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Transplant Error

Aired February 20, 2003 - 10:02   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DARYN KAGAN, CNN ANCHOR: We now turn to our top story, a life- or-death operation in North Carolina. Doctors say that 17-year-old Jesica Santillan has a 50-50 chance of surviving her second transplant surgery in just two weeks. Those are greatly improved odds for a girl who yesterday who was not expected to survive.
Our medical correspondent Elizabeth Cohen is monitoring the surgery. She's at Duke University Hospital in North Carolina. Having just arrived on the scene, and she will join us now by the phone.

Elizabeth, good morning.

ELIZABETH COHEN, CNN CORRESPONDENT: Good morning, Daryn.

Daryn, a family spokesman says that Jesica is barely hanging on. The surgery began at 5:30 a.m. to give her a new heart, a new set of lungs. You can bet that this time they double and tripled checked to make sure it was the right type. The original set of heart and lungs that she received were a type a, and she is a type o, and the body immediately began to reject the organs. As you said, they're giving her a 50/50 chance of survival, so she is still in surgery, and we'll let you know what they say once she is out of surgery -- Daryn.

KAGAN: Elizabeth, how long did they expect the surgery will take?

COHEN: I think that's unknown at this time, Daryn.

KAGAN: Do we know anything about the donor? I know these matters very confidential, but in this case, perhaps they are releasing information?

COHEN: No, they're not releasing information about the donor.

KAGAN: All right, Elizabeth Cohen, we will check back with you in North Carolina.

Right now for more insight on the transplant surgery now under way, our medical correspondent Dr. Sanjay Gupta joining us from Kuwait. About to get on the plane, but we held the plane so that we can get some more information.

Sanjay, hello.

SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: How are you doing, Daryn? It's been an interesting story, certainly -- I am sorry, go ahead, Daryn. KAGAN: No, you go ahead with your thought, please.

GUPTA: Yes, February 7th, the first operation taking place, as Elizabeth just mentioned, type o is the girl, type a were the organs. That is a problem. Several things that actually go into checking organ transplants before someone actually gets on the list.

Take a look at some of criteria. Certainly compatibility, including blood type, being one of the most important criteria. Also looking at how the health of the recipient and the health of the donor. Both of those things important as well, and also, just simply size. If you have someone who's too small or too large of the organs they are about to receive, sometimes that doesn't work.

Daryn, there's a lot of different factors that go into play here. I talked to a couple of friends who are transplant surgeons. When these list are created, it's possible that Jesica who is type o, placed on a type a list, which may have been the problem in the first place. Organs are typically typed again before they are actually -- the transplant actually takes place. Don't know if that actually occurred in this case -- Daryn.

KAGAN: Actually, at this point, could we tell would be at fault, Sanjay. Is it the surgeon whose responsibility is to check before this happens, or the donor agency that was coordinating this donation in the first place?

GUPTA: Well, you know, it is very difficult to assign blame right now, Daryn, although, a good question. Like I said, there are so many different factors that go into play here, and this is such a rare occurrence, it's going to require some investigation typically to find out what happens.

Let me tell you this, there are specific protocols that take place. The recipients blood is typed. That's first thing that actually takes place, when determining where on the list, which list, that person is actually going to be placed. For instance, in this case, Jessica being type o, already around the country, there are several centers that are looking at their type-o patients that may become organ donors.

If she was inadvertently placed on the type a list, the same process would have been taking place, except on the type-a list, and, Daryn, let me just point out some numbers as well. I think this is an important point. If you look the at number of people who are really waiting for organ transplants around the country, they had about 80,429 waiting. That was actually as of 7:30 this morning; 22,739 transplants were performed. You get a sense of just how many people were waiting and won't get organ transplants. If you look at heart and lung specifically, 199 waiting, about 55 performed over the last year or so, again, about four times as many people waiting as transplants actually performed -- Daryn.

KAGAN: And just finally, Sanjay, the challenges medically that Jesica faces right now. Clearly, she was a very sick teenager before she got the first transplant, near death before this one. She has quite a challenge ahead of her, does she not?

GUPTA: Yes, you know, you know, you are absolutely right. She was critically ill before the first operation, again two weeks ago on February 7th. She is a lot sicker now, Daryn, quite simply. Her heart and lungs didn't work. They started rejected immediately even before she left the operating room. She's been on heart and lung st support for quite some time.

A good piece of news is they also scanned the brain, as sometimes someone in that situation can develop a stroke. She did not have any evidence of that. That's a very good sign. She desperately needs these organs, because if she doesn't get them, her other organs will start to decompensate, not work as well, and that could possibly be a very serious problem.

Paradoxically as well, Daryn, let me just say, while she needs an operation very much, it is very difficult to actually put someone like her under general anesthesia. That presents a whole new set of risk to the organs, to the heart and lungs that are in existence right now, all those sorts of things, so in a paradoxical way, while she needs the operation the most, she's also one of the most difficult patients to operate on.

So these next few hours are going to very touch and go, I imagine, for the surgeons who are operating there.

Sanjay, we're just getting this bit of breaking news from the Associated Press. The family's lawyer, Jesica's family lawyer, has come out and said her new heart, the second transplanted heart is in, and it's beating on its own, and that is good news indeed. So that news coming from the Associated Press. We will keep you updated on Jesica's condition.

GUPTA: Yes, very good news indeed. No question. And the lungs as well. She is going to need immunosuppressive drugs after this. A long road ahead, still, but that certainly is very good news.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com






Aired February 20, 2003 - 10:02   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DARYN KAGAN, CNN ANCHOR: We now turn to our top story, a life- or-death operation in North Carolina. Doctors say that 17-year-old Jesica Santillan has a 50-50 chance of surviving her second transplant surgery in just two weeks. Those are greatly improved odds for a girl who yesterday who was not expected to survive.
Our medical correspondent Elizabeth Cohen is monitoring the surgery. She's at Duke University Hospital in North Carolina. Having just arrived on the scene, and she will join us now by the phone.

Elizabeth, good morning.

ELIZABETH COHEN, CNN CORRESPONDENT: Good morning, Daryn.

Daryn, a family spokesman says that Jesica is barely hanging on. The surgery began at 5:30 a.m. to give her a new heart, a new set of lungs. You can bet that this time they double and tripled checked to make sure it was the right type. The original set of heart and lungs that she received were a type a, and she is a type o, and the body immediately began to reject the organs. As you said, they're giving her a 50/50 chance of survival, so she is still in surgery, and we'll let you know what they say once she is out of surgery -- Daryn.

KAGAN: Elizabeth, how long did they expect the surgery will take?

COHEN: I think that's unknown at this time, Daryn.

KAGAN: Do we know anything about the donor? I know these matters very confidential, but in this case, perhaps they are releasing information?

COHEN: No, they're not releasing information about the donor.

KAGAN: All right, Elizabeth Cohen, we will check back with you in North Carolina.

Right now for more insight on the transplant surgery now under way, our medical correspondent Dr. Sanjay Gupta joining us from Kuwait. About to get on the plane, but we held the plane so that we can get some more information.

Sanjay, hello.

SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: How are you doing, Daryn? It's been an interesting story, certainly -- I am sorry, go ahead, Daryn. KAGAN: No, you go ahead with your thought, please.

GUPTA: Yes, February 7th, the first operation taking place, as Elizabeth just mentioned, type o is the girl, type a were the organs. That is a problem. Several things that actually go into checking organ transplants before someone actually gets on the list.

Take a look at some of criteria. Certainly compatibility, including blood type, being one of the most important criteria. Also looking at how the health of the recipient and the health of the donor. Both of those things important as well, and also, just simply size. If you have someone who's too small or too large of the organs they are about to receive, sometimes that doesn't work.

Daryn, there's a lot of different factors that go into play here. I talked to a couple of friends who are transplant surgeons. When these list are created, it's possible that Jesica who is type o, placed on a type a list, which may have been the problem in the first place. Organs are typically typed again before they are actually -- the transplant actually takes place. Don't know if that actually occurred in this case -- Daryn.

KAGAN: Actually, at this point, could we tell would be at fault, Sanjay. Is it the surgeon whose responsibility is to check before this happens, or the donor agency that was coordinating this donation in the first place?

GUPTA: Well, you know, it is very difficult to assign blame right now, Daryn, although, a good question. Like I said, there are so many different factors that go into play here, and this is such a rare occurrence, it's going to require some investigation typically to find out what happens.

Let me tell you this, there are specific protocols that take place. The recipients blood is typed. That's first thing that actually takes place, when determining where on the list, which list, that person is actually going to be placed. For instance, in this case, Jessica being type o, already around the country, there are several centers that are looking at their type-o patients that may become organ donors.

If she was inadvertently placed on the type a list, the same process would have been taking place, except on the type-a list, and, Daryn, let me just point out some numbers as well. I think this is an important point. If you look the at number of people who are really waiting for organ transplants around the country, they had about 80,429 waiting. That was actually as of 7:30 this morning; 22,739 transplants were performed. You get a sense of just how many people were waiting and won't get organ transplants. If you look at heart and lung specifically, 199 waiting, about 55 performed over the last year or so, again, about four times as many people waiting as transplants actually performed -- Daryn.

KAGAN: And just finally, Sanjay, the challenges medically that Jesica faces right now. Clearly, she was a very sick teenager before she got the first transplant, near death before this one. She has quite a challenge ahead of her, does she not?

GUPTA: Yes, you know, you know, you are absolutely right. She was critically ill before the first operation, again two weeks ago on February 7th. She is a lot sicker now, Daryn, quite simply. Her heart and lungs didn't work. They started rejected immediately even before she left the operating room. She's been on heart and lung st support for quite some time.

A good piece of news is they also scanned the brain, as sometimes someone in that situation can develop a stroke. She did not have any evidence of that. That's a very good sign. She desperately needs these organs, because if she doesn't get them, her other organs will start to decompensate, not work as well, and that could possibly be a very serious problem.

Paradoxically as well, Daryn, let me just say, while she needs an operation very much, it is very difficult to actually put someone like her under general anesthesia. That presents a whole new set of risk to the organs, to the heart and lungs that are in existence right now, all those sorts of things, so in a paradoxical way, while she needs the operation the most, she's also one of the most difficult patients to operate on.

So these next few hours are going to very touch and go, I imagine, for the surgeons who are operating there.

Sanjay, we're just getting this bit of breaking news from the Associated Press. The family's lawyer, Jesica's family lawyer, has come out and said her new heart, the second transplanted heart is in, and it's beating on its own, and that is good news indeed. So that news coming from the Associated Press. We will keep you updated on Jesica's condition.

GUPTA: Yes, very good news indeed. No question. And the lungs as well. She is going to need immunosuppressive drugs after this. A long road ahead, still, but that certainly is very good news.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com