Jenn Timperley was wrapping the very last Christmas presents for her family. One of them was for her 11-year-old son, Joseph, who really needed a new liver.

When Joseph was born with an incurable liver disease called biliary atresia, he was very sick. His parents, Jenn and Brent Timperley wanted the most advanced care available. "We would have traveled anywhere to get him the care he needed," says Jenn. "We chose Nebraska Medicine because we've always known how strong and successful their liver program is. They have the most amazing team full of so much knowledge and compassion. I felt immediate trust from the day he was diagnosed as a baby." Pediatric gastroenterologist Ruben Quiros, MD, developed an especially close connection with Joseph over many years of care.

Soon after Joseph's diagnosis in 2010, Jenn created Pediatric Liver Aid (PLaiD) with friend and fellow mother Becki Huether. Their local nonprofit helps families after transplant in little and big ways. Sometimes they provide meals, coffee or just support from someone who gets the trials of transplant. "You tend to connect with other liver families, as we call them," says Jenn. "We just feel so lucky that we're 20 minutes from our center. When people come here from out-of-state, we try to give them that same support network."

In 2019, Joseph's complications became so severe that he desperately needed a new liver. His spleen and vessels were so enlarged that he was at risk for internal bleeding. On Nov. 13, 2019, his doctors at Nebraska Medical Center placed him on the transplant waiting list.

As Jenn placed a bow on the family's last Christmas present on Dec. 19 of that year, her phone rang. It was transplant nurse coordinator April Romans, RN, BSN, calling to say that Joseph's "perfect match" was here. It was the call the Timperleys had been awaiting for 11 years. Their excitement for Joseph's new life was mixed with grief for what the donor's family must be feeling. "I had never understood that we were capable of feeling such conflicting feelings at the same time – intense joy and hope alongside such pain and sadness for our donor family," says Jenn.

She describes the moment as "the most giant flood of emotions ever." The Christmas presents would have to wait as Joseph and his family prepared for the big day.

Joseph smiled as he left for surgery on Dec. 20, 2019. He was happy, calm and ready. Jenn and Brent tried to hold back tears, reflecting on everything Joseph had been through the past 11 years and the new hope given to them that day. Transplant surgeon David Mercer, MD, successfully transplanted Joseph's new liver.

Everything looked great at first. But unfortunately, Joseph's body began to reject the liver. Jenn dreaded having to tell her son that he needed another surgery so soon.

"That was terrifying – watching him get sicker – and not knowing what was going on or if they would be able to correct it. We were worried he was going to potentially lose the liver if things couldn't get turned around very quickly," says Jenn.

"Mom, whatever happens I know it's going to be good," he responded. Like so many other times, Joseph's strength and bravery astonished his parents. After spending Christmas in the Pediatric Intensive Care Unit, he headed to the operating room again. Transplant surgeon Wendy Grant, MD, performed another operation and rerouted some of Joseph's bile ducts.

And the result was so good.

Joseph spent 27 days in the hospital following his transplant. When he was finally home, all the kids eagerly opened their Christmas presents.

Joseph unwrapped the present that Jenn held when she'd gotten "The Call." A sign that said, "Yes, you can." It was the answer to a question he'd been asking for as long as his parents could remember.

"For Christmas that year he told us all he wished for was first a new liver and then a dog," says Jenn. "We knew we weren't in control of when a new liver would come but we could make his dream of having a dog happen. Little did we know, both would."

His dog Ferguson has been his closest companion and the best therapy for him. Since COVID-19 precautions put in-person school, sports and other activities on hold, Joe's dog has been a huge help and his favorite hobby.

This past Christmas marked Joseph's one-year liver anniversary. While he continues to have some issues with liver rejection, he spent most of this time home. Instead of anxiously waiting for surgery, Joseph went sledding with his siblings. Joseph's older brother Jackson said, "This is the best Christmas ever because we're all home together with Joe."

"His donor family and remembering their loss were heavy on our minds," says Jenn. "We remain thankful that Joe's here with us and we can celebrate his bright future thanks to them."

For a boy who went from being told "you can't" for his health, now "yes, you can" is a constant reminder of his new freedom and hope for his future.

"I wanted a transplant because I knew it would be the greatest gift of my life," says Joseph. "I wanted it because I knew it would allow me to do all the things I want to do – even if I don't do them all – I know I will be allowed the chance to do them. I won't be told I can't anymore."

"The ‘yes you can' sign has so much more meaning than we ever realized it would have at the time, says Jenn. "It sits on display in our house as a reminder that yes, you can get through anything and you can do anything."

Written in partnership with Live On Nebraska. To learn more about organ donation, visit LiveOnNebraska.org.