First lung transplant from a 'still heart' donor

Share

15 November 2014 First lung transplant in Italy from a donor to a still heart at the Ca 'Granda Policlinico Foundation in Milan.

The intervention was made possible thanks to a new method developed at the Polyclinic, which could thus increase the number of organs available for transplantation by about 20-30%.

The operation took place on November 1st, and was performed on a 36-year-old girl with cystic fibrosis, already on the waiting list for the transplant and hospitalized for four months.

The operation, which lasted 18 hours, was successful and now the patient is reacting well to the post-operative course: she could go home in about ten days.

The lungs were taken at San Gerardo in Monza, from a 45-year-old man who died of aortic dissection.

After ascertaining death with a still heart (arrest

cardio-circulatory for at least 20 minutes), the organ was transported to the Milan Polyclinic where it underwent a treatment called EVLP (Ex vivo Lung Perfusion), after the transplant the lungs worked immediately, exchanging oxygen.

The number of patients on the waiting list for a transplant is higher than the number of transplants performed, due to the few organs available: about 20% of patients die waiting for a organ.

To tackle the serious problem of the scarcity of organs, recently, in addition to the 'classic' donors with brain death, also 'still heart' donors have been considered.

In these donors, the heart has stopped beating and the organs no longer receive oxygen: the rapidity of the collection therefore becomes an essential condition for the organs not to deteriorate, which makes this type of donation much more complex.

Franco Valenza, researcher at the Department of Anesthesia of the Polyclinic, with his team has developed a pre-clinical model of preservation of the lungs in the lifeless body, which allows to lengthen the useful times for collection in donors a steady heart.

The organs were then preserved for three hours before being removed, and then "resuscitated" before transplantation.

According to estimates, this innovative model of organ harvesting could make available about 12-15 lung donors per year in the Milan and Monza-Brianza area alone, increasing the number of transplants in Lombardy by 20-30%.

"However, unlike other models of donation with a still heart - the specialists conclude - the simplicity of the protocol developed in Milan could allow its application even in non-highly specialized hospitals, thus contributing to significantly increase the number of lungs available for this purpose. of transplant ".