Bright-eyed, with fresh faces and flowing blonde hair, triplet sisters Daisy, Amber and Lola Collins look like perfect angels.
But when they donned their first secondary school uniform to start the new term, it was not just their family resemblance that made the 11-year-old trio stand out.
For Daisy and Amber who, unlike Lola, are identical twins, both have a devastating kidney condition, diagnosed when they were just two-years-old.
Daisy had a transplant three years ago, while Amber desperately needs one to save her life.
Because their condition is so complex, it has to be from a live donor, but strict rules mean her parents cannot donate.
While Lola has been blessed with good health, her sisters have both endured dozens of hospital admissions and thousands of hours of dialysis to clean their blood.
Speaking out ahead of organ donation week, which starts tomorrow (Monday 23), mum Lucy Collins, of Umberleigh, Devon, says: “We want a future for Amber and our family.
“We never talk about next year. At night, we talk about tomorrow, because that’s why we attach Amber to a machine every evening. That’s why she has injections and takes fists full of tablets every day – so she can have a tomorrow.
“The girls have just started secondary school, but it’s hard for Amber watching Daisy get on with her life now she’s had her transplant. They have always been incredibly close. They still can’t settle when they are apart if Amber goes into hospital.”
Daisy and Amber both developed nephrotic syndrome, a form of kidney disease which caused protein to leak into their urine. That left insufficient protein in their blood to reabsorb water from the body, causing swelling, infections, and raised blood pressure.
Finally, their kidneys failed.
Daisy had a kidney transplant from a family friend in September 2021.
The surgery at London’s Great Ormond Street Hospital was a success.
But in a devastating twist, her kidney problems returned less than 12 hours later and she needed several months of pioneering and intensive treatment, with a cancer drug and donor plasma, to reboot her kidney function.
Dad Jan Collins says: “A little bit of me died when they told us that Daisy’s kidney diseases had come back with a vengeance. That transplant was her golden ticket to life.
“By then, Daisy had been ill for nearly seven years. Every test, every treatment, every tear was working towards this. We couldn’t tell her, after everything she had been through.
“But the continued treatment was all worthwhile. It meant the kidney works and the transplant has saved Daisy’s life. She is doing really well.
“We don’t know if her kidney disease will come back one day, but we take the good days and hold onto them tight.
“The girls have lost friends on this journey, other children with kidney disease who haven’t made it, so we know how lucky Daisy was to have a transplant.”
Daisy and Amber’s fight for survival began before they were born.
Former retail worker Lucy was 17 weeks pregnant with the natural triplets when she was diagnosed with twin-to-twin transfusion syndrome.
It meant Daisy and Amber shared a blood supply and were not getting the right nutrients.
Their non-identical sister, Lola, was not affected, but the condition is often fatal, so doctors performed laser surgery to separate the twins in the womb.
No-one knew they had kidney disease until Daisy fell ill during a family holiday to France when she and Amber were two years-old.
“On the last day of the holiday, Daisy came downstairs and her face, arms, and hands were puffed up,” says Jan.
Jan, an army veteran who has taken a break from his engineering career to care for Amber, adds: “Daisy came home after a month in hospital and the next morning Amber walked into the bedroom with the puffiest face you’d ever seen. Our hearts sank.
“Every other month we ended up in hospital in Bristol with Daisy or Amber with an infection.
“One time, they were on different wards at the same time.