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August 1, 2024 — National Multiethnic Donor Awareness Month honors communities of color who have been organ and tissue donors and encourages others to register as donors. It is about empowering multicultural communities to save and heal lives. Although organs are not matched according to ethnicity, and people of different races frequently match one another, individuals waiting for a transplant have a better chance of receiving an organ if there are large numbers of donors from their ethnic background. This is because compatible blood types and tissue markers (critical qualities for donor/recipient matching) are more likely to be found among members of the same ethnicity. COTA’s Mwamba family of Spokane, Washington, knows these facts all too well. Gabriel and Melissa were very excited to learn they were expecting their first child. Ruby Josephine Mwamba arrived in September 2018, and she was instantly beloved and treasured. The name ‘Ruby’ derives from a precious gemstone and has been associated with the qualities of health, strength and vitality. These characteristics would become very important as Gabriel and Melissa learned shortly after Ruby’s birth, she would soon be fighting a challenging diagnosis. On June 1, 2021, Ruby was officially placed on the transplant waiting list for a new liver, but she was listed with a low PELD score. The Pediatric End-stage Liver Disease (PELD) score has been used to allocate livers for transplant in children since February 27, 2002, when the Organ Procurement and Transplantation Network (OPTN) adopted a prioritization algorithm based on the risk of 90-day pretransplant death (death without receiving a transplant). The PELD score is calculated by bilirubin and albumin levels as well as failure to grow. On August 2, 2021, Gabriel sent a Get Started (COTAGetStarted.org) notification to the Children’s Organ Transplant Association’s headquarters requesting more information. COTA’s Family Outreach Specialist placed a call to Gabriel who said their transplant social worker suggested the organization might be able to help. Gabriel’s main concerns at this point in their journey were the distance from their home to the transplant center and the fact they had used both car and air travel to date. Travel, meals, lodging and parking were going to be significant for this family. Gabriel wanted to share all of the information with Melissa before making a decision but expressed his gratitude for the organization’s mission. Melissa can remember exactly where she was on April 19, 2022, when her phone rang. The call was from Seattle Children’s; the team had found the perfect liver match for Ruby. “It was exhilarating,” Melissa said. “My mind was not even comprehending what they were saying. Our wait was over. Excited and nervous, we made the four-hour trip the next day.” The family had anxiously waited more than 300 days for that phone call. Thanks to COTA, they did not have to stress over how they would afford to quickly get to Seattle or to worry about their living expenses once they arrived for what could be a lengthy stay. COTA continues to travel this journey with the Mwamba family. Melissa explained they still have frequent appointments and check-ups with Ruby’s transplant team in Seattle. The associated costs of these trips are transplant-related expenses for which COTA funds can be used. This has been a big relief for the family given the distance from their home to the transplant center. “Financial insecurity is one of the most daunting stressors in life,” Melissa said. “Adding a major organ transplant for a child adds additional stress. COTA has made it easier for us to breathe. We literally do not have to worry about the financial aspects of keeping our daughter healthy which include prescription medications, regular medical testing, and frequent lab work all of which add up very quickly when your child is post-transplant.” Today Ruby is thriving. She also has a new brother, Israel Lincoln, who is beloved by all of the Mwambas. Ruby’s favorite things are dancing, singing, doing crafts, helping make meals, reading books, playing at the park, going to church with her family, eating ice cream and pretending she is a doctor. She loves preschool and is thrilled that she is finally healthy enough to travel to Zambia Africa to meet her father’s family members in his home country.