Sunday, February 17, 2013

A 17-hour operation under four surgeons: The woman who became the third in Britain to survive a six-organ transplant


Saved survivor: Dawn Carter's six-organ transplant took 17 hours
Saved survivor: Dawn Carter's six-organ transplant surgery took 17 hours
It was an extraordinary operation – transplanting six organs into a 53-year-old woman in 17 hours of surgery. 
Dawn Carter, only the third patient in Britain to survive such a procedure, now has a new liver, kidney, pancreas, stomach, small intestine and colon.
The procedure required four consultants – one to retrieve Dawn’s organs and three to perform the implants, which all came from a 20-year-old female donor. 
There were also two anaesthetists present, two operating department practitioners, two theatre nurses and two other theatre staff.
Without the transplants, Dawn, an intensive care nurse from Northallerton, North Yorkshire, who was suffering from a serious liver disease, had been given just six months to live. 
Today, as she pats her three spaniels – Bonny, Skye and Jake – after their morning walk with her partner Martin Burch, she says: ‘I’m obviously meant to be here.’
Dawn’s problems started when she was diagnosed with Crohn’s disease, an inflammatory bowel complaint, at 19. 
A decade later, she underwent an operation to remove part of her colon at Leeds General Infirmary.
However, her problems continued and Dawn needed several more operations, which eventually left her with just five per cent of her intestine. This meant her only option was to receive all nutrition and fluids intravenously.
For the next 21 years, Dawn and Martin, who are keen motorsports fans, travelled to various Formula 1 events and spent several holidays in the United States.
But in 2011, she was told that her liquidised food had been damaging her liver and she had end-stage liver disease. Referred to Addenbrooke’s Hospital in Cambridge, her only chance of survival was a multi-organ transplant.
 

‘It never crossed my mind that I wouldn’t get a transplant,’ confides Dawn. And so it proved. Two days before Christmas 2011, she was told the organs had become available.
‘I didn’t hold any fear about the operation,’ remembers Dawn. ‘In the anaesthetic room I thought, “This might be the last time I am alive”. But I felt fortunate I was getting this chance.’
Her consultant, Andrew Butler, says Dawn is one of three people in the UK to survive a six-organ transplant in one operation. The first survivor was Stephen Hyett, who received a new liver, kidney, stomach, duodenum, pancreas and small bowel in 1994.
Careful timing: The procedure was carried out by four surgeons, two anaesthetists, two operating department practitioners, two theatre nurses and two other theatre staff
Careful timing: The procedure was carried out by four surgeons, two anaesthetists, two operating department practitioners, two theatre nurses and two other theatre staff
According to NHS Blood and Transplant, out of 88,052 transplants that have taken place in Britain, fewer than 30 have involved three or more  organs being transplanted at once. ‘The hard part is co-ordinating removing the old organs with the new ones arriving from another part of the country, as this all has to be done swiftly to ensure survival,’ says Mr Butler. ‘In Dawn’s case, the organs were implanted as one, with as few joins as possible.’
Dawn spent nine weeks on a ventilator in intensive care, with Martin, her mother Dorothy and her brother Larry by her side.
Unknown to Dawn at the time, during her stay in intensive care she needed a further 12 operations to rectify complications, which included bleeding from her new liver and pancreas. She also required a 17-pint blood transfusion.
When she became aware of her surroundings, she was being fed by tube into her stomach.
‘My fingers and toes were so swollen they looked like pigs’ trotters and my legs and arms were too heavy to lift,’ she says.
By March, Dawn had to learn to walk again because her leg muscles were so weak and she also experienced depression.
‘I wasn’t well enough to read and I had no other patients to talk to,’ says Dawn. ‘I hadn’t expected to feel so ill for so long. I lost my hair and nails because all my blood flow was going to my new organs to help them. But I got some wigs and make-up.
‘With my old digestive system, I could eat anything, but my new one felt uncomfortable when I ate and I felt full for hours. I started to wonder if my donor had allergies and if I would crave strange things, but I haven’t.’
After more than five months in hospital, Dawn went home last May. She takes 18 tablets a day – immunosuppressant drugs, antibiotics, enzymes and multi-vitamins.
She is now on a phased return to work. She is also setting up a multi-organ transplant support group at Addenbrooke’s Hospital.
She says.‘There isn’t a day goes by without me thinking of that person’s gift to me. I sometimes joke that there’s more of her in me than there is of me.


Read more: http://www.dailymail.co.uk/health/article-2279684/A-17-hour-operation-surgeons-The-woman-Britain-survive-organ-transplant.html#ixzz2LB39kaHI 
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