Teams on a transplant journey

In late February 2017, Christopher Castillo suited up for Hawaii’s annual Great Aloha Run. He wore two bib numbers pinned to his shirt: one for himself, and one for Cyehnna Lasconia, the 14-year-old girl he’d donated one of his kidneys to less than a month earlier.

Christopher Castillo and Lani Lasconia had been acquaintances since childhood, but could never have imagined how their paths would cross in adulthood to help save Lani’s daughter, Cyehnna. An elementary school music teacher, Christopher had spent several years preparing to be a stem cell donor, only to have the match fall through. When Lani told him Cyehnna’s story, he knew he wanted to help.

As a newborn, Cyehnna contracted E. coli, a bacterial infection of the intestine, which kept her hospitalized for a month and a half and permanently damaged her kidneys. “They told us to prepare for the possibility that she might not survive,” said Lani.

Cyehnna did survive, but required medical support over the years as she grew. On top of her medical needs, a chromosomal defect had affected Cyehnna’s learning abilities. At her school in Hawaii, Cyehnna was enrolled in special education classes, where she found support and understanding from loving teachers.

In 2012, doctors told Cyehnna’s parents that her condition had progressed into chronic kidney disease and she would need a transplant. That’s when Cyehnna first met her doctors from Stanford Medicine Children’s Health, a health care system with partnerships, collaborations and outreach programs at more than 100 locations in eight states throughout the U.S. western region.

“Cyehnna is a very special, loving, engaging young girl whom we’ve been seeing for quite a while,” said Waldo Concepcion, MD, chief of the Pediatric Kidney Transplantation program at Lucile Packard Children’s Hospital Stanford. Several times a year, Dr. Concepcion and four or five members of his team travel to Hawaii and other locations to see patients where they live and to work closely with the medical teams who care for those patients. These full-team, comprehensive visits are a keystone of what makes the Pediatric Kidney Transplantation program unique.

“We travel 4,000 miles, stay for 36 hours, see all these patients and make an impact at all levels — with insurance payers, Medicaid, social workers, caregivers, nephrologists — to make patients as safe as possible,” says Dr. Concepcion. “We bring the Stanford Medicine Children’s Health world-class level of care to the community without having to move patients here.”

Dr. Concepcion and his team worked with Cyehnna’s care team in Hawaii to provide medical support over the years, including recommending the placement of her gastrostomy tube, starting her on enteral nutrition when she needed it and supporting her health as she awaited transplant to ensure she’d be in good condition when the time came.

“We just waited,” says Lani. “Cyehnna was on the transplant list for nearly four years, but they were hardly getting any blood-type-B kidney offers.”

In early 2016, just a few weeks after family friends put Christopher and Lani in contact, a simple blood test showed that he was an excellent donor match for Cyehnna. “It was really fast,” recalls Christopher. “I told them, yes, I’d really like to go through with it.”

Christopher soon spoke with his donor surgeon, Amy Gallo, MD, assistant professor of surgery and abdominal transplantation at Lucile Packard Children’s Hospital Stanford. He stood out to Dr. Gallo not only for his character and commitment to helping people, but also for his “pure dedication.” “He was so unique in that he had thought through everything and made an educated decision on his own,” says Dr. Gallo. “It was clear that he was just motivated. It was seriously inspirational. I wanted to help Christopher reach one of his goals.”

A few years earlier, Christopher would not have been eligible to be a donor. He weighed 300 pounds and was close to having type 2 diabetes. He started running and eating healthier, and in time, lost nearly half his body weight. Yet nothing motivated him like the opportunity to help Cyehnna. “When it came to dieting and working out, it was about doing it for her because I felt like she deserved it. I switched up everything I knew because I wanted to be in the best shape possible so it would be a successful surgery. Cyehnna motivated me to do better for myself, in general.” In that sense, the kidney transplant was a promise of improved health for both of them.

At the beginning of this year, Cyehnna, her parents, and Christopher travelled to Palo Alto where, on January 24, 2017, Cyehnna and Christopher underwent their operations successfully at Lucile Packard Children’s Hospital Stanford. First, Dr. Gallo removed Christopher’s kidney, and then Dr. Concepcion transplanted it into Cyehnna. Afterward, “they were having a conversation,” says Lani. “They just clicked, they bonded. Cyehnna says, ‘Uncle Chris, where’s your kidney?’ and Chris says, ‘My kidney? You have my kidney!’ He’s so good with kids, but we always knew that.”

“Being an organ donor isn’t something everyone should do, but it’s something anyone can do,” says Christopher. “It was a real way of getting me to practice what I preach about helping people. For me, that was the whole gist of the entire journey.”

Cyehnna also made a strong recovery and is getting back to doing the things she loves: listening to music, going to the beach and hanging out with her three older sisters and her little brother.

Like Christopher and Cyehnna’s life-changing teamwork, the commitment of the team members in the Pediatric Kidney Transplantation program at Lucile Packard Children’s Hospital Stanford is key to transforming lives. “All of us have a commitment to each other to keep this high level of care for our children and families,” says Dr. Concepcion. “We put our time and our efforts and our everything to make this happen. Not only in the Bay Area, but across our entire Stanford Medicine Children’s Health system of care, including our work in Hawaii, it’s about making the community a better place.”