‘I Love You with All My Heart, and Now my Kidney.' Child Receives Transplant from His Mother.
Eileen Macias and Mikey Marshall anxiously awaited the gender reveal ultrasound of their fourth child, similar to many parents. The ultrasound technician not only revealed their child was a boy, but also a mass on his bladder, their first indication of kidney disease.
Their son, Brixton, was diagnosed with Lower Urinary Tract Obstruction (LUTO) 20 weeks in utero, and Eileen underwent a procedure to drain his bladder that was unable to drain by itself. Two weeks later, Brixton began to have the same issue; however this subsided on its own. The lasting effects of LUTO could be seen in his kidneys, ureters and bladder.
LUTO and Brixton’s other symptoms eventually supported his formal diagnosis of Prune Belly syndrome and chronic kidney disease. Eileen carried Brixton to term, where his nephrology team began ultrasounds, examinations and consults from four specialties, which led to seven surgeries beginning in 2018.
As Brixton celebrated his first birthday, his kidney function slowly dropped below 15%, and he eventually began dialysis under the direction of Cook Children’s Medical Director of Urology Blake Palmer, M.D.
Brixton’s early diagnosis of failure to thrive would prove to be one of his longest battles, and his parents struggled to watch him deteriorate with his diagnosis.
“As his mother, I remember I once offered him 10 different options to eat. I kept thinking that surely one of 10 would provoke some form of appetite,” Eileen said. “He used to throw up with just the idea of eating and almost always wanted water above anything else. As a couple we would cry of desperation with so much uncertainty through these vomiting spells and weight loss, on top of everything else.”
Brixton began dialysis in March 2019, but proved to be a short-term solution for Brixton. His numbers slowly rose, but it was excruciating on his small body. After a year of dialysis, Brixton’s Prune Belly Syndrome began to cause issues in draining fluid again. Three revision surgeries and a torn catheter later, Dr. Palmer and Brixton’s parents knew this could never be the solution.
Brixton needed a kidney transplant.
“Dr. Palmer spoke to us about whether or not we had discussed living donors and our initial conversation of me being his donor was always in my heart,” Eileen said. “When he said we could proceed with testing the best possible candidate, Mikey and I knew that it was time. We prayed about it and had spoken about it so many times that it was almost a surreal moment to actually have it come true.”
With COVID-19 dwindling surgeries and appointments, Dr. Palmer quickly proceeded with the prospect of one of Brixton’s parents becoming his donor as his best opportunity.
“A parent, from a kidney standpoint, should be a match. The specificities are less than they need to be for some types of transplants,” Dr. Palmer said. “We did the best we could to get one of them worked up to be his donor.”
Eileen and Mikey went back and forth between themselves and determined Eileen would be the best potential match, as Mikey was too tall for Brixton’s small body to be a viable option. There are some size constraints with transplants, but kidneys are more adaptable to a smaller recipient’s body than a heart or lung, according to Dr. Palmer.
Eileen underwent testing and was Brixton’s match. Her experience during one full day of testing gave her a glimpse of her son’s complex medical life to this point.
“I was elated thinking this would be it. God was opening doors for us to finally be able to provide Brixton a higher quality of life, Eileen said. “Every test made me wonder, ‘Is this how Brixton feels?’ I was beyond ready to give our baby this opportunity. “
Brixton received his mother’s kidney on May 11, 2020, just one day after Mother’s Day.
“I only thought about Mother's Day once someone brought it up to me and said,’ You get to give your child life for the second time and on Mother's Day’. I had been so focused on what this meant for Brixton that I hadn't given much thought to what it meant to me,” Eileen said. ” I can tell you now that this meant everything to me as a Mother. Being able to have a hand in providing my child a second chance at a better life. No more dialysis, no more sleepless nights, no more pain from the lack of fully functioning kidneys. Too many ‘never agains’ to mention.”
Eileen and Brixton are recovering from a successful live donor transplant, and Dr. Palmer believes her kidney will last Brixton at least a decade.
“I love all my children with every breath I have, and I wouldn't have hesitated to give any one of them any organ they needed. It just happened Brixton needed a kidney and I have a spare that I can share,” Eileen said.“Surgery happening so close to Mother's Day was confirmation to me that this was the selfless act my son needed to thrive. I love you Brixton Mecale Marshall, with all my heart, and now my kidney.”
About Prune Belly Syndrome
Prune Belly Syndrome, also known as Eagle Barrett Syndrome, is a rare urinary birth defect. Children born with PBS typically have a laxity or an abnormal abdominal wall. Their stomachs can appear wrinkled, undescended testicles in males and neurological abnormalities to an extent.
PBS is more common in males, and can range in severity of symptoms.
The cause of PBS is still unknown.
Get to know Blake Palmer, M.D.
Blake W. Palmer, M.D. believes that educating families and children about their urologic and kidney problems is the most important part of his job. Working together as a team results in making the best decisions for the child.
Dr. Palmer joined Cook Children's Health Care System to be a part of Pediatric Urology in 2016. He is also the Surgical Director of the Renal Transplantation program. Dr. Palmer has special interests in reconstruction of congenital malformations, robotic surgery for the pediatric population, disorders of sexual differentiation and pediatric renal transplantation. He has research interests in surgical education, disorders of sex development, use of cranberry supplements for recurrent UTIs in kids and renal transplantation. He is also a part of the American Academy of Pediatrics Section of Urology Executive Committee as the Vice-Chair for Education.