Teacher donates liver to save former student's life

When 5-year-old Ezra Toczek from Alden, New York, faced complications of progressive liver disease, his former daycare teacher, Carissa Fisher, became an unexpected hero. The 21-year-old teacher and member of the U.S. Air Force selflessly donated a portion of her liver, giving Ezra a second chance at life. The lifesaving transplant was performed by clinical teams at Hassenfeld Children's Hospital at NYU Langone and the NYU Langone Transplant Institute.

On May 25, 2024, Carissa surprised the Toczek family by knocking on their door with a sign that read, "Ezra, would you like to share my liver?" The perfect donor match sent her on a trajectory that would save Ezra's life, with the successful transplant taking place August 7, 2024, at NYU Langone Health.

From foster care to family: Ezra's early struggles with liver challenges

In 2019, Karen and Ron Toczek welcomed Ezra, at just 7 months old, into their home as a foster child. Ezra suffered severe liver damage at birth, which caused bile duct blockages and impaired liver function. Pediatric surgeon Kaveh Vali, MD, in Buffalo, New York, referred Ezra to Adam Griesemer, MD, surgical director of the Pediatric Liver Transplant Program at Hassenfeld Children's Hospital and director of NYU Langone's Living Donor Liver Transplant Program, to explore potential solutions.

"I can't imagine not having had that time with the nurses and doctors … his transplant team. It's just been really incredible," says Ezra's mom, Karen.

Karen drove six hours down to New York City, where Dr. Griesemer performed a surgical procedure to reconstruct and open Ezra's bile ducts, providing him with several years of normal liver function. "We essentially wanted to buy Ezra some time and allow him grow before considering a liver transplant," said Dr. Griesemer. "It was never a question of if he would need a new liver, but when."

Over time, Ezra became part of the Toczeks' large family, which includes seven biological kids and other foster children. In 2022, the couple officially adopted Ezra, a spunky and deeply loved addition to their household and community.

Ezra's hepatologist in Alden stayed in close touch with Dr. Griesemer and Jennifer M. Vittorio, MD, medical director of the Pediatric Liver Transplant Program at Hassenfeld Children's Hospital, to monitor and keep an eye on Ezra's liver condition as he continued to grow.

By February 2024, Ezra's condition had worsened, and he was diagnosed with end-stage liver disease. Symptoms such as severe itching, liver scarring, and fatigue made daily life difficult. "Ezra was having trouble sleeping and couldn't function like a typical 5-year-old despite maximal medical therapies. It was clear that we needed to list him for a liver transplant," said Dr. Vittorio.

A knock on the door that changed everything

Karen turned to social media to share her son's story, hoping to find a donor. "When it became a reality that Ezra needed a transplant, I couldn't help but think, 'How are we going to get this organ?' Ezra's care team mentioned all potential options, including a living donor. But it was so overwhelming at first," said Karen.

Carissa, who had been Ezra's daycare teacher years before, saw the post and immediately felt called to help. Without notifying the family, she applied to donate a portion of her liver through the Liver Transplant Program at NYU Langone's Transplant Institute. "I didn't hesitate for a second," said Carissa. "If I were 5 years old, I'd want someone to do it for me. I knew I could help, and I was determined to do so."

Carissa underwent an array of tests to confirm she'd be a good candidate and that it would be safe for her to donate a portion of her liver. The tests revealed she was a perfect match.

On the day she surprised the Toczek family with the news, Karen recalled, "it caught us off guard and it took a few moments to process what was happening. The relief of not waiting on the donor list was a gift beyond words."

A transplant that restored hope

On August 7, Carissa underwent a minimally invasive robotic surgery at NYU Langone, led by Karim J. Halazun, MD, surgical director of the Adult Liver Transplant Program, to remove 30 percent of her liver for donation. "NYU Langone is one of the few transplant centers in the United States able to perform this type of procedure robotically," explained Dr. Halazun. "Our cutting-edge techniques allow donors to heal more quickly and return to normal life."

Ezra's transplant was successfully performed by Dr. Griesemer and pediatric transplant surgeon Bernardo Daniel Campos, MD. "We only need a small portion of Carissa's liver for Ezra, as it will grow along with his body," said Dr. Griesemer.

The liver is the only organ that can regenerate and heal itself over time. "It's pretty incredible that in just six months, my liver will have fully grown back," said Carissa. "Not many people realize that."

Despite some complications during recovery, Ezra regained his lively personality. "His energy, mood, and appetite returned almost immediately," said Karen. Carissa was able to visit Ezra in the Pediatric Intensive Care Unit at Hassenfeld Children's Hospital during recovery, where she was greeted by his laughter, smiles, and jokes.

Ezra formed strong bonds with the care team, including certified child life specialist Molly McClure and pediatric liver transplant social worker Katie Sclafani, who helped provide emotional support during the process and recovery while ensuring a smooth transition home. These services are provided by Sala Institute for Child and Family Centered Care.

A new beginning and reunion at "Ezra's hospital"

By September 20, Ezra was discharged to a nearby Ronald McDonald House to continue follow-up care. On November 1, he returned home to his family. "Ezra has caught up on his growth and development, and he's just a remarkable child. The progress he's made is phenomenal," said Dr. Vittorio.

Karen felt immense relief after bringing Ezra home. "He's back at school, hanging out with friends and playing with his siblings. He's doing all the things he loves to do, and we know it will only get better from here. He has big dreams and plans."

Ezra shortly returned to Hassenfeld Children's Hospital on November 11 for a reunion with the multidisciplinary team that took care of him, where he saw Carissa for the first time since the transplant. "Ezra loves seeing all his best friends at 'his' hospital," said Karen. "He was sad to leave and certainly not afraid to come back."

Molly McClure, the child life specialist, added, "It brings us so much joy to celebrate Ezra's new beginning with his favorite things—dinosaurs and slime—and with all the people who helped and saved his life along the way."

Carissa and the Toczek family stay in close contact and look forward to seeing Ezra continue to thrive, thanks to Carissa's life-changing gift of organ donation. They hope their story encourages others to consider becoming organ donors.

"I am forever grateful to Carissa for giving Ezra this gift of life," said Karen.

"The reward of knowing you've helped someone in need is incredibly fulfilling," said Carissa. "I hope more people will consider becoming donors. It's a decision that can truly change lives."