Conjoined Twins Tug at Heartstrings as They Stretch Limits of Medicine

ByABC News
August 8, 2006, 5:27 PM

Aug. 9, 2006 — -- Every few months it seems another pair of conjoined twins makes international headlines.

This time it's Kendra and Maliyah Herrin, who were separated late Monday after more than a day of extensive surgery. The 4-year-old girls, from North Salt Lake City, were born fused at the chest, sharing several organs and a set of legs.

The harrowing stories of conjoined twins may garner lots of interest, and certainly trigger lots of hope, but the long-term outlook for most of them is for the most part unpredictable. Conjoined twins who survive beyond birth are so rare, and all so medically different, that generalizing or speculating about their prognosis after separation is a gamble, doctors said.

In many ways, it's still the Wild West of medicine, where doctors operate without the benefit of years of experience about what works. At the same time, emotions run high, since the patients are usually children with one of the oddest birth defects known to exist.

"We're so used to reading about the tremendous trials of thousands of patients and FDA approval of this drug and that device, and this just comes down to one step above bedside manner," explained Dr. David Staffenberg, chief of pediatric plastic surgery at the Children's Hospital at Montefiore Medical Center in the Bronx, N.Y.

What is known: Most conjoined twins are born stillborn or die within days after birth, and of those who do survive past the first few days of life are usually female, for unknown reasons. The easiest to separate are twins fused at the chest but who don't share a heart. The most difficult to separate are twins fused at the head, because of the vast blood supply in the brain, according to a fact sheet from the Johns Hopkins Children's Center.

But perhaps most important, twins who are separated generally do better than those who are left fused, which puts the impetus on surgeons to come up with newer and better ways to perform the often unimaginably challenging separation surgeries.