To the Editor. —
I cannot but admire the remarkable surgery performed by Starzl et al,1 as described in the March 10 issue of JAMA. However, I would suggest that patient 1 should not have undergone surgery.The list of her problems is forbidding. Apart from the abdominal mess, she had heart failure, pulmonary edema, pleural effusions, anasarca, renal failure, and liver failure. She needed transfusions of 61750 mL of blood. She died within 30 minutes of arrival in the intensive care unit. Is this the type of patient who should undergo such a massive surgical procedure? I would think not.
Davison S. Transplantation of Abdominal Viscera. JAMA. 1989;262(9):1183. doi:10.1001/jama.1989.03430090045015
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