Baby Given Eight New Organs in Record Transplant

An Italian baby with a life-threatening muscle disease has undergone a medical first - a successful eight-organ transplant, her surgeon said yesterday.

Alessia Di Matteo, aged eight months and from Genoa, received the liver, stomach, large intestine, small intestine, pancreas, spleen and two kidneys from a single donor, who was also an infant.

The surgery at the University of Miami was a case of operate or die, doctors said yesterday. The operation was on January 31, when Alessia was just six months old, but the hospital withheld information until she had survived the most dangerous period in terms of infection and bleeding.

Alessia was born with smooth muscle disorder (megacystis microcolon syndrome) which prevents normal function of her stomach, intestines and kidneys. The condition generally is fatal, with children dying of liver or kidney failure.

By the time she arrived at the University of Miami last January, with her parents, a factory worker and a bank teller, Alessia weighed just six kilograms (13lbs), and had been hanging on to life.

The procedure she underwent at Miami was an immense challenge to her tiny body. The entire package of organs weighed barely 400 grams (14oz), each kidney was the size of a walnut, and her intestine the width of spaghetti. A mistake in calculation of anesthesia could have cost her her life.

Yesterday, Alessia was deemed stable enough to be shown to the media. Her organs now function, and she has gained one pound in weight.

But the toll exerted by illness and successive surgeries remains unclear. Alessia's belly is criss-crossed by scars, a legacy of this surgery and half a dozen earlier procedures in Italy. Since the original surgery, she has undergone two additional procedures. She has also been treated for a rash, which is believed to be the result of infection.

She continues to receive nourishment through a tube, and weighs only half of what a child her age normally would: 6.5 kilograms (about 14lbs).

"One of the problems that baby has is that she never learnt how to eat," said the lead surgeon, the University of Miami's Andreas Tzakis. "This is a habit that has to be taught to her very carefully."

Alessia's future also includes a lifetime of anti-rejection drugs. The size of the transplant, relative to her body, multiplies the risk of rejection.

"We have an immediate challenge to adjust immuno-suppressants so that she does not reject the organs, and that the organs do not reject her. The graft is so massive that the organs can reject her," he said.

The Di Matteo baby is the second child from Genoa to undergo surgery at the University of Miami's Jackson Memorial Medical Centre. Her parents have two other children, neither of whom have the disorder.

While the latest surgery represents a first in terms of the number of organs involved, the field of transplant surgery has been advancing rapidly since the 1990s. Surgeons from the University of Miami have carried out 100 such procedures, including in 1997 a successful seven-organ transplant.

That patient is thriving today, Dr Tzakis said. Others who sought the pioneering surgery have not. A decade ago, Dr Tzakis performed a multi-organ transplant on a British patient, Laura Davies, who was born with short gut syndrome. Laura never emerged from intensive care.