Kidney transplant scheduled Tuesday for Herrin twin

Maliyah Herrin will receive one of her mother's kidneys today in what is hoped will be the last major childhood surgery for the formerly conjoined twin.

Maliyah and her twin sister, Kendra, 5, daughters of Jake and Erin Herrin of North Salt Lake, were born joined at the abdomen. They were separated in a 26-hour marathon surgery last August. Maliyah has undergone dialysis three times a week since that operation because the two girls had shared Kendra's kidney.

Monday morning, as mother and daughter were undergoing final tests prior to the transplant, an excited Maliyah told Primary Children's Medical Center spokeswomen Bonnie Midget, "I get my kidney tomorrow."

She's not particularly looking forward to an operation, but "she definitely wants a kidney," said Dr. John Sorensen, one of the transplant surgeons, who added that she has "incredible insight into what's happening."

When two large surgical teams separated the twins Aug. 7, many of the decisions they made in reconstructing Maliyah's abdomen had the

future kidney transplant in mind. For instance, Dr. Patrick Cartwright, a pediatric urologist, formed her bladder with an eye to the future transplant. He's part of today's surgical team as well.

An expander was also implanted in Maliyah's abdomen to make room for the kidney that would be implanted, said Dr. Rebecka Meyers, who led the separation-surgery teams and will be one of the kidney transplant surgeons. The adult-sized kidney will have to be placed so it doesn't put pressure on organs or blood vessels.

It is more common for children to receive an adult-size kidney than to receive a child-size one, Sorensen said.

Still, it will not be a routine transplant surgery, since Maliyah's anatomy is different. The twins shared an abdomen, and each had control of one leg. After separation, the surgeons had to build each girl a partial abdominal wall. There are other abnormalities as well, including unusual blood vessel anatomy and differences in Maliyah's urinary system. The surgeons will also face scar tissue and adhesions from the separation surgery, which is likely to extend the transplant time to as long as eight hours, rather than the more typical two or three hours, which is about how long Erin Herrin's surgery is expected to take.

Sorensen said the complexity of the surgery will increase the physiological demands on Maliyah's body.

"We don't necessarily have to create structures that don't exist, but we have to work within the confines of her structure," Sorensen said.