Pennsylvania Girl, 10, Recovering After Lung Transplant

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PHILADELPHIA
(AP) — A 10-year-old girl with cystic fibrosis was recovering from a
transplant of adult lungs after a judge's ruling expanded her options
for lifesaving surgery.

Sarah Murnaghan
underwent a six-hour surgery Wednesday at Children's Hospital of
Philadelphia, a procedure her aunt said resulted because of the larger
list of available organs.

“It was a direct
result of the ruling that allowed her to be put on the adult list,”
Sharon Ruddock said after her niece's surgery was completed
successfully. “It was not pediatric lungs. She would have never gotten
these lungs otherwise.”

She said the donor
lungs came through “normal channels” and not through the public appeals
the family made in its bid to find a compatible donor. No other details
about the donor lungs are known.

The Murnaghan
family's quest to qualify their daughter for an organ transplant
spurred public debate over how donor organs are allocated.

Her
family and the family of another cystic fibrosis patient at the same
hospital challenged existing transplant policy that made children under
12 wait for pediatric lungs to become available, or be offered lungs
donated by adults only after adolescents and adults on the waiting list
had been considered. They said pediatric lungs are rarely donated.

Sarah's
health was fading when U.S. District Judge Michael Baylson in
Philadelphia ruled June 5 that Sarah and 11-year-old Javier Acosta of
New York City should be eligible for adult lungs.

Critics
warned there could be a downside to having judges intervene in the
organ transplant system's allocation policy. Lung transplants are
difficult procedures and some say child patients tend to have more
trouble with them than adults.

During double
lung transplants, surgeons must open up the patient's chest.
Complications can include rejection of the new lung and infection.

“Her
doctors are very pleased with both her progress during the procedure
and her prognosis for recovery,” the family said in a statement. “The
surgeons had no challenges resizing and transplanting the donor lungs -
the surgery went smoothly, and Sarah did extremely well. She is in the
process of getting settled in the ICU and now her recovery begins. We
expect it will be a long road, but we're not going for easy, we're going
for possible.”

Ruddock said the family was optimistic about Sarah's recovery.

“If
everything goes perfectly, she could be out in a couple of weeks,
running down the hall,” Ruddock said. “It could take a couple of months,
it could take three weeks.”

The Murnaghan family noted that Sarah's successful surgery was the result of another family's loss:

“We
are elated this day has come, but we also know our good news is another
family's tragedy. That family made the decision to give Sarah the gift
of life – and they are the true heroes today.”

On
Wednesday, in a posting on her Facebook page, Janet Murnaghan said she
and the family were “overwhelmed with emotions” and thanked all her
supporters. She said the donor's family “has experienced a tremendous
loss, may God grant them a peace that surpasses understanding.”

Ruddock said Sarah doesn't yet know the full extent of the impact her case has had.

“She really wanted to Google herself the other day and we were like, no.”

The
Organ Procurement and Transplantation Network – the national
organization that manages organ transplants – added Sarah to the adult
waiting list after Baylson's ruling. Her transplant came just two days
before a hearing was scheduled on the family's request for a broader
injunction.

The network has said 31 children
under age 11 are on the waiting list for a lung transplant. Its
executive committee held an emergency meeting this week but resisted
making emergency rule changes for children under 12 who are waiting for
lungs, instead creating a special appeal and review system to hear such
cases.

Murnaghan's family “did have a
legitimate complaint” about the rule that limited her access to adult
lungs, said medical ethicist Arthur Caplan of the NYU Langone Medical
Center in New York.

“When the transplant
community met, they didn't want to change that rule without really
thinking carefully about it,” he said. The appeals process that was
established this week was “built on evidence, not on influence.”

He
added: “In general, the road to a transplant is still to let the system
decide who will do best with scarce, lifesaving organs. And it's
important that people understand that money, visibility, being
photogenic … are factors that have to be kept to a minimum if we're
going to get the best use out of the scarce supply of donated cadaver
organs.”


 

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