Sarah Murnaghan, a 10-year-old girl from Pennsylvania, received a second lung transplant three days after receiving her first one.  After a transplant using adult lungs on June 12, Sarah suffered severe complications, necessitating the second transplant.  Her parents publicly revealed yesterday that she had received the second transplant.  Between 2010 and 2012, only 42 lung-transplant patients, which is less than 1 percent, received a second lung transplant within six months.

Murnaghan came into the public eye after her parents sued to change a policy of the United Network for Organ Sharing (UNOS).  The policy put children behind adults and adolescents on the waiting list for adult lungs.  A federal court judge ordered that Sarah and another 11-year-old child named Javier Acosta be placed on the adult list.  Within a few days of that decision, Sarah received her first transplant.  UNOS also created a special appeals process for the other children, declining to automatically place them on the transplant list after the court ruling.

The story of Sarah was closely watched, with some criticizing Kathleen Sebelius, the Secretary of Health and Human Services, for acting “coldly” and not taking action to help save Murnaghan.  However, as others commented, if Sarah got a set of lungs by Sebelius circumventing UNOS policy, that would mean another dying person would not get them.  The rules were designed to minimize deaths and maximize effective use of donated organs.

Others remarked that the policy is in place for a reason.  If adult lungs are placed in a child, where they do not fit, there may be two victims: the adult that was skipped over and the child that may die of complications or will have to return to the list.  The latter seems to be what happened here.  There were complications with the adult lungs and Sarah needed another set.  This time, her family accepted lungs already infected with pneumonia, taking on the risk because Sarah had no other options.

Sarah and Javier, the other child added to the adult list, suffer from cystic fibrosis (CF).  An inherited condition, CF results in production of a thick and sticky mucus that clogs the lungs, leads to life-threatening infections, obstructs the pancreas, and stops natural digestive enzymes.  In the U.S., about 30,000 people suffer from CF.  There are 1,000 new cases of CF diagnosed annually, with 70 percent of those with the condition being diagnosed by the age of two.  The median age of survival for those with CF is the late 30s, but medical advances are consistently improving the survival rate.