One of PNG's rare conjoined twins dies after urgent surgery in Sydney, brother survives
Rare conjoined twins Sawong and Tom were urgently flown to Sydney last week. (Supplied)
In short:
A rare set of conjoined twins have undergone surgery to separate them after they were flown to Sydney from Papua New Guinea.
One of the twins, Tom, has died while his brother Sawong has survived. Sawong is in intensive care at Sydney Children's Hospital.
What's next?
Sawong is expected to remain in intensive care at Sydney's Children's Hospital for at least a week.
Surgeons have separated a rare set of conjoined twins after they were urgently flown from Papua New Guinea to Australia, but only one of the boys has survived.
Tom and Sawong, nearly two months old, underwent the seven-hour surgery at the Sydney Children's Hospital on Sunday, after arriving in Sydney late last week.
Tom died minutes after the surgery, according to pilot Jurgen Ruh, who was with the twins' parents in Sydney and first helped bring the babies to Port Moresby from remote PNG for treatment after they were born.
Sawong and Tom were born two months ago in a remote part of PNG. (Supplied)
Sawong is expected to remain in intensive care for at least a week, Mr Ruh told the ABC.
The twins were urgently flown to Australia on Thursday after doctors recommended they be separated as soon as possible.
Specialists from the Sydney Children's Hospitals Network arrived in Port Moresby to help transfer the babies.
The twins had been receiving care in Port Moresby after they were flown there. (Supplied)
Mr Ruh, who flew with the boys' father to Sydney, said the surgery was brought forward after the twins arrived.
"It was on Saturday lunchtime when the doctors called us in, and they said, 'Look, Tom is getting more swelling and he's going downhill'," he said.
"Initially, they were planning a separation for Tuesday, but they said it looks like we have to bring it early."
The boys were born on October 9 in remote Morobe province and were flown to Port Moresby for treatment.
They were joined at the lower abdomen and shared a single liver and parts of their gastrointestinal tract.
Tom, the smaller twin, had a congenital heart defect and only one kidney.
Jurgen Ruh, the pilot who was with the twins' parents in Sydney. (ABC News: Liam Patrick)
Medical team advised transfer
The surgery required to separate them could not be performed in PNG.
After several weeks of tense negotiations and earlier recommendations not to transport the twins overseas, the boys were moved to Sydney for the highly complex surgery when Tom's health deteriorated last week.
Papua New Guinea's Prime Minister James Marape told journalists on Monday that PNG's government had given "assurance that the medical bills" would be picked up.
"Based on our assurance [the Australian government] was able to facilitate the quick transfer to the hospital,"he said.
Polapoi Chalau, the chief executive of Paradise Private Hospital in Port Moresby — where the twins were being treated until Thursday — said last week that Tom had signs of low albumin, a protein important for balancing fluid levels in the body.
A team of specialists from the Sydney Children's Hospitals Network flew to Port Moresby two weeks ago to assess the twins and recommended the boys be transferred to a specialist facility as soon as possible.
The twins were joined at the lower abdomen and complex surgery was required to separate them. (ABC News: Marian Faa)
In a letter to doctors in PNG, the Sydney team said Tom had multiple congenital anomalies and his long-term survival was unlikely.
They said Sawong had a reasonable chance of survival after surgery.
"The reason for the early separation is that Sawong is working hard to support Tom. This is also why the team has recommended transfer as soon as possible," the letter said.
"The team has also recommended specialised transport to the facility with a specialised medical and nursing team."
In its letter, the Sydney Children's Hospitals Network said the twins would be treated in its facility at Westmead.
Pilot flew twins from remote PNG after stabilisation
Conjoined twins are extraordinarily rare, accounting for fewer than every two in 100,000 births.
After Tom and Sawong were born at Braun Hospital in Finschhafen in Morobe province, the twins were stabilised and flown to the larger Angau Memorial Hospital in Lae.
The small Braun Hospital is about three hours by boat from Lae, the provincial capital.
Kovei Umba, one of the doctors who helped deliver the twins, told the ABC in October he initially did not think the boys would survive, but they had started breastfeeding.
In the following days, Mr Ruh flew the twins with their parents to Port Moresby for further medical care.