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Four-year-old conjoined twins Kendra and Maliyah Herrin were separated just before 11 p.m. Monday, about an hour earlier than doctors expected. A hospital spokeswoman said both girls were doing well and were stable, and each had another five hours of surgery ahead of them.
Primary Children's Hospital spokeswoman Bonnie Midget was with the girls' parents, Erin and Jake Herrin, of North Salt Lake, when they got the news.
"It was a sweet moment. It was emotional. They were smiling but teary," she said, adding the parents hadn't seen the girls yet, but were to be reunited sometime this morning after they were transfered to intensive care.
Shortly after the announcement was made about the separation, the girls' parents thanked the community and expressed their relief.
"We have two separate little girls," said a beaming Jake Herrin. "We're very excited and hear they are doing great. We were nervous and scared but our faith brought us through it."
Kendra and Maliyah were born joined at the pelvis and sharing a pair of legs, a liver, a single working kidney and part of a large intestine.
Earlier Monday, Midget said efforts to separate tissue in the sisters' lower abdomen, intestine, bladder and some bones went smoothly, and that they had not required blood transfusions.
With the liver bisected, Maliyah's access to the single kidney the girls shared is cut off. Kendra retained the kidney, which is in her body, and Maliyah will be put on a dialysis machine.
If all goes according to plan, Maliyah will receive one of her mother's kidneys in three to six months.
Each girl has control over one leg and kept that leg. They are expected to be eventually fitted with prostheses.
In the months before surgery, the girls were fitted with tissue expanders to stretch their skin so it would cover their new bodies.
The plan was that after separation, the girls were to be taken to different operating rooms to complete the reconstruction process. They likely would be under anesthesia and on ventilators for a few days, Midget said, but they would sleep in their own beds side by side in one room for the first time.
The Herrins last spoke at 4 p.m., when they answered questions and expressed gratitude for the international support they have received. Members of The Church of Jesus Christ of Latter-day Saints, they have often spoken of the faith that has sustained them.
"Everything is going as well as we could hope and pray for," Jake Herrin said. "Prayers are working."
The Herrins marveled at the strength their girls showed in the days and moments before heading into the operating room. Their spirits remained high, and they broke into tears only at the last minute as their parents left them in the doctors' care.
"They've given us courage we didn't realize 4-year-olds could possess," said Erin Herrin, 25.
Said 26-year-old Jake: "Our family bond has just grown. We're very thankful to have been the parents of Kendra and Maliyah. They are so energetic, so lively and they inspire. We could all learn a lot from them."
Numerous relatives kept vigil with the couple, who also have a 6-year-old daughter and 14-month-old twin boys, company throughout the day.
Surgeons revised the order of some planned procedures, not because of complications but because opportunities presented themselves. The separation is believed to be the first of twins who share a single kidney, and before deciding to go ahead with the surgery, the Herrins consulted with ethicists and psychologists.
Conjoined twins occur when an embryo fails to completely separate within two weeks of fertilization. The condition occurs once in every 50,000 to 100,000 pregnancies but only once in every 200,000 live births. Most twins survive only a few days.
There are more than 30 types of conjoined conditions, with a connection at the chest being most common. Only about 6 percent are joined at the hip like Kendra and Maliyah, a type called ischiopagus.
While most conjoined twins are separated in infancy, the Herrin girls' single kidney complicated matters. The twins' separation needed to wait until Maliyah was big enough to handle dialysis and improve her odds for a successful kidney transplant.
Erin Herrin said she never thought twice about giving Maliyah one of her kidneys.
"As a mother, we give the gift of life," she said Monday afternoon, breaking down momentarily. "It's a privilege to a mother. I'd give both kidneys if I knew she'd never have to face anything hard again."
At a family party Sunday night, the twins shared their excitement about about being separated, said Marley Orton, Jake Herrin's sister.
They'd smile and say, We get to be cut apart tomorrow. We get to be separated,' '' Orton said. Knowing that they are aware of what is happening, and that they're excited about it, gives us a little more comfort.''
Jake and Erin Herrin gave the girls tearful hugs and kisses as they handed them off to anesthesiologists early Monday morning.
The girls enjoyed a sort of scavenger hunt as they rolled down the corridor toward to the operating room this morning. They stopped at numbered flaps posted along the walls. Under each flap was a sentence detailing the girls' favorite things, including baby tacos and hot dogs.
The girls were taken into the operating room around 7 a.m. to be positioned, padded and prepped for surgery, Midget said. Doctors began the procedure around 10:30 a.m., first working on the intestines and then moving to the girls' bladders.
Led by Pediatric Surgery Division Chief Rebecka Meyers, eight surgeons including specialists in urology, orthopedics and reconstructive surgery and dozens of operating staff, anesthesiologists, radiologists and pharmacists are involved in the operation. There were two surgeons for each speciality, trading off in shifts.
The separation consisted of a series of procedures, most of which surgeons have performed on individual patients in the past. At least one surgeon has been involved in a conjoined twin separation before, Midget said.
"Doctors are hopeful and would not have proceeded if they felt there was not a good chance of a successful outcome," Midget said.
Doctors expect the girls will be in intensive care for at least a week and in the hospital for about a month.
The Herrin family's Web site, http://www.herrintwins.com, had more than a million hits through Sunday and the traffic has caused it to crash.
The family also asks that in lieu of flowers, well-wishers make donations to Primary Children's Medical Center or the Make-a-Wish Foundation, which granted Kendra and Maliyah their wishes: Maliyah got a castle playroom, and Kendra got to meet all the princesses at Disney World.