Our patients’ stories: Yahya’s journey

The Boston Globe recently ran a story about a young Boston Children’s Hospital patient who came to the hospital from Palestine. Coordinating his care was a combined effort of many people, crossing geological and political borders.

Yahya at Boston Children's

When Yahya Ahmad Masalma was born in a small village in Palestine, Israeli doctors diagnosed him with posterior urethral valves (PUV), a congenital and chronic condition that compromises the kidneys and urological system. In Yahya’s case, his kidneys and bladder were unable to properly function, causing serious problems, so doctors in Jerusalem began performing regular dialysis—a process that takes the blood out of the body, filters it through a machine and puts back into the body.

But a person—especially a child—can only undergo dialysis for so long before the body begins to revolt. After five years, Yahya’s blood vessels were damaged and failing and he would soon be unable to undergo any more of the life-sustaining treatment.

Without dialysis, Yahya’s condition would worsen quickly, and the only way he could survive was to get a kidney transplant.

Michael Agus, MD, director of Medicine Critical Care Program Boston Children’s Hospital had heard about Yahya’s case through his Israeli colleagues, and made William Harmon, MD, chief of Boston Children’s Division of Nephrology, aware of the situation. Although the Israeli Hospital has performed kidney transplants in small children before, Yahya had very low blood pressure and they felt that it would not be safe to do so for him. The Israeli physicians could not find a transplant program that was willing to accept Yahya.

“The Israeli doctors had already been doing such great work with Yahya for five years,” says Harmon. “If they thought it was time for him to come here and get a transplant, we knew it was serious.”

Yahya’s father, Ahmad, was evaluated in Israel to see if he could donate his kidney, and was ultimately approved for the transplant. But coming to the United States presented a huge financial challenge to Yahya’s family—who survive only on the Ahmad’s part-time income. Not only would they need to pay for three flights to Boston and for Yahya’s kidney transplant, but Ahmad would need his own operation, and the family would need food, winter clothes and a place to stay for three months.

So Agus, Roberta Hoffman, LICSW, and the International Center at Boston Children’s set out to find a way to make the journey happen. They worked with several charities—Combined Jewish Philanthropies, the Ray Tye Foundation, Roche and the Palestinian Children’s Relief Fund—to pool their resources and bring Yahya and his parents from Palestine to the United States.

Suddenly, Yahya’s fate had changed. Because of the enormous charitable contributions, the family had their flights paid for, could stay at The Yawkey Family Inn for Yahya’s entire medical recovery, receive necessary winter clothing and eat three meals a day. Boston Children’s and the physicians involved in his care agreed to provide free care for what was not covered by donations, and Yahya received enough medication to prevent rejection until he could return to Palestine. The generosity and hard work of strangers across the ocean would ultimately save his life.

As soon as the family arrived on January 13, 2012, doctors got right to work. After some evaluation at Brigham and Women’s Hospital, Ahmad underwent the operation to donate his kidney on January 26, making a successful transplant into Yahya’s body.

The Masalma family

Now three months later, the family has begun adjusting to their lives at home, where Yahya can be cared for by his doctors in Jerusalem.

“His condition is better than it ever has been,” says Harmon. “He has normal kidney function for the first time ever, he’s more energetic and engaging, and he will only continue to improve. He’s one of the nurses’ favorites.”

Read the Boston Globe’s story about Yahya and his care at Boston Children’s.