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N.Y. Woman Has Pancreas Transplant

November 30, 1997

SYRACUSE, N.Y. (AP) _ Three years ago, Richard Higby awoke in the middle of the night and headed downstairs for a snack. When he passed his daughter Christine’s open bedroom door, he saw her lying on the floor.

Higby, a Lowville dentist, was not alarmed. He had been living with the effects of his daughter’s diabetes for nearly two decades.

``I walked into her room to pick her up and put her back to bed, and she was so stiff in my arms,″ Higby said. ``Her skin was so cold ... I thought she had died.″

When the ambulance arrived, Christine’s temperature was 88 degrees, almost 11 degrees below normal, and she was in a coma.

After suffering near-death experiences for years as her diabetes progressed beyond the point where drugs could control it, Christine has a new chance at life at age 27. A month ago Christine said good-bye to those three-a-day insulin injections _ she became the first person in New York state to undergo an isolated pancreas transplant.

So far, doctors at University Hospital, where the operation was performed, say she is doing fine.

Isolated pancreas transplants have been done only 300-400 times in the world during the past 25 years. The more common pancreas-kidney transplant has been done about 8,000 times. The pancreas creates insulin, needed for digesting many foods. Diabetes is the disease in which the body does not produce enough insulin.

Success rates of the pancreas transplant recently had improved to the point where Dr. Elizabeth Squiers, Christine’s surgeon, believed it was an option.

That, coupled with Christine’s critical condition, made her an ideal candidate for the four-hour operation. Her health had deteriorated to the point where she spent more than six of the past 10 months in the hospital.

``Over the years, I have watched my daughter melt before my eyes,″ Dr. Higby said. ``When she was younger, she was strong and active and she could do anything. When she went in for the transplant, she weighed 59 pounds.″

Christine Higby is 5-foot-2.

The surgery began during the evening of Oct. 30 when a local family donated the pancreas of a dying loved one. The anonymous donor had been declared brain dead, Squiers said.

The pancreas transplant is essentially the first half of the more common pancreas-kidney procedure.

``The pancreas is an extremely delicate organ, and its blood supply is related to the spleen, liver and small bowel,″ Squiers said.

So delicate, in fact, that surgeons use the donor’s spleen as a ``handle″ so they don’t have to touch it more than necessary.

After the donor’s pancreas is placed into the recipient, doctors remove the donor’s spleen. All told, they have 40 minutes from that point to complete the surgery or the patient will die.

``This is not an option for every patient with diabetes,″ Squiers said. ``But it may be a possibility for those whose day-to-day existence is seriously threatened.″

Breakthroughs in immunosupressive drugs are one reason the transplant has become more successful. The drugs prevent rejection of the grafts, but also severely lower a patient’s resistance to infections and other disease.

``With the new immunosuppressive drugs in this era, the results are almost as good as what we see with other transplants,″ Squiers said.

The next three months, when rejection of the donated organ occurs in one of four patients, are critical. While Christine, who suffered a urinary tract infection after the surgery, will never be out of the woods completely, doctors will breathe a sigh of relief when a year has passed.

Already, Dr. Higby said, his daughter is making plans to return to a premed program at college.

``You have to understand that for us, it was impossible to think more than a few hours ahead,″ he said. ``Her condition was so fragile that you could be sitting in the living room talking to her, get up to get a glass of milk and walk back into the room and she’d be on the floor.

``We know that another family had to go through intensive suffering, and will continue to suffer, for Christine to have this operation. But by doing what they did, they give birth to a new life for my daughter.″