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17-year-old girl gets organs with wrong blood type

Wednesday, February 19, 2003

DURHAM, N.C. -- A 17-year-old girl lay near death Tuesday after mistakenly receiving a heart and lung transplant from a donor with the wrong blood type, and hospital officials held out little hope of finding a new set of organs in time.

Jesica Santillan's condition steadily deteriorated after the botched operation Feb. 7. She suffered a heart attack Feb. 10 and a seizure on Sunday, and was in critical condition with a machine keeping her heart and lungs going.

"Right now my daughter is between life and death. She could die at any moment," her mother, Magdalena Santillan, said in Spanish through an interpreter. "My daughter needs a transplant of a heart and lungs to survive. It's the only hope that we have because the doctors made an error."

A family friend said the girl has only a few days left.

The girl has type O-positive blood but was given organs from a donor with type-A blood during the operation at Duke University Hospital.

Hospital spokesman Richard Puff said he could not specify how the mistake was made. But he said that the hospital staff believed the organs were compatible and that compatibility had been confirmed.

Jesica's body was rejecting the new organs because of the different blood types. Antibodies in her blood attacked the organs as foreign objects.

Slim hopes

Puff said the girl is a candidate for another transplant and "we remain hopeful that will happen." But he said the hospital can do little to improve her odds.

"We're going through the usual system of transplant agencies. That's all we can do," he said.

Jesica remained on the national waiting list kept by the United Network for Organ Sharing. Spokeswoman Anne Paschke said the national organ procurement group cannot specifically search for a heart and lungs for Jesica.

"Unfortunately, there are very few organs available," Paschke said. The organs not only have to be the right blood type, they have to be the right size to fit into the girl's chest cavity.

Mack Mahoney, the family friend, said Jesica is small for her age -- 5-foot-2 and 85 pounds -- and any donated organs would probably come from a child.

"We have a good chance of saving this child's life if we find a donor in the next couple of days," he said.

In the meantime, he said, the life-support apparatus was hurting Jesica, raising the danger of bleeding, stroke and kidney damage.

Jesica, who is from a small town near Guadalajara, Mexico, needed the transplant because a heart deformity kept her lungs from getting oxygen into her blood. Mahoney said she would have died within six months without a transplant.

The donated organs were flown in from Boston. They were sent with paperwork correctly listing the donor's type-A blood, said Sean Fitzpatrick of the New England Organ Bank, which sent the organs.

The hospital's chief executive, Dr. William Fulkerson, said it was still investigating how the mistake happened and whether any staff members should be disciplined. He said the hospital will add new confirmation requirements to ensure organ compatibility.

"This was a tragic event and our expectation is that, with these new procedures, this will not happen again," said Puff, the hospital spokesman. "We've done thousands of organ transplants and it's never happened before."

Organ network spokesman Bob Spieldenner said he knows of two similar cases in the past decade, both at Oregon Health Sciences University, now called Oregon Health and Science University.

In 1991, the hospital put a heart with the wrong blood type into a patient, but discovered the error. It gave him another heart and he survived. Three years later, surgeons opened the chest of a 15-year-old boy for a heart transplant, but discovered the organ was the wrong blood type and closed him up. The boy died 10 days later.

Heart and lung transplants are rare for teenagers: In the first 11 months of last year, there were four nationwide for children between the ages of 11 and 17, UNOS' records show. The previous year, there were four.

The Santillans moved to North Carolina nearly three years ago from Tamazula.

Mahoney, a businessman in Louisburg, got involved after he read news reports of the girl's ailment and her family's lack of money. He and his wife joined community efforts to raise money to pay for her medical care, and Jesica's parents gave Mahoney power of attorney for their daughter.

"I've been trying to save this girl's life," Mahoney said. "It's been a fight all the way."

Relatives said the girl's mother asked Mexican doctors about the possibility of an organ transplant in Mexico but was told it would be a long wait.

"The last we heard, she was getting much better, she wasn't fainting anymore," the girl's aunt, Ramona Santillan, said in an interview in Tamazula, 275 miles west of Mexico City.

"At that point my sister didn't want the operation anymore," she said. "But then the doctors told her they had a heart that would help her. Only it wasn't true."


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