Mickey Mantle was rushed into surgery again early today, but a single stitch near his transplanted liver stopped internal bleeding and doctors remained pleased with his progress.
The next two or three days are still crucial for the 63-year-old Hall-of-Famer who received a new liver Thursday to replace one damaged by cancer, hepatitis and years of alcohol abuse, doctors said.Dr. Robert Goldstein said the 30-minute procedure this morning at Baylor University Medical Center went very smoothly. Mantle was returned to the intensive care unit and his condition was upgraded to serious.
"He was awake, alert and responding to all commands," Goldstein said. We talked about the liver transplant, and he'd nod his head and respond.
"We are very pleased with his progress so far."
Goldstein said during a news conference that Mantle was taken off a respirator this morning and was breathing on his own. He said Mantle was very tired, but his spirits were good.Goldstein cautioned, however, that Mantle was not out of the woods.
"I think the next 48 hours will be very important for him," the surgeon said. "If he gets well and gets off the breathing machine in the next 48-72 hours, then I think he'll have a good chance for recovery."
Goldstein was interviewed this morning on ABC's "Good Morning America" and the "The Today Show" on NBC.
"I'd like to be able to get him off the breathing machine within the next 48 hours, and hopefully out of the ICU in about three days, and if everything goes well, out of the hospital in about 21/2-3 weeks."
Mantle's son, David, also appeared on both programs and was asked about criticism of his father getting a liver after only two days on the waiting list, since he may have brought about his physical problems with more than 40 years of heavy drinking.
"I can understand that," David Mantle said of the criticism. "I feel that the hepatitis C was in there, that was another factor. We're pretty sure, too, that the alcohol had something to do with it.
"I think also with the celebrity status, you're going to catch some extra flak for that."
The younger Mantle expressed appreciation to the donor whose identity remained a secret.
"I think the real hero is the person that was able to donate her organs, whatever, and the family," he said. "Without the donors, its really meaningless."
The type of bleeding that afflicted Mantle is not an infrequent occurrence, Goldstein said, adding that it was more common with patients like Mantle who were extremely ill prior to the transplant.
The bleeding was detected by nurses about 24 hours after the transplant. The problem is not related to whether Mantle's body is accepting or rejecting the liver, doctors said.
Goldstein said once the source of the bleeding was found, "we put one stitch in it and turned him back into the intensive care unit.
"Actually, it was an area where there was not a suture, but where a clot had formed previously and had broken down. The liver looked excellent and it went very well this morning."
Mantle was diagnosed with progressive liver failure after he was admitted to the hospital on May 28, complaining of abdominal pain.
Doctors said that in addition to cirrhosis brought on by years of alcohol abuse, Mantle also was found to have a malignant tumor blocking his bile duct and a long-dormant case of hepatitis C, apparently the result of blood transplants received during surgeries for various athletic injuries.
Dr. Goran Klintmalm, medical director of the Baylor Transplantation Institute, called early reports on the new liver "very excellent" and said Mantle's kidneys were returning to normal. Questions remain as to whether infection from the old liver might still be present, Klintmalm said Thursday. Cancer also could reoccur, as might the hepatitis C.
Goldstein said the scarred liver removed from Mantle was "lumpy, bumpy and hard" when it was removed.
Said Klintmalm: "He had a very sick, ugly liver."
All of Mantle's immediate family - wife Merlyn and sons Mickey Jr., David and Danny - were at the hospital Thursday. Doctors said Mantle awoke briefly four hours after the surgery but did not speak.
Mantle was not given any sedative, Klintmalm said, "because we want him to be awake. He's very groggy. It's the anesthesia."
Being in intensive care is difficult "because of the sleep deprivation," Klintmalm said. "There is no day, no night. it's a 24-hour day. There is no uninterrupted sleep. You doze off, and you're awakened again and again as doctors or nurses take tests or adjust something."