With the clock ticking away, back at the Vanderbilt Medical Center in Nashville the liver was secured for transport, moved quickly to a waiting car, and driven directly to the Air National Guard base. Under an armed escort, it was loaded on the waiting C-130. Seven minutes later, the Air Guard was granted permission to fly.
As the country's air space went from friendly skies to a potential battlefield, a 38-ton cargo transport plane carried one precious piece of cargo: an 11-ounce baby's liver.
"And then I got a phone call from Dr. John Goss (Kareena's transplant doctor) just out of the blue. I think it was about 11:30 a.m. And he said, 'The organ's on its way.' It was just unbelievable. I remember the phone fell out of my hand and I just couldn't believe that it was actually going to happen even with everything that was going on. It was just incredible," Kiran remembers.
For two hours, as one of only a handful of planes permitted in the air that day, the cargo plane flew through eerily quiet skies, no one speaking for the first 30 minutes of the flight. Tech. Sgt. Tracy Hobbs, one of two flight nurses on the plane, reflects, "We didn't know if there were going to be more attacks going on while we were in the air." At 2:05pm, the plane touched down and the race to save a life continued.
It was a whirlwind of late afternoon activity prepping Kareena for surgery, and six hours later, she was resting with her new liver in the hospital's intensive care unit
When asked about the day's events Kiran says, "I had no idea that there was all this activity going on behind the scenes and people were really fighting. They didn't want another life to be claimed. They really felt like they had some power over making this happen, and they weren't gonna take it lying down."
Ten years later, past the thick of the day's intensity, a decade of perspective leaves Kareena's mom with one word: Gratitude.
"Given all the horrible things that happened on that day," Kiran says, "I'm just thankful that people went so far and beyond for somebody they didn't know. That's always incredible to me. Everybody felt that they had it in their power to make a difference for just this one tiny little baby on that day. And they did, they did."
Today, Kareena is a vibrant 5th grader. The 10-year-old is a proud spelling bee champ who's getting ready to play the viola this year. Her hobbies include reading, collecting playing cards from different cities and swimming, because, as she says, "I'm a Pisces!" Perhaps not supringly, she plans to be a doctor when she grows up.
"I'm trying to decide whether transplant or baby doctor, and I want to be both," she says.
She is thankful for her second chance at life.
"If that baby hadn't passed away, they probably would have had a nice life and stuff. And I feel very sorry for that baby 'cause that could have been me, too," she says.
Kiran is similarly thankful to the family that decided to donate their daughter's liver.
"There's not a day goes by when I don't think of the donor family. And I always think, you know, their child would have been about this old now and how they must be feeling...how they remember 9/11."
Kareena still goes back to Texas Children's Hospital every year for a head to toe look over. During a recent medical exam, she declared she's feeling fine. Her liver numbers have been perfect with no signs of rejection and doctors are very happy with the transplant.
Kareena understands what it took -- the hard work that happened years ago amid extraordinary obstacles -- to keep her alive.
"I know that two planes crashed into the Twin Towers and many people died. Many people lost their families and friends. I feel very thankful cause I could have been one of those innocent people," she says.
"The people who saved my life tried so hard," she says. "So in their honor I'm going to do the best I can and I'll always remember the people who saved my life."
Watch "Remembrance and Renewal: Ten Years After the 9/11 Attacks," a "20/20" special, Sunday at 10 p.m. ET.