MassGeneral children's hospital physicians forced to choose 1 twin to save through operation

Physicians at Boston-based MassGeneral Hospital for Children were faced with a tough decision last year after a pair of conjoined twins arrived at the hospital seeking an operation in which only one of the newborns would survive, CBS News reports.

The case, published in The New England Journal of Medicine Oct. 26, involved operating on 22-month-old conjoined twin girls who were connected by the abdomen and pelvis, had three legs and shared a single liver, bladder and a fused gastrointestinal tract. The pair also only had one anus and one vagina, according to CBS News.

The girls' parents brought their daughters to the U.S. for treatment last year through the help of an undisclosed nonprofit organization. They reportedly sent out requests for surgery to nearly 20 hospitals nationwide, the report states.

However, MassGeneral physicians, who agreed to conduct the surgery, said any possible operation might significantly affect the twins — referred to by physicians as "Twin A" and "Twin B" — including the possibility that one or both may not survive. Additional testing also revealed Twin A's heart was undersized and had congenital defects, among other health issues. Physicians said her declining health was affecting the health of Twin B, according to the report.

"Twin B is normal and living relatively healthy and we know that she can live without her sister, whereas Twin A relies completely on her sister. Her sister is her life support," lead study author Allan Goldstein, MD, surgeon-in-chief and chief of pediatric surgery at MassGeneral Hospital for Children, said in an interview with CBS News.

Dr. Goldstein and his team were faced with a difficult situation: to operate and potentially lose Twin A, or not to operate, meaning both babies may not survive, the report states. Officials assembled a pediatric ethics committee to discuss the situation. The committee concluded that while each twin should be regarded as their own person, there was little to no chance of saving Twin A. Not attempting surgery would risk Twin B's life.

Following significant discussions, the twins' parents decided to proceed with the surgery. The operation lasted 14 hours, but Twin B survived and is now healthy and thriving, Dr. Goldstein told CBS News.

The child's parents said in a statement to NEJM their daughter was "doing very well," according to CBS News.

"We couldn't be prouder or happier of how we all came together for the well-being of our child."

To read the full report, click here.

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