Foster child gets a new liver and an adoptive family

Everyone knows you shouldn’t take your work home. But Melanie Merrill-Kennedy, a physician assistant with the transplant team at Lucile Packard Children’s Hospital Stanford, just couldn’t help it.

In 2012, she helped care for an 8-month-old liver transplant patient, a foster child born in Hayward, California, named Pocholo (Spanish for “cute”). “Pochie had such a personality,” says Melanie, 43. “He was this little smiley-faced boy, just so incredibly cute.”

Several months later, she and her husband Aaron, 46, became Pochie’s foster parents. Three years after that, Melanie and Aaron adopted the little boy. Over time, Pochie and their other son, Nickolas, bonded with each other. Both are now 5. “They’re each other’s best buddy,” says Melanie.

Pochie was born with biliary atresia, a condition where tubes in the liver, called bile ducts, don’t form properly, causing bile to back up into his liver and damage it. Doctors weren’t able to correct this life-threatening problem with surgery, and eventually he needed a new liver.

Pochie was on the wait list for a new liver for less than a month. In January 2012, a Packard Children’s team led by Dr. Carlos Esquivel, chief of the Division of Transplantation, successfully performed the transplant.

“My liver was sick,” Pochie recently said to Melanie while he was making a thank-you card for the donor’s parents. “I’m happy they gave me his liver. Now I can stay alive.”

After his transplant, Pochie spent three months in and out of the hospital. His foster mother at the time was busy and could only spend a few hours a day with him. But Packard Children’s clinicians, including Melanie, picked up the slack. After spending so much time cuddling and playing with him, Melanie grew attached to the little boy.

“After all that interaction, he just kind of locked up a place in my heart,” she says.

Six months before meeting Pochie, Melanie had given birth to her first child, Nickolas. She knew she wanted to expand her family someday, just not right away. But on an impulse, she asked Pochie’s social worker to let her know when and if the boy might need a new foster home. “I just love him, he’s so adorable,” she recalls saying.

Nine months later, Melanie was offered the chance to foster Pochie. She immediately said yes. Her husband Aaron, an adopted child himself, was on board right away. “Adoption is near and dear to my heart,” he says. “I was fortunate enough to be adopted by a loving family when I was 4 years old.”

Pochie, who was then about 18 months old, came to live with the family at their home in Napa, California. But until the transplant team figured out the right amount of medication to give him to suppress his immune system, Pochie had to make several visits back to Packard Children’s.

The Packard Children’s transplant team’s expertise is top notch. They perform an average of 30 liver transplants annually, with success rates above the national average. Melanie has been part of the team since 2007. In 2014, she started working only two days a week so she could spend as much time as possible raising her two boys.

Caring for Pochie during a complicated time came naturally to Melanie. As a child growing up in Sacramento, California, she wanted to be a veterinarian. As an adult, she focused her desire to care for others on people, serving as a medic in the United States Air Force for eight years.

Melanie often worked with physician assistants in the Air Force, and she admired how they combined hands-on clinical care with the careful work of helping families cope with serious medical problems. Inspired, she enrolled at Midwestern University in Illinois to become a physician assistant herself. In 2004, she joined Packard Children’s, where she spent three years with the cardiothoracic crew before joining the transplant team.

“Pochie and all the wonderful transplant children I’ve cared for are the reason I am so passionate about organ donation,” says Melanie. “None of them would be here today if it wasn’t for the selfless gifts of life they received in their time of need. I am forever grateful to Pochie’s donor and his family.”

Pochie must take several medications to help keep his donor liver as healthy as possible, but he’s thriving. He loves swimming, building things with Lego blocks, eating macaroni and cheese, and playing lightsaber wars with his brother.

He also spends time with his birth family. Melanie and Aaron chose to have an open adoption, and they maintain an ongoing relationship with Pochie’s birth parents and siblings. The two families spend time together at local parks or amusement areas.

“Pochie was put in front of Aaron and me because we were meant to care for him,” says Melanie. “We were destined to have him.”