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Twin admitted into hospital

By Edward Chiao

April 28, 2003 9:00 p.m.

Maria Teresa Quiej Alvarez, one of the formerly conjoined twins
separated at UCLA last year, is in critical condition in a
Guatemalan hospital.

On April 15, doctors discovered a pump they inserted in her
skull had become infected with E. coli bacteria.

Doctors at the Hospital del Pilar in Guatemala City successfully
removed the old pump, inserting a new device to keep liquid from
pooling and putting pressure on her brain.

“The good news is that Maria Teresa’s condition has
improved significantly and she is doing much better,” said
Dr. Jorge Lazareff, director of pediatric neurosurgery at
UCLA’s Mattel Children’s Hospital.

Lazareff and a team of UCLA anesthesiologists traveled to
Guatemala on Monday night to consult on Maria Teresa’s case
after being invited by Dr. Ludwig Ovalle, medical director of
Guatemala’s Pediatric Foundation.

Dr. Barbara Van De Wiele and Dr. Swati Patel, who led the team
of UCLA anesthesiologists during the 23-hour separation surgery
last August, accompanied Lazareff to Guatemala.

Despite the setback with Maria Teresa, Lazareff maintains his
confidence in the quality of care the separated twins are receiving
in Guatemala.

“We hold the utmost trust in our colleagues from Guatemala
and know they are providing Maria Teresa with the best of
care,” Lazareff said in a statement last Friday.

“The treatment she is receiving is appropriate, and her
pediatrician, Dr. Ludwig Ovalle, is an excellent
pediatrician,” he continued.

Lazareff and the team of anesthesiologists are scheduled to
return to Los Angeles on April 30.

Since the separation surgery last August, Maria Teresa has
recovered more slowly than her sister, Maria de Jesus.

Maria Teresa has required three additional surgeries to remove a
buildup of blood in her brain. She also suffered hearing loss in
one ear and wears a hearing aid.

This is also not the first time UCLA doctors have traveled to
Guatemala since the twins returned home on Jan. 13.

A seven-person UCLA medical team, which included Lazareff,
traveled back to Guatemala with the twins to oversee their
transition after they were released from UCLA.

UCLA medical specialists recently made several trips to
Guatemala to provide medical services to dozens of children
suffering from neurological diseases, as well as to help train
local doctors.

In March, Lazareff and two doctors reunited with the Quiej
Alvarez family in Guatemala during one such volunteer medical

The twins arrived at UCLA on June 7, 2002. The 20-month-old
twins were joined at the head and underwent separation surgery on
Aug. 6, 2002 at UCLA. They were scheduled to leave in late October
of last year, but minor complications delayed their departure.

Craniopagus twins ““ those joined at the head
““ make up only 2 percent of conjoined twins. Their
separation is one of the most dangerous of all operations.

Doctors have performed cranial separations only five times in
the past 10 years, and not all twins have survived. This was the
first time the procedure had been attempted at UCLA.

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Edward Chiao
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