Sarah Murnaghan waves, blows kiss in new video

Ten-year-old Sarah Murnaghan is still recovering from her second lung transplant, but she's awake and seems to be in good spirits.

Her mother, Janet Ruddock Murnaghan, shared a video of Sarah waving to the camera and blowing a kiss on Friday.

Sarah, who has end-stage cystic fibrosis, underwent her first adult double-lung transplant on June 12, but suffered a primary graft failure (PGF) due to the poor quality of her first set of lungs, not rejection, her mother reported. She received a second pair of lungs infected with pneumonia on June 15. Despite the high risk of taking infected lungs, her mother said Sarah was running out of time, so they decided to go forward with the procedure.

Sarah's first lung biopsy showed no signs of rejection, according to her mother.

Sarah had a procedure to fixed her paralyzed diaphragm on Monday, which was injured during her lung transplants. This will allow her lungs to expand further. She continues to recover at the Children's Hospital of Philadelphia.

Sarah's case garnered national attention when her parents started a petition, and then sued to get her added to the adult transplant waiting list. While she was at the top of the pediatric donor list, she would have had to wait until all people 12 and older with her blood type passed on adult lungs before she was eligible. Currently Organ Procurement and Transplantation Network (OPTN) rules rank patients 12 and older by need in order to determine who gets the first organs. Sarah, who will be celebrating her 11th birthday soon, would be put at the bottom of the list for an adult organ even though the severity of her illness would technically put her at the top.

The problem is child donors are very rare. According to Health Resources and Services Administration, there were 10 lung transplants completed on children 10 and under in 2012. For comparison, there were 1,744 lung transplants on people 11 and older that same year.

Last month, a Philadelphia judge ordered that Sarah and another 11-year-old Bronx boy be put on the adult waiting lists.

The medical community was divided especially since lung transplants have a 50 percent chance that they will fail within five years, regardless of the age of a patient. Dr. Margaret Moon, an assistant professor of pediatrics at Johns Hopkins Children's Center in Baltimore,previously told that because Sarah had cystic fibrosis and additional health problems, she might be at greater risk for failure. In addition, pediatric lung transplants have only been performed in the last few decades and are far less researched. Some doctors felt adult lungs should be given to people with the best chance of success, especially since transplantation was so rare.