Gabriel Sales, head of the Thoracic Surgery and Lung Transplant service at Hospital La Fe.
Spanish medicine has once once more demonstrated its ability to be world pioneer when making the first double-lung transplant to a baby with blood group incompatibility. A milestone reached by the team led by Gabriel Sales, head of the Thoracic Surgery and Lung Transplant service at Hospital La Fe.
This is the first intervention of these characteristics to be carried out in the world and the key to carrying it out successfully lies in the plasma filtering technique with immunological adsorption. Is regarding a procedure that allows shorten the waiting time for a compatible organ because it allows the use of incompatible lungs and makes transplantation possible. In this way it has been possible to avoid the rejection of the donor’s lungs.
The intervention was carried out last January, but the baby is now when is regarding to be transferred home. “It’s very good and we almost have it to go home”, explained Gabriel Sales in statements to the Efe Agency. When the patient arrived at the Hospital de la Fe he had a respiratory virus that deteriorated his underlying disease, pulmonary hypertension, and he was admitted to the ICU with a respiratory failure that might not be recovered. In this sense, the specialist explained that the recovery of the baby, who was admitted weighing just three kilos, has been “a challenge from all sides” and it has been a “long” process due to the added problem presented by the patient.
How did you design the intervention strategy?
After detecting global lung failure with pulmonary hypertension that deteriorated the heart and also made ventilation impossible, the specialists decided realize to the baby and administer a artificial extracorporeal circulatory support to keep him alive while thinking of a strategy.
Ultimately, the Sales team felt that the only solution was a transplant. To carry it out, their typing, blood type and response of their tissues to something strange were analyzed. Some actions that were intended to find a compatible organ, something that they did not achieve until After one month. Although the organ they found did not belong to the same blood group. “We had it very clear because it is a vital time and every day the patient can present a complication”, assures Sales.
Why did you opt for plasma filtering?
In order to avoid further delays and for this organ to be accepted by the baby’s body, the specialists opted for the plasma filtering technique with immunological adsorption. “We can shorten this waiting time with the procedure we have used, sincee allows us to use incompatible lungs and make the transplant possible”, explains the transplant coordinator.
As detailed by Sales, this filtering was carried out by the lung and heart transplant team, anesthesiologists and a team of trained perfusionists to be able to perform this technique. Something that for the specialist has been possible thanks to the fact that La Fe has a Pediatric Intensive Care Unit with “long experience and a track record in managing cardiorespiratory assistance to maintain the child until the possibility of having a donor.”
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