“They told me I was a match,” Ferrel recalls, “and there was no hesitation. I wanted to be the one who helped her. It’s a blessing for me to be the donor who cures her disease.”

The Ferrel family are active ranchers from Panhandle, Texas, and accustomed to the small-town way of life. In January 2018, 14-year-old Jackie started to look a little puffy, Audrey said, and her behavior was off.

Audrey took Jackie to their local doctor for what they thought would be a routine diagnosis. Instead, they got a call from the physician’s office that would change their lives.

“We had barely arrived home when they called with the results — Jackie was in end-stage renal failure,” Audrey said. “They told me, ‘You need to get back here right now. We’re flying her to Cook Children’s.’”

Audrey and her husband, Ty, packed up the family and drove to Cook Children’s Medical Center in Fort Worth. Cook Children’s urologist and surgical director Blake Palmer, M.D., diagnosed Jackie with IgA Nephropathy, or Berger’s Disease, which has no cure. The disease occurs when an antibody called immunoglobulin A builds up in the kidneys. They become inflamed and lose their ability to filter waste from the blood, which can be fatal if not treated.

Jackie would need a transplant to survive.

Berger’s Disease usually progresses slowly over years, but the course of the illness varies from person to person. Its exact cause is unknown.

Medication can treat some cases, but transplants are often needed. Initially, Jackie was hospitalized at Cook Children’s for a month, but she was eventually able to go home on dialysis. She resumed activity and even began track season.

“She had an awesome track season. She did very well,” Audrey said. “In addition to that, she still participated in cross country, qualified for regionals, and played basketball and tennis.”

Despite her outward progress, Jackie’s internal condition worsened, and a transplant was needed to save her life.

In December 2018 Jackie was placed on the transplant list, and they received a call for a high risk kidney shortly after, however they declined, knowing Audrey would begin testing for a live donor transplant.

“She told us she was feeling great, she didn’t want to take a high risk kidney if she could hold out,” Audrey said. “I was convicted from the beginning that my kidney was going to be the one.”

The process for matching with and receiving a live kidney donation is extensive and requires multiple EKGs, various scans and blood tests to ensure the kidney is a match and the risk is low. Surgeons at Texas Health Harris Methodist Hospital Fort Worth, which has collaborated with Cook Children’s for years on various projects, evaluated Audrey to determine whether she would be a candidate.

“Over time dialysis becomes less and less effective,” Dr. Palmer said. “She [Jackie] was more ill on a day-to-day basis, really just not able to thrive or have a normal life like we’d expect a normal 15 year-old. But after this transplant, she is going to get all those things back.”

Audrey’s tests confirmed she was a match. The final CT scan determines whether a donor is compatible based on the placement of an artery.

“We got the final call while at a basketball tournament,” Audrey said. “I just asked, ‘When can we schedule it?’”

Because Audrey was an adult, the surgery to remove one of her healthy kidneys would have to take place at Texas Health Fort Worth. The kidney would be walked across a sky bridge that connects the two hospitals and implanted in Jackie by a surgical team at Cook Children’s.

“The collaboration between our two hospitals is something I’m really proud of. I know the clinical teams on both sides of that sky bridge are really proud,” said Dr. Tariq N. Khan, transplant surgical director at Texas Health Fort Worth. “It’s about bringing the best resources together, with the single focus being the best possible care to the patients we serve.”

Audrey and Jackie scheduled their transplant for Aug. 27, 2019. The sky bridge cut the time from hours to just minutes for the donor kidney to be delivered. With Jackie feeling fatigued and unable to participate with her teams and work with the family’s ranch animals, the transplant could not have been scheduled at a better time.

“Toward the end I didn’t feel well at all,” she said. “I was ready by the time all the testing was done.”

Jackie checked in at Cook Children’s the night before to begin pre-op preparations and Audrey arrived at Texas Health Fort Worth the next morning, both of them with an entourage of family and friends.

Dr. Khan began Audrey’s surgery at 7 a.m. and by 10 a.m. he was transporting the kidney to Cook Children’s with the Fort Worth Life Gift transplant team.

Dr. Palmer and his team at Cook Children’s were waiting with Jackie prepped in the operating room. They knew as soon as the kidney was connected and producing urine that the transplant was successful.

The mother-daughter pair spent two months recovering Fort Worth, before heading back to ranch life. They have both recovered and Jackie is slowly easing back into her routine as a typical teenager.

“Jackie is feeling awesome. She is able to attend church, youth group, and 4H events. She is also keeping books for the varsity basketball team,” Audrey said. “She has begun to exercise again and has had her first ride [horses] since the surgery. While she’s not cleared to go back to school and regular sports yet, we anticipate that she will be cleared to do so soon. We are blessed beyond measure and are counting them out loud for sure.”

Though Audrey can’t physically donate again, she would make the same decision if she could go back, and encourages others to consider doing the same.

“Being a live donor was the best decision I’ve ever made. It’s a gift, really,” Audrey said. “It’s giving life twice.”

Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children’s, knows that guns will be a popular gift this holiday season for not only children, but for adults too.

According to the journal Injury Prevention more than one-third of American adults own a gun. Last year, Cook Children’s saw 10 total injuries related to shootings of a gun (ranging from a BB to rifle). Since 2009, Cook Children’s has seen 104 shootings and three deaths.

Dr. Warmink asks parents to explain to children that BB guns can be dangerous, with harm ranging from severe eye damage to liver and kidney injuries.

Dr. Warmink says it’s important that parents educate their children about gun safety and make sure kids know to leave the area if another child, or someone other than their parent, has a gun.

“We live in Texas and I know many kids are raised hunting and have guns in the home,” Dr. Warmink said. “But if you give your child a gun for the holidays or if the adult in the house is given a gun, it’s important to take the proper precautions. The thing we want parents to remember is to keep guns locked, unloaded and separate from ammunition”

1. Lock the gun and keep it out of reach of kids. Hiding the gun is not enough.

2. Unload your gun. Take all ammunition out of the firearm.

3. Store the keys for the gun in a cabinet or safe different from your household keys. Keep the keys out of the reach of children.

Along with guns and replica firearms, such as airsoft guns that use hydraulics to shoot pellets, Dr. Warmink lists these gifts as dangerous and even life threatening:

• Ripstik Casterboard, Skateboards, roller skates …
• Pull toys with strings over 12 inches
• Trampolines
• Backyard playground equipment
• Hard plastic swords

Sharon Evans, Trauma/Injury Prevention coordinator at Cook Children’s, knows that owning a bike or scooter is part of growing up. But she encourages parents to take the proper precautions before placing wheeled gifts under the tree.

“Parents, please don’t forget a helmet for all riding toys,” Evans said. “Make sure the helmet is on properly and read the instructions.”

For younger children, Dana Walraven, manager of Community Health Outreach at Cook Children's and coordinator of the Safe Kids Tarrant County Coalition, warns parents to be aware of any small parts or potential choking hazards from their own toys or perhaps older siblings.

“The holidays can be an especially dangerous time for the little ones,” Walraven said. “Pick out toys and activities that will be appropriate for their age. On Christmas, designate an adult to supervise the children. It’s surprisingly easy to lose track of small children and with just a little planning we can keep choking hazards away from them. When it comes to young children, preparation is key.”

Thanks to a gracious act of kindness from one teenager in Arizona, a 1 year old from Joshua, Texas is no longer on that list.

Following a head injury while competing in a North Texas motocross event, Kenneth “Buddy” Wentworth III died at the age of 16 on Oct. 3, 2014. Buddy’s parents gave consent for donation. Since his death, Buddy donated his heart, lungs, liver, pancreas, kidneys, corneas and other tissue at JPS Health Network.

Eli received one of Buddy’s kidneys. Eli’s kidneys were destroyed because of massive blood loss by placental abruption, a complication of pregnancy in which the placenta separates from the uterus before birth.

Eli was one of the 134 kidney transplants that have taken place at Cook Children’s since 1993, when the organ donation program began.

The Wentworths and the Marskis met for the first time this week as part of the annual “Life Gift” flag raising ceremony that took place at Cook Children’s on April 16, 2015. The Wentworths flew from their home in Arizona especially to be there.

Darbie, Buddy’s mom, said the organ donation was Buddy’s idea.

Darbie said, “When I took Buddy to get his license, he said, ‘Mom, can I be a donor?’ My response was, ‘Dude, do you know what that means?”

It meant saving a little Eli’s life.

“Because of Buddy’s choice, we have the opportunity to raise our child and for that I will be forever grateful,”said Kammi Marski, Eli’s mom.