Doctors find complications as girl recovers from second heart-lungs transplant

<br>DURHAM, N.C. (AP) _ The teenager who underwent a second heart-lung transplant after the first was botched, has severe and irreversible brain injury, hospital officials said Friday. <br><br>Doctors

Friday, February 21st 2003, 12:00 am

By: News On 6

DURHAM, N.C. (AP) _ The teenager who underwent a second heart-lung transplant after the first was botched, has severe and irreversible brain injury, hospital officials said Friday.

Doctors discovered early Friday, a day after the second transplant operation, that 17-year-old Jesica Santillan's brain had swelled and was bleeding.

``Yesterday after the transplant, we were all very hopeful,'' said Dr. Karen Frush, Duke University Hospital's medical director of children's services. But now, ``the swelling in her brain is severe, severe to the point we fear it's irreversible.''

Frush and Dr. William Fulkerson, the hospital's chief executive officer, said additional tests were planned for Friday to confirm the diagnosis.

Mexican-born Jesica was near death after her body began rejecting organs she received in a transplant Feb. 7 that didn't match her blood type. Against all odds, a matching donor was found, and the second transplant was done Thursday morning.

Doctors attributed Friday's complication to the amount of time Jesica was connected to life-support machines while she awaited the second transplant, said Mack Mahoney, a leader of fund-raising efforts to pay for Jesica's care.

Frush said Jesica's transplanted heart and lungs continued to function well, though her kidneys _ also compromised by the long period she spent on life support _ were ``somewhat of an issue'' and she was on dialysis.

Jesica had a heart deformity that kept her lungs from getting oxygen into her blood. Her family moved from a small town near Guadalajara, Mexico, to a relative's home in Louisburg so she could get medical care. She spent three years on a transplant waiting list before her first surgery.

In that operation, Dr. James Jaggers implanted organs from a donor with type A blood, rather than Jesica's O-positive, a mistake Duke officials say wasn't discovered until the surgery was almost over.

Fulkerson said Jaggers wrongly assumed compatibility had been confirmed when he was offered the organs, and later failed to double-check that assumption, a violation of the hospital's procedures.

The hospital has added additional levels of verification for organ compatibility, and Fulkerson said those new procedures were followed before Thursday's surgery.

The Herald-Sun of Durham reported Friday that the second heart-lung set came from a Michigan woman who suffered a stroke. The newspaper said it knew the donor's identity, but withheld it because the donor's family had asked for anonymity. It did not give the source of its information.

Both sets of organs were donated through the United Network for Organ Sharing, a national group that helps connect donors and potential transplant patients.

Hospitals may place non-U.S. citizens on their transplant waiting lists and must give them the same priority level as citizens, but can perform no more than 5 percent of their transplants on non-citizens, said group spokeswoman Anne Paschke.

``We want to make sure that with such a scarcity of organs that we take care of people in the U.S.''