Twenty-one years ago, Morgan Smith-Dennis went home as a typical 7-pound newborn. His parents, Moses Dennis and Mary Smith-Dennis had all the joy and hope of new parents. Things were settling in with life with a newborn in Olathe, Kan.
But they started to suspect something was wrong when their newborn would sleep most of the time and was very jaundiced. When they took him for his one-week checkup, the pediatrician ran routine tests. One came back indicating a problem with the liver. He referred the family to the children’s hospital in the Kansas City, Mo., where physicians confirmed a major problem.
Tests ultimately revealed tyrosinemia, a heriditary disease that brings on a protein deficiency, causing liver and sometimes kidney disorders, among other things.
“You could just tell he was not well. We never dreamed he would need a transplant,” said Mary Smith-Dennis. “We thought it was some kind of virus that medications would take care of.”
When Morgan’s condition deteriorated, he was admitted to the intensive care unit in critical condition. Physicians there phoned the University of Nebraska Medical Center.
In 1986, when the UNMC liver transplant program was just a year old, Byers “Bud” Shaw, Jr., M.D., and his team got the call from the hospital in Kansas City about Morgan. There was no question they would take on his case.
Dr. Shaw, one year earlier, launched at UNMC what became one of the country’s leading liver transplant programs. He was recruited from Pittsburgh, Pa., which was the top liver transplant program in the country.
“I don’t think there was a question of not doing it. It was a child who was desperately ill, who needed a liver transplant. We didn’t consider that he was too small,” said Dr. Shaw, chairman and Musselman Professor, UNMC Department of Surgery.
“The difficulty in a child that size at that time would have been finding a donor organ. Not only were tiny donors very rare, but also most of the babies in such a small size range would have been very ill prior to death, so the quality of organs was not likely to be good,” Dr. Shaw said.
Morgan flew in a medical helicopter and arrived at UNMC late in the evening of June 17, 1986, said Mary Smith-Dennis. The family met with Dr. Shaw and his team around 10 o’clock that night.
Moses Dennis, Morgan’s father, remembers the whole experience like it was yesterday. He remembers Mary calling him on the phone. “The doctors said there was 48 hours to get a donor,” he said. “The room was full of docs and it didn’t look good. No one had ever put a liver in a two week old. I was thinking, okay, what’s the good news?”
“There was no other hope at that point,” said Mary Smith-Dennis. “There was no one else in the country on the organ donor waiting list at that size.”
But at 9:30 a.m. the next day they were told there was a donor.
“It was one of happiest days in our lives,” said Moses Dennis, who also knows it was one of the most tragic days for the donor family. “I thought it would work out and we’d be home in a few weeks.”
The family was happy to have a donor, but also knew the transplant would only be the beginning of a potentially long struggle.
In the operating room, Dr. Shaw and the team began the very intricate and delicate surgery. Dr. Shaw said he used 10 power magnification glasses to operate. “The connection for the artery is the smallest one — probably a millimeter to a millimeter-and-a-half. We’re talking about a blood vessel that’s maybe as big around as a refill cartridge of a ball point pen and we had tiny little stitches that look thinner than a human hair.”
The family waited. And waited.
They remember the transplant team well, particularly Dr. Shaw and Laurie Williams Salonen, who at the time was nurse coordinator for the program.
“He (Dr. Shaw) had that poker face but you knew when he was concerned, and you knew when he was in an upbeat mood. I also remember Laurie Williams, our nurse. Moses was in surgery from 5 p.m. until 5 a.m. the next day. Laurie would give us updates every-hour-on-the-hour on how things were going.”
He said once Morgan got out of surgery, doctors came in to talk to them. “Man, they looked beat,” Moses Dennis said.
For the next six months, Morgan was hospitalized — three-and-a-half months of it spent in and out of the intensive care unit.
“It was a rough course. He had six more surgeries after the transplant for perforations and a bowel obstruction. He had an abscess in his new liver,” Mary Smith Dennis said.
He was in a coma after his second surgery. His kidneys weren’t working right. At his size, there were challenges with oxygen, nutrition issues, and the immunosuppressant drugs that would keep his body from rejecting the donor liver.
The couple remembers living day-to-day, hour-to-hour. “It seemed like one crisis or problem after the other,” Mary Smith-Dennis said. “It also seemed like the doctors were able to figure out and deal with them.”
Salonen, now manager of liver and intestinal transplantation, said she remembers the family well, particularly Mary Smith-Dennis, who spent most of the six months at the hospital.
“She took on the role of comforting others and didn’t let things get her down,” Salonen said. “Morgan didn’t have an easy post-operative course, yet she always maintained a calm and positive attitude and really was mentor and support for other families despite what was going on with her child.”
Though Morgan was small and fragile, Salonen said she was not surprised he survived. “I think that we have the type of team — experts in the field — and everyone here did their very, very best to make sure that this child had every possible chance of surviving. I believe that is the type of team we have here at the University of Nebraska.”
There was another silver lining in the cloud.
The city of Omaha took the family under their wings, particularly Omaha’s black community. Moses Dennis said it seemed like the whole city came to their aid. News reports about the family quickly spread the news.
They made friends in the community and in the hospital. People would take their 3-year-old son to the toy store to buy him things. Churches hosted Sunday dinners, they would see people around town who said they were praying for the family.
Though it’s been 21 years now, and the family lives in Minneapolis, they have never forgotten what Omaha means to them.
Morgan Smith-Dennis’s 21st birthday celebration was a quiet, family gathering.
Other than being hospitalized for an episode of rejection at around age two, and for chicken pox, Morgan’s been healthy. “He’s in very good health. He’s healthier than the rest of the bunch. He’s just tough,” Mary Smith-Dennis said.
She said Morgan’s three brothers don’t cut him any slack with it comes to being easy on him. “Okay, we won’t let them hit him in the stomach. That’s off-limits,” she said. “It’s amazing. We look back and think of how normal life is and how far we’ve come.”
Morgan graduated from high school a few years ago and works in an athletic fitness facility. He’s also training for a career in helping elementary school-age children with emotional and behavioral issues.
“He has a gift for building relationships with kids. He’s very sociable and empathetic,” Mary Smith-Dennis said.
Though Morgan Smith-Dennis doesn’t remember much about the transplant, what he remembers are the check ups over the years, and the transplant reunions where he and his family were reacquainted with other transplant families who’ve gotten to know each other over the years. He remembers hanging out at the hotel, eating at the reunion luncheon, the balloons and games.
Most wouldn’t know he’d had a transplant unless he told them or asked about the two pills he takes daily or the large scar on his stomach. His friends know and it’s no big deal.
Once in a while, he thinks about the fact that he had a transplant and the donor family who saved his life.
“I’m thankful. It’s a really special thing. I always wanted to meet them. I would love to do that,” Morgan Smith-Dennis said.
He will see Dr. Shaw and Salonen July 27 when the family travels here for the annual Transplant Reunion, which will be held the following day. Morgan Smith-Dennis doesn’t know yet what he’ll say. But he knows for sure he’ll say ‘Thank you.’
Like other members of the transplant profession, Salonen and Dr. Shaw are gratified by being able to make a positive impact on peoples’ lives.
“That’s what we are all in this business for,” Salonen said. “The bottom line is we are here because we believe in what we do and we believe that we can help people live a normal life.
“Anytime I see a patient that was a baby and now is taller than I, that’s always very impressive, but it certainly is the biggest reward that we have on a day-to-day basis – to be able to see patients come back who maybe 90 percent of the world would say, ‘This baby’s never going to survive, you’re wasting your time … don’t go through it.
“To be able to see hundreds of these children or adults that have undergone this experience and are doing the things that they want to do. that’s what we are all about. We are incredibly blessed to be able to be part of these peoples’ lives,” she said.