One liver saved the lives of two people in a rare split transplant. Three-year-old Cooper Cota, who was 2 years old at the time, and 63-year-old Susana Casio, both needed a liver transplant in 2023.
Cooper was in end-stage liver failure because of Alagille syndrome, an inherited condition in which bile builds up in the liver and damages it, according to Johns Hopkins Medicine. Susana was dealing with fatty liver disease worsened by her other health issues, which included intense back pain and autoimmune vasculitis that forced her to retire.
Over Labor Day weekend in 2023, Cooper and Susana both received part of the same donor liver, which marked NYU Langone’s first split liver transplant to ever happen. Susana received 80% of the organ, and the remaining 20% went to Cooper.
“It's a miracle, but it's really possible with the doctors that NYU [Langone] has. I can't stop thanking them,” Susana shared. “Everything is different," she added, noting that she is now pain-free.
More from LittleThings: 10-Year-Old Suffering Liver Transplant Complications Receives Support From Around The World
Cooper's parents, Amanda and Sherman, who live in Egg Harbor Township, New Jersey, knew that something wasn't right after their son’s birth. Amanda knew that Alagille syndrome runs in her family. She has a mild case, but her sister died from complications after a liver transplant just after her first birthday. Cooper was born on what would’ve been his aunt's 30th birthday.
"It just felt like a sign," Amanda said. "She's his guardian angel. She's been looking after him, and [his birthday] was meant to fall that way.” It wasn't long before Cooper was diagnosed with the condition. According to Boston's Children Hospital, Alagille syndrome is usually diagnosed during infancy or early childhood. About 1 in every 30,000 children is born with it.
The condition can lead to other complications, such as affecting the heart and other organ systems. Symptoms can include itchy skin, delayed growth, and severe jaundice, which Cooper experienced all of. "We never actually knew what color his eyes were until about two days after transplant,” Sherman said.
Amanda remembers receiving the call that a transplant was available for her son. “My phone rings — and from the moment he was listed, every time my phone rang, no matter who it was, I would jump out of my skin a little bit — and I saw the 'No Caller ID' and it's a Saturday, and they don't call me on Saturdays," she said. "I looked at my phone like, 'I know who this is and what they're about to say.' My baby needs this. And I know in the back of my mind, this is going to be the best thing for him and this is going to change his life and this is a good thing."
The procedure was done the next day. "We had surgeons on their weekend off come in. We had nursing staff on their weekend off come in; OR technicians come in so that we could basically do three operations all at the same time: the cutting of the liver into two halves and then the two transplants at the same time," Dr. Adam Griesemer, the surgical director of the Pediatric Liver Disease & Transplant Program at Hassenfeld Children’s Hospital, said. "A lot of people spent time away from their families, their barbecues, those kinds of things to make this happen to both of these patients."
On February 26, 2024, NYU Langone brought Cooper and Susana together for the first time to celebrate Cooper’s third birthday. “It was so beautiful,” Susana said. “You can't believe that he has a liver transplant. He's jumping up and down. He's so busy. He's so jolly. He's so smart. He sings.” Sherman also spoke about what it was like meeting Susana. "It's almost like a piece of your son lives in this other person. That was a surreal moment specifically for me."