This week conjoined twins Kendra and Maliyah Herrin,who were born connected at the abdomen, sharing a single kidney and a liver, were separated. The 25-hour operation was deemed a success, but what are the future prospects for separated twins?
Lewis Spitz, Britain's foremost expert in conjoined twins, says they should live as normal life as is possible given the disabilities they will inevitably be left with. This is largely because very few of the conjoined twins born (they occur once in 250,000 live births) are deemed fit for surgery. Around half arrive stillborn; a further 35% survive only one day; only a fifth of those who survive longer are deemed eligible for a separation. Those picked for surgery are the ones doctors are fairly confident will survive.
"When their hearts are separate and they've got no neurological fusion - either their heads or their spinal cords - then separation is possible," says Spitz, emeritus professor of paediatrics at Great Ormond Street Hospital.
Spitz's own experience provides a snapshot of how successful surgery is these days: of the 11 procedures he has carried out on conjoined twins since 1985, 19 children are still alive. The remaining three died within six months of their operations. Spitz says the relatively high success rate is thanks to better imaging technology, improved anaesthetics and more experience among surgeons in recent years.
For Maliyah and Kendra, the usual rules of recovery from major surgery will apply for the next few months. They will spend time in intensive care and each will be eventually be fitted with a prosthetic leg, as they now have one each. Kendra will need to take drugs to suppress her immune system for some time after her next operation, when she will receive a kidney from her mother. After that, however, there is no reason to suggest the girls will not go on to have fairly normal lives.
Though the risks of major surgery cannot be underestimated, and it is possible for conjoined twins to have long lives, Spitz says: "If there's a chance of a reasonable, acceptable life following separation, they should proceed."
