An 11-year-old girl named Gracie Greenlaw has received a groundbreaking dual heart and liver transplant at Children's Hospital Colorado, marking the hospital's first such procedure. Born with hypoplastic left heart syndrome, Gracie underwent the 16-hour surgery after years of medical management for her condition. Seven months later, she is back home and attending school.
Children's Hospital Colorado achieved a medical milestone by performing its inaugural dual heart and liver transplant on 11-year-old Gracie Greenlaw. The procedure, which lasted 16 hours, involved coordination among dozens of specialists from 25 multidisciplinary teams. Nationwide, only 38 pediatric patients have undergone this combined transplant before.
Gracie was born with hypoplastic left heart syndrome (HLHS), a congenital defect where the heart develops with just one functional pumping chamber. By age three, she had endured three major operations—the Norwood, Glenn, and Fontan procedures—to improve blood circulation. These interventions, while life-extending, often lead to complications like liver failure, which Gracie developed alongside plastic bronchitis.
To manage such cases, the hospital launched its Fontan Multidisciplinary Clinic in 2016 within the Single Ventricle Program. This initiative provides integrated care for patients with HLHS and similar conditions. Gracie's team, including cardiologist Dr. Kathleen Simpson and hepatologist Dr. Dania Brigham, monitored her closely. As her liver failure progressed over the past year, the experts determined a dual transplant offered the best path forward. She joined the transplant waitlist in April.
Less than a month later, donor organs became available thanks to another family's donation. The surgery prioritized the heart, which has a limited viability window. Dr. Matthew Stone, surgical director of the Pediatric Heart Transplant Program, and congenital heart surgeon Dr. Emily Downs completed the nine-hour heart transplant. Meanwhile, the donor liver was preserved using a TransMedics Organ Care System, mimicking normal liver function. Dr. Megan Adams and transplant surgeon Dr. Kendra Conzen then handled the seven-hour liver transplant, with anesthesiology teams ensuring stability throughout.
"Performing Children's Colorado's first-ever heart and liver dual organ transplant is an amazing accomplishment for our Pediatric Transplant Program," said Dr. Adams, surgical director of the Pediatric Liver and Kidney Transplant Programs. The effort reflects years of preparation and hospital support.
Gracie's recovery progressed well; she left the cardiac care unit after over a month and, seven months post-surgery, attends monthly check-ups while resuming normal activities with her dogs. Although she will require a future heart transplant, her new liver is expected to endure lifelong. Dr. Duncan Wilcox, the hospital's surgeon in chief, highlighted the procedure as evidence of their expertise in complex pediatric care.
