HEALTH

Race against the clock

KEVIN SCANLON October 6 1986
HEALTH

Race against the clock

KEVIN SCANLON October 6 1986

Race against the clock

HEALTH

A new life began for Gabriel Bruce at 8:52 a.m. on Monday, Sept. 22. At that moment, in the operating room known as OR2 at University Hospital in London, Ont., a team of three surgeons completed a liver transplant that saved the fouryear-old Winnipeg boy from certain death from liver failure. The six-hour operation followed a continent-wide search for a new liver to replace Gabriel’s own organ, which may have been destroyed by a bout of hepatitis. According to Dr. Morris Jenner, chief of the joint pediatric transplant unit of University Hospital and Children’s Hospital of Western Ontario, the boy was “fast running out of time” before he received the liver of a three-yearold American boy who was killed in a car accident near Joplin, Mo. After surgery Gabriel’s doctors were cautiously optimistic about his chances of full recovery. Said Jenner: “One would expect he would have a greater than 50-50 chance of making it.”

The Monday morning surgery concluded a dramatic overnight race against the clock. It began on Sunday evening when James Springer, co-ordinator of Kansas City’s Midwest Organ Bank, telephoned transplant coordinator Anita Hellstrom in London at 6:25 p.m. to inform her that a liver

from a child with O-type blood matching Bruce’s was available. Dr. Calvin Stiller, the chief of the multi-organ transplant unit, who had issued an extraordinary public appeal for a donor six days earlier, quickly assembled the transplant team for the 1,300-km flight to Joplin, 200 km south of Kansas City, aboard a corporate jet donated by Markham, Ont.-based auto parts maker Magna International Inc. At 3:30 a.m. in an operating room of Joplin’s Freeman Hospital, Dr. David Grant removed a healthy liver from the body of three-year-old Michael Box and placed it in a stainless steel bowl inside an ice-filled picnic cooler. The return flight to London began at 4:18 a.m.

Only two minutes after the Cessna Citation 3 jet took off from Joplin, Dr. David Girvin gave Gabriel an anesthetic in London. At 7:59 a.m., after the team from Joplin had arrived at OR2, Dr. William Wall and Grant removed Gabriel’s damaged liver. And seven minutes later they be-

gan the delicate task of connecting the healthy organ to the youngster. Finally, 46 minutes after doctors first placed the transplanted liver inside the boy, it started working, cleaning his body of poisons that had collected over six weeks of illness. The operation ended at 11:25 a.m., precisely 17 hours after the call from Kansas City. Dr. Paul Keown, a University Hospital kidney-transplant specialist, later told a news conference, “The surgery itself went very smoothly.”

Stiller said he took the unusual step of launching a public appeal for a donor because he could not bear to see “the little fellow die in silence and privacy.” He added, “Had he died without a donor, I would never have forgiven myself.” Gabriel, a Cree Indian, was born on the Poplar River Reserve, 482 km north of Winnipeg. Only six weeks before the operation, he had been a happy, healthy child living with his grandparents, Annie and Daniel Bruce, in Winnipeg. Then, his family physician noticed that fluids were building up to a dangerous level in the boy’s abdomen because a bout of hepatitis was destroying his liver. Gabriel began his 27-day wait for a new liver when he entered Children’s Hospital in London on Aug. 26. For all but the first five days, his grandparents maintained a bedside vigil. The boy’s mother, Phyllis Bruce, who has a three-year-old daughter, Jeannette, in Winnipeg, arrived in London three days before her son was transferred to University Hospital for the operation, the 69th liver transplant performed there since 1977.

By week’s end, Gabriel, whose condition was upgraded to serious but stable from critical, was breathing without the assistance of a respirator. And Stiller said, “To see the return of the sparkle of life into his eyes, I have just a tremendous gratitude to God that I could be part of it.” Doctors continued to give Gabriel the powerful antirejection drug antilymphocyctic globulin, but they moved the boy from the intensive care unit to the multi-organ transplant unit, where his family was able to visit. Their greatest fear now is that the boy’s body may attempt to reject the new organ, which happens in about half of all transplant cases. Still, Keown said that he expects the boy to be well enough to go home £ in six weeks.

'i -KEVIN SCANLON with

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