A teen patient smiles with his doctor at Levine Children's Hospital.

News | 2 months ago

Combined Liver-Kidney Transplant Makes Hospital History


Learn how Levine Children’s Hospital doctors joined forces to save a teen’s life.

Doctors at Carolinas HealthCare System’s Levine Children’s Hospital recently performed the hospital’s first combined liver-kidney transplant on a patient who made medical history shortly after he was born.

Bailey Frair’s connection to Levine Children’s Hospital began more than 16 years ago. Not long after his mom, Lisa Belcher, went to the hospital for her first ultrasound, doctors diagnosed Bailey with a rare liver disorder called biliary atresia – and treatment required a liver transplant.

Six months after Bailey’s birth, the tiny little boy became the youngest patient in LCH history to receive a liver transplant. Years later, Bailey’s liver started to fail. He also developed a rare form of nephrotic syndrome, a kidney disorder that requires dialysis and causes kidney failure.

These complications led to the teenager’s second historic transplant.

Rare Transplant, Renewed Life for Bailey

As few as 10 multiple-organ transplants are performed worldwide each year, making Bailey’s liver-kidney transplant quite rare. Doctors performed Bailey’s lengthy transplant surgery in July, and they expect him to make a full recovery.

Susan Massengill, MD, head of Levine Children’s Hospital’s Nephrology Center of Excellence, has cared for Bailey for more than a decade.

“Bailey had a lot of spillage of protein and blood in his urine, and that ultimately led to his need for a new liver and a new kidney,” says Dr. Massengill.

Many of the doctors and nurses have known Bailey since he was an infant, including Lon Eskind, MD, the surgeon who performed Bailey’s first liver transplant and also was involved with his second transplant.

“It gave us a lot of comfort knowing Dr. Eskind would be there for Bailey,” says Lisa. “He knew him and inside and out – literally – so having him around made it so much better for us.”

“Being able to provide his ongoing care is not only a privilege for us, it speaks to the trust he and his family have in our medical and surgical teams,” says Dr. Massengill. “Like all of our patients, we treat Bailey like one of our own children and we want to make sure he has every chance to live an active and productive life.”

Organ Donation Saves Lives

Because Bailey’s treatment involved a re-transplant, the operation was as challenging as it was risky.

“Complex cases like these highlight the collaboration that’s required for our care teams to give patients the very best chance at a good outcome,” says Jerome Menendez, MD, assistant vice president of transplant services. “But we should never lose sight of the importance of the organ donor and their family – and the fact that all those unselfish acts of kindness are truly what has given someone else’s loved one a chance at a better life.”

As challenging as the transplant surgeries were, the family and the medical team remained calm and confident.

“Bailey wasn’t worried, and there was just a sense of peace around everybody,” says Lisa. “He looked amazing as soon as he came out of the OR, and he was sitting up and walking within a couple hours after surgery. It’s such a blessing.”

A Brighter Future for Bailey

Life after transplant will be dramatically improved for Bailey. He’ll no longer need to sit through hours of grueling dialysis treatments. He can go to school regularly, get his driver’s license, and eat and drink all the foods teenagers love.

“Bailey’s family can look forward to a sense of normalcy as they return to a lifestyle that’s not dictated by the constraints of dialysis,” says Dr. Massengill. “The impact of chronic illness – on patients, their parents, siblings, education, and family finances – can be enormous. But the gift of a transplant helps lessen, or even eliminate, that impact.”

Meet Bailey’s Care Team

The double transplant surgery took a coordinated effort from the operating room and the Pediatric Intensive Care Unit to the nephrology, gastroenterology and transplant teams. The transplant surgeons involved with Bailey’s care include Dr. David Levi, Dr. Lon Eskind and Dr. Vincent Casingal. The medical team that cares for Bailey includes Dr. Massengill and Dr. Vani Gopalareddy.