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CNN LIVE EVENT/SPECIAL

Transplant Triumph

Aired February 20, 2003 - 13:29   ET

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

KYRA PHILLIPS, CNN ANCHOR: A news conference updating Jesica's condition is expected to start any minute now. CNN will bring that to you live right here from Durham, North Carolina.
Actually, it looks like they are stepping up to the podium. Let's listen in.

UNIDENTIFIED MALE: We are handing out right at this time a news release for all of you to have which gives you a little bit of information on her update. Also, some other information that you will find that will be useful.

We are going to begin this update this afternoon with Dr. William Fulkerson, a doctor here at Duke University Medical Center. He's the CEO of Duke University Hospital. We'll also have Dr. Duane Davis. He's director of the thoracic transplantation service here at Duke University Medical Center. He's associate director of surgery, and he did participate this morning in Jesica's surgery.

Before we begin, and Dr. Fulkerson has some comments to make to you, we did want to tell you very quickly the family has asked for donation requests. They have some specific things here, because there have been so many people calling in throughout United States trying to offer money, other things to donate. Some of the information I'll give to you now. The rest I'll give to you at the end of the update so you can use this information to use this in your newspapers, radio, television whatnot.

The family's requested that donates go to primarily the Duke Chaplain's Fund, the Ronald McDonald House, the Jesica Santillan Fund, care of CCB Bank, and last, but not least, is Jesica's Hope Chest.

At this time, I'd like to introduce, Dr. William Fulkerson. He is CEO of Duke University Hospital. He will be making some opening comments. He'll be followed by Dr. Duane Davis. After that, we will be taking a limited amount of questions from the audience to try to give you some more details of Jesica's surgery this morning -- Dr. Fulkerson.

DR. WILLIAM FULKERSON, CEO, DUKE UNIV. HOSPITAL: Thank you. I'm just going to take a minute and make a statement from the statement that's been handed out to you by Mr. Multer (ph). So if you want to follow me along with that, you can. I just want to make a few introductory comments about the events of the past 24 hours.

Jesica is now back in the pediatric intensive care unit at Duke Hospital. She underwent a four-hour operation this morning in the heart/lung transplant procedure. Her physician's said the procedure went as expected, and she remains in critical condition in the intensive care unit now.

I want to speak for Duke Hospital and all of the doctors and nurses and other members of the health care team that have been taking care of her, to say we are grateful organs became available for Jesica.

Our heart, of course, goes out to the family of the donor, because of their loss. Just to give you some ideas of the events that occurred last night, the transplant process began some time before Midnight Eastern Standard Time, when Dr. Jaggers (ph) was contacted by Carolina Donor Services and told that compatible organs were available for Jesica. The procedure for ensuring compatible was completed, and the surgical team discussed the situation with Jesica's family and support, friends shortly after midnight, I believe. And consent was obtained to proceed with the transplant procedure. At about 5:15 this morning, Jesica was taken to the operating room. The operation began about 6:00, and was completed at approximately 10:15 this morning.

The family of course received updates throughout the course of the surgery. And as I said initially, Jessica's now back in the intensive care unit, receiving aggressive support by her team of doctors, nurses and other folks on the health care team here at Duke.

As I said in earlier statements and interviews, and as you know, Jesica originally received a transplant here at Duke on February 7th, but because of a mismatch and incompatibility of the organs, the organs were being rejected by Jesica's body. We've identified errors that occurred, and additional reviews of the events leading up to the mismatch are ongoing.

As a result of the investigation so far, we have put in place additional procedures in order to prevent these kinds of errors from ever happening again in the future. As a result of these new processes and procedures, three additional physicians involved in the organ compatibility process, confirmed compatibility before the transplant this morning.

Dr. Jaggers (ph) performed both of Jesica's transplants. He is in the intensive care unit now, directing her care. Duane Davis, my colleague here, is the surgical director of our transplant program, thoracic transplant program, and he assisted in the second transplant this morning, due to Jesica's medical complexities.

This has been a very difficult and a heart-wrenching time for many people here at duke. It certainly has resulted in an intense reexamination of internal controls in transplantation. I also hope that we can use this event, as tragic as it has been, to re-emphasize the need for organ donations in the country, and indeed throughout the world. And we sincerely hope through the widespread appeal for organs for Jesica that more individuals and families will be considering becoming organ donors.

If people across America can take the time today to consider becoming an organ donor, not one, but several patients and their families will benefit from their actions.

I want to step aside and ask Dr. Davis to make a few comments, and then, as Jeff said, we'll entertain questions.

Thank you.

DR. DUANE DAVIS, CARDIOTHORACIC SURGEON: I'll keep my comments extremely brief. But Dr. Jaggers (ph) and I performed the heart/lung transplant this morning, took about four hours. Technically, it went well. She was removed from the heart/lung bypass machine without difficulties, and the organs are performing as we would expect. She was transferred back to the intensive care unit. Dr. Jaggers (ph) is taking care of her there now.

Dr. Jaggers (ph) and I would personally like to thank and express our personal gratitude to the family of the donor and our heart really goes out to them at their time of grief.

And as Dr. Fulkerson has expressed, there are over 80,000 people in the United States waiting for organ transplants at this point. Every one donor can often benefit literally tens of people, some of those in a life-saving fashion, and I'm hoping the events that were tragic can lead to some good from that standpoint.

I think we'll entertain questions.

UNIDENTIFIED MALE: We have a little bit of time for questions. If you would like to ask a question of either Dr. Fulkerson or Dr. Davis, direct it at either one of the gentleman, and also identify what media you're from.

Yes?

DAVIS: No, we can't actually tell you anything about the donor. In a lot of ways, this is the whole aspect of the donor process. This is a family that has made probably one of the greatest gifts that you can ever give, and at their time of grief they were able and willing to do that, and their privacy is utmost.

If they wish to have contact with Jesica's family and vice versa, there are pathways in which that can occur. And if the family, the donor family wishes to come forth, that's up to them.

In terms of actually how the process works, it goes through very systemic approach. When somebody is declared brain dead, and there is consent to donation, then the organs are offered through a UNOs (ph) pathway. We heard about them through the Carolina Donor Service. Obviously, Jesica was in desperate need, and it was an appropriate blood, size, and type match. It came through routine pathways.

Yes, sir?

FULKERSON: Let me just restate your question. You want to know what the critical time is between when a donor is identified or...

I'll refer to dr. Davis. DAVIS: Yes, I really can't give you an exact timeframe. She will be monitored extremely carefully. There is a team of physicians and nurses that will be taking care of her. She will essentially let us know when she is out of the critical period. She has a number of hurdles to overcome. Our hopes and prayers are that she will overcome all those.

PHILLIPS: Dr. Duane Davis, one of two doctors that performed surgery this morning on 17-year-old Jesica Santillan. She is now recovering after having her second heart and lung transplant, in critical care now, in ICU.

Our Elizabeth Cohen also there with us. She's been monitoring the press conference out of Durham, North Carolina. Sounds so good -- well, so far so good, Elizabeth. I think a lot of people are wondering, at what point does she get out of the critical zone? Right now, in ICU. You want to know, indeed, how long it takes to see if this operation is completely successful.

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Right, that's what everyone wants to know, Kyra. In fact, there's really no way of answering that question. I was speaking to a pediatric heart/lung surgeon. She said there's really no way; the day that she walks out of the hospital, that's when you know that the critical period has ended.

There is a sobering statistic, which is that, for people Jesica's age who get a heart/lung transplant, a year later, only about half are alive. There are, unfortunately, so many things that can go wrong. Other organs can shut down. The patient can get an infection. There are things that can go wrong.

However, right now, at this stage, the doctors were happy to report that the surgery went well, that she was taken off of life support, they said, without any difficulties.

Of course they talked about the error that led to the second transplant surgery to begin with, and what they said was the error that led to the mismatched organs has been identified, but they did not elaborate about what that particular error was. They did say that this time when they did the operation, that three different physicians confirmed that this time they did have a correct match. So this time, they definitely wanted to get it right -- Kyra.

PHILLIPS: And also, the CEO of Duke Hospital, Dr. William Fulkerson, making the point that this has been, as he said, heart- wrenching and difficult for everyone at Duke, and now they are taking a hard look at their internal controls when it comes to procedures like this, right, Elizabeth?

COHEN: Absolutely. I thought it was very interesting that the family has not been expressing anger towards these surgeons. They've expressed anger at the process that led to the mistake, but the spokesman for the family said, look, they made a mistake, but we don't question the doctor's surgical skills. The whole era of medical errors, that we've all heard so much about, basically what we've learned over the years is that hospitals have systems that don't always work, or they are lacking a system to make sure that things work correctly. And here, apparently what happened is there were perhaps assumptions made, people didn't ask enough questions, and the organs were not of the same type -- Kyra.

PHILLIPS: Our Elizabeth Cohen, live at Duke University Hospital in North Carolina, thank you.

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