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Timing, teamwork key for young liver transplant patient

Aug. 11, 2016, 9:36 AM

Liver transplant patient Antwane Cole Jr. and his mother, Monjineh Singer, share a moment during a recent follow-up visit to Monroe Carell Jr. Children’s Hospital at Vanderbilt. (photo by Joe Howell)
Liver transplant patient Antwane Cole Jr. and his mother, Monjineh Singer, share a moment during a recent follow-up visit to Monroe Carell Jr. Children’s Hospital at Vanderbilt. (photo by Joe Howell)

Antwane Cole Jr., known as “AJ” to friends and family, began his summer playing football and enjoying his favorite superhero, Spiderman.

A seemingly healthy 7-year-old, the whites of his eyes suddenly turned bright yellow. No previous signs indicated that in a three-week span his health would be in such dire straits that his liver would fail, requiring a transplant at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

But because of his mother’s intuition and persistence, coupled with the comprehensive team approach of Children’s Hospital’s pediatric liver transplant team, Antwane is once again superhero tough. Antwane, diagnosed with autoimmune hepatitis, is the sixth pediatric patient to receive a liver transplant at Children’s Hospital since the program launched in June 2015. He received a new liver in fewer than three days after being listed for transplant.

“Antwane is doing very well. He is an excellent example of how the (pediatric liver transplant) program is functioning very efficiently and very collaboratively. He was admitted on a Friday and his evaluation was completed in less than a day,” said Douglas Hanto, M.D., Ph.D., chief of the Pediatric Liver Transplant Program and director of the Vanderbilt Transplant Center.

“The program is running on all cylinders and everyone is working very well together. He was evaluated and listed (for transplant) and his status on the list was upgraded two days later very efficiently and appropriately when his condition deteriorated.”

Antwane’s journey began in June when his mother, Monjineh Singer, noticed his eyes were turning golden yellow, and appeared almost catlike. Worried about jaundice, she took him to the local emergency department in Mississippi. After two visits, three days apart, and no improvement in his eye color, the hospital told Singer he might have acute viral hepatitis, inflammation of the liver caused by an infection from viral hepatitis. The infection, they said, would clear up on its own.

A follow-up with their family doctor and blood tests revealed that he had extremely abnormal liver function. He was referred to a pediatric gastrointestinal specialist in Jackson, Mississippi, Sara Rippel, M.D., who trained at Vanderbilt. Concerned for his health, Rippel immediately called Lynette Gillis, M.D., assistant professor of Pediatrics and medical director of Pediatric Hepatology and Liver Transplantation.

The pediatric liver transplant team gathered for a photo during Antwane Cole Jr.’s recent followup visit. (photo by John Russell)
The pediatric liver transplant team gathered for a photo during Antwane Cole Jr.’s recent followup visit. (photo by John Russell)

Rippel then sent Antwane to Baptist in Jackson, Mississippi, where he was transported by LifeFlight to Children’s Hospital. He arrived in Nashville on June 17, suffering from acute liver failure caused by the autoimmune hepatitis, which is characterized by the body’s immune system attacking its own liver cells.

Close, continuous monitoring of Antwane’s neurological and liver function would lead to him being moved up on the transplant list. He would get a new liver June 20, following a six-hour surgery led by Hanto with a team of doctors, nurses, anesthesiologist and techs.

“He got the transplant that Monday and the liver was a perfect match almost,” said Singer. “One family lost their child and we were able to save our child. It was sad and amazing all at once.”

Once discharged post-transplant on Aug. 2, Antwane stayed at the Ronald McDonald House down the road from Children’s Hospital. He spent time exploring Nashville, including Pancake Pantry and Dragon Park.

He will continue to receive follow-up care in Nashville from Gillis and Hanto as well as from Rippel in Jackson, Mississippi.

“Our superhero has won the battle, and is ready to start second grade,” said Gillis. “And like all superheroes, his friends and teachers won’t know his ‘secret powers’ as he looks and acts just like he did at the beginning of summer vacation. How great is that?”

On a recent follow up visit to Children’s Hospital, Antwane, his mother and his brother, Braylen “BJ” Singer, 8, were able to meet many of the members of the transplant team who saved his life.

“Our journey here has been amazing,” said Singer. “The transplant team, all the doctors, all the surgeons, all the nurses, the care partners, have been great. I have the utmost respect for all of them. This has been the best medical team I have ever seen.”

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