Originally created 02/23/01

Infant receives new liver in 'bloodless' surgery



LOS ANGELES - The 7-month-old son of Jehovah's Witnesses received part of his grandmother's liver in one of the first "bloodless" surgeries of its kind performed on an infant, doctors said.

The family's religion opposes blood transfusions, which are typical in pediatric liver operations.

Instead of using the usual two to three units of transfused blood during the infant's surgery, doctors used drugs to stimulate his production of red blood cells, and the blood from his incisions was recycled.

Similar techniques have been used for heart surgery for years on Jehovah's Witnesses, who say the Bible prohibits them from accepting transfusions of whole blood or blood products.

The "bloodless" operation performed Feb. 7 on Aiden Michael Rush's liver was so successful, it could become routine, doctors said Wednesday.

"We made special arrangements in this case because of this family's religious beliefs, but from now on, we'll do this on every child to reduce our use of blood products," said Dr. Yuri Genyk, a member of the team that performed the surgery at Childrens Hospital Los Angeles.

Twenty adults are now being evaluated for the "bloodless" liver procedure at USC University Hospital, said Dr. Nicolas Jabbour, a member of that hospital's transplant team. The hospital has performed the operation on four adult Jehovah's Witnesses since 1999.

That history drew the Rush family to Los Angeles from their home in Tipton, Iowa.

"I had people tell me flat out I wouldn't find anybody who would do this surgery," said Heather Rush, 26, Aiden's mother. "But I wasn't going to give up until I found someone to help us."

Aiden was born with biliary atresia, a condition where the bile duct is obstructed. He had surgery to connect his bile duct to his intestine but developed end-stage liver disease. Without a transplant, the disease likely would have been fatal.

In the surgery at Childrens Hospital, Aiden received 20 percent of his grandmother Vicky Rush's liver, which should grow back in six to eight weeks.

In the two weeks since the surgery, the infant's distended stomach has returned to normal size and the bronze-yellowish cast of his skin has begun to disappear, Heather Rush said.

"Now he's just like a normal baby: He smiles, he plays with toys," she said. "It's the first time I have ever heard him laugh out loud."

In a separate case, the Pennsylvania Supreme Court ruled Wednesday that people who reject blood transfusions on religious grounds can't be forced to have the treatment even if it could save their lives.

The case involved Maria Duran, 34, a Jehovah's Witness who died in 1999 after two failed liver transplants. The court said a lower court was wrong to appoint her husband as emergency guardian for the limited purpose of approving a blood transfusion.

"It is a difficult thing to decline potentially lifesaving treatment for a loved one, rendered mute by her condition, on the basis of her devotion to religious beliefs," the ruling said. "Nevertheless, absent evidence of overarching state interests, the patient's clear and unequivocal wishes should generally be respected."

The case has been filed by a health guardian appointed by Duran with the sole duty of preventing a blood transfusion in case she became incapacitated.

On the Net:

USC transplant team: http://www.usctransplant.org/liver-bloodlesssurgery.html

Childrens Hospital: http://chla.org

Pennsylvania Supreme Court ruling: http://www.courts.state.pa.us/OpPosting/Superior/out/a02026-01.PDF