Healthy Kids Summer 2022

A young life saved by the gift of a dual organ transplant


had worked with Dr. Nigro and recommended we come here,” Lopez explains. The Rady Children’s team told Nemo’s parents that he needed a heart transplant. “We were very surprised,” Lopez says. “I didn’t know anything about transplants or cardiologists, and it’s very surreal to see your child in an ICU bed, but Dr. Nigro was very highly recommended, so we listened.” Nemo was admitted to Rady Children’s on Aug. 16, 2021. What followed was an eight-month fight for his life, filled with complication after complication. He was hit with infections and put on a left ventricular assist device, which replaces the function of a failing heart. “Everything you could imagine going wrong did,” Lopez says. “He was so sick they had to make him inactive on the transplant list until he was well enough to survive a transplant. It took quite some time, but he did it!” As a consequence of all the complications Nemo faced, and the fact that his heart was failing, other organs followed suit. Because he lost function in his kidneys, the transplant team at Rady Children’s determined that his best chance for a positive outcome would be a kidney transplant as well as a heart transplant—something that had never been done before at Rady Children’s. The transplant team was up for the challenge. “Nemo’s heart disease was very severe. Life-threatening. He was transferred to us in extremely critical condition, and the heart team truly saved his life,” explains Elizabeth Ingulli, MD, a pediatric kidney transplant specialist and medical director of the Kidney Transplant Program at Rady Children’s. “His heart disease was so severe that his kidneys weren’t getting what they needed, and they did not survive his illness. Once he was in better shape and was able to get a new heart, we had to decide if he would

n July 2021, Nehemiah “Nemo” Maldonado was a healthy, active 12-year-old playing with friends and family in his home state of Arizona. Weeks later, he was fighting for his life, facing an illness that came on suddenly and progressed rapidly. Within months, he would become the first patient at Rady Children’s Hospital to receive a dual organ transplant. “He was always a healthy kid—nothing was wrong with him,” recalls Nemo’s mother, Mary Lopez. “Then one day he wasn’t feeling well. We thought it was just a stomach flu because he couldn’t keep anything down. We tried to keep him hydrated and we took him to urgent care, but they sent us home.” A week later, Nemo still wasn’t feeling well. His parents took him to see his pediatrician, who quickly realized that something was very wrong. “As soon as she listened to his heart, she told us to go straight to the emergency room,” says Lopez, who adds that they also noticed Nemo’s feet were swelling. “It all happened so fast—it was just one thing after another.” After specialists looked at Nemo’s echocardiogram in the family’s local children’s hospital, they admitted him to the intensive care unit. Nemo’s condition continued to worsen, and within four days, he was placed on extracorporeal membrane oxygenation, a process that pumps blood to a heart-lung machine that removes carbon dioxide and adds oxygen before returning it to the body. Within hours of being placed on the machine, Nemo was transported by air from Arizona to Rady Children’s to receive care from John Nigro, MD, a cardiothoracic and heart transplant surgeon, chief of cardiac surgery, director of cardiac transplantation and the mechanical assist program, and director of the Rady Children’s Heart Institute. “The cardiologist in Tucson


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