Medicine: Patients’ Progress

Medicine: Patients Progress
TRANSPLANTS Four little girls, bright-eyed and decked out in their best dresses,
met the press last week at Colorado General Hospital in Denver.
Ranging in age from 16 months to two years, all four were gravely ill,
and the University of Colorado doctors who described their cases
were guarded in discussing the children's prospects for recovery. But
merely by being alive, all were making medical history. They had
survived a complete liver transplant for periods ranging from 45 to 122
days, longer than any previous patient, for whom the record had been 23
days. Julie Rodriguez, from Pueblo, Colo., had liver cancer, which spread
despite surgery and drug and X-ray treatment. On July 23, Dr. Thomas
Starzl's University of Colorado transplant team removed her liver
and replaced it with one from a child killed in an accident. Julie has
since had part of a lung and another tumor removed; she may still have
cancer. But, says her mother, “she's a lot happier. She's really 100%
better. The future—we don't know. We didn't have any before. But
I've had her four months longer than I would have otherwise.” The three
other girls had no cancer, but biliary atresia—a congenital absence of
bile ducts. This behaves for all practical purposes like a
malignancy, and usually proves fatal within 18 months. Since
construction of a normal route for the bile was impossible in these
cases, the Starzl team did transplants for Paula Kay Hansen, aged 2, of
Fort Worth; Kerri Lynn Brown, 16 months, of Long Beach, Calif.; and
Carol Lynne Macourt, 16 months, of Salt Lake City. All the children
received a cortisone-type hormone to reduce the inflammatory reaction
against the transplant; when two showed severe infections, the drug was
stopped. All except Carol Macourt have suffered paralysis of the right
diaphragm. Three have had severe infections in the transplanted
livers. One had to have part of the liver removed; two more still have
open drains. Even so, said Surgeon Carl G. Groth, there is evidence
that three of the transplanted livers are regenerating.