(Majadahonda) Removal of liver, kidney and heart for reimplantation, all in oversaturated intensive care units: In the midst of a pandemic, organ donation is proving to be an even more difficult challenge than the world champion Spain succeeded in doing.
Posted on Aug 31, 2021 at 3:35 pm
Marie GIFFARD Agence France-Presse
The ambulance sped at open speed at 150 km / h along the Madrid ring road towards the airport. The cars drive off when the blue flashing light goes by and the words “Organ donation” appear.
A private jet is waiting on the tarmac, ready to take off. The three nurses in green surgical equipment rush into the device, one is dragging a blue cool box on wheels.
Somewhere in Spain a person is brain dead. You have to get its heart to bring it back to Madrid and try to save a life.
The key role of intensive care
On the plane, Juan Estebán de Villarreal, 28-year-old surgeon, and Erika Martínez, 41-year-old nurse, remember the first wave when the pace of transplants suddenly slowed.
“The pandemic has changed one thing in particular: the number of transplants. The main problem was the collapse of the intensive care unit in all hospitals, ”says the nurse, who has had 450 transplants for 15 years.
Transplants are also decided in the intensive care unit, where the COVID-19 tragedy is taking place.
“In these units, the donors are identified and the collection takes place,” explains Beatriz Domínguez-Gil, Director of the National Transplant Organization (ONT). “Recipients should stay here for at least the first few days after their transplantation”.
In 2020, the number of transplants in Spain had decreased by around 20%, she said, but even at the height of the health crisis, the country had outperformed other pre-pandemic countries (compared to 37.4 donors per million in 2020 29.4 in France and 36.1 in the US in 2019).
Spain has thus maintained its leading position with 5% of transplants in the world, while it represents only 0.6% of the world population.
In March 2020, at the beginning of the pandemic, Amparo Curt was urgently put on the waiting list after a devastating autoimmune hepatitis. He only has “a few days” to live. “You realize that you are going to die. And you think: what organ will I be able to have in the middle of COVID-19? »Confides this 51-year-old woman. A few days later, it was said of “miracles” that a new liver would be obtained “at the peak of the pandemic”.
Subjected three consecutive PCR tests during her hospital stay (like all donors and recipients as of March 2020), she returned home five days later.
A “science fiction” scenario that she recounts between a few sobs: “Grateful for life”, Amparo “understood that anything was possible”.
“He moves well”
In Majadahonda, near Madrid, a recipient is waiting for the heart at the Puerta de Hierro hospital, which the medical team is looking for in a location whose whereabouts remain confidential in order to protect the donor’s identity.
Somewhere in the air, Juan Estebán de Villarreal doesn’t know whether the very expensive trip will be successful, but “you can’t buy a heart”.
Three-quarters of organ shipments that are made by air are on commercial lines (which offer this service for free), but some organs that can’t wait have to travel by private jet.
In the first wave with reduced air traffic it was necessary to improvise, to juggle with mobility restrictions, – in the case of heart transplants – to accept the removal of teams near the donor hospital and to let the organ travel alone.
The plane landed at an airport. Ambulance, hospital, locker room, equipment change.
In front of the sliding door of the operating room, several cool boxes wait for their organ before they set off to unknown destinations and recipients.
About fifteen people are employed within the block.
Juan Estebán de Villarreal approaches the body, gently feeling the still beating organ in the gaping chest.
After a few minutes he goes away. “I would say yes, he moves well,” he said on the phone. Green light for the extraction.
The heart is placed in a simple Tupperware filled with serum and then placed in three hermetically sealed plastic bags. “Air is the enemy,” repeats the surgeon.
Cooler. Changing room. Ambulance, asphalt, off to Madrid.
In the middle of the plane there is a blue plastic chest filled with a treasure: an organ, isolated from a body and from the rest of the world, is waiting to come to life.
Landing, ambulance and finally Majadahonda Hospital.
The patient is already open. The old heart is withdrawn.
A few hours later, the patient is ex-case. A new life begins for this heart and especially for its new owner.