Doctors at the Children's Hospital of Pittsburgh, Pennsylvania, said yesterday that, if drug treatment fails, Laura may need a new stomach, pancreas and kidneys, in addition to a liver and small intestine.
The decision to list Laura for a multiple transplant reflects the gravity of her condition. Such 'cluster' transplants are rare and have been discontinued in many centres because of poor success rates. Only 50 to 60 have been carried out, with about half performed by Dr Thomas Starzl and his team in Pittsburgh. These operations are not believed to have included kidneys.
Laura, who is five and comes from Eccles in Greater Manchester, underwent a liver and small intestine transplant in Pittsburgh last year. She made a good recovery, but afterwards had intensive treatment with powerful immunosuppressive drugs to stop her body rejecting the new organs. As a result she developed a blood disorder affecting her white blood cells and surgeons had to remove her spleen earlier this year. Doctors were then forced to cut back on the anti-rejection drugs and this is believed to have contributed to the problems she is now suffering.
Paul McMaster, director of liver transplant services at Queen Elizabeth Hospital, Birmingham, where the only European liver and small intestine transplant in a child has been carried out, said yesterday that Laura's situation was grave.
'My concern is that she is going into multi-system failure . . . the intestine seems to be failing and probably the other organs are in trouble too.'
Laura's condition was described as 'fair' yesterday. Her mother Fran, 27, said Laura was in better spirits after being moved out of an intensive care unit to a children's ward. But she added: 'It is all a bit overwhelming and we are more frightened now than we were at the start because we know so much more about her condition. There is a high risk of her not surviving the (multiple organ) transplant, but she is in a hole now. There is hardly any chance of her surviving as she is in the long term, so we hope she will be able to have the transplant soon.'