Smallest Liver Transplant Recipient Leaves Shands

December 3, 2001

GAINESVILLE, Fla. — Eleven-week-old Bethany Joy Mullins was discharged today from Shands Children’s Hospital at the University of Florida — just in time for the holidays. She is the smallest infant in North America to successfully undergo liver transplantation.

The Mullins family came to Shands Children’s Hospital Oct. 9 from their hometown, Orlando, Fla., to face an uncertain future. Bethany and her twin sister were born Sept. 18, nearly seven weeks premature, both with a liver condition that could not be diagnosed. Bethany’s success is a triumph against all odds, but a bittersweet one for her parents, Heather and Daniel Mullins: Their other twin, Jordan Grace, could not be saved and died before she could receive a transplant.

“When Bethany’s liver began failing, we knew we had to act fast to do something about it,” said Dr. Alan Hemming, UF College of Medicine assistant professor of surgery. “We immediately placed her on the national organ donor waiting list.”

Since tiny Bethany weighed only 4 1/2 pounds — about 2 kilograms — a successful transplant outcome would be improbable, yet it was her only hope. There is little compiled data for liver transplantation on infants of Bethany’s size. In addition, the unavailability of organs suitable for premature infants and the high risks associated with the procedure made the outcome uncertain.

“Getting an organ to fit Bethany was a technical challenge,” Hemming said. “There are very few infants who are transplanted under 3 kilograms. Transplanting infants under 5 kilos imposes a higher risk of vascular thromboses and other problems.” Because Bethany’s condition was critical, she was placed high on the waiting list and a donor organ became available four days after her arrival at Shands. A team of transplant surgeons, led by Hemming, performed the transplant on Oct. 13. Now, seven weeks later, the infant is beating the odds.

“Bethany is currently the smallest surviving liver transplant recipient in North America. She is a real fighter,” Hemming said.

“We had been told that coming to Shands was our last medical option. In fact, we really only thought the doctors would evaluate Bethany and Jordan. We were unsure that they would be viable transplant candidates and prayed for a miracle,” said Bethany’s father, Daniel, a ninth-grade math teacher at Winter Park High School. He and his wife, Heather, a homemaker, also have an 18-month-old son, Daniel Jr.

“The transplant surgeons were wonderful,” Daniel Mullins said. “They kept us informed and made us feel comfortable every step of the way.”

Shands Transplant Center is ranked by the United Network for Organ Sharing as the nation’s eighth busiest center for liver transplants and 11th overall for volume of solid-organ transplants. UF surgeons at Shands perform an average of 115 pediatric and adult liver transplants annually.

“Bethany’s transplant went very smoothly and there were very few problems,” Hemming said. “I’m happy with the technical aspects of the transplant. But that’s just the beginning. We have to now think about everything else, like rejection, infection and complications of immunosuppression.”

The Mullins family will return to Shands weekly so Bethany’s transplant team can monitor her progress.

“We would like to thank God for his gift of life,” Daniel Mullins said from the hospital. “We would like to thank the donor family for making a difficult yet generous decision and we encourage others to become donors. We are grateful to the Shands transplant team for their great medical treatment. Above all else, we praise God for giving Bethany a second chance at life.”