The University Hospital of La Paz in Madrid has successfully performed multivisceral intestinal transplantation from controlled pediatric donor asystole to a 13-month-old girl with intestinal failure diagnosed from the first month of her life, who has already been discharged and is in “excellent health”. .”

In recent years, there has been an increase in the number of patients requiring solid organ transplants to stay alive, and asystolic donation, i.e. donation of deceased people, already accounts for a third of donations made in Spain. This method, according to Beatriz Domínguez-Gil, Director General of the National Organization for Transplantation (ONT), makes it possible to consider donation as part of end-of-life care in those patients in whom the adequacy of life support measures has been decided.

In addition, this type of donation allows, after the declaration of death, to preserve organs with perfusion of oxygenated blood through the extracorporeal membrane oxygenation (ECMO) system so that the transplanted organ does not deteriorate. This donation produces the same results as the classic brain death donation.

Despite the fact that 30 percent of candidates die on the waiting list, Francisco Hernandez Oliveros, head of the Pediatric Surgery Service at La Paz Hospital, has never used intestines from an asystolic donor, believing it to be invalid. considering the characteristics of this body.

Since the scientific data did not show that this could not be done, specialists from the Madrid hospital, part of the IdiPAZ congenital malformation and transplantation group, launched a three-year research project thanks to the institutional support and funding of Mutua Madrileña. Fund.

Once the team was able to demonstrate in various experimental models that the intestine was valid, it could be delivered to the clinic with the help of a multidisciplinary team consisting of specialists in pediatric gastroenterology, pediatric surgery, pediatric cardiac surgery, pediatric intensive care, anesthesiology. and Resuscitation and Coordination of Transplantation, Experimental Surgery and IdiPAZ.

The patient, as explained by Esther Ramos, head of the Department of Rehabilitation and Intestinal Transplantation, suffered from short bowel syndrome, which caused intestinal failure, and that after several interventions, she had to undergo transplantation since the choice of treatment, which is administered intravenously, causes complications such as liver problems.

The challenge now in the medium to short term is to eliminate parenteral nutrition in minors. During the transplant presentation ceremony, Daniel, the father of a transplanted minor, wanted to thank the team’s professional “and humane” work because he “gave life” to three.

“Today, the health sector of Madrid is adding a new milestone to its history of achievement and success as a result of the tremendous work done by its health professionals,” said Health Minister of the Community of Madrid Enrique Ruiz Escudero.