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M E T H O D I S T H E A L T H C A R E — S A N A N T O N I O
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S U M M E R 2 0 1 5
“This was a rare event for us,” says
PrestonFoster,MD, FACS,
surgical director
of the liver disease and transplant program
at the Texas Transplant Institute atMethodist
Specialty and Transplant Hospital and a
liver, kidney and pancreas transplant sur-
geon. Methodist Specialty and Transplant
Hospital is a campus of Methodist Hospital.
“Inmy years of liver transplantation,
this was the first such case for me, and
only a very few other case reports have
been described in themedical literature,”
Foster says. The complex case involved
staffs from two hospitals and coordina-
tion across various departments. About
Methodist Special Delivery
M
ore women de-
liver their babies
at Methodist
Hospital than at any other
hospital in San Antonio.
We welcome into the world
more than 5,000 babies
each year!
The Women’s Pavilion at
Methodist Hospital is newly
expanded, renovated and
upgraded to ensure that
you welcome your bundle
of joy in the newest and
most modern facility in
San Antonio. We have a
new and easy-to-find en-
trance to labor and delivery
through the Central Tower
Lobby. Our 26 private Labor/
Delivery/Recovery rooms are
outfitted with new homelike
furnishings and technology.
Methodist Hospital also
has a newly renovated
unit devoted to high-risk
pregnancies. It is the larg-
est and most sophisticated
newborn intensive care unit
(NICU) in the region, with
78 beds, and it offers the
highest level of neonatal
care as the largest Level 4
NICU in South Texas. Here
we offer direct access to
all the children’s doctors
your new baby may need, in
association with Methodist
Children’s Hospital. The unit
is certified as a neonatal
center of excellence by
United Healthcare. Learn
more at
www.Methodist SpecialDelivery.com.
medical professionals were involved
in Ramos’ liver transplant, plus another
seven who were involved in the delivery
of her baby andhis treatment in theNICU.
HOVERING NEAR DEATH
Ramos was
26 weeks into her pregnancy when her liver
began to fail. She was transported to Meth-
odist Specialty and Transplant Hospital, first
by helicopter and then by ambulance, from
a Harlingen hospital. The symptoms started
with jaundice and markedly elevated liver
enzymes and quickly turned to confusion
and coma. Prior to this, she had no medical
problems, and liver disease was not part of
her family medical history. Foster says that
tests did not indicate the specific cause of the
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.
Ramos was placed on theUnitedNetwork
for Organ Sharing (UNOS) liver location
waiting list at the highest status within
36 hours of admission, giving her access
to organs from Texas and Oklahoma.
TWO LIVES AT STAKE
“Dr. Foster told
me that my liver was completely gone
and I had 48 hours to live unless a donor
liver was located,” Ramos says. “Luckily,
72 hours passed and I was still fighting.”
Then she went into a deep coma. The ob-
stetrics and neonatal services personnel met
with the liver transplant team, led by Foster.
“We decided to performa C-section delivery
when the donor organ was on the way back
from procurement and then complete the
liver transplant,” he says. The medical team
was on standby, andwhen the organ arrived,
both surgeries were performed at Methodist
Hospital in the hybrid operating room.
Lamar J. Albritton,MD,
an obstetrician-
gynecologist experienced in high-risk
pregnancies, delivered the baby. He is
part of the maternal transport team at
Methodist Hospital. “Many meetings and
a lot of coordination was involved,” he
says. “The entire operation took 8 hours.”
REASONS 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. Ramos awoke from her coma
without neurological deficiencies from
her brain swelling and quickly returned to
normal. Max was in the newborn intensive
care unit for 2½months, and though there
was concern that the medications his
mom was on might affect him, he came
through without any medical issues.
“My mother was told that I would need
6 months to a year to recover,” Ramos says.
“But I was released to my family 14 days
after the procedure, and now I go in to
Methodist Specialty and Transplant Hospital
once a month for a checkup.”
Saving
mom
AND
F
rances Ramos, 21, was excited about being a mom for the first time. She received appropriate
prenatal care in her hometown of Harlingen and was eager to welcome her baby into the world.
Suddenly, her liver began to fail, and her family turned to doctors at Methodist Hospital and
Methodist Specialty and Transplant Hospital in San Antonio to save her baby and her life.
Specialty teams at Methodist Hospital and Methodist Specialty and
Transplant Hospital work together on a unique case of sudden liver failure
A PAIR OF SURVIVORS:
Frances Ramos with her
son, Max Joseph Ramos
See page 4 for more
about our organ
transplant program.
S P E C I A L R E P O R T