Mexican transplant patients pose quandary for doctors
By EDWARD HEGSTROM
Flores is just 2 years old and already dying, a child with a bad liver born
in a country where liver transplants are rarely done.
odds seem to work against the little girl from Mexico City. But her family
refuses to let her give up without a fight.
Mexican doctors told Jessica's parents their only hope was to seek treatment
in the United States, the family of three packed up their belongings,
scraped together just enough money for air fare, and got on a jet bound for
Houston. They have spent the last several months begging doctors here to put
Jessica on a waiting list for a liver transplant.
came here to give our daughter a chance to continue living," said
Jessica's father, Armando Flores.
Flores family is part of a small but growing movement. Just in the past year,
at least five Mexican families have come to Houston in search of the liver
transplants their children need to stay alive -- transplants they could not
get back in Mexico.
crossing the border in search of livers, the families have forced doctors to
confront a number of troubling ethical questions involving financing and
organ distribution. Even in this country, donated livers are so scarce that
more than 1,000 U.S. citizens die every year while awaiting one.
doctors say they won't even consider bending federal guidelines that permit
the allocation of no more than 5 percent of donated livers to foreigners.
They also won't allow foreigners a place on the waiting list until they have
$250,000 cash up front to pay for the operation.
the plight of poor Mexican children tugs on the heartstrings, we also have
American children dying on the waiting list," notes Dr. R. Patrick Wood,
who is the head of liver transplants for St. Luke's Episcopal Hospital and
also performs the operation at Texas Children's Hospital, where most of the
Mexican children are being seen.
the five children brought here in the last year, one died while awaiting a
transplant, one received a liver and the other three are still desperately
trying to raise the money they need for the operation.
the one child who received a liver -- Damaris Cantu, age 2 -- got hers only
last January, the other three Mexican families have been told that they will
have to wait until next year before their names can be added to the waiting
on their doctors' advice, two of the families have undergone tests to see if
the mothers could donate part of their own livers to keep their children
alive, even though the operation is risky for the mother.
Flores' mother, Olga, is now being tested to see if she could donate to her
Olga Flores is not compatible, the family will be right back where they
started: pleading for a liver, begging for dollars.
children haven't done anything wrong, and yet they are condemned to die,"
said Armando Flores. "They don't understand politics and borders and
laws. All they want is to play -- to live."
all of the Mexican children have cirrhosis of the liver, typically a result
and the other parents all praise the United States for at least allowing
them into the country to try to raise money for a transplant. "The
gratitude we feel for this country is immense," Flores said.
of the parents acknowledge that any blame for their predicament should be
placed on their own government.
is a large and powerful nation," said Fidencio Acevedo, a native of
Matamoros who has brought his 15-year-old daughter Claudia to Houston in
search of a transplant. "So why do we have to run to another country to
save our child? Where are our taxes going?"
has been building its own transplant program in the past few years, said
Ramiro Nepita, who heads the Houston office of the Mexican Institute of
Social Security, the government medical service. Yet the numbers remain
a nation of nearly 100 million people, performed 48 liver transplants last
year. By comparison, the United States, with a population of roughly 250
million, had 4,700 liver transplants in 1999.
even in the United States, donor livers are in short supply. More than
15,000 people are on a waiting list for a liver.
one time, experts proposed excluding foreigners as potential organ
recipients, according to Bob Spieldenner, spokesman for the United Network
for Organ Sharing (UNOS), the policymaking organization for organ
distribution. But some doctors complained that barring foreigners would be
eventually set the threshold for nonresident foreign recipients at 5 percent,
a limit hospitals have always respected, according to Spieldenner. Hospitals
have the right to demand that foreigners show they can pay for the operation
before being put on the waiting list.
once foreign patients are on the list, they must receive the same treatment
U.S. citizens do.
have been scattered reports of Mexicans coming to Texas and California in
search of livers for years. But many Mexicans learned about American liver
transplants after famous Mexican television personality Raul Velasco came to
Houston to receive one in 1998. Mexican television and newspaper reporters
came to Houston to broadcast news of Velasco's successful transplant that
returned to Mexico City vowing to lobby for improved transplant services in
his own nation. But his personal success probably helped spread the word
that Mexicans in need of a liver should head to Houston, according to
MaryRuth Martinez, a local activist who educates Hispanics about organ
Cantu's parents came to Houston in October 1998, after raising $250,000 in
Mexico to pay for the U.S. operation for their young daughter. Damaris got
on the waiting list and finally got a liver early this year.
infant, Jasmine Bautista, came to Houston just last March. The Bautistas
came with almost no money, but Raul Brindis, disc jockey at the
Spanish-language radio station Estereo Latino, raised more than $360,000 for
the baby in just 48 hours.
Bautista died in August, before she could receive a transplant. Her parents
returned the money to Estereo Latino.
and Armando Flores say they got a donation of $2,000 from the group for
Jessica. The Acevedos received $100,000 toward the liver transplant for
Claudia from Estereo Latino.
Floreses, meanwhile, have found other ways to raise the money they need
before the operation. A Mexican immigrant with a restaurant has donated
food, and a car dealer at Interstate 45 and Wayside has donated space so
that the family can set up a barbecue stand where they sell fajitas every
who came here at just under 2 years old and unable to talk, is now 29 months
old and able to chatter away in Spanish. She's particularly fond of watching
Barney in Spanish, which her parents have on video. She knows she is sick,
but she has never met healthy children, so she thinks of that as normal.
we forget to give her her medicines, she reminds us," Armando Flores
Flores' parents have been able to come to Houston to help. And with the
donations they have gotten so far, the family has been able to rent a clean
apartment in southwest Houston.
the $100,000 they have raised is far short of the $250,000 they will need to
doctors say Jessica needs surgery," her father said. "They also
say she won't get it until we can pay the deposit."
least five Mexican children have come to Houston recently in search of liver
transplants. Most have struggled to raise the $250,000 needed to get the
Damaris Cantu. Born with liver failure in Monterrey, Mexico, in 1998,
Damaris was given six months to live. For reasons no one can explain,
Damaris became a cause celebre to the national media in Mexico. The family
was able to raise the $250,000 they needed from donations in Mexico before
even coming to Houston. Damaris, now 2, got a liver transplant at Texas
Children's Hospital this past January.
Jasmine Bautista. Also born with liver failure, Jasmine's parents brought
her to Houston from their home in San Luis Potosi in March 1999 when she was
3 months old. She died in August, after a local radio station had helped
raise $360,000 for her cause.
Jessica Flores. Jessica was also born in 1998 with liver failure. The native
of Mexico City was brought to Houston in September 1999 after doctors told
her parents it was their only hope. Her family has raised about $100,000.
Claudia Acevedo. The 13-year-old from the border town of Matamoros came to
Houston four months ago. Her parents say they learned of the possibility of
seeking a liver in the United States from watching Mexican television.
Claudia has been told she won't make it without a liver. "I almost
always have to be tranquil," Claudia says in Spanish. "People in
Houston have been very friendly. But I'm not in my country, and I don't
understand the language."
Rigoberto Delgado. Also 13, Rigoberto came to Houston last year after a
series of unsuccessful surgeries in his native state of Guerrero. His father
was already here. The family has managed to raise just $10,000 so far.