Posts Tagged ‘ surgery ’

Hand Transplants for Kids Pioneered at Boston Hospital

Wednesday, June 19th, 2013

A hand transplant program is under development at Boston Children’s Hospital, and researchers say it will lead the field in offering face transplants and other radical surgeries that can greatly improve the quality of life for children.  More from NBC News:

The move shows the growing willingness to do transplants to enhance a patient’s life rather than to save it as donated hearts, livers and other organs have done in the past. More than 70 hands and at least 20 faces have been transplanted in adults, and doctors say it’s clear these operations are safe enough to offer to children in certain cases, too.

“We feel that this is justifiable,” said Dr. Amir Taghinia, who will lead the pediatric hand program at Boston Children’s Hospital.

“Children will potentially benefit even more from this procedure than adults” because they regrow nerves more quickly and have more problems from prosthetic hands, he said.

Only one hand transplant is known to have been done in a child — a baby in Malaysia in 2000. Because the donor was a twin who died at birth, her sister did not need to take drugs to prevent rejection.

That’s the main risk in offering children hand transplants — the immune-suppressing drugs carry side effects and may raise the risk of cancer over the long term.

However, one independent expert thinks the gains may be worth it in certain cases.

“We understand so much more about immune suppression” that it’s less of a risk to put children on the drugs, said Dr. Simon Horslen, medical director of the liver and intestine transplant program at Seattle Children’s Hospital. “This is never going to be done as an emergency procedure, so the families will have plenty of opportunity to weigh the options.”

Also, a hand can be removed if rejection occurs, and that would not leave the child worse off than before the transplant, Horslen said.

Image: Child’s hand in hospital, via Shutterstock

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Ectopic Pregnancy Treatments Found to Protect Fertility

Tuesday, March 19th, 2013

The three main methods that are used to treat ectopic pregnancies–when an embryo implants in a woman’s fallopian tube instead of in her uterus–are equally helpful in preserving that woman’s chances of becoming pregnant in the future, according to a new study published in the journal Human Reproduction.  More from The New York Times:

Ectopic pregnancies can be ended by administration of a drug, methotrexate; conservative surgery that preserves the fallopian tube; or radical surgery that removes it. Methotrexate may be used alone or combined with surgery….

….Within two years [of undergoing one of the three treatments], 67 percent of the women who had the drug alone became pregnant again, compared with 71 percent of those who had the medicine and conservative surgery. In the other group, pregnancy rates were 70 percent after conservative surgery with methotrexate, compared with 64 percent after radical surgery. None of these differences was statistically significant.

“The message is that women should be reassured that removing the fallopian tube does not affect future fertility,” said an author of the study, Dr. Perrine Capmas, an obstetrician at Bicêtre Hospital in Le Kremlin-Bicêtre, near Paris. “It’s important to take into account other factors — the woman’s preference, for example — because fertility will be the same whatever treatment is used.”

Image: Doctor, via Shutterstock

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Complexities of Surrogacy, Abortion, and Law Highlighted in Multi-State Case

Wednesday, March 6th, 2013

Surrogate pregnancy is not uncommon, and it usually ends well for all involved.  But a story out of Connecticut and Michigan is almost operatic in its complexity, drama, and high stakes.  CNN.com tells the story of Crystal Kelley, who acted as a gestational carrier to a Connecticut couple who wanted a fourth child and had frozen embryos from previous in vitro fertilization cycles.

Kelley became pregnant, but a routine ultrasound uncovered a number of severe birth defects in the fetus, including brain and heart abnormalities as well as a severely cleft lip and palate.  The biological parents, on hearing the news, wanted Kelley to terminate the pregnancy, but Kelley refused.

After a legal battle erupted–the contract Kelley had signed stipulated “abortion in case of severe fetus abnormality,” but didn’t specify what that meant–the biological parents said they wanted to take custody of the child at birth and then turn her over to Connecticut’s state-run foster care system.  The case became even more complicated when it was discovered that the couple had used an anonymous egg donor to make the embryo.

Kelley, disturbed by all options on the table, fled to Michigan, where she would be considered to be the baby’s mother under that state’s laws.

While in Michigan, Kelley gave birth to the girl and found adoptive parents for her.  From CNN:

Baby S. — her adoptive parents are comfortable using her first initial — has a long road in front of her. She’s already had one open-heart surgery and surgery on her intestines, and in the next year she’ll need one or two more cardiac surgeries in addition to procedures to repair her cleft lip and palate. Later in childhood she’ll need surgeries on her jaw and ear and more heart surgeries.

Her adoptive parents, who asked to remain anonymous to protect their family’s privacy, know Baby S. might not be with them for long. The cardiac procedures she needs are risky, and her heterotaxy and holoprosencephaly, though mild, carry a risk of early death, according to doctors.

If Baby S. does survive, there’s a 50% chance she won’t be able to walk, talk or use her hands normally.

In some ways, Baby S. looks different from other 8-month-olds babies. In addition to the facial abnormalities, she’s very small, weighing only 11 pounds and she gets food through a tube directly into her stomach so she’ll grow faster.

Her adoptive parents know some people look at her and see a baby born to suffer — a baby who’s suffering could have been prevented with an abortion.

But that’s not the way they see it. They see a little girl who’s defied the odds, who constantly surprises her doctors with what she’s able to do — make eye contact, giggle at her siblings, grab toys, eye strangers warily.

“S. wakes up every single morning with an infectious smile. She greets her world with a constant sense of enthusiasm,” her mother said in an e-mail to CNN. “Ultimately, we hold onto a faith that in providing S. with love, opportunity, encouragement, she will be the one to show us what is possible for her life and what she is capable of achieving….”

….Just as there are two ways to look at Baby S., there are two ways to look at Crystal Kelley, the woman who carried her.

In one view, she’s a saint who fought at great personal sacrifice for an unborn child whose own parents did not want her to live. In another view, she recklessly absconded with someone else’s child and brought into the world a baby who faces serious medical challenges when that wasn’t her decision to make.

Image: Pregnant woman in hospital, via Shutterstock

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Baby Born with Serious Heart Defect Leaving Hospital

Friday, January 25th, 2013

Audrina Cardenes, a three-month-old Texas baby born with a rare and usually fatal condition called ectopia cordis, in which the child is born with all or part of the heart outside the body, is going home.  Though 90 percent babies born with ectopia cordis die within days or are stillborn, doctors are “optimistic” after Audrina’s surgery to put her heart back into her chest.  More from the New York Daily News:

Two months after her operation to place her heart back inside her chest, the baby is now ready to leave the hospital and go home with her family.

“Audrina is a true fighter and we are hopeful that she will continue to progress,” Audrina’s surgeon, Dr. Charles D. Fraser, said shortly after the risky operation. “I am also hopeful that Audrina’s case marks the beginning of our ability to care for more children diagnosed with ectopia cordis in the future.”

 

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Conjoined Twins Recovering After Separation Surgery

Thursday, December 27th, 2012

A set of 8-month-old twin girls who were conjoined at the chest, sharing a diaphragm, pericardium, and liver, are recovering after major surgery to separate them.  From NBC News:

“Both Allison and Amelia are doing well, and we expect them both to enjoy full, healthy and independent lives,” said Dr. Holly L. Hedrick, the pediatric general, thoracic and fetal surgeon who led the 40-member multidisciplinary team that carried out the complex separation early last month. It was the 21st time that The Children’s Hospital of Philadelphia (CHOP) has separated a pair of conjoined twins.

Allison is home with her parents now, while Amelia remains in the hospital.

“The separation was successful because of the bravery of the family and the team,” Hedrick said Thursday. ”I’m convinced that Allison, the smaller twin, is the tougher one. She was the first to have her drainage tube removed and first to be discharged. Amelia also tough but a little more laid back. She’s the larger twin but she’s had a more challenging recovery. But she’s improving every day.”

The sisters love being held and love being together, their mother said.

“Once they are held they are happy. When they get together they are totally different babies. You can tell they are happy and relieved to be with their sister,” Shellie Tucker said. She seemed to agree with Hedrick’s take on her daughters’ personalities: “Allison is the feisty one, like her brother… kind of loud. Amelia is laid back, very serious. But once she relaxes she welcomes you with smiles every time.”

Image: Surgeons, via Shutterstock

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