Friday, April 4, 1997
MEDICAL:
Deteriorating patient put on artificial heart-lung machineBy
Hannah Miller
Daily Bruin Contributor
Eight-year-old Miyuki Monobe has only opened her eyes for a few
moments this week. She hasn’t been able to speak to her parents or
move her limbs because of the machines  the machines that
sustain her lungs and her pulse.
Born with a heart defect, Miyuki has been in the intensive care
unit at the UCLA Medical Center since last Saturday, hoping to
receive a child-sized donor heart.
To receive the last-resort treatment, she has been flown in from
her native Shinigawa, Japan where national regulations make heart
transplants impossible to obtain.
Time is growing increasingly more precious. Five days into her
wait, Miyuki went into cardiac arrest and has since been placed on
an artificial heart-lung machine.
Donor hearts for children are particularly rare, said Dr. Juan
Alejos, a pediatric cardiologist .
"When a heart becomes available of the appropriate size and
type, she’s on the list to receive it," said Alejos. "But a lot of
children die waiting for hearts."
It’s the sixth day now, and her parents are also waiting.
"They’re very worried, very tired, but very grateful for all the
support they’ve received," said Alejos. Her parents have received
over $560,000 in donations from across Japan over the past two
weeks. The operation will cost $600,000.
Her case has gained prominence as the focus of a move to change
Japan’s legal definition of death. Parliament is currently
considering legislation that would change this definition and ease
the way for domestic heart transplants. Over 4,000 physicians have
advocated for such reforms.
Current Japanese regulations define death as the lack of a
heartbeat. After the heartbeat stops, the heart quickly becomes
unsuitable for transplantation. The American concept of ‘brain
death,’ on the other hand, allows the heart to be retrieved while
still viable for transplant.
Heart-transplant patients from Japan have been transferred to
UCLA four times in the last four years in the pediatrics division
alone. The only heart transplant to ever occur in Japan was
performed 30 years ago.
Miyuki’s plight has gained even more attention because it has
come on the heels of a transplantation success. Last year, two
Japanese children were able to receive donor organs from an
American boy who died at a U.S. naval base. The base was considered
American soil, so the American regulations applied.
UCLA initiated the contact with Miyuki’s doctors in Tokyo,
offering priority status for the operation because of her rapidly
deteriorating health.
Miyuki’s heart has two structural problems. One is an opening
between two of the four ventricles, and the other is a narrowed
aorta that carries blood out of the body. "Her heart chamber is
having to work really hard," said Alejo.
If the transplant comes through, it will be her fifth heart
operation. Miyuki has been in and out of hospitals all of her life,
and a heart transplant operation was recommended by her
cardiologist in Japan as a last resort.
Few around her are willing to guess on her chances. "We don’t
know how long she is going to be here," said hospital spokeswoman
Ruthie Marick. Alejo says he can’t estimate the length of the wait
for a suitable donor.
Her Tokyo cardiologist, Hidemiº Dodo, is the one to report
a hopeful guess  that she could survive for up to a few
months until the transplant can be done. "If she is lucky , she
will find a donor in a couple of days," Dodo told the Associated
Press Wednesday. Until then, the wait continues.
With Daily Bruin wire reports.