Savana Calero, a kindergartner from Rensselaer, Ind., has already begun charting her career path. So far she knows it will include a stop at Riley at IU Health, where she’ll work as a nurse. Some people might say a 6-year-old has no idea what being a nurse involves, but after 14 surgeries and two intestinal transplants, Savana has done more than her share of job shadowing.

The youngest of four children, Savana was born three months early. She developed necrotizing entercolitis (NEC), an infection and inflammation of the intestines. It primarily affects premature babies and damages or destroys the intestines.

According to her mother Mary, the condition caused Savana’s small intestine to “flip and clamp off,” resulting in her first surgery at Riley at IU Health when she was only four months old.

Over the next four years, more surgeries to remove dead tissue caused by the repeated flipping and clamping took more of Savana’s intestines each time. On Jan. 5, 2011, doctors had to remove what was left of her small intestine.

“That’s when they told us she needed a transplant,” says Mary.

Although Savana required intravenous feeding 24 hours a day, she was eventually able to go home while her parents and the IU Health transplant coordinator worked through the process of getting her on the transplant list. Savana went on the list on April 27, and just two weeks later, received a healthy small intestine.

“It was my Mother’s Day present,” Mary says.

The road to recovery takes a bad turn

After a successful surgery and a month-long recovery in the hospital, doctors OK’d Savana to go home. Unfortunately, their trip was cut short. Twenty miles from home, a tire on their van blew, Mary lost control and the van rolled three times. Mary was airlifted to an Indianapolis hospital, and later that day, Savana’s body went into rejection and she was back at Riley at IU Health.

Two weeks of medication shut down the rejection and Savana headed home—Mary had already been released—to learn what it was like to live as a healthy preschooler.

“Life was awesome,” remembers Mary. “She was doing well—eating, drinking, going to preschool and only going to Riley at IU Health for doctor visits. We had slipped into a normal routine and she was loving life.”

In February, rejection hit again, “out of nowhere,” says Mary. Savana had extreme vomiting and diarrhea and by the time they got to Riley at IU Health, Savana was in septic shock and full-blown rejection.

This time medication couldn’t pull her out of it, and doctors had no choice but to remove the transplanted intestine.

Savana loses — then finds — her smile

Too ill to go home, Savana settled into Riley at IU Health, and Mary at the Ronald McDonald House at Riley at IU Health, for what would be the next six months while they waited for Savana to go back on the transplant list and for donor organs to become available. The second time around, Savana required a multi-visceral transplant, which would include a stomach, liver, pancreas and small intestine.

A young life filled with surgeries and hospital stays finally took its toll on Savana, who until then had been high-spirited and outgoing.

“She was down and wasn’t her happy self,” says Mary.

Music and art therapy helped, but it was news in May that gave her hope: She was back on the transplant list with the end to the hospital life in sight. On July 17, Richard Mangus, MD, performed her second transplant surgery, bringing a new beginning at home even closer.

Mary says it didn’t take long for the Savana she knew to return. “You couldn’t tell she had major surgery,” says Mary, “her spirits were great.”

Despite a lingering fever, Savana and Mary headed home on Sept. 9. It was just the medicine Savana needed—the fever finally broke. Savana can’t wait to start kindergarten in November, something Mary can see she’s ready for since, as she says with a laugh, Savana’s “back to being her ornery self.”

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