A 'miracle baby' is on the mend after undergoing a liver transplant at less than four weeks old - the smallest person to receive the life saving surgery in New Zealand.

After surviving ten hours of surgery in late January, little Pīpīwharauroa Wallace is on the road to recovery, thanks to her aunt Mina Steedman, 23, donating part of her liver.

Pīpīwharauroa was born on Christmas Eve last December and for the first few weeks of her life she seemed to be a perfectly healthy baby, her mum Ashley Steedman said.

Steedman's midwife had noticed Pīpīwharauroa was a little jaundiced, but that isn't necessarily unusual for newborns.

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Mina Steedman holds Pīpīwharauroa after their surgeries. Steedman, 23, donated part of her liver to save her niece's life. Photo / Supplied
Mina Steedman holds Pīpīwharauroa after their surgeries. Steedman, 23, donated part of her liver to save her niece's life. Photo / Supplied

Then, about two weeks after she was born Pīpīwharauroa was put down for a nap at home in Tokoroa and woke up with bright yellow eyes.

By the end of the day Steedman had travelled all the way to Starship Children's Hospital in Auckland, having learned Pīpīwharauroa had acute liver disease and might need a transplant.

"It happened super quick," she said.

"We went from breakfast and cuddles to finding out her liver was failing in a matter of hours."

Steedman and her mother took Pīpīwharauroa first to Tokoroa Hospital, then to Waikato Hospital before being sent to Starship in an ambulance.

Pīpīwharauroa Wallace, now 10 weeks old, had a liver transplant at four weeks after being diagnosed with acute liver failure. Photo / Supplied
Pīpīwharauroa Wallace, now 10 weeks old, had a liver transplant at four weeks after being diagnosed with acute liver failure. Photo / Supplied

The baby's jaundice levels had been climbing all day, from 506 in the morning to 520 by the time she reached Starship.

Starship doctor Helen Evans, paediatric gastroenterologist and heptologist, said newborn babies can have relatively high jaundice levels, but "you wouldn't expect a healthy baby with an innocent level of jaundice to have a level of 500".

At Starship, doctors explained Pīpīwharauroa might need surgery due to neo natal acute liver failure, but said they wanted to avoid it if possible because she was so tiny.

Pīpīwharauroa was the youngest and smallest Kiwi to ever undergo the surgery, Evans confirmed.

The cause of her liver failure was unclear, which can often be the case with young children, Evans said.

Pīpīwharauroa Wallace in hospital. She was diagnosed with acute liver failure at just two and a half weeks old and has received a liver donation from her aunt. Photo / Supplied
Pīpīwharauroa Wallace in hospital. She was diagnosed with acute liver failure at just two and a half weeks old and has received a liver donation from her aunt. Photo / Supplied

Pīpīwharauroa went on, then off, and then back on the donor transplant list after initial hopes she might battle her illness on her own faded.

The possibility of using a live donor liver was suggested and Steedman's sister Mina put her hand up as a potential donor, flying over from Australia for surgery after it was confirmed she was a match.

A day after on January 23, less than a month after Pīpīwharauroa was born, the pair were in surgery.

"That day was super scary for my whole family," Steedman said.

She was worried not only for her child, but also her sister, with whom she is close.

"I was like 'are you sure you want to do this?' and she said 'Ash, she's only three weeks old, this is my gift to her'."

It was 12 hours until Steedman and Wallace saw their baby girl again, and when they did things were looking up.

"She pulled through, she was super strong. The surgeons she had, they were just so amazing."

Mina was also doing well and she and her niece got to see each other two days after surgery.

Mina Steedman touches Pīpīwharauroa for the first time after their surgeries. Photo / Supplied
Mina Steedman touches Pīpīwharauroa for the first time after their surgeries. Photo / Supplied

Defying expectations, Pīpīwharauroa was only in the Intensive Care Unit for a week, though she will need to stay in hospital for a minimum of three months after the surgery.

"Her doctor just looked at me and said 'there's nothing I can say to you, she is truly our miracle baby'," Steedman said.

"We're so proud of her. It's a bit of an understatement calling her a miracle baby, she makes us speechless."

While Steedman stays with Pīpīwharauroa around the clock, Wallace has been coming up on weekends from Tokoroa.

The couple have been sharing the care of their 4 year old daughter Amohia with Wallace's parents and a Givealittle page has been set up to help ease the financial pressure for the young family.

Pīpīwharauroa will be vulnerable to infection, but Steedman and Wallace want her to go to creche and kindy and live a normal life.

Getting sick could actually help strengthen Pīpīwharauroa's immune system, but she cannot be around unvaccinated children because the risk is too high.

"We can't protect her from everything, she is going to catch infections," Steedman said.

"We're ready for it, they [the doctors] have prepared us for it."

Dr Evans said due to their size surgery itself was the most difficult part and once a baby or small child had made it through, their prognosis was generally good.

"Long term they should do really well."