Transplant Saves Life of Baby with Rare Cancer

Makinley Edwards, who turned 1 on June 14, is like lots of adorable baby girls. She loves going to the beach, watching Mickey Mouse Clubhouse, and eating chicken fingers and French fries. She also likes looking into the mirror and trying to figure out who the other baby is.

Just a few months ago, however, her prospects were grim. Shortly after her birth, Makinley was diagnosed with stage 3 hepatoblastoma — a form of liver cancer that tends to strike young children. Without the life-saving liver transplant she received on Valentine’s Day at the Miami Transplant Institute, a collaborative program between the University of Miami Miller School of Medicine and Jackson Memorial Hospital, Makinley never would have reached her first birthday, according to her father, Michael.

“After months of ineffective treatments, we were referred to Holtz Children’s Hospital at UM/Jackson,” he said. “When we got there, the good things started happening. They stopped the treatments Makinley was on and put her on a whole different path.

“If we had not gone there, my daughter would not be alive today. There are very few centers that would have been able to take care of her. We’re very lucky to have UM/Jackson’s capabilities so close to home.”

With her tumor too advanced for surgical removal and not curable solely through the use of chemotherapy, Makinley’s new doctors determined that the only way to save her life was through organ donation, and she was put on the liver transplant list.

“It’s a rare disease, but transplant can actually save a lot of patients with this type of cancer,” said Rodrigo Vianna, M.D., professor of surgery and Director of Transplant Services and Chief of Liver and Gastrointestinal Transplant at the Institute.

On February 14, doctors delivered the gift that Makinley’s parents had been waiting for — the news that there was a match for their eight-month-old daughter. That same day, Makinley successfully underwent liver transplant surgery at Holtz Children’s.

Vianna performed the operation, assisted by a surgical team that included another transplant surgeon, Akin Tekin, M.D., assistant professor of surgery, who is following Makinley’s recovery. Although she now has a healthy donor liver, Makinley will undergo monitoring for several years to make sure the cancer had not spread before surgery and that her body is not rejecting the transplanted organ.

“Makinley’s outcome will be great, because she does not have any hepatic disease,” said Tekin. “It’s a difficult surgery at this age and weight. Complications are more frequent because children like her are so small, but we did not have any complications. The tumor has been taken care of completely, and she should have a normal life.”

“Her type of cancer is very responsive to treatment,” said Antonello Podda, M.D., assistant professor of pediatrics and Director of the Pediatric Hematology-Oncology Fellowship Training Program, who is Makinley’s pediatric oncologist, “but it requires surgery and chemotherapy working very well together. She will still need to be seen for a minimum of five years, but so far she is doing well. There is no evidence of residual disease, and we consider her to be in complete remission.”

Jennifer Garcia, M.D., assistant professor of pediatrics and Medical Director of Pediatric Liver and Gastrointestinal Transplant, is a transplant hepatologist who also sees Makinley regularly.

“Makinley’s prognosis is very good,” she said. “It has been almost six months since the transplant, and the liver is working quite well. Most of our appointments now involve lab work and adjusting her medications, but we are slowly decreasing their frequency. She originally was underweight because her own liver was not helping her absorb foods, and she developed an eating aversion. Now she is eating table food and regular formula, and her weight is in the normal range.”

Makinley’s parents share her doctors’ positive attitude.

“She’s doing great,” said Michael, “and we’re slowly getting back to having a normal life. Her numbers have improved significantly, and she’s going in the right direction, but she’s still undergoing tests and treatments at least three days a week.”

Her parents have also become advocates for organ donation.

“We are so thankful to the parents who made the decision to donate their child’s organs,” said her mother, Nicki, “but it’s bittersweet because I know those parents also lost a child.”
And they have become big supporters of the quality of care their daughter received, and continues to receive, at UM.

“If you want the best care, you need a teaching facility,” said Michael. “UM is on the cutting edge, and we’re only 15 minutes away.”

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