ANN ARBOR, Mich. - A 12-year-old boy from Linden survived what could have been a fatal motorbike crash thanks to a daring medical procedure performed by doctors at C.S. Mott Children's Hospital at the University of Michigan.
The hospital said this is the first time someone has survived the high-risk surgery.
Max Bontekoe was riding his motorbike when he was involved in a head-on crash that would change his life.
Max was with his brother and his friend racing motorbikes around the fields behind the Bontekoe's home in Linden last summer when the crash happened.
"The group got separated, and they came around a blind corner of a cornfield and hit head on," said Jacob Bontekoe, Max's father.
Max's father quickly arrived to the crash scene and was surprised to see him standing and walking.
"You wouldn't know that it was as bad as it was," said Jacob Bontekoe.
Max's father checked him for any serious physical injuries, it had appeared he had no broken bones, yet Max was still feeling pain.
Then they removed his shirt and made a shocking discovery.
"I remember in the house, my dad took off my shirt, and I found bloody tire marks going across my chest," said Max Bontekoe.
Jacob Bontekoe took his son to a nearby hospital. Once they arrived, doctors were moving quickly and got Max in for a cat scan.
"They found internal bleeding. At that point, the decision was made, that he needs to be airlifted to U of M," Jacob Bontekoe said.
Doctor Ronald Hirschl was the pediatrics surgeon who was on call at the University of Michigan C.S. Mott Children's Hospital that day.
"Once we were there, all I remember is Doctor Hirschl pushing the stretcher at a dead run with Dr. Thatch, having me sign consent forms and reassuring me with there's nobody else he would want his kids with other than Dr. Hirschl," said Jacob Bontekoe.
Once Dr. Hirschl had a look inside, Bontekoe's condition was worse than he thought.
Dr. Hirschl saw that Bontekoe's liver had had a severe injury in which two of the three veins had been torn off, and the third was partially torn and was bleeding.
"It was really a surgeon's nightmare, one of the most difficult things to take care of and handle. There are lots of ways that people have tried to do so, but none of them very successful," Hirschl said.
According to Dr. Hirschl, to try to slow the bleeding further, surgeons clamped off the aorta, which blocks blood flow to the lower half of Max's body. At that point, the clock was ticking faster, and without blood, organ damage would begin.
Max was losing massive amounts of blood at this point. During his operation, they used a total of about 50 units of blood on him and they worried they would run out.
Dr. Hirschl soon realized that Max wasn't going to live if this injury couldn't be repaired, and so far they were having no success, which gave rise to a radical idea that proved to be a turning point in the surgery.
"I had the idea that perhaps we could take the liver out and repair those veins and then put it back in," Dr. Hirschl said.
The problem was this had only been successfully attempted once before in the world, and their measure of success was that the patient only survived four more days, then died. This made Max's prospects even more risky.
Dr. Shawn Pelletier, director of the Liver Transplant Program at the University of Michigan, wasn't on call, but he was the surgeon they needed. Pelletier was familiar with removing livers, but unlike Max's case, those were carefully planned operations.
"I was walking into this almost completely blindly. Essentially, you were trying to repair this under a pool of blood and place stitches in something that you couldn't see so you were blindly trying to repair it," Pelletier said.
Then another turning point -- the hospital was running out of blood.
According to Pelletier, the blood bank called and said they had only 10 units of blood left for Max, and they were calling other hospitals trying to get more.
"I was worried that Max was going to bleed to death and we wouldn't have blood to save his life. I thought of Max's parents that point. The only thing left to do, was to remove his liver," said Pelletier.
According to Pelletier, this was a huge gamble. If they weren't able to preserve it, fix the injuries and replace it, Max would not survive.
Once the liver was out, surgeons could focus on repairing the damaged blood vessels and the liver separately.
"You take the largest organ out of the body, and you now have a lot of room and great exposure. It was really quite honestly straight forward and easy to get the bleeding to stop," said Pelletier.
Finally, things were starting to turn around for Max and the doctors. Pelletier said when Max's liver was reconnected, he was relatively stable to allow blood flow going to his new, auto transplanted liver.
Max made it out of the operating room, but he still had a long road ahead -- four months in the Intensive Care Unit and two more months in rehabilitation.
Max wants to get back on a motorbike, but understandably, his dad's still not sure.
"I'm just not ready to put him back on a motorcycle, " said Jacob Bontekoe.
"I feel a little more special, because I am the only one in the world who survived this injury, " said Max.
If you would like to see the videos Max's family made of his recovery, click here.
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