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Boy Gets Second, 4-Organ Transplant

June 4, 1998

MIAMI (AP) _ A surgical team worked overnight to give a 13-year-old Maryland boy his second four-organ transplant in less than three weeks, and said when it finished Wednesday that the procedure went smoothly.

Eight doctors from the University of Miami gave Daniel Canal of Wheaton, Md., a new stomach, liver, pancreas and small intestine after his body violently rejected the set he got in an identical procedure May 15.

``The doctors feel the surgery went smoothly,″ Jackson Children’s Hospital spokesman Omar Montejo said Wednesday after the 13-hour operation.

``He’s critical but stable now, but that’s standard right out of surgery,″ Montejo added. ``He’s probably going to be like that for a few days.″

The procedure got under way at 11 p.m. Tuesday and ended at noon Wednesday. The team was led by University of Miami transplant surgeon Andreas Tzarkis.

``The liver had to be reduced a little bit to fit in (Daniel’s) abdomen, because the organs this time were from an adult,″ Montejo said. ``We didn’t have the luxury of time to wait for a perfect match, so we went with these. But the doctors are happy with the organs.″

On Sunday, Daniel’s body rejected the small intestine implanted last month. That rejection so damaged the new stomach, liver and pancreas that they, too, needed to be replaced again.

Montejo said the donated organs were flown to Miami late Tuesday from the University of Pittsburgh Regional Organ Procurement Team.

Before the second quadruple transplant, Montejo said that the decision was made to not wait for better-matching child organs because Daniel was ``so sick, and we’re in such a desperate race against time.″

Last month, after the first operation, Tzarkis said the procedure appeared to have gone well.

But Monday, two weeks after that hopeful assessment, Daniel was back on a top-priority list of patients needing donor organs. He had waited five years for his first set.

Originally, Daniel’s small intestine failed. And as he waited months _ then years _ for a donor organ, his worsening condition ``had a negative domino effect for the other organs, and slowly damaged the liver, pancreas and the stomach,″ Montejo said.

His case drew national attention, with advocates of reform for the nation’s distribution system for donor organs claiming that Daniel’s long wait could have killed him.

Under current donor-organ distribution procedures, priority is given to patients who live closest to the donor.

But Health and Human Services Secretary Donna Shalala, backed by the national movement for reform, has announced plans to overhaul the system to ensure that donor organs go to the sickest patients, no matter where they are.

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