Patients' Progress

TRANSPLANTS

Four little girls, bright-eyed and decked out in their best dresses, met the press last week at Colorado General Hospital in Denver. Ranging in age from 16 months to two years, all four were gravely ill, and the University of Colorado doctors who described their cases were guarded in discussing the children's prospects for recovery. But merely by being alive, all were making medical history. They had survived a complete liver transplant for periods ranging from 45 to 122 days, longer than any previous patient, for whom the record had been 23 days.

Julie Rodriguez, from Pueblo, Colo., had liver cancer, which spread despite surgery and drug and X-ray treatment. On July 23, Dr. Thomas Starzl's University of Colorado transplant team removed her liver and replaced it with one from a child killed in an accident. Julie has since had part of a lung and another tumor removed; she may still have cancer. But, says her mother, "she's a lot happier. She's really 100% better. The future--we don't know. We didn't have any before. But I've had her four months longer than I would have otherwise."

The three other girls had no cancer, but biliary atresia--a congenital absence of bile ducts. This behaves for all practical purposes like a malignancy, and usually proves fatal within 18 months. Since construction of a normal route for the bile was impossible in these cases, the Starzl team did transplants for Paula Kay Hansen, aged 2, of Fort Worth; Kerri Lynn Brown, 16 months, of Long Beach, Calif.; and Carol Lynne Macourt, 16 months, of Salt Lake City.

All the children received a cortisone-type hormone to reduce the inflammatory reaction against the transplant; when two showed severe infections, the drug was stopped. All except Carol Macourt have suffered paralysis of the right diaphragm. Three have had severe infections in the transplanted livers. One had to have part of the liver removed; two more still have open drains. Even so, said Surgeon Carl G. Groth, there is evidence that three of the transplanted livers are regenerating.

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