Winding back the clock for Zoe

Zoe Brookes weighed just 12 kilograms when she was wheeled into an operating theatre at The Alfred late last year. She was desperately ill - a reality all too clear to her family and to the teams of doctors, nurses and allied health specialists that watched as her health rapidly declined.

But what took place in the sterile surrounds of the operating room, and during the critical hours that followed, seemed to wind back the clock for the little girl from the south-eastern suburbs of Melbourne, Victoria.

The Brookes' were soon to learn that their darkest thoughts were no longer the most likely outcome. Suddenly, a future was again possible for Zoe; challenging her siblings in the playground became thinkable; and starting primary school, like all children her age do, was something wonderful to strive for.

Respiratory physician Associate Professor Glenn Westall is head of the National Paediatric Lung Transplant Program at The Alfred. Dr Westall said the team was calm as they prepared for the transplant, with theatre nurses sewing a special bright gown and surgical cap for his youngest patient.

"The positive feeling of teamwork - and the way the hospital came together for this ambitious procedure - was impressive," A/Prof Westall said.

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Zoe had pulmonary arterial hypertension. It's a devastating illness that increases pressure in the arteries and lungs and eventually leads to heart failure if not controlled.

Cardiothoracic surgeon, A/Prof Silvana Marasco said while the illness can sometimes be controlled with medication, this is not always the case.

"The heart's right ventricle eventually becomes thick and dilated and it can no longer do its job properly. This eventually affects the blood vessels in the lungs and, by this stage, survival is poor," A/Prof Marasco said.

Zoe's illness had damaged her own heart and lungs and she urgently needed a transplant. In the eleventh hour, a chance at life arose. Some tiny donor organs, elsewhere in Australia, became Zoe's only hope. That hope later became joy.

The Alfred is home to the Nationally Funded Centre (NFC) for Paediatric Lung and Heart-Lung Transplantation and, since becoming Australia's only dedicated paediatric lung transplant service, has given a second chance to 27 children, like Zoe, from all corners of the country.

"To offer an operation and lifelong care to a five-year-old who is about four times smaller than our average transplant patient is always going to represent a challenge, but it's an opportunity we embrace," Dr Westall said.

"Zoe is an absolute delight; she's grabbing life with both hands and we couldn't be happier for the Brookes family."