Sierra was born with a heart defect and had open-heart surgery for the first time at 8 months. She had several more corrective surgeries. At age 10, Sierra developed primary pulmonary hypertension. She was stable for 5 years with medication. The meds stopped working. She was admitted to the Monroe Carroll Jr Children’s Hospital Aug 05 in both heart and lung failure. The family waited 11 weeks with her number 1 on the list as being the most critical and in need of a heart/double lung transplant. On Nov 8, she got a donor and became the first and only heart/double lung transplant performed at the Children’s Hospital. Sierra has done very well for years. Last year, after developing pneumonia, she went into acute aggressive rejection. She has undergone months of treatments. The rejection remains. Her only course is a second heart/double lung and possibly a kidney transplant. It can’t be performed at Vanderbilt. The family is waiting for an appointment with UAB in Birmingham. They have reviewed her records and are waiting for insurance approval.