A team by his side: How Manning Family Children’s helped Abram face lupus, kidney failure, and transplant care

In late 2019, Abram Gailes was an active kid who loved baseball and proudly wore number 42 on his jersey in honor of the late, great Jackie Robinson. At 12 years old, he was focused on school, sports, and friends. His future, as the saying goes, was “so bright he had to wear shades.”

But in early 2020, just a couple of months before the COVID-19 pandemic tightened its grip on the world, the Gailes family faced challenges closer to home.

Abram’s mother, Jennifer, had been battling lupus, a severe autoimmune disease that severely affected her kidney function. She was on dialysis and awaiting news that she would soon have a kidney transplant.

At the same time, Abram wasn’t feeling well. Family and teachers noticed he was sluggish and retaining fluid, and his exhaustion had begun to affect his performance on the baseball field. A month earlier, Abram and his dad, Jamar, had walked away from a near-fatal car crash, so Jamar reasoned that the changes might be aftereffects of the accident.

In a way, they were.

A diagnosis they prayed would never come

On the way to a doctor’s appointment, Abram went into cardiac arrest. He was rushed to a hospital near his Louisiana home before being airlifted to Manning Family Children's in New Orleans for specialized pediatric care.

Doctors at Manning Family Children’s soon uncovered the true cause of Abram’s symptoms. Like his mother, Abram had systemic lupus erythematosus (SLE), or lupus as it is commonly known. The trauma from the accident had activated a dormant lupus gene, Abram’s father said, and by the time he was diagnosed at age 12, Abram’s lupus had already severely damaged his kidneys. He had lupus nephritis; the same serious form of kidney inflammation Jennifer had been battling.

Lupus affects an estimated 1.5 million Americans and can appear at any age. It can involve nearly every part of the body, including the kidneys, heart, brain, blood, joints, and skin.

Abram’s doctor, Anita Dhanrajani, MD, a pediatric rheumatologist at Manning Family Children’s, explained that while lupus is far more common in girls, boys can develop severe forms of lupus as well—and lupus that begins during childhood is often more aggressive than lupus diagnosed in adults.

“When lupus develops in children, major organs are more likely to be affected early, especially the kidneys,” said Dr. Dhanrajani. “That’s why early diagnosis, coordinated care, and long-term follow-up are so important.”

​The family knew Abram was at risk for lupus but prayed the diagnosis would never come. In fact, statistically speaking, Dr. Dhanrajani explained, pediatric cases are relatively uncommon. Children account for up to 20% of lupus cases, and this is far more likely to affect females. For broader context, the Centers for Disease Control and Prevention (CDC) estimates that about 204,000 Americans live with SLE, the most common form of lupus. Of those patients, only 20,000 are male while 184,000 are female cases.

For Abram, the disease had already progressed to kidney failure by the time it was found. "Recognizing symptoms early can make a difference," Dr. Dhanrajani said. "So can access to specialized, coordinated care."

An interdisciplinary team working together at Manning Family Children’s

As a patient at Manning Family Children’s, Abram began dialysis right away. Dialysis is a treatment that filters waste and excess fluid from the blood when the kidneys can no longer do the job themselves, but dialysis was only one part of a much larger care plan.

Abram’s care at Manning Family Children’s involved a coordinated team of specialists working together across multiple disciplines. Nephrologists, or kidney specialists, managed Abram’s dialysis and kidney function. Rheumatologists treated the lupus itself, which was the underlying cause of his illness. Cardiologists monitored his heart's function, and neurologists evaluated his brain function and recovery.

For Jamar, the teamwork at Manning Family Children’s stood out immediately.

“There was truly an interdisciplinary approach to Abram’s care,” Jamar said. “You could tell the physicians were not working in silos. Everybody communicated with each other for Abram’s benefit.”

He specifically remembers the compassion and communication from Abram’s physicians and the way they answered every question he had. “I was a very active parent and wanted to be involved,” Jamar said. “They explained everything—the good, the bad, and the risks.”

Forty-two difficult days

Abram spent 42 days in the hospital receiving dialysis and intensive treatment. It was then that Jamar realized how much the number 42 truly meant to the Gailes family—it would later inspire the title of his award-winning memoir, Loving 42: A Mother’s Prayer, A Son’s Journey, A Father’s Strength.

As Abram's hospital stay was coming to an end, the kidney Jennifer had prayed for finally became available, and she underwent her transplant. While Abram recovered in New Orleans, the family stayed in constant contact with her.

Then, on April 1, 2020—the day Abram was discharged—the family received devastating news. Jennifer had passed away from complications related to her transplant surgery.

Abram’s kidney transplant and a new chapter

After leaving the hospital, Abram continued dialysis for nearly two years while waiting for a donor kidney. Then, in February 2022, he received a successful kidney transplant from an anonymous donor. A kidney transplant replaces a failing kidney with a healthy donor kidney, restoring the body’s ability to filter blood and regulate fluid balance properly.

Today, Abram’s lupus is in remission, meaning the disease is currently under control with no active inflammation. He still takes medications to manage the disease and prevent his body from rejecting the transplanted kidney, and he continues regular follow-up visits through both the transplant clinic and the lupus clinic.

Dr. Dhanrajani is the director of the multidisciplinary pediatric Lupus Clinic at Manning Family Children’s. She established this clinic in 2024 in collaboration with pediatric nephrologist Caroline Straatmann, MD, and Eyad Khorki, MD. The multidisciplinary clinic ensures that children like Abram can receive the best quality of coordinated care in one location rather than traveling out of state.

“There are only a handful of clinics in North America that offer this level of pediatric lupus care,” Dr. Dhanrajani said. “Bringing specialists together under one roof improves convenience for families, but it also improves quality of care.”

The importance of long-term lupus management

Abram continues his care with specialists focused on lupus and kidney health. Physicians like Dr. Dhanrajani and Dr. Straatmann have guided his treatment over time, adjusting medications and monitoring his condition.

“All of the clinicians at Children’s are committed to their patients and their patients’ families in a way that is hard to describe,” Jamar said. “I felt like it was a true partnership.”

He emphasized how much that relationship matters. “Dr. Dhanrajani listens. She explains. She’s engaged. That matters when you’re dealing with something this serious. Clear communication and trust between families and care teams play a major role in managing chronic illness.”

Looking toward the future

Now 18, Abram is a rising sophomore at the University of Louisiana at Lafayette studying biology on a pre-med track. His experiences have inspired him to pursue medicine, with hopes of becoming a pediatric rheumatologist himself in the future. Dr. Dhanrajani is so proud of Abram’s educational choices and looks forward to working with him someday.

“We are all excited that Abram wants to become a pediatric lupus and kidney doctor,” Jamar said. “The staff and medical team at Children’s are so excited for him to succeed.”

For Abram and his family, the journey has never been about one doctor or one treatment alone. It has been about an entire team working together to help a child survive, recover, and move forward.

For more information about the Lupus Clinic at Manning Family Children’s, please visit: https://www.manningchildrens.org/services/rheumatology/programs-specialty-clinics/lupus-clinic/

For more information on Abram’s story “Loving 42: A Mother’s Prayer, A Son’s Journey, A Father’s Strength”, please visit: www.jamarlgailes.com

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About Manning Family Children’s: Manning Family Children’s is a 263-bed, non-profit academic pediatric medical center that offers comprehensive healthcare services, including over 40 pediatric specialties, just for children. With more than 600 pediatric providers, Manning Family Children’s offers a comprehensive array of specialized pediatric services in Louisiana and the Gulf South. In addition to its main campus located in New Orleans, Children’s operates a network of specialty clinics across Louisiana, including in Covington, Baton Rouge, Alexandria, Lafayette, and the Mississippi Gulf Coast. Children’s offers primary care at 17 convenient locations, along with a network of statewide pediatric affiliations. Children’s is a proud member of LCMC Health, a Louisiana-based, not-for-profit hospital system which also includes New Orleans East Hospital, Touro, University Medical Center New Orleans, West Jefferson Medical Center, East Jefferson General Hospital, Lakeview Hospital, and Lakeside Hospital. Learn more at manningchildrens.org.