LONDON — Ailing toddler Alfie Evans will not be permitted to fly to Rome for additional treatment, a judge ruled on Tuesday during an emergency hearing.

This came the day after Alfie’s life support machine was removed, then oxygen and hydration were re-administered when the boy survived for several hours, contrary to the prediction of doctors.

Judge Anthony Hayden of the High Court said that this will be the “final chapter in the case of this extraordinary little boy.”

Earlier this week, Alfie had been granted Italian citizenship in hopes that this would convince the court to allow him to be sent to Rome to be treated at the Vatican-owned Bambino Gesù Pediatric Hospital.

The judge, however, ruled that this would not be within his best interest and he would not be allowed to travel to Rome or Munich, where another hospital had offered to treat him. An air ambulance had been at the ready to quickly transport Afie to Italy had the judge approved the transfer.

Instead, Alfie will remain at Alder Hey Children’s Hospital, but he may eventually be permitted to return home with his parents.

Alfie is a 23-month-old toddler who is in what physicians have described as a “semi-vegetative state” due to a mysterious degenerative neurological condition that doctors at Alder Hey Hospital have not been able to properly diagnose. He has been hospitalized since December of 2016.

In March, London’s Court of Appeal upheld a lower court’s decision to end life support for Alfie. Hayden ruled that “continued ventilator support is no longer in Alfie’s interests.”

Alfie’s parents, Kate James and Tom Evans, had repeatedly made requests to transfer him to the Bambino Gesù for further diagnosis and treatment.

They said that Alfie had recently grown “stronger and more responsive,” noting that he could take a few breaths on his own and was stretching, coughing, swallowing, and yawning. However, Alder Hey Hospital repeatedly refused the transfer, deeming it “futile.”

Until Monday, doctors did not believe that he was capable of breathing on his own, but he surprised his doctors by surviving the night breathing unaided after the removal of his ventilator. According to his father, doctors eventually gave Alfie water and supplemental oxygen, but the child has not been given nutrition for nearly a day.

“Coming up to 24 hours (without breathing assistance) and he’s fighting,” said his father. “Gorgeous features, pink lips, handsome grown up face, an odd cheeky smile now and again.”

Alfie’s father traveled to Rome to meet with Pope Francis on April 18. He pleaded for asylum for his family in Italy, so that his son could be moved.

Francis had offered prayers for Alfie and his family several times, including at a general audience and in several Twitter posts.

“Moved by the prayers and immense solidarity shown little Alfie Evans, I renew my appeal that the suffering of his parents may be heard and that their desire to seek new forms of treatment may be granted,” he said on Twitter on Monday.

On April 23, Italian Foreign Minister Angelino Alfano and Italian Interior Minister Marco Minniti granted citizenship to the toddler, in hopes that being an Italian citizen would allow the child to be transferred to Italy immediately.

Alfie’s supporters who include bishops, members of parliament, and other prominent figures, have dubbed themselves “Alfie’s Army” to spread awareness and to provide encouragement for the family.

In recent days, protesters numbering in the hundreds had swarmed around Alder Hey Hospital, calling on the institution to respect the rights of Alfie’s parents and allow him to be transferred.