A pair of conjoined twin boys born to a couple living in Cork were today described as being "medically very well" prior to their discharge from Cork University Maternity Hospital where they've been treated for the past few weeks.
The two little boys were born six weeks ago at University College Hospital in London but were transferred to CUMH when they were deemed strong and well enough to make the journey back home to Ireland.
The parents of the two little boys issued a statement through the HSE in which they appealed for privacy and said they wanted to enjoy their time with their children prior to them undergoing separation later this year at Great Ormond Street Hospital in London
"We are issuing a statement now because we feel the time is right to announce the twins' birth. We are very proud of our two little boys and we feel blessed by their arrival six weeks ago. We needed time together first as a family and to see how the boys were doing.
"Presently, they are feeding well and gaining weight. We are planning for the boys to come home soon and we are asking the media and the public to let us enjoy this special time with our "two little fighters" before their separation later this year," said the parents.
The HSE statement did not identify where the twins are conjoined but the fact that they are due to undergo a separation procedure later this year suggests that they do not share a common heart or liver as sharing such organs means separation is not possible.
Consultant paediatric surgeon at Great Ormond Street Hospital, Cork-born Edward Kiely, who has been managing conjoined twin cases at the hospital since the 1980s, said it's hoped to separate the twins later this year.
"If all goes according to plan the children will return to Great Ormond Street Hospital later in the year. The surgical team here is the most experienced in Europe at assessing and, if necessary, separating conjoined twins," said Mr Kiely.
The case involved close liasion between CUMH and University College Hospital in London once it became apparent from scans that the mother was carrying conjoined twins and yesterday the HSE said that both boys were responding well to care at CUMH.
"Both boys are medically very well, taking their feeds and gaining weight. The neonatal team in Cork is working closely with the family and Great Ormond Street Hospital with the boys' treatment and clinical care," said a HSE South spokeswoman.
The boys' parents paid tribute to staff in all three hospitals. "We would like to take this opportunity to personally thank all the wonderful people who cared for us and the boys at University College Hospital, Great Ormond Street Hospital and Cork University Maternity Hospital.
"We would also like to thank our family and friends who have helped us through such a difficult time and let them know just how much we appreciate their ongoing support," said the parents in their statement.
Meanwhile Mr Kiely revealed that Great Ormond Street Hospital is the most experienced centre in Europe for the management and, if necessary, the separation of conjoined twins with the teams having dealt with some 21 separations and some nine inoperable cases to date.
"Separation is best carried out at a tertiary centre with the full range of specialties on hand. "We have the two most experienced surgeons in the UK in this work leading a team of expert nurses, doctors, and other health professionals, providing the full range of expertise needed."
According to Mr Kiely, there are a number of scenarios possible when it comes to managing conjoined twins whose prospects can vary widely depending on their general health, how they are joined and what organs are shared.
The survival rate at Great Ormond Street Hospital for planned separations where the children are stable and separation can be done at a suitable time is around 80 per cent and under these circumstances both usually survive and have a good quality of life, he said.
In emergency separation cases where one or both children are dead or dying and where separation is undertaken to try and save at least one baby, survival rates are in the region of 20-25 per cent and survivors may have a good quality of life, he said.
However some cases are inoperable such as where children are joined at the heart where sadly, they usually die or where they are joined at the brain when they are often inoperable but may survive for many years, he said.
"We have successfully separated twins joined at the brain and they are doing well. Even within these categories success rates will vary depending on case by case circumstances," said Mr Kiely.
Mr Kiely said that sacrifice surgery, where surgeons try to make one viable child out of two has not been carried out at Great Ormond Street Hospital and, in general, tends to lead to the death of both children.