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Toddler Undergoes Multi-Organ Transplant

November 2, 1987

PITTSBURGH (AP) _ Surgeons transplanted a liver, pancreas, small intestine and part of a stomach and colon Sunday into a 3-year-old girl who has never eaten solid food because of a deadly defect in her digestive system.

Doctors said that without the experimental surgery, Tabatha Foster of Madisonville, Ky., would have died within weeks.

The operation began at 10 p.m. Saturday and ended nearly 15 hours later at 12:45 p.m. Sunday, said Lynn McMahon, spokeswoman for Children’s Hospital.

Tabatha was in the hospital’s intensive care unit in critical condition, which is normal following transplant operations, Ms. McMahon said.

″Tabatha is doing very well now, taking into consideration that she’s had a very large operation that went into the night,″ Dr. Marc Rowe, the hospital’s chief surgeon, said Sunday evening. ″She looks good.″

Surgeons removed Tabatha’s spleen, an organ that acts as a blood filter and can trigger rejection of transplanted organs, said Rowe, who watched the operation and acted as spokesman for the eight surgeons who took part.

Ms. McMahon said earlier that Tabatha probably would remain unconscious Sunday and doctors would watch her closely for signs of rejection and to ensure that the organs were functioning properly. ″The first 72 hours are critical,″ she said.

Similar transplants have been performed only twice, and the patients died, said Sue Cardillo, another hospital spokeswoman.

″There are risks involved technically in terms of making the connections with the transplanted organs to the recipients and there are dangers associated with rejection,″ Ms. McMahon said. ″Since this procedure hasn’t been done many times before, physicians themselves aren’t sure what all the risks might be.″

Tabatha was born with short gut syndrome, a fatal condition in which her twisted intestines interfered with blood circulation.

Two days after birth, surgeons removed a major portion of her small intestine, Ms. McMahon said. The operation corrected the blood flow problem but necessitated a highly concentrated nutritious feeding that in turn led to liver disease, she said.

The transplant became possible when the parents of an infant who died after an automobile accident in Virginia agreed to donate their daughter’s organs, said Marty Walker, senior coordinator for the Knoxville Organ Donor Program in Tennessee.

Tabatha’s parents, who consented to the transplant Tuesday, spent the night at the hospital with friends, Ms. McMahon said. They declined to comment on their daughter’s condition.

Tabatha’s mother, Sandra, has said she and her husband, Roy, decided to allow the surgery to give her daughter a second chance. Mrs. Foster said Tabatha, her only child, had spent all but two months of her life in hospitals.

Although Tabatha needed only a small intestine and liver to survive, it was easier for surgeons to also transplant the pancreas and part of the stomach and large intestine, Ms. McMahon said.

″The abdominal organs are so intricately connected that for technical reasons it’s easier to just do the transplant in one piece,″ she said.

The two similar transplants were performed at Children’s Hospital in 1983 and at Rush-Presbyterian-St. Luke’s Medical Center in Chicago last year.

Walker said the donor was 7 1/2 -week-old Heather Orick of Pennington Gap, Va., who was declared brain dead Saturday afternoon as a result of head injuries she suffered in an Oct. 9 accident, Walker said.

After the accident, Heather was moved to the University of Tennessee Medical Center at Knoxville, where Walker said her brain function began failing.

The infant’s parents, Rebecca Orick and Earl Shirks, decided Saturday afternoon to donate the organs, and a computer system matched the donor and recipient hours later, Walker said.

″They chose this option because, even though Heather was dead, she could make that an opportunity for someone else to have a sceond chance at life,″ he said.

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