The Iranian twin sisters joined at the head since birth 29 years ago died within hours of each other yesterday from massive blood loss after surgeons in Singapore separated them in an operation they knew could cost their lives.
The deaths of Laleh and Ladan Bijani after a 52-hour operation by 28 specialists and 100 assistants plunged Iran into grief and brought shock and tears to Singapore's Raffles Hospital where the surgery took place.
"We were hoping to try and do better than the worst odds. But alas we didn't make it," said Raffles Hospital chairman Dr Loo Choon Yong.
"When we undertook this challenge, we knew the risks were great. We knew that one of the scenarios was that we may lose both of them. Ladan and Laleh knew it too," Dr Loo said.
In Iran, there was widespread shock and grieving at the death of the twins. Their suffering and bravery captivated the country and Iranian television cut into scheduled programmes to announce the deaths.
"It is a sad day for Iran," said Vice-President Mohammad Ali Abtahi. "The Iranian nation and a lot of people around the world were hoping these two would be rescued. "I express my condolences to their family and the Iranian nation and thank the medical team who were unsuccessful despite their best efforts," he said.
The twins, who died within 90 minutes of each other, had said last month they were willing to risk death for the chance to live separately, after sacrifice and compromise because of their very different personalities.
Both had law degrees, but Ladan - the more outspoken of the two - had said she wanted to be a lawyer, while Laleh wished to be a journalist in Tehran.
"I was shocked. I still don't believe it," said an Iranian living in Singapore for 15 years.
The operation, led by neurosurgeon Dr Keith Goh, ran into several major complications. The women's blood pressure had been fluctuating and surgeons discovered the brains were more closely linked than had previously been thought.
"The twins lost a lot of blood and were in a critical situation as the surgery was coming to an end," the hospital said.
After the operation began on Sunday, doctors opened the joined skull of the pair, peeling a strip of scalp from each woman. The bone proved surprisingly thick, causing delays.
The surgical team then battled to reroute a shared vein that drained blood from the twins' brains to their hearts. Then five neurosurgeons began the extremely delicate process of prying apart the brains millimetre by millimetre.
By yesterday morning, they had fully teased apart their tightly packed brain tissue and blood vessels, and the doctors announced the twins had been separated, causing a roar of applause and cheers from friends and supporters keeping vigil at the hospital.
But Ladan, considered more at risk after receiving a new vein grafted from her thigh, soon began losing blood and died. Surgery continued on Laleh, who passed away 90 minutes later.
The father of the twins, Dadollah Bijani, a poor Iranian farmer, said the sisters were kept in a hospital for years under the care of US doctors, but then went missing during the confusion of Iran's 1979 Islamic revolution.
He eventually tracked them down to Karaj, near Tehran, where they had been adopted by a doctor, Alireza Safaian.
Despite a court ruling awarding father-of-11 Mr Bijani custody, the twins decided to stay with Dr Safaian, who said they had been abandoned when he adopted them .- (Reuters)