ST. LOUIS -- Ronald Murphy wasn't expected to make it to his 18th birthday, so his family celebrated on a recent Saturday with a big surprise party.
Murphy wasn't the only guest of honor, though. The family of the infant girl whose heart keeps Murphy alive was there, too.
Murphy was born with a rare birth defect called hypoplastic left heart syndrome, which means his left ventricle was not fully developed. Doctors knew of his condition from prenatal ultrasounds, and he was placed on a waiting list for a heart transplant soon after his birth.
Nearly one in 100 babies is born with a congenital heart defect, and 10 percent of those are considered candidates for transplants because their defects can't be corrected with surgery or other treatments.
Hypoplastic left heart syndrome is no longer considered an automatic cause for transplant, in part because of new surgical techniques but also because of a shortage of donor hearts. But when Murphy was born in 1996, a transplant was his only chance for survival.
At age 11 weeks, an infant heart became available. Kaylee Kunkel had died in Illinois two weeks after being born with multiple health problems, and her heart was sent to St. Louis Children's Hospital.
The families first communicated through letters. They met when Ronald was a toddler, which he doesn't remember. On that recent Saturday, they met once again to celebrate Ronald's birthday, a reminder that the Kunkels' daughter would have been the same age.
Kevin and Michelle Kunkel along with daughters Kenzie, 14, and Maddy, 11, drove from Pecatonica, Ill., near Rockford, because "18 is a big deal," Michelle Kunkel said.
The Kunkels said it was not a difficult decision to donate Kaylee's heart and liver. The young boy who received Kaylee's liver died within five years of the transplant. But her heart has reached adulthood inside Ronald Murphy.
There are 21 children currently on the waiting list for a heart transplant at St. Louis Children's Hospital. Last year, the hospital performed 16 of the surgeries.
Children with donor hearts are at higher risk of developing cancer, kidney disease and diabetes, among other complications. Still, more than 80 percent can be expected to survive the first year, and about 60 percent are still alive at age 25.
"It's what you want for them -- you want them to have the most normal life they can," said Donna Marshall, a transplant nurse at Cardinal Glennon Children's Medical Center in St. Louis.
Dr. Ken Haller, Murphy's pediatrician at Cardinal Glennon, called him a "focused, dedicated kid" who has fierce advocates in his parents. Murphy has medical checkups every three months.
"It reminds me of what a privilege it is to be a pediatrician and be there for kids at all stages of their lives," Haller said at Ronald Murphy's birthday party.
After dinner, cake and confetti at his surprise party, Murphy danced with Michelle Kunkel to Nat King Cole's "If I Give My Heart to You."
"Knowing their daughter's heart is inside me, I consider them my family, too," Murphy said.
His parents, Catherine and Ronald Murphy of Bridgeton, said it was hard to find words to describe their emotions on seeing their son dance with his donor's mother, but they started with "grateful."
"Just to know because of her decision, Ronald is here," Catherine Murphy said. "Her child's heart beats inside of mine. My son's life goes on because of her daughter."
The Murphys put together a memory chest for the Kunkels with trinkets and photos of Ronald as a baby and child. A plaque inside read: "A mother holds her children's hands for a little while, but their hearts forever."
A Section on 09/14/2014