Teen Undergoes 2nd Quadruple Transplant Operation

A Maryland teenager at the center of a national debate over organ transplants was given his second set of four new organs Wednesday after his body rejected the first set, doctors said.

Surgeons at the University of Miami’s Jackson Children’s Hospital began Daniel Canal’s latest 13-hour operation about 11 p.m. Tuesday, less than three weeks after his first quadruple transplant.

They replaced the 13-year-old’s liver, pancreas, stomach and small intestine.

Canal, who is from Wheaton, Md., was listed in critical but stable condition.

“The surgery went well,” said Dr. Tomoaki Kato, a member of the transplant team.

He said doctors had to cut away part of the boy’s second new liver because his condition was so critical he was given donor organs from an adult rather than risking the wait for a suitable child donor.

Canal and his family had waited five years in three states before his first transplant. His long wait while his health deteriorated made him a symbol of a bitter national debate over organ allocation.

He needed only a small intestine five years ago, but his other organs weakened during the wait, forcing doctors to replace four in a complicated procedure with about a 50% survival rate.

Under the current U.S. system, organs are offered first to patients who live near where they become available, regardless of whether someone living farther away is more in need.

Advocates of a change in the system say this method means a patient’s access to a lifesaving new liver or heart can depend on the simple luck of living where a suitable organ becomes available.

Canal was listed at the University of Pittsburgh Medical Center for five years without receiving the transplant he needed. But he waited only three days after being added to the University of Miami’s list.

“Something needs to be done,” Lori Canal said. “If they’re [organ allocation rules] changed to help other kids who are sicker, other adults who are sicker, so that they don’t have to move thousands of miles from home, from state to state, then it will be worth it.”

Health and Human Services Secretary Donna Shalala proposed new rules in March to distribute organs based on medical criteria rather than by region. The organ transplant community has since debated whether Shalala’s proposal would make the system more equitable.

Doctors said it was too early to discuss Daniel’s prognosis. Lori Canal said Daniel’s surgeons had performed three repeat operations on teenagers, none of whom survived.