“Doctor, even if there’s only a 1% chance to save her, I’m ready to give part of my liver as a donor. If you can perform the transplant, we’ll be grateful.” These were the words I heard from the father of a 17-year-old girl in 2009.

This case wasn’t just a medical challenge; it was an ethical one. Contrary to popular belief, doctors are also human. They consider life situations, families and how treatments impact them. When someone comes to you with a problem, you think of the best standard of care and provide it. But sometimes, the story is much bigger.

The 17-year-old arrived at the hospital in a deep coma in 2009, suffering from liver failure. She had been perfectly healthy until just ten days earlier, when she developed a fever and jaundice, which is the yellowing of the eyes, skin, and urine. A week later, she became drowsy and eventually slipped into a coma. She was rushed to the emergency room and diagnosed with acute liver failure.

Acute liver failure happens when someone who was previously healthy suddenly suffers liver damage, often due to a viral infection or drug-related causes. The only life-saving treatment for acute liver failure is a liver transplant. However, not everyone is suitable for a transplant. Some may have infections or failing organs that make them poor candidates for such an intense procedure.

When a liver fails, other organs often follow suit. In this case, the girl’s kidneys were affected and her blood pressure dropped. She had a chest infection, likely pneumonia, due to weakened immunity. With multi-organ failure and infection in her lungs, she was not a suitable candidate for a liver transplant as her body might not be able to tolerate such a complex surgery.

I examined her and reviewed all her test results. International guidelines help us determine who is fit for a transplant, and she fell outside of those criteria. I sat down with the family and said, “I’m so sorry. She’s too far gone for a transplant. Her condition is so severe that I’ve never operated on a case this complex and saved anyone in similar circumstances.”

Families are often emotionally overwhelmed and it’s challenging for doctors to balance their emotions with the need to make the best medical decision. When a family member offers to donate half their liver, spending money and enduring agony, the decision becomes even more difficult. Doctors, like anyone else, can’t ignore the emotional plea, but we have to make sure the effort will lead to a positive outcome. It’s not ethically right to proceed if we don’t believe the patient can survive.

However, when I looked into the father’s eyes, my heart melted. He was pleading, falling to the floor, asking me to save his daughter and offering any part of his liver. Despite my initial reservations, I felt compelled to help.

My team shared my concern that the surgery could be too risky, but we decided to proceed. The chances of survival were very slim, possibly only 5%, but we took on the challenge. Within eight to ten hours, we had completed the evaluation of both the patient and the father, who was to donate part of his liver. The transplant was extremely difficult, given the girl’s low blood pressure, poor kidney function and severe lung infection. We had to support her organs heavily during the procedure.

The 11-to-12-hour surgery was gruelling, and the first two days post-op were stormy. She wasn’t doing well. Slowly, her blood pressure stabilised and, on the third day, she finally opened her eyes. Her kidney started working again and her chest infection cleared up. With a good liver, the body sometimes happily responds, and other systems get better. Her body began to recover, and after two weeks, she was discharged.