Nine years after bone-marrow transplant, sister saves brother with liver donation - Haaretz

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Thu., January 03, 2008 Tevet 25, 5768

Israel Time: 01:25 (EST+7)

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Nine years after bone-marrow transplant, sister saves brother with liver donation

By Yuval Azoulay

A 30-year-old woman donated her liver to her 9-year-old brother two weeks ago, saving his life for a second time since he was born.

Nine years ago, bone marrow from the sister was transplanted into her baby brother who was born suffering from Severe Combined Immunodeficiency, a genetic disorder that impairs the immune system.

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At the time, doctors at the Sheba Medical Center, Tel Hashomer, believed that bone marrow from his sister would cure his illness and allow him to lead a normal life. Without hesitation, the sister gladly obliged to make the donation.

After the operation, the child grew up in good health. Three months ago, however, his situation suddenly deteriorated. Tests showed he was suffering from a very serious kidney disease that damaged his lungs. His breathing became labored, and the oxygen level in his blood was half its normal level in a healthy child.

"The disease was very serious, and there was no other option but to carry out a liver transplant," said Dr. Yaron Avitzur, a specialist in children's liver diseases at Petah Tikva's Schneider Children's Medical Center. "For three months, he lied here by an oxygen tank. Even with the tank, his oxygen levels were low and his physical functioning was very limited."

Because of his perilous condition, doctors decided to transplant a liver, but worried that if the body rejected the organ, the side effects might further deteriorate his condition. While examining the boy's medical history, doctors discovered that his sister's liver would not be rejected because of her bone marrow donation nine years ago.

Quick decision

Now a mother of two, the sister had to reach a quick decision. By agreeing to donate the organ, she was exposing herself to a potentially life-threatening situation, doctors told her. Unlike donating bone marrow, removing a liver for donation was a complicated procedure.

"At the start I was terrified," she said. "This wasn't like donating bone marrow. In this instance, they make a cut in the body and remove an organ. After realizing that it would allow my brother to lead a normal life, I had no doubt I would go through with it. I consulted with the rebbetzin [the rabbi's wife] and received her blessing, and I entered the operation room as though I were walking into a hotel."

After hours of operation, the liver was successfully transplanted.

"The liver is functioning in the boy's body," said a doctor who was part of the team that carried out the operation. "He will be let out of the emergency care ward next week and sent home. He no longer has to take medication against his body rejection the transplant, nor did he need such medication during the operation."

Hospital officials said the transplant was a rare medical case almost without precedent in the annals of medical history. "This is a rare case, and we estimate that in the entire world only a few similar cases have occurred," Dr. Avitzur said.

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