One Surgery, Two Lives

HCA Healthcare specialty medical teams in San Antonio save mother and unborn child in rare procedure

As a healthy young woman, Frances Ramos didn’t expect any complications during her pregnancy – at least, no major ones. She received appropriate prenatal care in her hometown of Harlingen, Texas, 250 miles south of San Antonio. Suddenly, at 26 weeks into her pregnancy, her liver began to fail and she was quickly transported to Methodist Healthcare in San Antonio, where she would receive maternity care, neonatal care and a liver transplant.

By the time the young woman arrived at Methodist Hospital, she was in total liver failure and in need of an immediate trans- plant so she and her unborn baby could live. “This was a rare event for us,” explains Preston Foster, MD, FACS, surgical director of the liver disease and transplant program at the Texas Trans- plant Institute at Methodist Transplant and Specialty Hospital. Methodist Specialty and Transplant Hospital is a campus of Methodist Hospital.

Dr. Foster, along with a team at Methodist Hospital that would eventually include more than 75 people, began to organize around Ramos’ care as she slipped into a coma. She remained stable for 72 hours, during which time a donor was found, and then a simultaneous C-section birth and liver transplant procedure took place in Methodist Hospital’s hybrid OR.

Race against the clock

Despite the enormous odds, both mother and son made it through the surgery. Dr. Foster says he’d never seen anything like it in his 30 years of performing liver transplants.

“There are about eight cases in the history of the world that were published,” he says. “It’s a one-in-a-million kind of thing with a premature infant.”

After Ramos arrived in San Antonio, the medical team added her to the United Network for Organ Sharing (UNOS) waiting list at the highest status, giving her access to organs from Texas and Oklahoma. Her medical team began to coordinate a joint operation between the three Methodist hospitals. The team included members from the liver transplant, critical care, neonatal intensive care, labor and delivery, and surgery departments.

When the donor organ was found, Ramos was moved into a hybrid surgery suite at Methodist Hospital. Lamar Albritton, MD, OB/GYN physician, delivered her son by caesarean section while the liver was en route. Max Joseph Ramos weighed only one pound, 13.5 ounces, and was immediately moved to Methodist Children’s Hospital’s neonatal ICU. Next, Dr. Foster and the transplant team removed Ramos’ liver and implanted the donor organ.

The entire process took eight hours, and Ramos awoke without any complications. Fourteen days later she went home. Baby Max stayed in the NICU for two and a half months. In July, the two of them came back for a six-month anniversary celebration and reunion with their caregivers.

The event was even more poignant when Ramos told everyone that she had signed up to be an organ donor long before she knew she would wind up needing a transplant, so now she is encouraging everyone she knows to be donors as well. She also can’t say enough about the Methodist Healthcare teams.

“I’m beyond blessed,” Ramos says. “Who could have known this would happen? Six months ago nothing was looking good for me. They were thinking I wasn’t going to make it. But because of Methodist Healthcare’s teamwork and collaboration, both me and my baby are healthy and here today.”