Twin’s Transplant Hits Trouble
Nick Draper, a 7-month-old twin whose struggle to beat a fatal heart condition has been the focus of a series of Times articles, was in critical condition Thursday after undergoing transplant surgery at UCLA Medical Center, hospital officials said.
During an arduous, nearly seven-hour operation that started when he was anesthetized at 3:30 a.m., surgeons opened up Nick’s chest, took out his heart and replaced it with a donor heart that the doctors assumed would work efficiently right away.
Instead, Dr. Mark Plunkett, surgical director of UCLA’s pediatric transplant program, implanted the new organ and then watched as it failed to beat strongly enough to keep Nick alive on its own. Concerned that the boy’s body might be rejecting the new organ, Plunkett connected the heart to a machine that should temporarily make it beat efficiently.
“We can’t be sure what’s going on right now,” the doctor said. “Right now we’re going to provide the power, we’re going to give his heart a rest. His heart doesn’t have to do the work.”
Plunkett added that the sophisticated machine can help keep Nick’s new heart beating for more than a month but not much longer. The original heart is now unusable.
Over the next two to three days, Plunkett said, his team will probably be able to figure out what is going wrong.
Nick’s body might be rejecting the new organ. The heart could also simply be warming up, taking a while to beat the way it should because it took an unusually long time, about seven hours, to transport the organ from its donor to UCLA. Citing confidentiality laws, transplant officials did not provide details such as the donor’s age, gender and hometown or how the donor died.
The options for Nick appear limited. The gray-eyed baby, who has never lived outside a hospital, could get better soon if his heart starts working properly, either on its own or with new doses of medicine. Doctors might put him back on the heart transplant list. If he doesn’t improve, he would need a new organ within the next several weeks or he would probably die.
The unexpected struggle Thursday was another blow for Nick’s parents, Michael and Nicole Draper, who have battled since July to keep their twins alive. Soon after the boys were born in Phoenix, where the family lives, the twins were diagnosed with dilated cardiomyopathy, a rare condition that caused their hearts to swell and barely pump. The twins were so close to dying that they were airlifted to UCLA Medical Center, known for its heart care and transplant program.
The Drapers followed Nick and Nate to Los Angeles, bringing along their three other children. The family lived for months in a $15-a-night, one-bedroom apartment at Hollywood’s Ronald McDonald House, an hour’s drive in traffic from UCLA. After a recent story in The Times focused on the family’s plight, the Drapers moved to Tiverton House, a hotel across the street from the hospital that offered them two rooms at cut rates.
All along, they believed that their boys would live, if they could just get transplants. Nick received a heart first because he was put on the transplant list ahead of his brother. At the time of their birth, Nick’s health was better than Nate’s.
In the hours before Thursday’s surgery, the Drapers felt sure that they were soon to clear at least one hurdle. Both parents knew the risks, but hours before the operation they noted how they were confident because of their strong Mormon faith and because of statistics: About 95% of infant heart transplant operations are initially successful.
But then the surgery dragged on, an hour and then two hours longer than they had expected. Kept from the operating room by hospital rules, they stayed with Nate in the third-floor room he has long shared with Nick. They struggled through the morning as they received updates from doctors and nurses that the surgery was not going well. At one point, hit with the fact that Nick might not make it, they rushed from the hospital for fresh air and to clear their thoughts.
In midafternoon -- their son out of surgery but in critical condition in the intensive care unit -- the Drapers sat in the third-floor room. Nicole, 32, held Nate, who still needs a new heart. She was numb, but spoke of their journey.
“From the moment they were born, we’ve been faced with the unthinkable, with the prospect of them not making it,” she said. “Then, today, it seemed like there was finally some light at the end of the tunnel. We were feeling great. These operations are usually a sure thing.... And we get this fluke.”
Yet she remained optimistic. They both were. Michael, 33, interrupted, finishing her thought.
“Dr. Plunkett said there are still things that can be done,” he said. “And Dr. Plunkett came in here after the operation and said, ‘We are not dead in the water.’ Well, we take that to be very encouraging. We figure, why not? There’s no reason why Nick can’t make it. No reason.”
