When Sue Ramirez looks back on her son Nathaniel’s life, she does so with profound gratitude, steady courage and a mother’s unshakable hope. His journey, filled with both unimaginable challenges and extraordinary triumphs, continues to be defined by resilience and the health care teams who have supported him every step of the way.
Nathaniel has been a Kaiser Permanente San Bernardino County patient since birth — a true “Kaiser baby” from the start.
At just six weeks old, he was diagnosed with a rare and complex set of congenital heart conditions: L-TGA (Levo-Transposition of the Great Arteries), Ebstein’s anomaly, and severe tricuspid valve regurgitation. Yet even with such a serious diagnosis, Nathaniel thrived throughout childhood.
“His first 12 years were amazingly stable,” Sue recalls. “Minimal medications, no symptoms. He was just a normal kid.”
Everything changed in 2020 when she noticed swelling in her son’s legs and tenderness in his abdomen, so she rushed him to the emergency room. Doctors removed 52 pounds of fluid and discovered that Nathaniel was in heart failure.
He was transferred to Kaiser Permanente Los Angeles Medical Center, benefiting from the health system’s integrated approach to ensure seamless care between hospitals and specialists. He then received additional highly specialized care at Children’s Hospital Los Angeles, thanks to a collaboration with that hospital, while his Kaiser Permanente doctors remained involved every step of the way.
The entire care team ultimately concluded that the only way forward was a heart transplant.
In December 2020, just 50 minutes after being placed on the transplant list, Nathaniel received the call: a perfect match had been found, and the transplant was performed at Children’s Hospital Los Angeles. By noon, his new heart was beating on its own.
“When I first saw him in recovery, he didn’t have his eyes open yet, but he was already managing his own breathing with the suction device,” Sue says. “That’s who he is - strong, determined and always pushing forward.”
But there were more challenges years later when Sue noticed swelling and other signs that Nathaniel wasn’t feeling well. Doctors discovered that his kidneys were failing, a side effect of the medications that protect his transplanted heart. He was placed on the kidney transplant list and now undergoes dialysis four times a week under the supervision of his pediatric nephrologist, Dr. James Tong, at Kaiser Permanente Fontana Medical Center.
In September 2025, they thought a match had come through. But three children were ahead of him on the list, and the kidney went to one of them.
“That’s okay,” Sue says. “That kidney wasn’t for him. Nathaniel is patient. He’s seen very young kids on dialysis. He knows everyone is fighting their own battle.”
With National Donate Life Month in April, Nathaniel’s story highlights the life-changing impact of organ donation and the hope it brings to thousands of children and adults on transplant waiting lists. Through it all, Nathaniel has continued to face each day with remarkable calm.
“He just says, ‘Let’s get this kidney so I can move on with my life.’ That’s his spirit.”
Nathaniel’s journey is far from over, but his heart and the unwavering love surrounding him continue to carry him forward. And while he waits for the gift that will give him the next chapter of his life, his family holds tight to what has sustained them all along: hope.
Surviving on Heart and Hope
When Sue Ramirez looks back on her son Nathaniel’s life, she does so with profound gratitude, steady courage and a mother’s unshakable hope. His journey, filled with both unimaginable challenges and extraordinary triumphs, continues to be defined by resilience and the health care teams who have supported him every step of the way.
Nathaniel has been a Kaiser Permanente San Bernardino County patient since birth — a true “Kaiser baby” from the start.
At just six weeks old, he was diagnosed with a rare and complex set of congenital heart conditions: L?TGA (Levo?Transposition of the Great Arteries), Ebstein’s anomaly, and severe tricuspid valve regurgitation. Yet even with such a serious diagnosis, Nathaniel thrived throughout childhood.
“His first 12 years were amazingly stable,” Sue recalls. “Minimal medications, no symptoms. He was just a normal kid.”
Everything changed in 2020 when she noticed swelling in her son’s legs and tenderness in his abdomen, so she rushed him to the emergency room. Doctors removed 52 pounds of fluid and discovered that Nathaniel was in heart failure.
He was transferred to Kaiser Permanente Los Angeles Medical Center, benefiting from the health system’s integrated approach to ensure seamless care between hospitals and specialists. He then received additional highly specialized care at Children’s Hospital Los Angeles, thanks to a collaboration with that hospital, while his Kaiser Permanente doctors remained involved every step of the way.
The entire care team ultimately concluded that the only way forward was a heart transplant.
In December 2020, just 50 minutes after being placed on the transplant list, Nathaniel received the call: a perfect match had been found, and the transplant was performed at Children’s Hospital Los Angeles. By noon, his new heart was beating on its own.
“When I first saw him in recovery, he didn’t have his eyes open yet, but he was already managing his own breathing with the suction device,” Sue says. “That’s who he is - strong, determined and always pushing forward.”
But there were more challenges years later when Sue noticed swelling and other signs that Nathaniel wasn’t feeling well. Doctors discovered that his kidneys were failing, a side effect of the medications that protect his transplanted heart. He was placed on the kidney transplant list and now undergoes dialysis four times a week under the supervision of his pediatric nephrologist, Dr. James Tong, at Kaiser Permanente Fontana Medical Center.
In September 2025, they thought a match had come through. But three children were ahead of him on the list, and the kidney went to one of them.
“That’s okay,” Sue says. “That kidney wasn’t for him. Nathaniel is patient. He’s seen very young kids on dialysis. He knows everyone is fighting their own battle.”
With National Donate Life Month in April, Nathaniel’s story highlights the life-changing impact of organ donation and the hope it brings to thousands of children and adults on transplant waiting lists. Through it all, Nathaniel has continued to face each day with remarkable calm.
“He just says, ‘Let’s get this kidney so I can move on with my life.’ That’s his spirit.”
Nathaniel’s journey is far from over, but his heart and the unwavering love surrounding him continue to carry him forward. And while he waits for the gift that will give him the next chapter of his life, his family holds tight to what has sustained them all along: hope.
Inspired by patients like Nathaniel, Kaiser Permanente San Bernardino County and Kaiser Permanente Riverside County are teaming up to participate in the American Heart Association’s Inland Empire Heart & Stroke Walk on Saturday, April 25 at ONT Field in Ontario. More than 500 employees, along with families and friends, will join the walk, and have raised more than $51,000 so far to champion heart health education and prevention. The community is invited to take part in the day’s activities to honor this important cause.