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Liver Transplant: Violet’s Story

Meet Violet 

Violet with dad Brannon


Sleeping peacefully on her father’s shoulder, little Violet looks as sweet and delicate as her floral name suggests. But in her waking hours, this fighter is as smart and tough as her middle namesake: Kenobi   — yes, as in Obi-Wan.

Violet’s family lives on tribal lands in northern Iowa owned by the Meskwaki Sac and Fox   tribe, which she and her father Brannon belong to. Brannon and Violet’s mom, Shawna, met while working together at their local Menards home repair center near Tama, Iowa. They immediately hit it off — so much so that Shawna took a job somewhere else because the store didn’t allow employees to date one another! Just a few months later, they found out they were expecting Violet and were excited to start their family together. But they never expected the journey that lay ahead for their little girl.

Something’s not right

When Violet was just three months old, Brannon and Shawna were concerned about her jaundice, which had persisted long after what’s typical for a newborn. Doctors at their regional hospital in Iowa diagnosed a serious liver problem called biliary atresia and emphasized how serious Violet’s condition was. 

“They said she wouldn’t make it past a year if we didn’t get the right help,” said Shawna. Given the option of going to Chicago or Kansas City for higher-level care, the family chose Children’s Mercy Kansas City and are so grateful that they did.

“As first-time parents, we were really scared and new to everything,” said Shawna. “When we came down here and met [Dr. Bhargava Mullapudi, Pediatric Transplant Surgeon], we instantly felt comfortable with him. He was very invested in helping Violet.” Brannon agreed, saying, “We could tell that the people here really cared. They assured us we are going to get through this together.” 

Another key member of Violet’s team is Ryan Fischer, MD, her primary liver care specialist at Children’s Mercy and the Chief of Hepatology and Transplant Medicine. “Violet was born with biliary atresia, a congenital disorder of the bile ducts where the ducts are not properly formed and where bile cannot exit the liver,” Dr. Fischer explained. “This results in advancing liver damage and scar tissue formation due to the bile that is ‘stuck’ in the liver.” Violet’s liver damage was extensive, which caused jaundice, poor growth, recurrent infections and the dire need for a new liver. Once Violet arrived at Children’s Mercy, Dr. Fischer and team were able to quickly evaluate her condition and add her to the transplant waiting list.

Waiting for a miracle


“When we found out Violet was going to need a transplant, we decided to move down to Kansas City while we were waiting (even though it was not required),” Brannon said. That way, they’d be close to Children's Mercy rather than four hours away in their Iowa home when the time came. Transplant nurse coordinator Molly Hufferd, BSN, RN, CPN, guided the family through every step of the process. When Brannon got the call that there was a liver for Violet, he said, “I didn’t believe it at first. Then, it was like a big weight lifted.” Brannon and Shawna said they would be forever grateful to the family who donated the liver.  

Left to right: Violet, Dr. Mullapudi, Dad: Brannon, Mom: Shawna

As luck would have it, they already had their bags packed for a planned visit to their family in Iowa, so they grabbed them and headed straight to Children’s Mercy instead. Meanwhile, Dr. Mullapudi flew to the East Coast  to retrieve the liver. As the liver was too large for Violet, he performed an in-situ split: he would bring a portion of the liver back for Violet and the rest would go to help an adult recipient also in need of a transplant.    While he was performing the split, back home at Children’s Mercy, his surgical partner Richard Hendrickson, MD, FAAP, FACS,   pediatric transplant surgeon, and Stephanie Bennett, RNFA, were preparing Violet to undergo her transplant. 

A symphony of surgical expertise

Dr. Mullapudi flew back with the donor liver and, together with Dr. Hendrickson, performed the transplant surgery that would save Violet’s life. The whole surgery took 11 hours and involved a large team of professionals to get the job done. Neal Campbell, MD, liver transplant anesthesiologist, kept her stable during the transplant. Karissa Shumake, RN, Assistant Director of OR nursing, put together a terrific team who all helped orchestrate the transplant: scrub nurse Alyssa Buzzelli, RN, BSN, and circulators Emily Harlan, RN,  BSN; Lindsay Christensen, RN; Veronica Perez, RN; and Codi Fritchie, RN, BSN. Meanwhile, throughout the lengthy surgery, Megan Faseler, RN, BSN, CPN, CCTC, transplant nurse coordinator, kept the parents updated on all the events in the operating room.

But Violet was not out of the woods yet. “Seeing her come into the ICU all swollen after surgery, that was kind of scary,” Shawna recalled. Brannon agreed: “When I got to hold her for the first time after surgery, it was emotional. I cried,” he shared.

After the operation, Violet’s liver recovered well without any vascular or biliary complications. She developed a lymphatic leak that kept her in the hospital a bit longer than expected. Her parents took turns staying at Children's Mercy with her and going home to rest. Shawna said those days were a bit of blur, since she was a full-time caregiver and Brannon was working two jobs. “We were anxious to get home; it was rough,” Shawna recalled. “But Violet was a trooper. When she got discharged, she was a totally different baby. She was just happy, more energetic, crawling faster — she was thriving.”


Violet and mom Shawna


“The force is strong with this one!”

Now, as a busy 1-year-old, Violet is doing well and has already caught up with milestones like walking and talking that they were concerned she might be a little behind on. “She’s crazy! She’s always on the move and ready to have fun,” Brannon laughed. “She loves Bluey right now, but I’m hoping to turn her into a giant Star Wars nerd like me someday.” Dr. Mullapudi agrees: “The force is exceptionally strong with this one!” 

Between visits to Kansas City, the Children’s Mercy transplant team collaborates with other pediatric providers close to Violet’s home to make sure she has the resources she needs locally. “Kids and families are going through a profound life experience during transplantation, and they thrive closer to home with family support,” said Dr. Mullapudi. “That’s why we take a holistic approach and coordinate care with local providers.”     

Shawna and Brannon are incredibly grateful for the caring and patient Liver Care team Violet has at Children’s Mercy. “Molly, Angela, Dr. Fischer, Dr. Mullapudi — really everyone! We trust everyone on our team,” Brannon said. Even though the family has moved back to Iowa to be near their extended family, “we will always make the drive to see our team at Children's Mercy,” Shawna said.  

And next time, maybe Violet will bring a toy light saber along for the ride.