|
A confluence of events, choices by grieving parents and skills at the NU Medical Center bring about the miracle of four liver transplants in one hectic evening. by Patrick Strawbridge Omaha-World-Herald Nov. 11, 2001 Last week, four young children died. They died in hospitals in separate parts of this country, under varying circumstances. They died despite the efforts of doctors and the hopes of their families. Their lives ended, and this story begins. It is a story of the overlap between coincidence and miracle. It is a story of hard work and long hours, of speed and precision. It is the story of how four children ended up receiving liver transplants, and a second chance at life, in one extraordinary night at the University of Nebraska Medical Center. Making the story even more noteworthy is the fact that two of the children also received small-bowel transplants. It started on Nov. 4, at about 7:30 p.m. That's when Kolleen Thompson received word that a liver had become available. Thompson, who manages the Nebraska Health System Organ Recovery Services, worked to dispatch a team of surgeons to harvest the liver and bring it to Omaha. Then came another call. And another. And a fourth. Four livers were ready for transplantation. Four children were going to get the chance their parents had prayed for. For that to happen, however, the staff, nurses and surgeons at the Medical Center were going to have to get to work. Thompson and her associates quickly assembled two teams of doctors to recover the organs. Two jets were chartered and dispatched with the teams on board. Confidentiality rules prevent hospital staff from saying where the organs were, but the recovery teams traveled to three states. Arrangements were made to return the first harvested organs on the jets, while the doctors took new flights to get to the next assignment. "As soon as they would finish one case, they'd start moving to the next hospital," Thompson said. As the recovery teams worked into the early morning hours, a new round of calls was going out. At 5:05 a.m. Monday, a phone in Grand Rapids, Mich., began to ring. It was the telephone call Dusty McAllister will remember for the rest of her life. McAllister's daughter, Adrianna Gammon, had been on the waiting list for a liver transplant for nearly a year. When Adrianna was born, her bowels were outside her body. Her digestive system was devastated. She spent 12 of the first 15 months of her life in the hospital. The only food she was ever given came through a tube. McAllister, 26, watched her daughter struggle to live. As Adrianna's condition worsened, her skin grew as yellow as a legal pad. The whites of her eyes took on a greenish hue. "It's the hardest torment you can think of," McAllister said. "You know that if you don't get the transplant, your child is going to die." When McAllister heard the voice on the other end of the line and realized what it was telling her, all she could say was: "Oh my God, thank you." Then, crying, she began to throw her things together. Elsewhere, three other families were receiving the same joyous news, making the same hurried arrangements. They were going to Omaha. Back at the Medical Center, Shelly Schwedhelm and her staff were scanning the day's schedule. As director of surgical services at NHS, Schwedhelm's job was to prepare the staff and operating rooms needed for the transplants. "Around 3 p.m., it became evident: We were going to have quite a few issues," she said. Some elective surgeries scheduled for the day had to be moved to other NHS facilities. Day-shift staffers were asked to stick around to help. On-call assistants were summoned. "We were using everyone," she said. The organs arrived in good shape, as did the patients. The oldest child receiving a transplant was younger than 5; the other three were younger than 2. The last rounds of pre-op tests were run. One by one, the patients were prepared for surgery. Dr. Byers Shaw Jr. began the first liver-small bowel transplant at 5:49 p.m. Dr. Deb Sudan started the next liver transplant within an hour. At 8:15 p.m., Dr. Kishore Iyer began the other liver-small bowel transplant. Dr. Alan Langnas went into surgery at 11:26 p.m. with the final case. In the waiting room, four families had watched their ailing children wheeled away. After months of waiting on the transplant list, now the hours of surgery stretched out, one minute at a time. "You don't know what you're doing," McAllister said. "Everything's been going so fast, and now it slowly plays out." In the operating rooms, everything was in place. It was not unusual to have two transplant surgeries on one night, but to have four going at once - all on small children - was exceptional, said Langnas. "We've been doing this for so long, we have so many experienced people around us," he said. "It was just a matter of calling on people's good nature. Everybody understands the reasons we ask them to do it. We're trying to save lives." The last surgery ended at 6 a.m. Tuesday. All the early signs were good, although the children remain in critical condition and will be watched closely for complications or signs of rejection in the coming weeks. McAllister said Adrianna is "doing great" after the procedure. The surgeons, anesthesiologists, nurses and staff are feeling pretty good, too. "It takes an unbelievable amount of teamwork," Schwedhelm said. Said Thompson: "I've never seen anything like it. It was something to remember." For Langnas, the most important part of the story was the beginning. Four families, stricken by the deaths of four young children, made a choice. "They're heroes," he said. "They agreed to organ donation to allow other children an opportunity at life. When you get down to it, those families really did a special thing." |
