Infant with rare genetic disease needs risky transplant at New York City hospital as only treatment option.

At just seven weeks old, Dhruvan Gopi experienced a health crisis that would change his life and spotlight the intricacies of pediatric medicine. Taken by his parents to an urgent care center in New Jersey, they were confronted with the shocking diagnosis of acute liver failure, a condition unprecedented for someone so young. This unforeseen revelation prompted an urgent need for a complex organ transplant, ultimately leading his care team to Manhattan’s Mount Sinai Hospital.

In the days following his initial visit, Dhruvan’s condition rapidly deteriorated. Despite appearing healthy shortly before, he experienced alarming symptoms: dark urine and persistent vomiting. His parents sought medical attention, and the infant was devastated by a series of escalating health complications. Dhruvan was transferred to St. Peter’s University Hospital, where treatments for a suspected urinary tract infection failed to improve his liver function. His situation remained precarious; he suffered from a stoppage of blood clotting, leading to necessary blood transfusions for stabilization.

Upon arriving at Mount Sinai’s neonatal intensive care unit on December 2, 2024, doctors declared that Dhruvan had little time left, battling what they termed rapidly progressive liver failure. Dr. Sander Florman, the surgical director at the Recanati/Miller Transplantation Institute, noted the urgency of the situation, indicating that the infant would need immediate intervention or risk succumbing within the next 24 hours.

As the medical team prepared to place Dhruvan on a transplant waiting list, a groundbreaking opportunity arose. A colleague inquired about using a liver from a two-year-old child undergoing treatment for Maple Syrup Urine Disease (MSUD), a rare metabolic condition. Dhruvan and the donor child shared a compatible blood type, making a domino transplant—a rare medical procedure where one donor’s liver is split and donated to two recipients—a possibility. Given Dhruvan’s critical condition, his parents were approached with the proposal. Despite their apprehension, they understood that this transplant might be his only avenue for survival.

On December 4, 2024, the unusual transplant was executed. Florman and his team meticulously trimmed the donor liver to fit the anatomy of the tiny patient, a feat rarely accomplished for infants under ten pounds. After the surgery, Dhruvan faced a long recovery path filled with complications, including blood clots, infections, and significant swelling, but he exhibited signs of resilience.

Following a challenging four-and-a-half-month hospital stay, Dhruvan returned home, thrusting his family into a new routine of daily medication and careful health management. His parents provided around-the-clock care, managing his condition while navigating the complexities of his immune suppression.

As he continues to grow and thrive, now fifteen months old, Dhruvan’s story is one of not merely survival, but triumph over adversity. This journey has not only deepened his family’s gratitude but also brought joy to the medical team that fought for his life. The saga underscores both the miracles of modern medicine and the ever-evolving complexities of pediatric care. Each routine check-up reinforces the hope that Dhruvan will continue to develop like any healthy child, a testament to the efficacy of experimental medicine when circumstances become dire.

Dhruvan Gopi’s case serves as a powerful reminder of the fragility of life and the immense strength within families and medical teams alike, working in concert to achieve what once seemed impossible.