The 10 year old Pennsylvania girl, Sarah Murnaghan, who had both longs transplanted using adult lungs has since developed pneumonia. Doctors believe that the infection resulted from “aspirations from her belly.” This occurs when stomach contents enter the lungs.
Sarah has been a patient at Children’s Hospital of Philadelphia for months, suffering from end-stage cystic fibrosis. This is a chronic genetic disorder that causes the build-up of sticky mucus in the lungs, pancreas, and other organs. She was a top candidate to receive an organ from a child donor. However there were no child lungs available. Her parents sued to have the national transplant policy changed.
Sarah’s family fought hard to allow children to be eligible for adult lungs, allowing them to compete with adults on the waiting list for lungs based on sickness. This push for changes in the organ transplant policy resulted in the Organ Procurement and Transplant Network’s executive committee to approve a one year change to their policy, allowing for children under the age of 12 to be eligible for the adult lung transplant lists.
There are several factors that determine where someone is placed in line on the adult list, such as distance from donor to the potential recipient, an allocation score that is determined by a patient’s diagnosis and test results, and the blood type of the patient. In order for adult lungs to be transplanted into a child, they need to be modified.
Sarah received an adult set of lungs on June 12th. However they failed within hours of the transplant. She needed to stay on a ventilator until a new set of lungs became available for a second surgery. This occurred on June 15th. Her mother claims that the lungs used for the second lung transplant were infected with pneumonia. However, doctors had already removed the infected portion of the lungs prior to transplant and Sarah’s condition was too serious to wait for a third set of lungs to become available.
The second transplant was more successful, with Sarah being able to breathe a few breaths on her own after the removal of the breathing tube. However, she had to once again go on the ventilator due to diaphragm paralysis. According to Sarah’s mother, this is a common complication that prevents the full expansion of the lungs. Another surgery was performed to repair the diaphragm on July 2nd.
Cystic fibrosis patients have the typical life expectancy of 37 years. This continues to rise due to the development of new medical advances. A patient’s life can be extended with lung transplants; however this is not a cure for the condition.
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