Christmas Eve 2020 is burned into the memory of Juan Antonio Encarnación, a radiation oncologist from La Arrixaca. That day, a brain scan performed on his father, José María Encarnación, set off all the alarms. The confirmation of the diagnosis left the family in ‘shock’: it was a gioblastoma, an extraordinarily aggressive brain tumor with an average survival of barely one year.
“My father had always wanted to be a donor. When the tumor was detected, we knew the evolution that he would unfortunately have, so I asked the Transplant Coordination of La Arrixaca if a patient with his characteristics could donate. They told me no, that at that time it was not authorized”, recalls Juan Antonio. But his colleagues encouraged him to look at the guidelines and protocols to study the possibilities, and he did so.
Patients with a high-grade malignant brain tumor were banned from the transplant program in Spain, but the truth is that it is a cancer that, despite being very aggressive, usually develops in a “very localized” way, with low rates of metastases in organs likely to be used for transplants. Specifically, the risk of spreading malignant cells to the heart, kidney, or liver is very low, and sometimes almost nonexistent. So, in collaboration with Mario Royo-Villanova, transplant coordinator at La Arrixaca, Juan Antonio Encarnación set out to study the possibility of including these patients in organ donation. From there arose his doctoral thesis but, above all, an exciting gift to his father, which finally, and against all odds, he was able to donate after his death.
“They told me that these donations were not authorized, but we verified that the risk was very low”
In October 2021, the Region of Murcia became the first community in Spain to open the door to these patients with high-grade brain tumors, through a pilot project. Since then, 16 of these patients have been able to donate, and 22 transplants have been carried out (15 liver, 5 kidney and 2 heart).
“Everything started thanks to him”
“This all came about thanks to my father. We saw that he was safe, and he was able to donate », sums up Juan Antonio excitedly. Now, the National Transplant Organization (ONT) is studying the results of the pilot program developed in La Arrixaca to assess its possible validation and extension to other hospitals in Spain.
José María, the father of Juan Antonio, was the protagonist this Tuesday of the act held at the Ministry of Health on the occasion of National Donor Day. An anniversary conceived precisely to pay tribute to those who with this gesture of solidarity contribute to saving lives. The pilot donation program for patients with brain tumors is one more of the pioneering initiatives that the Regional Transplant Coordination has been successfully developing: from donating patients with a positive covid test result to promoting heart transplantation with donors in asystole ( died from cardiorespiratory arrest).
Extractions in asystole already exceed the traditional route
The Region of Murcia continues with above-average donation rates, Ricardo Robles, regional transplant coordinator, highlighted yesterday. In the first five months of the year, 39 donations have been registered, ten more than in the same period of 2022. This has allowed 203 transplants to be carried out, 23 more.
But, beyond the increase in donors, the regional program has gained momentum thanks to the better use of organs: the use of equipment for extracorporeal membrane oxygenation of blood (ECMO) has been key to multiplying the useful organs that are extracted in asystolic (heart-beating) donations.
In fact, so far this year the Region of Murcia has made a new leap in this direction: of the 39 registered donations, 23 were in asystole and 16 after brain death. It is the first time that this new method of donation exceeds the one that had traditionally supported transplant programs. Among these donations in asystole are those carried out by patients with brain tumors.
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