Hepatitis: Organ donation saves three lives at Children’s Hospital

One organ donor saves three lives at Packard Children’s

For Release: December 20, 2010 PALO ALTO, Calif. --

It's not every day that one organ donation saves three lives at the same hospital. But that's what happened recently at Lucile Packard Children's Hospital, when surgeons transplanted organs from a single donor to three gravely ill children.Before the November 9 transplants, 2-year-old Micah Leon had been dependent on kidney dialysis, 8-year-old Becky K. urgently needed a heart transplant and 5-month-old Alexie C. was experiencing advanced liver failure."It's rare for one organ donor to match three different recipients at the same hospital," said cardiothoracic surgeon Olaf Reinhartz, MD, who performed Becky's heart transplant.The three pediatric transplants required exquisitely coordinated teamwork from dozens of people. Because it has the region's only pediatric heart transplant program, Packard Children's is the only hospital in Northern California equipped for such a feat.When the donor organs became available, the first step was an intense round of planning. Denise Bickert, RN, director of pediatric perioperative services, checked the schedule in the hospital’s Ford Family Surgery Center to determine which surgeries for non-life-threatening conditions could be postponed to accommodate the transplants. The transplant teams and intensive care unit staff made sure they were prepared.Meanwhile, transplant staff began calling the children's families to tell them about the matching organs. All three children had experienced organ failure as a result of congenital organ defects. The news gave them a second chance at life, though bittersweet.

One family’s gift in a time of unbelievable grief would now enable three other children to live.Very early on Nov. 9, two surgical organ retrieval teams from Packard Children's were dispatched in a Stanford Life Flight airplane to the home city of the donor, a 7-year-old girl who had died. (The standard protocol in organ donation specifies that recipients learn only the donor's age and sex.) The heart was flown back to Packard Children's first, since it is most sensitive to delays in transplantation. The second team remained behind to transport the liver and kidney on another flight. Back at the hospital, the transplant teams were standing by for all three surgeries.Becky's heart transplant began at 8 a.m., hours before the donated heart got to the hospital.

The anesthesiologist, Manchula Navaratnam, MD, needed time to induce anesthesia safely in the fragile patient, and the surgical team wanted to be sure there would be no delay in implanting the organ once it arrived at midday."She was extremely sick when she got listed for her transplant," Reinhartz said, noting the girl's failing heart had deteriorated further as she waited for a donor organ.At 12:30 p.m., Becky's new heart arrived.

As Reinhartz implanted it, another surgical suite was being readied for Alexie's liver transplant. The heart and liver transplant teams are completely separate, with specially trained surgeons, anesthesiologists and nurses for both groups, so it posed no problem for the two groups to work simultaneously.Alexie's surgery began at 3 p.m."She was very sick – she got the liver in the nick of time," said Carlos Esquivel, MD, PhD, the surgeon who performed Alexie's transplant. Alexie was tiny; her poorly-functioning liver had hampered her growth. "The donor liver was a bit large for her," Esquivel said. He trimmed the liver to make it fit. "When we have a liver that is bigger, we have to be creative in hooking up the vein and artery," he added.A few hours later, after Becky had already been wheeled to the cardiovascular intensive care unit and Alexie was on her way to the pediatric intensive care unit, Micah Leon was being prepared for his kidney transplant. Micah's family had driven that morning from their home in Fresno, Calif.

Two-year-old kidney transplant recipient Micah Leon is pictured with parents Melindaand David shortly after his kidney transplant. On November 9, 2010, Micah was one of threegravely ill patients at Packard Children’sreceiving a transplanted organ from a singledonor.The night before the surgery, mom Melinda Leon said, "I didn't really sleep." Micah's kidney problem had been diagnosed in a prenatal ultrasound, and he had been on dialysis since 10 days of age. The Leon family had always known Micah would need a transplant, and now, almost three years later, they were excited and anxious that the big day had finally come. The operation, led by Waldo Concepcion, MD, began at 8 p.m., and a few hours later, Micah was also on his way to the pediatric intensive care unit for follow-up care.The three families feel truly fortunate that their children's lives were saved."Doctors here make miracles happen," said Alexie's mom, Andrea, standing at the bedside as Alexie made a strong recovery. "She's a miracle baby. I never stopped praying that soon she would get a transplant."Micah is recovering well, too, showing the energy that Melinda loves in her little boy. "He's really, really active – wild active," she said with a laugh. The kidney transplant gives him the chance to keep enjoying ordinary childhood pleasures. "He loves to play with our two dogs outdoors, run, ride little cars … normal things that 2-year-olds like."And Becky's family is planning to celebrate future Nov. 9ths like birthdays, said her mom, Anna. She is finding great joy in watching her daughter return to life after months in the hospital with heart failure. Among other challenges, Becky had to eat a very low-sodium diet while she waited for transplant. Soon after surgery, Anna was delighted to be able to indulge the little girl's request for a favorite salty treat: caviar.Anna thinks often of the donor family's generosity in giving her daughter a new heart. "The day that my daughter had surgery, I was crying thinking about that family, their kindness, how courageous it was of them," she said, expressing the gratitude all three families feel. "It is, in a true sense, a gift."The fact that three diverse transplants could be accomplished so smoothly is a testament to the hospital's nationally-recognized leadership in transplant surgery, care and research. “It’s also a salute to the quality of our staff,” said Concepcion, noting the many disciplines and specialists involved in the complex surgical process. "When the moment arrived, everyone knew exactly what to do in order to save these three lives.

That’s why we are among the best in the country at what we do." About Lucile Packard Children's HospitalCelebrating its 20th anniversary in 2011, Lucile Packard Children’s Hospital is annually ranked as one of the nation’s best pediatric hospitals by U.S. News & World Report, and is the only San Francisco Bay Area children’s hospital with programs ranked in the U.S. News Top Ten. The 311-bed hospital is devoted to the care of children and expectant mothers, and provides pediatric and obstetric medical and surgical services in association with the Stanford University School of Medicine. Packard Children's offers patients locally, regionally and nationally a full range of health-care programs and services, from preventive and routine care to the diagnosis and treatment of serious illness and injury.

For more information, visit http://www.lpch.org/index.html. About The Stanford University School of MedicineThe Stanford University School of Medicine consistently ranks among the nation’s top medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://mednews.stanford.edu/.

The medical school is part of Stanford Medicine, which includes Stanford Hospital & Clinics and Lucile Packard Children’s Hospital.

For information about all three, please visit http://stanfordmedicine.org/about/news.html.