(Press-News.org) AURORA, Colo. (Dec. 19, 2025) – Children’s Hospital Colorado (Children’s Colorado) successfully performed the hospital’s first-ever heart and liver dual organ transplant, with support from dozens of team members across 25 different multidisciplinary care teams. Only 38 other pediatric heart and liver dual organ transplants have been completed in the United States.
“Performing Children’s Colorado’s first-ever heart and liver dual organ transplant is an amazing accomplishment for our Pediatric Transplant Program,” said Dr. Megan Adams, surgical director of the Pediatric Liver Transplant and Kidney Transplant Programs. “Thanks to years of dedication and a team committed to being the trusted leaders in pediatric transplant across our seven-state region, we’re grateful to provide this level of care to even more kids who need complex organ transplants to treat life-threatening illnesses and help them live healthy and happy lives.”
Children’s Colorado care teams have been preparing for years to perform a dual heart and liver transplant in anticipation of future patient needs. Thanks to strong collaboration across specialties — including surgery, cardiology, hepatology and more — in addition to unwavering support from hospital leadership, the team was ready when 11-year-old Gracie Greenlaw and her family needed them most.
Born with hypoplastic left heart syndrome (HLHS), Gracie’s heart had only one chamber pumping blood into her body. Gracie would need three surgeries before the age of three – the Norwood, the Glenn and the Fontan – which made it possible for her heart to function. While most children with HLHS live into adulthood, there are long-term effects of this heart defect, including liver dysfunction and even liver failure because of the way the heart defect and treatments affect other organs.
In 2016, Children’s Colorado founded the Fontan Multidisciplinary Clinic as part of the Single Ventricle Program to address this chronic outcome for HLHS patients and to provide holistic care to patients with multiple single ventricle diagnoses, like tricuspid atresia, unbalanced common atrioventricular canal and more. With support from the multidisciplinary team of experts, including Dr. Kathleen Simpson, cardiologist, and Dr. Dania Brigham, hepatologist, Gracie received integrated care for her heart and liver up until her team determined it was time for the transplant.
“The Fontan is a lifesaving surgery, but the longer someone lives after the procedure, there is an increased chance of developing comorbidities,” Simpson said. “Our care team worked to keep her healthy and living a typical day-to-day life as long as possible before we determined a dual organ transplant would give her the best long-term quality of life.”
Gracie had been living with plastic bronchitis – a condition that causes thick, protein-like deposits in her airways – for years. In the last year, the condition worsened, and her liver also started to fail. Her care team determined it was time to move forward, and she was officially put on the waitlist for a dual organ transplant in April. A multidisciplinary team with dozens of experts met regularly to prepare for every possible scenario in the operating room. They developed a plan of action that took into consideration the complexity of transplanting two organs with unique surgical considerations, like different blood volume requirements and electrolyte needs.
Within one month of being on the waitlist, a heart and liver became available for Gracie, thanks to another family giving the gift of life through organ donation. Because the heart has a limited amount of time it can remain viable, Dr. Matthew Stone, surgical director of the Pediatric Heart Transplant Program, and Dr. Emily Downs, congenital heart surgeon, performed the heart transplant first, which took nine hours alone. During this time, the donor liver was kept on a TransMedics Organ Care System – a specialized pump that mimics the body’s normal liver function – which kept the liver viable for longer and gave the heart surgeons ample time to complete the heart transplant. Adams and Dr. Kendra Conzen, transplant surgeon, took over to perform the liver transplant, which took an additional seven hours. Coordinating closely with the anesthesiology team was critical to ensure Gracie’s health and safety during the procedure.
The surgery was a success. Gracie was discharged from the cardiac progress care unit just over one month after her surgery. Now seven months post-transplant, Gracie continues monthly appointments with her care team, but more importantly, she’s back in school and back home with her dogs. Like all pediatric heart transplant patients, she will need an additional heart transplant in the future, but her new liver will last her a lifetime.
“This procedure showcases the expertise, talent and level of care Children’s Colorado provides to our patients, including those with complex medical needs,” said Dr. Duncan Wilcox, Surgeon in Chief. “As the top-ranked pediatric hospital in Colorado and the Rocky Mountain region, we are proud of our leading-edge transplant care and look forward to supporting more patients who need dual organ transplants in the future.”
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ABOUT CHILDREN’S HOSPITAL COLORADO
Children’s Hospital Colorado is one of the nation’s leading and most expansive nonprofit pediatric healthcare systems with a mission to improve the health of children through patient care, education, research and advocacy. Founded in 1908 and ranked among the best children’s hospitals in the nation as recognized by U.S. News & World Report, Children’s Colorado has established itself as a pioneer in the discovery of innovative and groundbreaking treatments that are shaping the future of pediatric healthcare worldwide. Children’s Colorado offers a full spectrum of family-centered care at its urgent, emergency and specialty care locations throughout Colorado, including an academic medical center on the Anschutz Medical Campus in Aurora, hospitals in Colorado Springs, Highlands Ranch and Broomfield, and outreach clinics across the region. For more information, visit www.childrenscolorado.org or connect with us on Facebook, Instagram and YouTube.
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