A Pittsburgh boy with a rare liver disease is fighting for his life — and his family is hoping for a second miracle to save him.
Lucas Goeller, now 10, was born with a rare, life-threatening kidney disease called biliary atresia, which is a blockage that prevents bile from traveling from the liver to the gallbladder.
Eight years after he received his first transplant as a toddler, his transplanted organ is now failing again — and his life depends on receiving another donation.
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In 2015, when he was just a toddler, the child's health declined rapidly.
He spent 18 months on the liver transplant list, getting sicker each week, and did not receive a single organ donation offer.
"He was on the brink of death, unable to walk or talk," said his mother, Jessica Goeller, in an interview with Fox News Digital.
"God told me to start a Facebook page for him, and at the time I really wasn't into social media."
That page led to a viral national campaign — complete with local news stories and donated billboards — that attracted the attention of a Nebraska family.
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And in July of that year, at UPMC Children’s Hospital of Pittsburgh, little 2-year-old Lucas received the liver of 3-year-old Olivia Swedberg, who had passed away a day earlier of brain cancer.
"I'm in awe when someone can take their suffering and turn it into something beautiful by donating and giving someone a second chance," said Goeller.
After that first transplant, her young son made a "miraculous recovery," Goeller said.
For "eight beautiful years," Goeller said, Lucas experienced a normal life as a happy, healthy boy.
"He was able to do things that he never could do before," she said. "He went from watching out of windows to being an active participant in life."
But all of that changed this year, when his routine medical scans and blood work indicated that his liver had begun to fail.
"His failing liver is affecting his lung function and his ammonia levels," Goeller told Fox News Digital.
"That would be drastic for anyone, but for a child who's growing and cognitively developing, it is devastating to [his] development."
Dr. George Mazeriegos, chief of pediatric transplantation at UPMC Children's Hospital of Pittsburgh, said Lucas is experiencing some of the more subtle changes of liver failure.
"Those include not being able to grow normally and not getting the proper levels of oxygen to his body and brain, because the blood is being shunted away from the liver," he told Fox News Digital.
"Those are important and potentially life-threatening complications."
As of now, Lucas is still at home and "managing his symptoms," Mazeriegos said, but the doctor emphasized the importance of his receiving a timely transplant before further complications occur.
The Goellers are now seeking support again, launching the "Save Lucas" campaign across social media.
And the city of Pittsburgh has rallied once more behind the family, with newly donated billboards and media campaigns.
"We're trying to not only save Lucas, but also to build organ donation awareness for both deceased and living donors," said Goeller.
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"We want it to really sink into hearts around the world because it's so important."
Despite his challenges, young Lucas Goeller remains positive, active and upbeat, continuing to enjoy his love of the outdoors and hunting with his father and his three brothers, aged 12, 8, and 4.
"He's always filled with so much joy," his mother said. "We get our strength from him. He encourages all of us to continue to look at the positives in life."
The ideal living donor for Lucas is someone with type O blood, aged 20 to 49, with a BMI below 30.
Beyond seeking a liver for their son, the Goellers are looking to raise awareness about the critical need for donors to help the more than 100,000 individuals on the organ donor list.
Children on transplant lists in the U.S. face three key challenges, Mazeriegos said.
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"First, there is a great demand for life-saving transplants, and there are 10 times the number of adults on the liver transplant list as there are children," he told Fox News Digital.
"This creates a challenge to allocate the right or the best organ for the children who are waiting on the list."
While Mazeriegos noted that the allocation policy is slowly improving, it's still imperfect and doesn't always prioritize children appropriately.
Each year, dozens of children in the U.S. die while awaiting a new liver.
Mazeriegos is determined to eliminate this "wait list mortality" through the use of partial liver transplants. That's when either a living or deceased donor’s liver is donated to two different recipients.
Another challenge is that not all the centers in the country have the capacity to perform highly complex transplants like the one Lucas needs.
"We need to train centers across the country on the techniques that will allow them to transplant these children," Mazeriegos said.
Both the Goeller family and the UPMC doctors stressed the importance of raising organ donor awareness so that more families register as organ donors.
Mazeriegos noted that people need to be made aware of living donation, which is when donors give part of their liver to a recipient.
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In 2018, UPMC started a learning network, the Starzl Network for Excellence in Pediatric Transplantation, in honor of Dr. Thomas Starzl, who is recognized as the father of transplantation.
"This is an effort to level the playing field and extend the expertise to centers that want to provide the same level of care their patients deserve."
In Pennsylvania alone, 18 children are waiting for liver transplants, while 300 children are on the list nationwide, Goeller pointed out.
"Life-saving donation is only possible through somebody else's love," she said.
She said she hopes "this campaign will inspire others to keep the conversation going and keep talking about Lucas and about other children and adults who need transplants."
She added, "Saving lives is not about competition — it’s about collaboration. It’s going to take more than a village to get this message across the entire world."