14 March 2013

5-organ transplant patient gives birth

A woman whose doctors believe is the first known case of a five-organ transplant patient to deliver a baby said Wednesday her joy is hard to describe.

A woman whose doctors believe is the first known case of a five-organ transplant patient to deliver a baby said Wednesday her joy is hard to describe.

Fatema Al Ansari, 26, was given a new liver, pancreas, stomach and small and large intestine at a Miami hospital in 2007. Five years after that surgery, she gave birth Feb. 26 at the same hospital, Jackson Memorial, with her transplant doctor on a team closely watching.

"It's a hard feeling to express," the new mother said of the cesarean birth of a healthy girl, who weighed 4 pounds 7 ounces upon arrival. "It's the best feeling in the world," she said in Arabic, her words translated by an interpreter.

The infant, Alkadi Alhayal, snuggling in a white blanket and white cap, slept quietly in her mother's arms while her parents addressed reporters' questions with her doctors Wednesday at the hospital.

A world first

The woman, who lives in Qatar and plans to return home in the coming weeks, was there at 19 when she was diagnosed with a blood clot in a major vein to the intestine - requiring transplant surgery.

Just over 600 five-organ transplants have been recorded as of 2011, according to the latest figures available from the Intestinal Transplant Association.

The most recent annual report by the National Transplantation Pregnancy Registry also indicates she is the first reported case of a five-organ transplant patient in the world to give birth.

Dr. Shalih Y. Yasin, the woman's obstetrician , said there have been some cases in Europe of births by transplant patients who had two organs "but not five."

"We have searched all medical literature all over the world for any pregnancy that had five multi-transplants and this is the first case to our knowledge," said the doctor with the University of Miami Health System.

Yasin said an adult with five transplanted organs healthy enough to even consider having a child "is a miracle by itself."

Al Ansari was forced to terminate a previous pregnancy early on after her diagnosis, which made her think she would never be able to get pregnant. She said her husband, Khalifa Alhayal, gave her hope to realize her dream and they became parents through in vitro fertilization.

High risk pregnancy

Her recent pregnancy was considered high-risk and she was monitored closely by her team of transplant doctors and gynecologists in Miami.

She did not have an infection during her pregnancy, as her doctors had prepared for, but she faced minor complications including the flu, some bleeding and physical discomfort from her growing baby.

"It's not an easy pregnancy to go through," Yasin said. "One has to make sure the transplant organ is not rejected, that the medications are safe to the baby."

Experts noted the uniqueness of the case.

"While we have a good success rate to get patients to survive and back to normal, almost none of them go on to bear children," said Dr. Thomas Fishbein, Executive Director at the Georgetown Transplant Institute, who was not part of Al Ansari's medical team.

He said he has seen multi-organ patients go through pregnancy, but not five-organ transplants.

"So this is very good news for the field," he said, noting the number of patients who have had successful bowel transplants is very small because of difficulty achieving stable, long-term acceptance of that organ.

Al Ansari's doctors said she is in fact healthy enough to try for a second baby. And they said her case also offers some hope to other multi-organ transplant patients.

"We wanted to say that this was a very hard decision," said Al Ansari's husband, also speaking through an interpreter. "But we wanted to give hope to other people who have transplants and give them a chance, too."




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