Liver Lobe Transplant

The transplant of a liver lobe, altruistically donated by Hussan Terrif, an officer in the Prisons Service, took place recently at Schneider Children’s. Hussan, a father of 3 from Kafr Mejar, decided to save the life of 8-year-old Mursal Elbalaus from the Druze community in Jordan by donating a liver lobe to him despite not knowing him.

Mursal suffered from Alagille Syndrome, a chronic multisystem hereditary disorder that affects various organs in the body, particularly the liver. Pediatric liver transplants are not conducted in Jordan and so his parents sought a place that could operate on their son to save his life. Through the efforts of the Druze community, they succeeded in raising sufficient funds so that Mursal could undergo the transplant at Schneider Children’s.

The dramatic saga was the culmination of support by the entire Druze community. Since the patient was a child from Jordan, Sheikh Mufak Terrif, the spiritual head of the Druze community and chair of the Supreme Druze Religious Council in Israel, spearheaded the fundraising. Amira Kra, the daughter of former MK Ayub Kra and a medical student, accompanied the child and his family from the moment of their arrival in Israel, organized the search for a suitable altruistic donor, and persisted until she found Hussam Terrif, who agreed to save the boy’s life by donating a liver lobe.

This is the second time that a liver lobe transplant has taken place in Israel between two people who are not family members and don’t know one another. A year ago, the first altruistic transplant took place at Schneider Children’s in a 15-month-old infant, Karish Faarmaar, the son of foreign workers from India.

The transplant was performed by Dr. Michael Gurewitz and Dr. Sigal Eisner, senior physicians in the Organ Transplantation Department at Schneider Children’s, together with anesthetist Dr. Mila Katchko. In order to conduct liver transplants in children, which are difficult and complex, and even more complicated in small infants, special preparedness is demanded of the highly skilled and experienced multidisciplinary staff in the hospital, among whom are pediatric transplant surgeons, ultrasound technicians, gastroenterologists, transplant coordinators, social workers, dieticians, anesthetists and surgical nurses, intensivists, and the staff of Pediatrics C, which specializes in treating organ transplant recipients.

A living related liver lobe transplant is especially lengthy and complex, demanding special preparedness. During the procedure, both donor and recipient are placed in adjacent operating rooms at the same time. Once the liver lobe has been removed from the donor in one operating room, it is transferred to the other operating room where the recipient is awaiting the transplant.

As opposed to other organ transplantations, the liver is an organ that can rapidly regenerate itself even after serious damage or when a large portion is removed. Therefore, it is possible to remove a liver lobe from a living donor (even up to 2/3 of the liver), and implant it into the recipient. Within 8-12 weeks post-op, the liver will grow to more than 90% of its original pre-op size and function normally, in both donor and recipient.

Schneider Children’s performs the majority of organ transplantations in children in Israel and is among the first in the world to conduct living donor-related liver lobe transplants in children. Since its establishment, Schneider Children’s has performed over 600 transplants of heart, lungs, liver and kidneys in infants, children and adolescents, with a success rate on a par with leading medical centers in the world.