If you ask anyone who knows Michael Borg to describe the 4-year-old boy, you’ll probably hear about his positive energy and infectious smile. 

“Michael is a tenacious little boy filled with an unshakable joy,” says his mother, Tricia Borg. “If his sole purpose in life was to spread joy through his smile, it would be enough.”

This unwavering sense of joy is particularly impressive considering that Michael has been subject to a string of complex medical diagnoses that began well before he was even born. 

While Michael was still in the womb, his urethra became blocked and caused severe kidney damage. Although he had two surgeries while still in utero, he was born with kidney failure and, because his lungs did not develop adequately as a result of the obstruction, respiratory failure. 

“We have a very strong pediatric kidney program at M Health Fairview Masonic Children’s Hospital, one of the top in the country,” says Scott McEwan, MD, PhD, an M Health Fairview Pediatrics nephrologist and assistant professor at the University of Minnesota Medical School. “Even so, Michael is one of the most complex patients I have ever cared for.” 

Multidisciplinary care in action 

Because of his kidney failure, Michael needed dialysis from birth. By the time he was 3 months old, he also had a tracheostomy and was on a ventilator to support his lungs. Dialysis took 10 to 12 hours every night to complete—but until he could receive a kidney transplant, there was no other option. 

His care required an all-hands-on-deck approach, one that involved a team including a dialysis nurse, multiple physicians, a dietitian, and a social worker. This carefully coordinated care plan was essential as Michael navigated an increasingly complicated path toward his kidney transplant. 

“He has had a very long journey to transplant,” Tricia says. “He’s had some challenges, and he’s thrown us some curveballs.” 

Not one but two curveballs came in the form of cancer. When Michael was 5 months old, his doctors found tumors on his adrenal gland and on his liver. The tumor on his adrenal gland was surgically removed and required no further treatment; the other tumor required the removal of half of his liver as well as multiple rounds of chemotherapy. 

The cancer discovery pushed Michael’s kidney transplant well into the future, as he would have to be cancer-free for two years before a transplant could be considered. 

“We do have situations like this arise from time to time,” says M Health Fairview Pediatrics hematologist/oncologist Emily Greengard, MD, referring to Michael’s multiple diagnoses. “Our goal is to provide the best cancer-directed therapy available to maximize the chance for cure. This was the best way to ensure that Michael could move forward with his transplant at the soonest timepoint allowable.” 

Michael’s cancer treatment was a success, putting him on the path to his eventual kidney transplant. In the meantime, Greengard and her team monitored Michael closely, seeing him every three months to watch for cancer recurrence or new malignancies. 

“Although we initially chose M Health Fairview Pediatrics and Masonic Children’s Hospital for their pediatric nephrology and solid organ transplant programs, we had no idea that Michael would be receiving services from almost every department,” Tricia says. “All of the departments that care for Michael have been equally as impressive in their care and compassion.” 

Time for a transplant

Once Michael had been in remission for two years, it was finally time to discuss a kidney transplant. The team decided to go ahead with the procedure, even though Michael still had a tracheostomy for breathing support, which typically disqualifies patients from transplant because of the heightened infection risk. 

Despite the risk, it only took one meeting with Michael for M Health Fairview transplant surgeon Srinath Chinnakotla, MD, to take on his surgery. 

“Here was a kid with so much going on, medically speaking, who nevertheless had so much joy and positivity in his heart that he smiled and waved at me. It made my day,” says Chinnakotla, the surgical director of liver transplantation and executive medical director of pediatric transplantation. “I knew I wanted to do the transplant for him. Obviously, it was a very high-risk procedure with many technical challenges, but I was determined to do what I could to help him.” 

In September 2023, Michael had the kidney transplant he had been waiting for. His father, Brian Borg, was the donor. 

“Being Michael’s kidney donor is my greatest privilege,” Brian says. “It’s an honor to be able to join Michael in his fight for life in a very tangible way, and I would do it again in a heartbeat.”

Today, Michael’s family and care team are looking forward to seeing him continue to grow and develop, now that the burden of nightly dialysis is gone and cancer is behind him. 

“Michael has complex medical needs that are a part of who he is, but they do not define him. He has many scars, and those scars help to tell his story. And he has an incredible story to tell,” Tricia says. “The world is a more joyful place with Michael in it.”