The organ from a six-and-a-half-year-old girl from Kafr Qasim, an Arab-Israeli city east of Tel Aviv, saved the life of a three-and-a-half-year-old boy from Jerusalem with a long-awaited heart transplant this week.
Rafael had been in Clalit-Schneider Children's Medical Center for nine months before receiving the heart that saved his life.
Rafael was born with a complex congenital heart defect. At just three and a half months old, he underwent his first heart surgery, followed by countless hospitalizations and treatments. Despite the efforts of his physicians, his heart continued to weaken.
Dr. Amichay Rotstein, the senior pediatric cardiologist who had been caring for Rafael since he was one year old, recalled having to tell his family about Rafael’s failing heart.
"We went through many hardships," he said. "I had to tell the family that we were not moving in the right direction, that his heart was failing, and that he would most likely need a transplant."
Rafael's recovery
Doctors placed Rafael on ECMO after his heart collapsed during surgery. He was later connected to a Berlin Heart ventricular assist device.
"Suddenly, we saw a different child," recalled Dr. Rotstein. "A child who had barely been functioning began eating again, gaining weight, and smiling.”
“There is something remarkable about children,” he continued. “They adapt to this reality. Rafael learned to live with the device and to protect the tubes as though they were part of him."
Rafael's mother said that her son was aware that it was the machine keeping him alive.
"Whenever the machine beeped, he would immediately check that the tubes weren't bent. At night, he would remind me to connect it. He embraced the device with love because he knew it gave him strength," she explained.
After nine months on the machine, doctors decided Rafael would travel to the US, where waiting times for heart transplants are shorter.
Meanwhile, six-and-a-half-year-old Saba, the youngest of four sisters, had traveled to Eilat to accompany her father, Mahren Badir, and her sister on a work trip and short vacation.
The day before her death, Saba spent time with her family at the beach. "She laughed and enjoyed herself. We had plans for the next day," her father recalled. But on Friday morning, everything changed. "I woke her up, but she didn't respond. I tried again and again, but she wouldn't wake up."
Saba was first taken to Yoseftal Medical Center in Eilat and then airlifted to Beersheba’s Soroka Medical Center. Physicians discovered that a congenital weakness in a vein in her brain had ruptured, causing a large bleed.
Two days later, she was declared dead. When they asked us about organ donation, her father said, “We immediately said yes, without hesitation."
"My daughter is gone," he said in a broken voice. "What am I going to do with her heart? What am I going to do with her kidneys? The body is buried, but the organs can give life. At least let them save other children."
Preparations for NYC flight were complete
Rafael’s father had already flown to New York to prepare for his son’s arrival. Two physicians, a nurse, a technician in charge of the ventricular assist device, and his mother were two hours away from leaving for the airport when they received a call that a heart had been found.
"When I entered the room, there were far more doctors than usual," Rafael's mother recalls. "I thought they were coming to talk about the flight. Then the doctor told me, 'We've found a heart for Rafael.' I almost fainted. I was in complete shock."
At that very moment, Rafael's trip to the United States was canceled.
At Soroka Medical Center, medical teams began the process of recovering Saba's organs. Meanwhile, doctors began prepping Rafael for the heart’s arrival.
Director of Neonatal Cardiac Surgery Service at Clalit-Schneider Dr. Gabriel Amir and his team disconnected Rafael from the Berlin Heart device that had kept him alive.
"Everything is timed down to the minute," said Dr. Amir. "The goal is to have the child ready at the exact moment the donor heart arrives. The shorter the waiting time, the better the chances for the new heart."
‘Beginning of a new life’
Saba's heart was transported from Soroka to Schneider, and a complex operation began. "The heart started beating," recalled Dr. Rotstein. "It was the beginning of a new life. It was everything we had hoped for."
For Dr. Rotstein, the moment carried another meaning. He had lost his son last year while in combat in Gaza.
"There are mornings when all you want to do is stay under the blanket," he said. "Then you receive the news that there is a heart for a child waiting for a transplant, and you throw off the blanket and get up. This work sustains me. It gives me a reason to get up in the morning and continue living."
Weeks after the transplant, Rafael is beginning to discover a new life. "He's not even sure where home is anymore," his doctors said with a smile, as the hospital had become like a second home to him.
His first wish after the transplant was to feed a giraffe at the zoo, and he has already fulfilled that dream.
Looking at photographs of Rafael, Saba's father said, "My daughter's heart is alive. It is a gift from God. Thank you."
"She was the spirit of our home," he said. "The most playful one. Daddy's girl. Whenever she heard my truck coming home, she would run to greet me."
"It is not something we take for granted that we reached this moment,” reflected Dr. Rotstein. “There were times when hope seemed to be fading. But organ donation gives life, literally. Whoever saves one life, saves an entire world."