Second liver transplant gives Mya a new lease on life

We met Mya Santini a decade ago. Just 4 years old at the time, she had experienced a series of worrisome symptoms – throwing up, gaining weight and culminating with extreme exhaustion.

After extensive testing, she was diagnosed with autoimmune hepatitis type 2 – and her liver was failing. Thankfully, her mother Bridget was a match and could donate a portion of her liver to Mya. Following successful operations, both mother and daughter recovered and flourished.

Heading into the holidays, hopeful for another gift of life

Now 15, Mya’s world was again turned upside-down when her autoimmune hepatitis returned. She was in need of another liver transplant and no one in her immediate family was eligible to donate this time. Her brother is too young, her father is diabetic and Mya has developed anti-bodies to her mother’s body. It was a race against time, awaiting an organ – from a living or deceased donor – as her aggressive condition continued to fight her fragile body.

“It would have been possible to do a repeat living donor procedure, but there is certainly an increased level of difficulty involved with re-transplanting someone who has already had a partial graft,” said Dr. David Bruno, who specializes in liver transplantation at the VCU Health Hume-Lee Transplant Center. “While looking for a living donor, it was fortuitous that an organ from a deceased donor became available first. We were able to mitigate those issues by transplanting a whole liver.”

Dr. Bruno also acknowledges the bittersweet nature of the situation.

“It’s always emotionally challenging to know that someone has lost their life. Though it will never be easy, we hope their family can take pride and find a degree of solace in knowing their loved one’s willingness to donate saved other lives.”

A time of thanks and giving

Tired of being sick and tired, Mya was relieved to receive the news that there was a match. She underwent an 8-hour surgery in early November, followed by a second surgery two days later. The process was technically challenging and demanding on Mya’s body as a result of scar tissue from her initial transplant, so the team broke it into two procedures.

While adults can often return home a few days after transplant surgery, due to Mya’s young age and severity of illness, coupled with the COVID-19 pandemic, Dr. Bruno was exceedingly cautious. Mya stayed in the hospital for 16 days, returning home just in time, fittingly, for Thanksgiving.

“I have a lot of people and things to be thankful for this year,” Mya said in an interview with WTVR6.

Since leaving the hospital, Mya has been taking 29 pills a day. Dr. Bruno explained that several of these are necessary early on to suppress the immune system so it won’t attack the new organ, while others protect against opportunistic infections that the weakened immune system can’t fight. The goal is to start peeling medications off one-by-one as soon as it’s safe to do so, though Mya will likely continue a regimen of some medications for the rest of her life to treat her autoimmune condition and, if all goes according to plan, ward off another transplant.

What’s Mya’s prognosis moving forward?

“My goal and intention is that this is the last transplant Mya will need and she’ll have a long, normal life,” added Dr. Bruno.

And Mya certainly has many milestones ahead of her.

“Once we addressed her medical needs, Mya and I spent some time in her last appointment talking about her learner’s permit and learning to drive. I have a lot of fun with her – she’s a delightful teenager.”

Learn more about transplant care at CHoR and through the VCU Health Hume-Lee Transplant Center.