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Getting new lungs

BR fifth-grader first child to have transplant at hospital

By LAURIE SMITH ANDERSON

landerson@...

Advocate staff writer

Photo by Kuntz

  Eleven-year-old Shari Melon of Baton Rouge talks with Dr.

Mallory Jr., director of Texas Children's Hospital's transplant program,

and Pegg Dobmeier, transplant coordinator. Shari was the hospital's first

patient to undergo a pediatric lung transplant.

HOUSTON -- Eleven-year-old Shari Melon of Baton Rouge was the first

patient to undergo a pediatric lung transplant at Texas Children's

Hospital here.The fifth-grader from Wildwood Elementary School will

remain in Texas through the end of the year where she will continue to be

closely monitored by physicians. However, she is keeping up with her

lessons with a homebound teacher and hopes to return to Baton Rouge and

school after the first of the year. " We have complete faith in the doctors

here, " Leilani Melon said of the team who operated on her daughter for

six hours on Oct. 4. " Shari's doing great. She's already gained 9 pounds.

We had to go shopping for new clothes. " The newly launched pediatric lung

transplant program is touted as the only one of its kind in the

Southwest. Ochsner Clinic Foundation in New Orleans has an adult

transplant program, but the next closest pediatric program is in St.

Louis, Mo. " Pediatric transplant candidates need specialized pediatric

care not available at adult hospitals, " said program director Dr.

Mallory Jr.In 1996, Shari was diagnosed with a rare disorder -- primary

pulmonary hypertension (PPH).PPH involves a narrowing of lung blood

vessels, which leads to elevated blood pressure in the vessels that carry

blood from the heart to the lungs. Ten years ago, it was considered a

" relentlessly, progressive fatal disease. " Today, treatments exist for

PPH, but if a patient does not respond well to them, the only other

option is a lung transplant. " Shari was really going down in the last

year, " her mother said. " Her lungs were starting to give up, and the

doctors said she could die at any time. Just before she had the

operation, she weighed only 48 pounds. " Shari was on the waiting list for

a lung transplant in St. Louis, but her doctors thought she might not

survive the wait. Already seeing Dr. Felix Shardonofsky at Texas

Children's Hospital, she was selected as an ideal candidate when that

hospital launched its new program, pending match of a donor organ.On Oct.

3, the wait was over. The family of a boy who had died who was close in

age to Shari had agreed to donate his organs through LifeGift, a Texas

organ procurement organization. The lungs had to be transplanted within

hours. " If there's a somber note to this story, it is that a grieving

family had to make a decision (to donate organs) so that someone could

live. That's awe inspiring, " Mallory said.Starting at 4 a.m., a

multidisciplinary team performed a bilateral lung transplant (replacement

of both lungs) on Shari.The blood type matched. The boy was taller than

Shari, and the lungs had to be stapled to fit her smaller

body. " Everything went extremely well. We couldn't have asked for a

smoother first lung transplant, " said surgical director Dr. E. Dean

McKenzie.Shari was released in good condition 12 days after the

procedure. Her health and lungs will be closely monitored through

follow-up treatments at the hospital.A lifelong process of taking

antirejection medications and frequent visits with transplant specialists

will follow. " Shari was glowing two weeks after surgery, " Mallory said.

" She came into the clinic for Halloween dressed as a cat. Now, she's

feeling better than she has in two years. That's the great thing about

working with kids. Adults dwell on the past and worry about the future.

Shari lives day to day. " The 11-year-old will be able to resume a normal

life, though she will be more susceptible to infections. " She can't get

involved in contact sports. She can't smoke. She needs to be careful

about being around sick people. And she can't date 'til she's 30, "

Mallory said.Described as " outgoing, mature and responsible for her age, "

Shari is a great patient, and her mother is devoted to getting her the

best possible care, the doctor said.Meanwhile, there are two other

children on the waiting list for lung transplants and others who are

being evaluated.Mallory said he is seeking referrals from area doctors.

" This is a great time to refer patients because our waiting list is so

short. " The lung transplant program at Texas Children's, one of six active

pediatric programs in the United States, treats children and adolescents

with lung diseases that cannot be improved by either medical therapy or

minor surgery.Seriously ill children can be transported by ambulance or

plane to the hospital via its intensive care Kangaroo Crew Team.The

transplant team includes pediatric specialists in pulmonology,

cardiothoracic surgery, anesthesiology, psychology and nursing.In

addition, transplant candidates and their families meet with pediatric

respiratory and physical therapists, social workers and dietitians. " I

think our volume and high success rate in pediatric heart transplants

prepared us well for a safe and successful lung transplant, " Mallory

said. " We provide an option to families when all other efforts have been

exhausted. I'm confident because of the quality of Texas Children's lung

transplant team and its facilities, that the program will be successful

in giving really sick children a chance for longer, healthier lives. " And

children living in the southwest United States and Latin American

countries will have access to a pediatric lung transplant program closer

to home, he said.For additional information on the program, call

or visit the hospital's Web site at

http://www.texaschildrenshospital.org.

Becki

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