Mexico City. For the first time in the world, the La Paz University Hospital in Madrid has performed a multivisceral intestine transplant from a controlled pediatric asystole donation to a 13-month-old girl with intestinal failure diagnosed since her first month of life, who has already been discharged and is in “perfect health”.
In recent years, the number of patients who require a solid organ transplant to stay alive has increased, and non-heart beating donation already represents a third of donations made in Spain. This technique, as reported by the general director of the National Transplant Organization (ONT), Beatriz Domínguez-Gil, makes it possible to contemplate the possibility of donation within end-of-life care in those patients in whom it has been decided the adequacy of life support measures.
In addition, this type of donation allows, after certification of death, to preserve the organs with perfusion of oxygenated blood through the Extracorporeal Membrane Oxygenation (ECMO) system, so that the organ to be transplanted does not deteriorate. This donation offers similar results to the classic donation in brain death.
Despite the fact that 30 percent of the candidates die on the waiting list, the section chief of the Pediatric Surgery Service at Hospital La Paz, Francisco Hernández Oliveros, had never used the intestine from an asystolic donation, considering that it was not would be valid given the special characteristics of this body.
As the scientific evidence did not show that it could not be done either, the professionals from the Madrid hospital, belonging to the IdiPAZ Congenital Malformations and Transplant Group, launched a three-year research project thanks to the institutional support and funding of the Mutua Madrileña Foundation .
Once the team was able to demonstrate, in various experimental models, that the intestine was valid, it could be transferred to the clinic through a multidisciplinary team made up of professionals from Pediatric Gastroenterology, Pediatric Surgery, Pediatric Cardiac Surgery, Pediatric Intensive Care, Anesthesiology and Resuscitation and Coordination of Transplants, Experimental Surgery and IdiPAZ.
The patient, as explained by the head of the Rehabilitation and Intestinal Transplant Unit, Esther Ramos, suffered from short bowel syndrome that caused intestinal failure and that, after several interventions, she had to undergo a transplant since the treatment of choice, in the which is fed intravenously, causes complications such as liver problems.
The objective now in the medium or short term is to remove parenteral nutrition from the minor. During the presentation ceremony of the transplant, Daniel, the father of the transplanted minor, wanted to thank the professional “and human” work of the team because he has “given life” to the three of them.
“Today Madrid’s health sector adds a new milestone in its history of achievements and successes as a result of the enormous work carried out by its health professionals”, said the Minister of Health of the Community of Madrid, Enrique Ruiz Escudero.
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