RIYADH, Saudi Arabia — Saudi doctors have indicated that Azora Elson, one of the formerly conjoined Jamaican twins who were separated in Saudi Arabia on November 13, will need a heart transplant to survive.

Azora remains in the paediatric intensive care unit (ICU) at King Salman Humanitarian Aid and Relief Centre (KSrelief), according to KSrelief Supervisor General Dr Abdullah Al Rabeeah, as per an update from the Saudi Press Agency.

Azora’s twin, Azaria, has left the ICU. The agency reports that her vital signs are back to normal, and she is eating and interacting normally.

Unfortunately, Azora is still dealing with heart problems two weeks after the operation and is now on ventilation. She is currently receiving medication to stave off heart failure and fluid build-up in her lungs.

The twin has had an enlarged heart and weakened cardiac muscle since birth, with the report now indicating her heart pumps at less than 20 per cent of the normal rate, requiring medical support.

Al Rabeeah indicated that a team with doctors, including cardiac disease specialists and transplantation specialists, held several meetings and concluded that the young girl will need a heart transplant to survive.

But Dr Al Rabeeah indicated that Azora’s age, weight and the absence of a compatible donor organ that suits her size have proven to be roadblocks in the process. Based on Saudi transplant criteria, the doctors say a transplant is not possible, reducing her chances of survival.

The report said this was a known possibility, and the situation had been explained to the girl’s mother before and after the complex separation surgery, and she accepted the medical decision.

At birth, the twin girls had been conjoined at the lower chest, abdomen and liver; their eventual separation, thanks to the Saudi Conjoined Twins Programme, was carried out over a five-hour period in six stages with 25 medical personnel.