to their shared hometown in Orlando.

“She’s our miracle! We often questioned whether we were in the right place and if we were getting the care we needed,” Cotto said. “But today proves we were exactly where we needed to be.”

For pictures, interviews, and b-roll, visit https://bit.ly/3ooHa4M

Nicole Hannah-Edgecomb was 24 weeks pregnant with her second child when she went to see her obstetrician for a checkup. An ultrasound had already revealed that her baby had fluid around the heart. Four weeks later, another ultrasound showed a large mass was now covering the baby’s heart.

“At that point, my doctor realized the severity of my baby’s case,” Nicole said. “I was sent to another hospital to receive treatment, but that hospital, too, couldn’t handle my case. I was told my only hope was Jackson Memorial Hospital.”

At 29 weeks, Nicole was transferred to Jackson Memorial Hospital, where she began receiving care from Salih Yasin, MD, UHealth – University of Miami Health System obstetrician/gynecologist, who specializes in high-risk pregnancies and the delivery of multiple babies.

Two weeks later, a multidisciplinary team of UHealth doctors and Jackson nurses prepared for a complex surgery to save the baby at Holtz Children’s Hospital at the University of Miami/Jackson Memorial Medical Center. On February 23, doctors performed a Cesarean section and delivered Symphony Harmony Edgecomb, a four-pound, four-ounce baby girl.

Immediately following the delivery, and in the same operating room, Eliot Rosenkranz, MD, a UHealth pediatric cardiac surgeon at Holtz Children’s, and his team performed an ex utero intrapartum treatment, also call an EXIT procedure, in which they opened the baby’s chest while she was still attached to her mother’s placenta.

The placenta provided Symphony with oxygenated blood from her mother, while doctors removed the fluid around her heart. They also removed the plum-size teratoma, or tumor, covering the heart, and immediately placed a tracheostomy tube to help her breathe. The tumor was crushing both of her lungs, which would have made survival outside the womb impossible.

Immediately following the two-hour surgery, Symphony was moved to Holtz Children’s pediatric intensive care unit. After one week there, she was transferred to the hospital’s neonatal intensive care unit (NICU), where she received care for four months.

“It was somewhat traumatizing. She’s so precious,” Nicole said. “I never thought I could get through something like this. I am so thankful for these doctors for everything they did.”

Nicole and her husband, Steven Edgecomb, say their faith and support from family and friends kept them strong.

“This child is a miracle baby. She is so special. She’s here for a reason,” Steven said. “These doctors worked around the clock. They treated her like it was their child they were trying to save. We appreciate that.”

After four months in the NICU at Holtz Children’s, Symphony went home on just in time for Father’s Day. Her parents were so excited to bring her home and introduce her to her big brother, 18-month-old Jeremiah.

“We wanted everyone to know about Symphony’s case, especially other parents going through the same thing,” Steven said. “Our child could have died in the womb. If you have a special case, a special need, Jackson is the place to go.”

In February 2014, Ivanna Cardenas Gutierrez was excited to learn that she was going to be a mom. When she and her husband, David Gutierrez, went to the doctor to confirm her pregnancy, they received an unexpected surprise.

“The doctor said we were having twins – and I was shocked,” David Gutierrez said. “Then, he said there were three babies. Two minutes later, he said there was a fourth. I was speechless.”

The couple conceived quadruplets naturally, an extremely rare occurrence that happens in just 1 in 700,000 pregnancies. Approximately 90 percent of quadruplets are conceived with the assistance of medical technology.

Ivanna, 27, turned to Salih Yasin, M.D., a University of Miami/Jackson obstetrician/gynecologist who specializes in high-risk pregnancies and the delivery of multiples, to care for her throughout the pregnancy.

The pregnancy was going smoothly and Ivanna was feeling great when she went in for her 27 week check-up. But tests revealed that one of the babies was not getting enough nutrients and was at risk of dying. A decision was made to deliver all of the babies that day, August 18, 2014 – three months earlier than their November 15 due date.

A multidisciplinary team of specialists, including doctors to care for Ivanna, and neonatologists to care for the newborns, staffed the operating room at Jackson Memorial Hospital for the emergency Cesarean section. In less than two minutes, Dr. Yasin delivered three boys and one girl—Julian, Sebastian, Gabriel, and Francesca. Julian, the largest, weighed 2 pounds, 3 ounces, while Gabriel, the smallest, weighed 1 pound, 3 ounces.

The babies were under the care of a team of neonatologists at the Schatzi Kassal Project: New Born Neonatal Intensive Care Unit (NICU) at Holtz Children’s Hospital, where they continued to grow and get stronger until they all came home.

“There have been a lot of ups and downs, but we have gotten through it,” Ivanna said. “We know how blessed we are.”