A 13-month-old baby receives an intestine transplant in Madrid with a technique hitherto unheard of in the world

The Madrid public hospital in La Paz has successfully performed, for the first time in the world, a multivisceral transplant from a pediatric controlled asystole donation to a 13-month-old girl who has already been discharged and is in perfect health in Your domicile.

This was reported this Tuesday by the Madrid regional government, in an act in which the Minister of Health, Enrique Ruiz Escudero, presented this medical advance together with the director of the National Transplant Organization (ONT), Beatriz Domínguez-Gil, hospital medical staff and the patient's parents.

The donation "in asystole", which is its technical name, is the donation of organs and tissues that come from a person who is diagnosed dead after confirmation of the irreversible cessation of cardiorespiratory functions (absence of heartbeat and spontaneous breathing), organs that are preserved with an extracorporeal oxygenation system.

The Madrid health authorities have highlighted that this technique “makes possible the use of solid organs that would otherwise be lost”.

The recipient of the donated organs has been a 13-month-old girl with intestinal failure diagnosed since her first month of life and who was in a very deteriorated state of health, explains the Madrid Health Department in a press release.

Despite the fact that 30% of the candidates die on the waiting list, the intestine from an asystolic donation had never been used, as it was considered invalid, given the special characteristics of this organ.

However, the scientific evidence did not show that it could not be done either, which led the Congenital Malformations and Transplant Group of the Health Research Institute (IdiPAZ) to launch a three-year research project, with institutional support and financial support. of the Mutua Madrileña Foundation.

According to the Community of Madrid, after experimenting and demonstrating that the intestine was valid, it was possible to transfer it to the clinic and it was a success obtained by a multidisciplinary team made up of professionals from various hospital services, especially Pediatric Gastroenterology, Pediatric Surgery, Pediatric Cardiac Surgery, Pediatric Intensive Care, Anesthesiology and Resuscitation, as well as the Coordination of Transplants, Experimental Surgery and IdiPAZ.

According to the Madrid Health Department, in recent years the number of patients who require a solid organ transplant to stay alive has increased and "asystole donation is becoming an increasingly important source, since in adults it already represents a third of the donations” made in Spain.

This technique 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.

Controlled asystole donation, says the note, has shown similar results to classic brain death donation and its use is also increasing in other European countries.

This technique was used in La Paz for the first time in 2014 in adults and in September 2021 in children, although previously the pediatric transplant team had performed it with the itinerant ECMO team in three hospitals in Madrid, the Basque Country and Andalusia, the first of them in 2018.

The Community of Madrid also highlights that Hospital La Paz is consolidated as "one of the best transplant centers for children both in Spain and in Europe", and that it is the only one accredited in Spain to carry out all existing programs for children. and the only one that performs intestinal and multivisceral transplants.

"Within the techniques used, transplantation is the last resort, but the only one that can save the lives of certain patients," says the note, and stresses that this month marks the 23rd anniversary of the first intestine performed in Spain by this equipment.

It happened in October 1999 and the recipient was a two-year-old boy who suffered from a congenital disease that had no treatment and made it impossible for him to be fed through the digestive tract, for which he had to receive parenteral nutrition from the age of 15 days.

Since then, 120 intestinal transplants have been performed in La Paz, 72 of them multivisceral.

Hospital La Paz is one of the most active pediatric transplant centers in Europe and coordinates TransplantChild, one of the 23 European Reference Networks (ERN) approved by the European Commission in compliance with the European directive on patient rights in the cross-border assistance.

And it is also the only European network coordinated by Spain and made up of 40 centers from 11 countries.