Rambam Surgeons Perform Living Donor Kidney Transplant on Gaza Toddler
August 20, 2020 – A toddler from Gaza underwent a kidney transplant at Rambam Health Care Campus. The boy’s mother donated her kidney. Abed al-Karim Abu Grad was born in Gaza with a kidney disease that led to kidney failure, requiring treatment that was unavailable there. In coordination with the Palestinian National Authority’s Department of Health, he was transferred to Rambam Health Care Campus, where a medical team led by Dr. Daniella Magen, Director of the Pediatric Division in Ruth Rappaport Children’s Hospital and Director of Rambam's Pediatric Nephrology Institute, concluded that Abed was suffering from an inherited kidney disorder that could only be treated with dialysis and a kidney transplant. The Pediatric Nephrology Institute’s comprehensive system of abdominal dialysis for children in Abed's condition enabled him to be released from the hospital and return to his family in Gaza, where he underwent dialysis treatment while continuing to be monitored by the Pediatric Nephrology Institute at Rambam. At the end of 2019, however, Abed began to suffer from an infection and returned to Rambam, where his medical team was forced to switch from abdominal dialysis to hemodialysis (blood dialysis). Because this type of dialysis was not readily available in Gaza for children, the medical team at Rambam recommended to Abed's mother, Maali, that he remain in Israel for hemodialysis treatment until he was strong enough to receive a kidney transplant. Maali, a mother of five, was found to be a suitable match for the kidney transplant, and stayed with Abed at Rambam for eight months for the duration of his treatment, unable to see her four other children who remained in Gaza. Unfortunately, when Abed was found to be sufficiently healthy for the transplant, the Palestinian National Authority refused to commit to covering the costs. Abed's medical team at Rambam, however, was determined to save the toddler's life. Yazed Falah, Rambam's health coordinator for patients from the Palestinian National Authority, sought help from Gadir Abu Sharab, founder and director of the "Think about Others Association". The Association's 375 volunteers undertook an energetic campaign, and within six days, they raised the funds needed for Abed's surgery. But little Abed's troubles did not end there. The outbreak of COVID-19 in the spring of 2020 paralyzed the entire system of live donor transplants in Israel and around the world, necessitating an additional delay. Nevertheless, the transplant was eventually performed successfully in July. Dr. Ran Steinberg, Director of the Department of Pediatric Surgery at Rambam's Ruth Rappaport Children's Hospital, performed the procedure to reduce the size of the mother's kidney and the transplant surgery together with Dr. Tony Karram, Director of Rambam's Department of Vascular Surgery and Transplantation. "The complexity of this type of surgery arises out of the need to adapt the mother's larger kidney to make it suitable for the toddler's little body. I am delighted that the surgery was successful, and that we were able to see Abed’s body accept his mother's kidney and begin to function normally," stated Dr. Steinberg. Dr. Yisrael Eisenstein, Director of the Pediatric Kidney Transplant Service, said, "As of now, following the kidney transplant, Abed's condition is excellent and his kidney function is entirely normal." Dr. Magen explained that, "Following the transplant surgery, Abed requires intensive monitoring, with blood tests every three days. Due to COVID-19, if he were to travel to Gaza, he would need to go into isolation, making it difficult to perform regular examinations of his kidney function. As such, Maali decided that staff she and Abed would remain in Israel for the first two months following the kidney transplant so that he could be properly monitored. Thereafter, he will be allowed to return to his home, and will only need to return to Rambam for monthly follow-up examinations." This August, Abed is celebrating his third birthday, and for the first time in his young life, he has a fully functioning kidney and no more need for dialysis treatment. His miraculous recovery required the determination and commitment of many people—his mother, who spent months with him at Rambam and donated her own kidney, the medical teams at Rambam, and the generosity of the Think About Others Association, which made his surgery possible. To learn more about Abed’s and Maali’s time at Rambam, watch the following video: https://youtu.be/8Lebdny6kDw In the photo: Maali and Abed al-Karim Abu Grad at Rambam. In the photo: Surgeons at Rambam performing a kidney transplant. In the photo: Abed al-Karim Abu Grad playing in the hallway at Rambam. Photography courtesy of Rambam Health Care Campus
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