Second Transplants For Patients Not As Rare As They Are Risky
Posted February 20, 2003
RALEIGH, N.C. — Although they are rare, second heart-and-lung transplants for individual patients aren't unheard of.
But they do carry additional risks, especially in Jesica Santillan's case.
Family and friends called Santillan's second transplant a miracle on Thursday. According to doctors, the four-hour transplant procedure was a success just less than two weeks after Santillan's body rejected the first transplant operation.
Santillan wasn't the first person to receive a second heart-lung transplant. According to the United Organ Sharing Network, 10 people received repeat heart-lung transplants between 1988 and November 2002, including one at Duke Medical Center.
"It's very uncommon, certainly, to do a repeat heart-lung transplantation," Dr. Kenneth McCurry said.
Dr. McCurry directs the Heart Lung Transplant Program at the University of Pittsburgh Medical Center, which has performed four repeat transplants.
McCurry said "redo's" carry additional risks, especially if it's been a while since the patient's first transplant.
"They have a lot of scar inside their chest," McCurry said. "It increases the complexity of the operation a great deal."
Second transplants are technically easier when done soon after the first one.
"Because they would have done all the dissection the first time," McCurry said, "to separate the tissues to get out all of the structures and things that they needed to."
Santillan's chances of survival depend on how much her other organs were damaged and how quickly they recover. There's also the threat of infection.
"If she's able to get through these next few days, to a week to two weeks or so, and ultimately does well," Dr. McCurry said, "her chances of doing as well as first-time transplant recipients will hopefully be pretty comparable to that."
Dr. McCurry added that, if Santillan makes it through this critical window, her risk of rejection would be about that of someone who received just one transplant.
Every 13 minutes, a name is added to the national transplant waiting list.
The organ matching process involves several steps. After an organ is donated, the donor's information is entered into the Organ Center's national database, generating a list of patients who match the donor.
The hospital with the top patient on the list is notified. The transplant team then decides whether to accept or reject the organ.
Seventy-five percent of heart-lung transplant patients live at least one year. Fifty percent survive three years or more.