Conjoined Twins Separated Successfully in Landmark Surgery

By Linda Orlando

After 26 hours of surgery, which began just before 11:00 p.m. on Monday, 4-year old sisters Kendra and Maliyah Herrin have been successfully separated. Just 10 minutes after the surgery began, the conjoined twins were able to be moved into separate operating rooms and the single surgery became two separate surgeries for the more intricate, complex reconstruction operations. The girls’ parents, 26-year old Jake and 25-year old Erin, broke into tears and hugged each other when told that the separation had been successful.

Kendra and Maliyah were born February 26, 2002, at the University of Utah Medical Center in Salt Lake City, Utah. They were fused at the abdomen, sharing a kidney, bladder, liver, large intestine, and one pair of legs. In most cases, conjoined twins undergo separation surgery when they are between 6 and 12 months old, but in the case of the Herrin twins, the shared kidney forced the surgeons to wait until the children were older.

Rebecka Meyers, the chief pediatric surgeon at Primary Children’s Medical Center, is leading the team of surgeons for this landmark operation. Meyers said this is the first known attempt to separate twins with a shared kidney. After the initial separation phase of the surgery, Meyers issued a statement about the success of dividing the twins. "It's exciting they're doing really, really well," said Rebecka Meyers, chief pediatric surgeon at Primary Children's Medical Center. "When a patient does well, it's awesome. It's what you hope for."

Before making a final decision about the surgery, the Herrins and their daughters all spent time with a psychologist discussing the pros and cons of being separated. They also met with ethicists to discuss the problems Maliyah will face because of the risky prospect of a kidney transplant. "We have more than one ethicist who thinks these girls don’t need to be separated," Meyers said. "Mom and Dad have had a chance to hear all of that and talk to people on both sides." But after talking with the psychologist and their daughters, the couple concluded that being separated "was how they saw themselves when they were older," according to their father. So the surgery was scheduled.

To prepare the girls for separation, doctors inserted 17 expanding balloons into their torsos in June. The balloons were filled with saline, with more saline added each week, to stretch the skin and muscles so doctors would have more tissue to work with during the reconstruction phase of the surgery.

During the initial separation, doctors divided the girls’ shared liver, separated their intestines, and disconnected Maliyah’s connection to Kendra’s kidney. Then the girls were moved into separate operating rooms for the reconstruction of their pelvic rings and several internal organs. The reconstruction surgeries ended at different times for the girls, and Maliyah was placed on dialysis while she waits for a kidney transplant. Once she is stable and fully recovered from the separation surgery, Maliyah will receive a kidney from her mother. Eventually, each girl will receive a prosthetic leg. The twins are expected to remain in intensive care for about a week, and then spend at least a month in the hospital recovering.

When the little blonde girls wake up in the recovery room, it will be the first time in their young lives that they have awakened without being locked in an embrace with each other. Their parents said that they are nervous about seeing the girls for the first time. "I don’t know that it’s set in yet," Jake said. "We’re not going to feel totally comfortable until they’re out of the OR and everything’s stable." The couple, who also have a 6-year-old daughter and twin 14-month-old boys, said they are anxious to tell the girls how brave they have been and how proud they have made their family. Erin added, "And we can hold them."