A Lot to Digest
Texas woman gets a second chance at life with a successful intestinal transplant surgery.
How could a quarter pound of meat inspire such reflection? "A lot of people take being able to eat for granted. Not me," says the 24-year-old Midland, Texas, resident.
At 17, Jessica was diagnosed with Hirschsprung's disease, a rare congenital condition in which dying nerves in the intestine prevent food from moving through the digestive system. Bit by bit, doctors in Midland removed sections of her failing intestine. By 22, she could not digest food, and she spent 12 hours a day on an IV machine.
Every time she orders a hamburger loaded with everything, Jessica Terrazas thinks of her new lease on life.
"I had to be home every night by 8 p.m. to hook myself up to the IV," Jessica says. And while the IV nourished her, it also triggered cirrhosis of the liver.
"It was a difficult life," says Goran Klintmalm, M.D., Ph.D., a transplant surgeon on the medical staff at Baylor University Medical Center at Dallas and chief of the Baylor Regional Transplant Institute. "She clearly perceived she was near the end."
The good news is that Jessica's story continues. In August 2005, surgeons on the medical staff at Baylor Dallas performed the first successful adult liver-intestinal transplant in Texas on her-giving Jessica new hope.
Such surgeries are rare and are very technically complicated. "This is not just about getting a needle and thread in there," Dr. Klintmalm says, adding that post-transplant care is especially tricky. "The intestine is exposed to incompletely cooked foods, unwashed vegetables, bacteria and viruses. It has a natural immune system built in, so the potential for rejection is huge."
In Jessica's case, surgeons also had to transplant a new liver-and perform the procedure between her bouts with pneumonia and sepsis.
"This combined intestinal-liver transplant saved her life," says Srinath Chinnakotla, M.D., assistant director of transplant surgery on the medical staff at Baylor Dallas. Trained in intestinal transplant surgery, Dr. Chinnakotla says Jessica's is the best outcome he has seen.
That holds out new hope for the approximately 20 patients in Texas who need an intestinal transplant for survival, he says. "Those patients can now stay in-state. We have expertise and success at Baylor," he says.
Jessica still has to make regular monthly visits to Baylor Dallas for organ biopsies with Daniel DeMarco, M.D., a gastroenterologist on the medical staff at Baylor Dallas. It was Dr. DeMarco, a specialist in digestive diseases, who first treated Jessica when she came to Baylor as a patient, and he continues to be part of her continuum of care. As for Jessica? "Today, I eat what I want. I like to exercise and go shopping," she says. "Basically, I have a second chance to live."
By Laurie Davies