Young Georgian woman gets new liver and life

Gov't expedites citizenship of birthright participant to allow transplant here.

Miriam Kisishvili 248 88 (photo credit: Courtesy)
Miriam Kisishvili 248 88
(photo credit: Courtesy)
A 19-year-old Jewish woman from the former Soviet republic of Georgia was fortunate that Wilson disease, a rare genetic liver disorder she didn't even know she had, caused a sudden life-threatening attack while she was touring here. Miriam Kishishvili, who was here on a birthright program, became an Israeli citizen and three days later underwent a free liver transplant here that constitutes a cure for the rare disorder. Now, with a new liver, she has decided to remain here, as has her 17-year-old brother. The woman, who came her from the city of Guri to participate in the program arranged by Netiv, suddenly became very ill after visiting a Beduin encampment and eating food from copper plates. Wilson disease prevents the liver from filtering out excess copper due to a mutation of the ATP7B gene. Thus, natural copper in the diet and the environment can cause a toxic oversupply. Victims of the disease gradually accumulate copper in the liver, brain, eyes and other organs. Most people with Wilson disease have no known family history of it, but it affects about one in 40,000 individuals. Only rarely does acute liver failure occur - though this is what happened to Kishishvili, who said she has always been healthy. When she suddenly developed edema in her limbs and a swollen abdomen, she was rushed to Eilat's Josephthal Hospital and then was transferred to the Rabin Medical Center-Beilinson Campus in Petah Tikva. Prof. Ran Tur-Kaspa, a senior liver expert and head of the Beilinson's internal medicine D department, arranged for the transfer after hearing her symptoms and getting a medical report. Tur-Kaspa said the attack might have been triggered by eating from copper utensils, but in any case the disease would have eventually presented symptoms. Tur-Kaspa said on Tuesday that he was sure after examining Kisishvili that she needed an immediate liver transplant. When her mother arrived from Georgia, he asked her to donate a lobe of her liver to save her daughter's life. But Israel Transplant learned of a suitable cadaver liver that had just become available. Unable to pay for the surgery and treatment, which costs NIS 850,000, the family was told to ask the Prime Minister's Office if she could immediately become an Israeli citizen so that the operation could be covered by Clalit Health Services, which became her insurer. The government agreed in a race against time to make her a citizen on the spot and give her health insurance coverage, as she was very unlikely to survive if she returned without a healthy liver to Georgia. The transplant was performed by Prof. Eitan Mor, head of the hospital's transplant department, and his colleague Dr. Yvgeny Solomonov. After the operation, Kisishvili was treated in the intensive care unit headed by Prof. Pierre Singer. Her condition now, not long after the surgery, is good, and she is recovering, with her mother and brother at her bedside. Her mother plans to stay here for at least a year. Hospital social worker Rahel Singer said it was a hectic few days, as the Absorption Ministry made arrangements, the family opened a bank account and the health fund membership was approved.