Biliary atresia, liver transplant

Ezra Lawler loves to learn about new things, play sports and build with Legos. He is a passionate, resilient 6 year old, ready for any challenge he may face.
 
Ezra was born healthy, but when he was 6 weeks old, his mom, Nicole, took him to the pediatrician because he looked yellow and bloated. After reviewing lab results, his pediatrician sent him to the nearest hospital, the Medical University of South Carolina in Charleston. There, he was diagnosed with biliary atresia and, at 7 weeks old, underwent a Kasai procedure, which connects the liver to the small intestine.
 
After the procedure, Ezra’s family decided to move back home to Birmingham to be closer to family and receive care from Children’s of Alabama. When he was 8 months old, he was evaluated for a liver transplant at Children’s, but it was determined his liver disease had not progressed to the point of needing a transplant. He began frequent clinic visits, where he was monitored by a hepatologist to ensure he was continuing to gain weight and grow.
 
Just before Ezra turned 4, he was hospitalized for esophageal varices—the enlargement of blood vessels in the esophagus caused by portal hypertension, a complication of biliary atresia. With the development of these new complications, his doctors decided to re-evaluate him for a transplant, and he was placed on the transplant list.
 
As he awaited his transplant, he was in and out of the hospital. During each stay at Children’s, the staff worked hard to give Ezra the best care and make his family feel comfortable. “It never felt like we didn’t have the right people in his corner to take care of him,” Nicole said. “The staff has been nothing but fabulous.”
 
But as the wait continued, the family was always on edge, waiting to receive the call that a liver was available. “You don’t really know what to expect until it happens, but the team and our transplant coordinator were wonderful at trying to help us understand what would happen, as well as prepare us for best case scenario and worst case scenario,” she said. 
 
The situation also affected Ezra’s family. His sister, Simone, is only 10 months older than him, so their bond is very close. Throughout Ezra’s journey, Simone learned to ask questions and be supportive for her brother. “Because they’re so close in age, they had a lot of questions together and were trying to understand what all this meant,” Nicole said. Ezra’s parents were very open with both their children about what was happening and that they didn’t have answers for everything.
 
After 10 months on the waiting list, Ezra received his liver transplant in 2023. He was hospitalized for 15 days while he recovered.
 
Ezra still visits various clinics at Children’s frequently to support his recovery journey. And while a hospital stay can be intimidating and scary for young children, Ezra sees Children’s in a different light. He is always excited to visit the clinics because he knows a child life specialist will come around with the toy box, or he can go on a scavenger hunt for a prize. “He’s sitting there laughing and running around the whole clinic, looking for little pictures for the scavenger hunt,” Nicole said. He also frequently visits Children’s Harbor to get a stuffed animal from the claw machine and play basketball.
 
Ezra is resilient and adaptable because of the long, hard journey he has been on. “He has the ability to become whatever he wants to be,” Nicole said. “He has big dreams and looks at life like anything is possible.”