Jesica's Family Hopes For Miracle

Only a new heart and lung can save Jesica Santillan, the 17-year-old critically ill girl at Duke University Hospital whose family thought her lucky day had come when she received a heart and lung transplant on Feb. 7.

They now know that a tragic mistake was made - one the hospital is acknowledging and investigating - because Jesica, who is blood type O, received blood type A organs and will die if she does not get replacement organs within days.

They're hoping against hope, but they say her chances are not good, because donor organs are scarce and not only the blood type, but also the size and other factors, must be just right.

The hospital meanwhile has announced new procedures to prevent another such mistake - unprecedented at Duke, but not in the U.S. - from happening.

Jesica - who has been waiting three years for donor organs - has a heart deformity that prevents her lungs from pumping enough oxygen into her blood.

She is from a small town near Guadalajara, Mexico, and moved to North Carolina with her family several years ago, believing that she would have a better chance for a transplant if she were in the U.S.

Jesica's condition has steadily deteriorated since the botched operation. She suffered a heart attack Feb. 10 and a seizure on Sunday, and is in critical condition now 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."

Jesica's case reminds those in the organ donation community of two similar errors in the past - both at the hospital now called Oregon Health and Science University.

In 1994, according to organ network spokesman Bob Spieldenner, surgeons opened the chest of a 15-year-old, discovered a blood type error at the last minute, and closed him up without implanting the incompatible organ. He died ten days later.

Spieldenner says in 1991, a heart with the wrong blood type was transplanted into a patient. When the error was discovered, the patient was given a new heart - and survived.

At Duke University, hospital CEO Dr. William Fulkerson says the mistake made in Jesica's case is "a tragic error, and we accept responsibility for our part... This is an especially sad situation since we intended this operation to save the life of a girl whose prognosis was grave."

To prevent such a tragedy from ever happening again, the hospital says it has put in place new procedures including "multiple confirmations of donor match by members of the care team before the transplantation process begins and improved communications between Duke and the organ procurement organization."

Duke University Hospital spokesman Richard Puff could not specify how the mistake was made in Jesica's case. But he says the hospital staff believed the organs were compatible and that compatibility had been confirmed.

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

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

Puff says the girl is a candidate for another transplant and "we remain hopeful that will happen." But he notes that 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.

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

"Unfortunately, there are very few organs available," says Paschke.

Mack Mahoney, a family friend, says 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," says Mahoney.

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

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.

According to Carolina Donor Services, an organ procurement organization, the heart and lung became available from a donor in New England and were offered by the New England Organ Bank after being matched to two North Carolina patients on a national database.

Two Duke surgeons declined the organs but a third Duke surgeon requested them for Santillan, Carolina Donor Services said in a written statement late Tuesday. The organization did not identify the doctor.

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.

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," says Mahoney. "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, the family's hometown, 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."