Francis Ramos, 21, was excited about being a mom. She received prenatal care in her hometown of Harlingen and was eager to welcome her first baby into the world. But at 26 weeks pregnant, something wasn’t quite right. Francis had developed jaundice and markedly elevated liver enzymes which quickly turned to confusion and a coma. Her liver was failing.
She was transported to Methodist Specialty and Transplant Hospital, first by helicopter and then by ambulance, from Valley Baptist Hospital in Harlingen, TX. Preston Foster, MD, FACS, surgical director of the liver disease and transplant program at the Texas Transplant Institute at Methodist Speciality and Transplant Hospital, said that tests did not indicate the specific cause of Francis’ liver failure, which is often the case. “With acute liver failure, a person can be fine one week and near death the next,” he says.
FIGHTING FOR TWO LIVES The only hope for Francis and her baby was a high-risk liver transplant. Within 36 hours of admission, Francis was placed on the United Network for Organ Sharing (UNOS) liver location waiting list at the highest status, giving her access to organs from Texas and Oklahoma. “Dr. Foster told me that my liver was completely gone and I had 48 hours to live unless a donor liver was located,” Francis said. “Luckily, 72 hours passed, and I was still fighting.” Then she went into a deep coma.
“We decided to perform a C-section delivery when the donor organ was on the way back from procurement and then complete the liver transplant,” Foster said. The medical team was on standby, and when the organ arrived, both surgeries were performed at Methodist Hospital in the hybrid operating room. It was critical that the specialized team had the ability to perform the transplant and C-section without transferring Francis to another facility. Lamar J. Albritton, MD, an obstetrician-gynecologist experienced in high-risk pregnancies and a member of the maternal transport team at Methodist Hospital, delivered the baby. “Many meetings and a lot of coordination was involved,” he says. “The entire operation took 8 hours.”
REASON TO CELEBRATE On Jan. 17, Max Joseph Ramos was born, weighing 1 pound 13½ ounces, and also that day, his mom got a second chance at life with her new liver. Max was in the newborn intensive care unit for 2½ months, and he came through without any medical issues. His mom was released to her family just 14 days after her transplant, several months earlier than expected. Today, their case remains unprecedented and is considered a medical miracle.