Carter Wilson is inquisitive. He loves to laugh and joke around. He’s loving and caring.

His passions vary—from swimming and playing basketball to playing the piano and listening to music. He loves cars. And above all, he loves tacos.

He’s strong and resilient.

Carter is five years old and going into kindergarten at Providence Day. To say his transitional kindergarten year was tumultuous is an understatement. Carter went through hell and came out of it with a new kidney he received from a complete stranger.

His kidney donor is Caroline Dudley, a parent of four children who also attend Providence Day, proving that family here - beyond the traditional sense - is powerful.

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Carter was four years old when he was hospitalized for pneumonia in March 2023. He spent five days in the hospital. When he was getting ready for discharge, doctors caught it: there were large amounts of protein in his urine. The family was referred to a nephrologist or kidney doctor.

His protein levels remained high, and he was diagnosed with nephrotic syndrome, a kidney disorder that causes the body to pass too much protein in the urine.

Dr. Susan Massengill, Carter’s kidney specialist and director of Levine Children’s Pediatric Nephrology and Hypertension in Charlotte, says Carter experienced serious complications from his nephrotic syndrome, including blood clots in his lungs, rapid progression to kidney failure, and severely high blood pressure causing heart dysfunction, among others. He didn’t respond to high-dose steroids, which 90% of children with the condition do.

He was repeatedly hospitalized and needed outpatient infusions three days a week and later on outpatient dialysis three to four times a week for four to six hours each time.

“The burden of chronic kidney disease is huge and impacts education, employment (parents), nutrition, etc.,” Dr. Massengill, whose adult children also attended Providence Day, says. “So many times, they do not excel academically due to their absences from school.”

Dialysis treatments were grueling, involving sitting in a chair for four hours three days a week. Oftentimes, he received a double dose of treatment, which meant he was stuck in the dialysis chair for eight hours.

He was on fluid restrictions and could only consume 20 ounces of fluid a day.

“Carter could no longer swim and no longer played sports because he would be too thirsty,” Dewett says. “His heart failure, constant dialysis treatments, and fluid restrictions made him very lethargic and irritable.”

But shortly after starting dialysis at home, the family got the news that Carter had a living donor.

***

On a particularly tough night, Caroline saw a post about Carter’s story shared by a transitional kindergarten parent on a Providence Day School Families Facebook page.

“Reading his story and more about him from the comments his teacher Kelly Smith shared and that I was a blood type match prompted me to reach out to learn more,” she says.

Caroline submitted her form to the Atrium Health transplant team to start the learning process. For her, it “was a pretty simple decision.”

“I researched the impact to my own health long-term (minimal risks), the likely impact to Carter’s health (hugely positive upside), and the likelihood of my own kids perhaps needing my kidney someday (minuscule),” she says.

Caroline continues: “Because I was healthy, did pretty well in surgeries, and in a position of privilege to be able to take a few days off work, it was a way I could put a little positivity back into the world and Carter’s family.”

She didn’t meet Carter or his parents - the Wilsons didn’t know who she was until the day before Carter’s transplant surgery was scheduled.

“When we found out that he had a living donor, we were in shock because our applications were still in process and eventually rejected for other reasons,” Dewett says. “Our other family members’ applications were also still in process. We couldn’t think of who his donor could be, but we were extremely grateful andin tears. We called her and expressed our gratitude.”

***

Carter received his new kidney on Wednesday, April 24, 2024.

His family, including mom Sadna, saw the complex personality he had when he was ill.

But two traits never faded in their son - his strength and resilience.

“Dialysis days, fluid restriction, sodium restrictions, missing school trips, hospitalizations, injections, etc. were all very tough on him, but he always found a way to smile during it all,” Carter’s Dad says. “He also cried a lot at times, mainly out of frustration. We tried to get him to focus on the positive and have him do things that he enjoyed. Honestly, I'm really amazed at how he persevered through the whole thing.”

Carter was very involved in his care. As long as his parents could explain what was happening and why it was happening, he was OK to get through it.

Dr. Massengill says Carter has two nonfunctioning kidneys plus the new transplant that was placed in the abdominal cavity because he’s a small child, she says.

“In his condition, we sometimes have to remove the kidneys,” she says. “But it was not necessary for Carter due to his rapid progression toward kidney failure.

When he found out he was getting a new kidney, he had a ton of questions, Carter’s Dad says. They included: What will happen with my old kidneys? Will I pee again? Do I still need to do dialysis? How long is the surgery? Where is the kidney coming from? Can I go swimming again? Can I drink whatever I want?

“He said: ‘Wait, I'll have three kidneys...that's cool, right?!’’ Dewett says. “With all the questions, he was also very excited about the whole thing. He kept talking about all the things he was going to do when he got a new kidney.”

Caroline was discharged from the hospital on Friday after Carter received his new kidney. Her kids had prom that weekend, after all, and she wasn’t going to miss the festivities.

She came to see Carter in the hospital the following Wednesday. He spent a little over two weeks in the hospital after receiving his kidney. Caroline was also there for his discharge.

***

Carter joined Kelly Smith’s and Monica Narang’s transitional kindergarten class last year as a bright-eyed, happy, and playful four-year-old.

He loved coming to school each day to play with his friends and learn new things.

“He also loved knowing that he was at the same school that his dad attended so many years earlier,” Ms. Smith says. “Carter has the most handsome smile, the best manners, and is just such a dapper little guy. He was one of those kids who enjoyed everything we prepared for him.”

As the school year got underway, his teachers began to understand the depth of Carter's diagnosis and how vital it would be for us to adhere to the guidelines set forth by his medical team.

They worked hand-in-hand with Providence Day School nurses Anne Worgan and Irene Lucia, who joined every parent meeting and became the liaison between Carter's medical representative and the classroom.

“No matter what the restrictions were, Carter remained positive, playful, and hopeful,” Ms. Smith says. “He kept his eye on his long-term goal and cared nothing about the hurdles in between …’ When I get better, I'm going to take swimming lessons,’ he'd say. Or, ‘When I get a new kidney, I'll get to drink all the water I want.’”

Carter, Ms. Smith says, learned invaluable lessons about patience, responsibility, resilience, and gratitude. And the example he set taught the rest of the class about those things, too.

“Even on days when we knew he wasn't feeling his best, Carter never complained,” Ms. Smith says. “We never saw tears. He never asked why. He would face each new day with a quiet confidence, eagerly awaiting the day when everything would be better. I believe coming to school every day provided just the distraction Carter needed.”

All year long, not only Carter's classmates but also friends from all divisions cheered him on. His classmates made banners, wore bracelets, sent videos, collected gifts, and offered meals.

When the school found out he was scheduled for a transplant and he would have to end his school year early, they threw him a wonderful going away party, Dewett says.

“Carter's story reminds us to be grateful for the simple things - a glass of water, a dip in the pool, playtime with friends,” Ms. Smith says. “In the blink of an eye, things can change. Carter kept his eyes focused on the goal, and nothing else mattered. He taught us to live strong and to persevere. Carter inspired his teachers and classmates every day. He taught us to live, to face our challenges with confidence, and to enjoy every moment with gratitude.”

Ms. Smith continues: “And what a miracle that Caroline Dudley, who ironically has been a parent in my TK classroom twice before, heard of Carter's need (a child she did not know at the time) and quietly and selflessly donated a matching kidney. Her generous act speaks volumes of the Providence Day community. We are truly a family. We watch out for one another, help one another, and lift one another up when troubles arise.”

***

Carter is getting back to all the things he loved before he got sick - something Dr. Massengill is happy to see.

“As with all the kids or adolescents I care for, my goal is that he will define himself by who he is meant to be and not define himself by his chronic illness,” Dr. Massengill says. “Sounds so simple, but not so easy.

“Unfortunately, kidney transplantation is not curative. He will always have stages of chronic kidney disease in need of lifelong medications and will one day need another transplant.”

He’s swimming, playing T-ball and the piano, and enjoying being a kid again. Since his transplant, the family has been to the Georgia Aquarium in Atlanta and an indoor water park in Virginia.

Carter’s heart function is now back in the normal range, too.

“Carter is back to being a funny and energetic kid who loves life,” Dewett says. “We are forever grateful for Caroline. She’s a wonderful human being, and we are now bonded for life.”

Caroline says the Wilsons became an “instant family.”

“No one starts their year thinking they will donate a kidney,” she says, “but every day, we are grateful for how much we’ve truly gained from this unexpected experience.”