Transplant team helps aunt realize lifesaving dream for 2-year-old niece

August 05, 2022
Natalyn Mann holds up a hand to her aunt Sara Cathey to freeze her. Natalynn is wearing a blue princess dress. Sara is wearing a bright pink t-shirt. Sara looks delighted.
Two-year-old Natalyn Mann "freezes" her aunt Sara Cathey, imitating Elsa from the movie "Frozen." Photo by Sarah Pack

Natalyn Mann was just a year-and-a-half old when the Beaufort girl’s parents realized something was terribly wrong. “She didn’t want to wake up. She was very lethargic and swollen and she hadn’t peed,” said her mother, Erika Mann.

“So we called the number on the back of her Medicaid card. It was Memorial Day weekend, so no doctor’s offices were open. They told us to give her Benadryl and wait 12 hours. If she hasn’t peed by then, then take her to the hospital. And I’m like, 12 hours would be like three o’clock in the morning. We’ve got to take her now.”

She and Natalyn’s dad drove their daughter to a local hospital. “At Beaufort Memorial, they’re like, ‘Yeah, we need to run tests.’ Then, ‘We need to run some more tests.’ And my wife said immediately, ‘When they redo the test, they don’t like the results of the first,’” Mikeal Mann said.

She was right. The results showed she was in a medical crisis. 

“One day Natalyn’s fine. She was playing the day before, swimming, jumping on the trampoline. I mean very active. The next day they’re sending a helicopter from Charleston to pick her up,” her father said.

Natalyn arrived at MUSC Shawn Jenkins Children’s Hospital with both kidneys failing. She was suffering from bilateral renal artery stenosis and diffuse mesangial sclerosis. The arteries to her kidneys were too narrow, which affected blood flow and caused high blood pressure. 

Natalynn Mann sips from a straw while wearing a blue princess costume. 
Natalyn drinks water, a habit she picked up from her Aunt Sara. Photo by Sarah Pack

Prabhakar Baliga, M.D., chairman of the Medical University of South Carolina’s Department of Surgery, had to operate. “At an early age, I had to take both her kidneys. She unfortunately became dialysis-bound fairly early in life.”

Dialysis involves a machine doing the work of the kidneys. “Dialysis in children is not a good option because it impacts growth and development,” Baliga said.

Natalyn’s parents were in shock, her dad said. “We spent days in here sleeping in like 30- minute shifts, pretty much passing out. We’re trying to stay up the whole time to make sure she’s OK. She’s just a baby. And then they had her connected to machines 24 hours a day. And you know, the first thought is, ‘Is that what she gets now? Is that how she lives? Her life is connected to a machine?’”

Then, they learned Natalyn could get a kidney transplant that would free her from dialysis – if they could find a donor. “You get a kind of a feeling of relief. Like there is something, a light, something to look forward to,” her dad said.

And right away, Natalyn’s mom's sister, Sara Cathey, offered to donate one of her kidneys. “We’ve always had a really close bond,” Cathey said.

But there was a problem. “I was morbidly obese. I was not eligible to even be tested at my weight.”

Darkened hospital room with Sara Cathey and her niece Natalyn Mann sleeping after one of Cathey's kidneys was transplanted into the little girl. 
Sara Cathey and her niece, Natalyn, in the hospital for transplant surgery. Cathey lost more than 100 pounds to make that operation possible. Photo provided

Cathey, a paramedic, stood 5 feet, 6 inches tall and weighed 278 pounds.“I’ve never been one to be able to lose weight. Trust me, I have tried and tried. But I never really had a reason to be healthy. I never really worried about myself. I worry about everybody else. And that’s just the kind of person I am. But seeing her struggling and knowing that she absolutely needed it made me determined.”

She cut calories and exercised, inspired by the niece she sometimes talked to while on the treadmill. She got her weight down to about 150. Baliga, Natalyn’s surgeon, was amazed.

“I think for a person to come forward and then find out that they were medically, initially, not suitable but then to have that commitment and lose that weight and come back with that commitment to donate – that speaks volumes of this person.”

He called living donors such as Cathey the real heroes of the transplant world.“Many people will just run the other way. There are, you know, a hundred or a thousand reasons not to do it. For a healthy person to donate an organ is huge. It’s a tremendous decision.”

Erika Mann helps with her daughter's medical tube. Natalyn, age 2, is wearing a blue princess dress. 
Erika Mann with her daughter Natalyn in MUSC Shawn Jenkins Children's Hospital after Natalyn's transplant surgery. Photo by Sarah Pack

On July 6, Baliga transplanted one of Cathey’s kidneys into Natalyn, one of about 400 kidney transplants his team performs each year.MUSC Health has one of the largest kidney transplant programs in the country. 

“In pediatric patients, one of the things you are careful about is the size of the blood vessels. And two, you have to be careful there’s enough space for the adult kidney and does not get compressed, or the vein, particularly, can clot,” the surgeon said.

The operation was a success. Baliga credited not only Cathey but also the team of specialists at MUSC Health and the MUSC Shawn Jenkins Children’s Hospital who came together to make it happen. “I think having a hospital and a system that can bring in such talent and skills together is extremely important for the success,” Baliga said.

Prabhakar Baliga, MD 
Dr. Prabhakar Baliga 

Natalyn’s mother was thrilled and grateful that her daughter would have a fresh start. “Now, she’s going to be able to do whatever she wants. It won’t be her last transplant. She’ll need another one eventually. But this will get her, hopefully, through high school and into adulthood.”

Cathey said she was proud to be able to help. “I think I’m just being a good human. I did what any family member would’ve done. And it feels good. I want to see her grow up. I want to see her experience life, and she hasn’t gotten to do that without tubes and doctors and being away from her family.”

She also encouraged other people to consider becoming living donors. “Share your spare. You give somebody a second chance. I had already made up my mind that if I was not a match to her, when I was losing weight, that I was going to give up my kidney anyway. Because to watch my family struggle, I didn’t want somebody else to struggle. So I was going to donate regardless. I’m just glad that we’re a perfect match.”

She and Natalyn are back in their homes, now. Natalyn’s mother described her daughter’s outlook. “Sassy, smart. And just a wonderful, joyful person.”

Natalyn’s dad had some advice for other parents. “Just keep an eye on how your kids behave. If anything is abnormal, definitely have it checked out. Because if we waited another day, she wouldn’t be here now.”

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