Posted: Saturday January 16, 2021 8:17 AM
If the announcement of the transplant goes off, the world stops for a brief moment. Immediately after, the maelstrom and the fight against the clock, in addition to strict adherence to protocol, take over. There is nothing to stop an organ alert available. There is little that is so important.
Not even the biggest weather phenomenon that much of Spain has known in half a century. Not Filomena, not the ice cream. Never mind that the capital of Spain, and the epicenter of the snow, has collapsed. That the roads are impassable. Let the thermometers themselves freeze. If there is a transplant, nothing can stop.
This happened during the storm in the Community of Madrid. Between January 7 and 13, the extraction of nine solid organs was performed at the university hospitals of La Paz, Ramón y Cajal and Clínico San Carlos. And of all, who competed for both solid organs and tissues, more than 23 patients have benefited across the country.
Liver, kidneys and corneas removed on the same night
The storm was a real challenge for these health teams, specialized to say enough. “We have never known this storm before,” smiles Adolfo Martínez Pérez, transplant coordinator at Ramón y Cajal University Hospital in the capital of Madrid, in conversation with LaSexta.
Not them … not just anyone. Filomena left town and many other towns across the country stranded and without sufficient resources to deal with it, despite repeated warnings from meteorological institutions. But, with everything and with him, everything worked: in Ramón y Cajal, for example, in the early morning of Friday January 8, when Madrid was already covered in a generous layer of snow never seen before – and this would multiply with the Hours passed – an extraction of the liver, kidneys and cornea was performed.
Five patients benefited from organ extractions performed by Ramón y Cajal on Friday 8
The beneficiaries were five patients. One of them, the one who received the liver transplant and who lived in Andalusia, “was on the verge of death”. Meanwhile, on the same day, this same hospital received a liver from another health complex in the Community of Madrid, and it was successfully implanted.
It is no coincidence: these parts of the body are Ramón y Cajal’s specialties. It is a reference hospital for liver and kidney transplantation. “Kidney transplantation began with the opening of the hospital in 78. Liver transplantation [cabe recordar que es un órgano de riesgo vital], since the early 1980s, ”says Dr Martínez.
Six organs implanted in Madrid during the snowfall
Similar activity was observed in other health complexes in the Autonomous Community. In the wee hours of Thursday through Friday, the kidneys and liver were extracted at the clinical hospital, along with the corneas from a donor. On the same day 8, at La Paz hospital, the liver, kidneys, corneas and osteotendinous tissues were extracted from which more than ten patients benefited.
In addition to the extraction activity, in the Community of Madrid, even with the persistent snowfall, six organs were implanted that allowed other patients to come out of dialysis or save lives. One of them, as detailed above, was in Ramón y Cajal himself.
“We were ready to transplant even under these conditions”
Within the walls of this center, heavy snowfall was the last thought. Fortunately, all the extractions could still be done “without logistical complications”, confirms the coordinator of Ramón y Cajal. But when the regional transplant coordination office -ORCT- again sent out a notice that a hospital in Madrid might have another organ available, the snow was already almost half a meter high on the street. “We were ready to work even in these conditions, he would have moved as he could, even if, ultimately, the organ of the possible donor could not be valid”, he sighs.
Half of the staff could not reach the hospital
With the pandemic, first, and with Filomena, later, the whole protocol has changed a bit. The same is done, “but warn before you see if it’s possible”, laughs Dr Martínez. Especially with the heavy snowfall the challenge was to have staff available. “They call us to see which hospital is the least isolated, to see if we could do it, if there were enough nurses. Some of the transplant staff couldn’t come to work, ”he laments.
Workers who went to the hospital did so because they were traveling by metro, living next door, or extending their shift
Those who took part were thanks to the metro or, directly, to the walk “because they lived very close to the hospital”. In addition, those who were already in turn enlarged them due to the impossibility of being replaced.
Under normal conditions, the transplant team (made up of doctors, nurses, anesthetists and the entire chain of care) is made up of more than a hundred professionals. “And that day more or less half arrived,” explains the coordinator.
This is how a transplant is done
However, despite being 50% workers, all parties knew the procedure by heart and the wheel kept running. First, as health sources explain to this channel, what is done to guarantee the effectiveness of the donation and that the organ actually arrives ready to be transplanted is to offer it “in stereo”. This means that possible receiving hospitals are coordinated to locate patients and see if their mobilization is possible, because some of them are at home, not necessarily admitted.
It’s usually in one, two, three different hospitals. Once all the information has been collected, it is the National Transplantation Organization that decides, regarding a series of parameters – which are not public to protect patient privacy, as happens with other data. such as age, sex or province. residence, as well as pathology -, where this organ goes.
Organs can travel by road, train or plane
Once the destination is ready, the extraction is prepared and the trip is organized. “The possibilities are numerous: the organ can be moved by road, train and plane. If they are scheduled transplants, they usually have a standardized Renfe procedure. Normally the organ goes in a refrigerator and the person in charge sits in the next seat, ”explains coordinator Martínez.
The kidneys, for example, “always come by road”. The liver depends on the distance. “It can be by ambulance or by a private road transport company. If it is further away, if it comes from Andalusia or Galicia, directly by plane, ”he explains.
Not all surgeons know how to transplant
Once at the destination station, the organ is usually transported by regional medical transport (SUMMA, in the case of Madrid). “Sometimes they accompany the health team. Before, it was not uncommon for our surgeons to go to the donation site to remove it. But, since the pandemic, we try that the teams do not move, and the teams of other neighboring hospitals are leaving ”, explains Martínez.
This may be striking, but the reason is not trivial. Not all surgeons know how to harvest organs. Some are simpler and others more sophisticated and require a high qualification to be able to carry them out.
Removing organs like the liver requires scarce specialists
In the case of the kidneys, for example, it is very rare for a urologist to have to extract it because it is a more common procedure. The liver, on the other hand, is more specific, and there aren’t many surgeons who can do this, so a team is usually mobilized.
With Filomena, it wasn’t going to be easy. However, against the snow and the tide, everything went perfectly. “Everything we do is for patients and it is thanks to them,” says Adolfo Martínez emphatically. “It all works because donors and their families are very generous people at all times.”