A 3-year-old Texas boy clung to life with the help of a heart-lung machine Wednesday while awaiting the possibility of a second heart transplant operation at Loma Linda University Medical Center.
Physicians led by Dr. Leonard L. Bailey decided that a second transplant was needed after Nicky Carrizales of San Antonio had to be placed on the heart-lung machine to relieve stress on the first heart he was given on Tuesday, said hospital spokeswoman Anita Rockwell.
Nicky suffers from cardiomyopathy, a degenerative heart disease, and was listed in "extremely critical" condition.
Rockwell announced at 4 p.m. that an unidentified potential donor for the second heart had been found and that "if everything works out, the plan is to do another transplant on Nicky . . ."
The second surgery was to be carried out pending completion of tests on the compatibility of blood and tissue types between Nicky and the donor, who was due to arrive at nearby Norton Air Force base late Wednesday, base officials said.
Nicky is the sixth and oldest child to receive a new heart at Loma Linda in seven months and the first to suffer an immediate failure, officials said.
Nicky's parents requested that the boy, one of two children at the hospital in desperate need of a new heart, be flown here last week, officials said.
The child underwent surgery Tuesday night, shortly after the hospital obtained a donor heart from a 2-year-old Fullerton girl who had died in a hit-and-run traffic accident.
Bailey, chief of pediatric cardiac surgery, and Dr. John Jacobson, completed surgery at 1:45 a.m., Rockwell said.
"The patient's cardiac condition deteriorated and he was returned to the operating room at 4 a.m.," Rockwell said. "He was put back on the heart-lung machine to take stress off the heart."
Rockwell said his condition at the time was "extremely critical" and that the "outcome was uncertain."
Loma Linda officials immediately placed an urgent request for another donor heart with the Regional Organ Procurement Agency at UCLA, which coordinates organ donations throughout Southern California, Rockwell said.
"The agency, in turn, contacted all major procurement agencies in the western United States and alerted intensive-care units at hospitals on the extreme urgency in obtaining another heart," Rockwell said.
Hospital officials would not disclose information about the new donor, calling it confidential.
But Debbie Felker, a spokeswoman at Swedish Medical Center in the Denver, Colo., suburb of Englewood said Jason Lars Kendrick, a 6-year-old boy declared brain-dead after he was accidentally shot by a playmate, was flown to Loma Linda after his parents, John and Paula Kendrick of Aurora, volunteered his organs.
Nicky arrived at Loma Linda along with his father, Rudy Carrizales, an X-ray technician at Kelley Air Force Base near San Antonio, and his mother, Mary Lou Carrizales, on June 9 with funds raised by Project Any Baby Can, a San Antonio support service for children with chronic diseases.
Dr. Marian Sokol, a spokeswoman for Project Any Baby Can, said she talked to Nicky's parents after the first transplant.
"Our understanding is that they couldn't regulate his heartbeat or stabilize his condition after surgery," Sokol said in a telephone interview. "The parents are saying the surgery was successful but that complications occurred later."
Sokol also said Nicky "has had a long history of heart problems" and "has been a patient since he was 2 weeks old."
In early June, Nicky's parents and their son's physician, Dr. Kenneth Bloom, requested that the service help locate a donor heart for the child, Sokol said.
Sokol said Bloom next advised Nicky's parents to have the child flown to Loma Linda for a week of testing that began June 9. "But on Thursday (June 12) Nicky's condition deteriorated and he was placed in intensive care," Sokol said.
"Bloom wanted Leonard Bailey to do the heart transplant," she added, "because Loma Linda has quite a reputation for excellence in that area."
Bailey's most recent infant-to-infant heart transplant was June 10 on Jesse Dean Sepulveda, who was 16 days old at the time.
On Wednesday, hospital officials described Jesse's progress as "most gratifying."