NNSL (Dec 15/97) - A Cambridge Bay infant survived a delicate lung transplant 10 days ago and is recovering in a St. Louis, Mo., hospital.

Three-month-old Amelia Lyall was admitted to St. Louis Children's Hospital

in late October while waiting for new lungs. Her doctors said the operation became necessary after tests revealed her lungs were immature. Because of her condition, Amelia has spent her entire life in hospital.

She was born Aug. 20 in Yellowknife to Fiona Lyall of Cambridge Bay. It was an uneventful delivery. Initially, Amelia was considered healthy, though somewhat light at six pounds 10 ounces. Amelia's father, Mike Knappman, said there were no hints of problems.

Shortly after delivery however, she was diagnosed with pulmonary dysmaturity -- improperly formed lungs. Without a lung transplant, she would die.

Amelia was immediately medevaced to University Hospital in Edmonton, where she stayed until early the next morning. She was then transferred to the Royal Alexandra Hospital, where her blood could be treated with oxygen through a machine.

"We were prepared for her to die any day at that point," said Knappman.

Amelia nearly died several times during that period doctors, as her heartbeat dropped, her blood pressure sank and she couldn't breathe by herself, he added. "Several times, they had to take her off the respirator and use the 'football' to keep her breathing."

(A "football" is a plastic, manually-operated respirator.)

Towards the end of October, the decision was made for Amelia to get the transplant she desperately needed. Unfortunately, no Canadian hospital could handle the operation.

"It came down to a choice between sending Amelia to Pittsburgh, Penn., or St. Louis, Mo." he said from his room at the Ronald McDonald House in St. Louis. The hospital in St. Louis performs two or three lung transplants on infants per year.

Doctors there described the situation in tenuous terms.

"I am quite certain that she had very little time left had she not received the transplant when she did," said Dr. Charles Huddleston, the surgeon who performed the life-saving operation.

"We proceeded with the transplant in her because she had a lethal disease isolated to the lungs with otherwise normal organ function in the rest of her body," he said.

Early on Friday, Dec. 5, Amelia was prepared for the operation. At 10 a.m., doctors made the first incision, with donor lungs from "somewhere in the continental U.S." said Huddleston.

The operation went smoothly.

"The procedure involved opening Amelia's chest across the front and dividing the breastbone horizontally. She was then placed on the heart-lung machine used for open-heart surgery and her lungs removed. We then sewed in the new lungs by attaching the airway, artery and vein on each side." he explained.

Amelia was wheeled out of the operating room six hours later. But she isn't out of the woods yet. She is breathing with the help of a machine and is likely to stay on it for several days. She must still learn how to breathe on her own, said Huddleston.

Doctors at the hospital said the first five months are crucial in determining whether or not an individual rejects an organ.

She will be placed in intensive care for several days after coming off the breathing machine, and later be transferred to a general ward while her parents learn how to provide care for her.

They also have to learn how to evaluate her situation for organ rejection, something, which is not unusual in a case like this, Huddleston said.

It's a long, difficult process, but a necessary one, said Knappman.

Amelia is likely to remain in St. Louis for another month. After that, she will receive three different medications to prevent rejection and two antibiotics to prevent infection.

"She's a fighter," her father said. "We just take it one day at a time, take the good days with the bad days, and hope for the best. We just keep praying."

At press time, Amelia's condition had worsened somewhat, as she was combatting fever. Knappman said they remain hopeful and continue to spend most of their days at Amelia's bedside.