The parents of the youngest liver transplant recipent greet their son in the intensive care unit of the Schneider Children’s Medical Center.The health of children knows no barriers at Schneider Children’s Medical Center of Israel. An 11-month-old Arab boy, the son of an Israeli Christian Arab and a Palestinian mother, underwent a life-saving liver lobe transplant in November. The donor was the baby’s mother.

The boy, born with severely constricted bile ducts, arrived at Schneider undernourished and close to liver failure. Surgeons decided to proceed with the operation, which is extremely rare, given the infant’s serious condition. The father had first contacted renowned liver transplant surgeon Eytan Mor, head of the Rabin Live Transfer Unit at the Rabin Center on the Petach Tikvah campus, offering himself as the donor.

“I sat with the young guy for about an hour to explain to him the process of segmental liver donation, the risks and benefits,” Mor said. “He was listening very carefully and asked the right questions. There was no question in my mind that he would do anything to save his kid’s life. I said, ‘You know that despite the fact that you have the right blood type to be a donor, we might find your liver too big and I prefer to check the mother too and speak to her because she might be a better candidate.’

“It took a week to get permission for the mother to come to the hospital – but at 8:30 in the morning seven days later, the young couple with their yellow tiny baby were waiting outside my room. She looked very handsome and shy. I repeated the explanation regarding the donation process and risks. He did all the talking for her and repeated my explanation although she could understand Hebrew. She would just sit there with her own shy smile knowing that she will be found to be a better candidate.”

And so, indeed, it proved to be the case.

“The father stepped up first for the whole check-up including blood tests and CT Scan in which we measured the volume of the liver segment we wanted to use. As I expected, this piece of segment was almost 2.5 times bigger than the ideal volume. We then moved to check the mother and she was right: Her liver segment was just the right size the baby needed. We immediately prepared for the procedure.

“Usually I don’t sleep well the night before such a mission. I have to care for everything so that the two procedures, in the mother and the son, will go in concert. Once it started I lost any emotional stress, focusing fully on the surgery. In a segmental transplant, you remove a third of a liver from the parent and transplant it in the child. You have to take care not to harm any structures of either portion. Any mistake during the donor operation [in the parent] may kill the transplant before it even starts.”

He shakes his head. “This is not a one-man job though, and I’m lucky to have a professional team helping me so we can start to remove the sick liver in the child before closing the mother’s incision and save valuable time in the process. The two procedures [removing the segment liver in the mother and exchanging the sick liver in the child] may last over 12 hours. And saving any hours in an operation is important because the critical part where you sew the tiny vessels and bile duct can only come in the late-night hours toward the end of the whole operation.

“We finished and we were happy with the result. The mother was already awake, back in the ward when we finished the transplant. The grandparents, who were allowed to come a day before straight from Beit Jalla, were sitting there with tears in their eyes after a long wait to hear the outcome.”

Following the surgery, the baby’s condition improved and he was soon breathing without the aid of a respirator. He is expected to be discharged shortly and Mor said the child can look forward to a “full and healthy life.”

It was the 10th successful liver transplant Mor has completed in Israel, but the first on such a young patient.

“The mother was discharged after a few days to go to her child. It has been six weeks since the transplant and the child is not yellow anymore. He will grow up to become a healthy child.”

“I hope that one day I will be able to visit his grandparents house in Beit Jalla to watch him play outside safely.”