Twin gets kidney

Transplant goes smoothly from mom to Maliyah
By Lois M. CollinsDeseret Morning News
Maliyah Herrin, 5, is in critical condition at Primary Children's Medical Center after receiving her mother's right kidney in an operation that took nearly seven hours Tuesday. Erin, her mother, is in fair condition.
The surgery team cheered when Erin Herrin's kidney changed ownership and started producing urine just minutes after it was implanted in the little girl's abdomen.
"It's always exciting to see a kidney that has been taken from one individual basically come alive in another individual," said transplant surgeon Dr. John Sorensen. "I never get tired of it." Maliyah and her twin sister, Kendra, were born joined at the abdomen. They shared several organs and a pelvis, as well as use of Kendra's kidney until they were surgically separated in August. The decision on when to separate them and much of the reconstruction done during that operation were driven by knowledge that Maliyah would need a kidney transplant afterward. She has since been on dialysis three days a week.
"Looking back, it's amazing how far we've come. We thought we'd never get to this point. We're really through the big challenges," said Jake Herrin after the transplant, which is expected to be the last major childhood surgery for either twin.
The entire transplant took nearly seven hours and was much less complex than doctors had feared it would be. There were no complications, said Sorensen and Dr. Rebecka Meyers, who was on Maliyah's transplant team and who was coordinating surgeon during the 26-hour separation surgery last summer.
When the surgery transferring the kidney from his wife to his daughter was over, Jake Herrin thanked the surgical teams repeatedly for what he called "miracle after miracle."
Monday, Maliyah had been excited and "bouncing off the walls" happy after her final dialysis session, Jake said. She told everyone she met she was getting a new kidney tomorrow.
She had a good night's sleep Monday and was groggy and tired when it was time to go to surgery. She didn't fuss, although she clouded up briefly as she was taken from her parents. She was calm as child life specialist Holly Moss-Rosen carried her into the operating room at 7:46 a.m., where a staffer read "Madeleine" to her until the anesthesia put her to sleep. Doctors spent the next hour assessing what to do and examining images before making the first incision. They feared they would find a lot of scar tissue and adhesions from the extensive separation surgery but were "pleasantly surprised," said Meyers, who said the less-than-expected scarring indicates Maliyah heals well.
The bladder reconstruction that urologist Dr. Patrick Cartwright did in August to prepare for a kidney transplant had held up well, too. And Dr. Eric Scaife, a transplant surgeon who was part of the team working on Erin, said the donor kidney was healthy and had a single artery and a single vein, which makes implantation much simpler. Everything went smoothly removing the kidney from Erin, "with zero blood loss."
Surgeons had also worried that space in Maliyah's abdomen would be a problem, since the two girls had shared one abdomen only slightly larger than that of a normal child. Although it was tight, it was adequate, helped in part by the fact that the kidney Erin donated was slightly small for an adult kidney.
The surgical team for Maliyah included two transplant surgeons, a urologist, a plastic surgeon and an anesthesiologist. Erin's team included two transplant surgeons and an anesthesiologist. Each team also had a registered nurse and an operating room tech, and another of each helped as needed.
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