What are the stages and challenges of organ transplantation in Argentina

“Argentina has always been at the forefront of organ transplantation,” said Dr. Roberto Cambariere, president of the Favaloro Foundation’s Bioethics Committee.

In five days, the most important experts and references in transplantation and organ donation in the world will meet in the city of Buenos Aires, within the 29th International Transplantation Congress which will take place in Argentina from tomorrow until September 14.

The doctor Robert Cambarierreference on the subject and author of the book “History of transplants in Argentina and around the world”, described to Infobae cornerstones most importantly and current challenges of this life-saving branch of medicine.

At the end of 1954in Boston, USA, nephrologist John P. Merrill, surgeon Joseph Murray, and urologist Hartwell Harrison performed the first successful kidney transplant in history. And only 3 years later, in 1957at the so-called “old” Hospital de Clínicas de la Ciudad de Buenos Aires, Dr. Alfredo Lanari performed the first human kidney transplant in our country.

Argentina was always on top“said Dr. Roberto Cambariere, President of the Bioethics Committee of the Favaloro Foundationformer president of INCUCAI, who has been dedicated to transplants since the beginning of his career as a doctor, more than 60 years ago.

It is estimated that donated organs meet only 10% of the global demand
It is estimated that donated organs meet only 10% of the global demand

The beginning was not easy. The procedures were experimental. Many of the doctors who dared to perform them were interrogated and even there were criminal cases Against them. Therefore, in the 1960s, as kidney transplants were added to transplants of other organs, a new discipline emerged: bioethicsfor which the transplant served as a test bed, because both started almost at the same time and had a parallel evolution”, the expert pointed out.

in 1963in the United States, James Daniel Hardy did the first lung transplant. He was received by a man very ill with tuberculosis; the donor is a patient who has suffered a cardiopulmonary arrest. “The patient lived for 18 days. Just 4 years later, in 1967, the first human lung transplant was reported at the Maria Ferrer Institute in the city of Buenos Aires, by Dr. Macheltz Molins. Once again, Argentina continued very close to the pioneers”, Cambariere tells in his book “History of transplants in Argentina and around the world”.

In 1963, Thomas Earl Starzl, in Denver, USA, did the first liver transplant, a procedure that failed due to a lack of proper surgical techniques. The first liver transplant in our country was performed by a doctor Eduardo de Santibanezat the Italian Hospital in Buenos Aires, c 1988.

In late 1954, the first ever successful transplant was performed in Boston, USA (Getty)
In late 1954, the first ever successful transplant was performed in Boston, USA (Getty)

in 1968at the Bazterrica clinic in the city of Buenos Aires, Dr. Mario Chapo Bortagaray performed the first pancreas transplant in the history of Argentina and the third in the world.

Argentinian cardiologist Domingo Liotta is the creator of the first artificial heartsuccessfully implanted for the first time in April 1969 by Denton Cooley in the US. The first heart transplant with a guard was performed in South Africa in 1967 by Christian Barnard, but the patient lived for 12 days and it was not until the following year that the first successful transplant was performed in that country. The same year in Argentina Dr. Michael Bellizzi in a clinic in Lanus, he performed the first heart transplant in the country, but the recipient died 96 hours later.

had to wait until 1980at the Güemes Sanatorium in the city of Buenos Aires, where dr. Rene Favaloro performed the first successful heart transplant in the history of our country.

No doubt Favaloro should have been a Nobel Prize winner. cardiology has changed. Before him, patients with coronary problems died. Today, bypass is combined with angioplasties, but its contribution is undoubted. Favaloro was an unrecognized pioneerCambarier said.

Dr. Rene Favaloro performed the first heart transplant in Argentina
Dr. Rene Favaloro performed the first heart transplant in Argentina

In 1987, there was also an important event with a major impact on pediatric transplants: the creation of the Juan P. Garrahan National Pediatric Hospitalwhich has performed more than 2,800 transplants since its inception.

The president of the Bioethics Committee of the Favaloro Foundation explained to Infobae that in 1977 the first National Law on Transplants and a Unique Center for Ablation and Implantation (CUCAI) was established. In 1992, the National Central Unified Coordinating Institute for Ablation and Implantation (INCUKAY).

Cambariere emphasized: “Once again, Argentina has marked its leadership, if you consider that the first transplant law in Spain dates from 1978 and that of the United States from 1984, and they are the two countries with the largest number of donors in the world per million inhabitants.”.

“For many years, Argentina, along with Uruguay and France, was one of the few countries that had state-dependent public procurement regulatory agencies,” noted Cambariere, who was also a transplant coordinator at Italy’s Marini Hospital and Clinic, among others. .

In our country, Law No. 24 193 in Article 15 provides for the donation of organs from living beings only for the purpose of transplantation and between related persons (Getty)
In our country, Law No. 24 193 in Article 15 provides for the donation of organs from living beings only for the purpose of transplantation and between related persons (Getty)

Procurement, the process by which an organ or tissue is obtained, is measured by the number of donors per million population.

“In our country, in terms of implants, we have a relatively good situation, but we are 50% of the way in deliveries. In 2019, across the country, we reached approx 20 donors per million, but we have big differences in jurisdictions. In the city of Buenos Aires, the average is 20 to 25 donors per million; but the northwestern provinces did not exceed 4 or 5″, the specialist explained.

The situation is very different in other countries that serve as an example to improve the current scenario: “Spain reaches an average of 40 per million, with regions such as Cantabria or Navarre where they exceed 60 per million. There the figure of Hospital Transplant Coordinator contributed to these numbers. Asking a family to donate organs to a loved one is not a pleasant task. You have to have a calling and support.”

The expert explained that Spain also has death criterion for “cardiac arrest” (asystole) In addition to the already known brain death criteriawhich is usually used to rule the potential donor dead, this greatly increases the number of possible donors. In our country, donation through asystole is not yet in force.

In January of this year, a team of doctors from the United States performed the first human transplant of a genetically modified pig organ (EFE).
In January of this year, a team of doctors from the United States performed the first human transplant of a genetically modified pig organ (EFE).

There’s an account that never closes: the number of people who need an organ to continue living versus the number of people who actually donate their organs. For this reason, the possibility of obtaining organs from other species for transplantation in humans has long been thought about, i.e. xenotransplantation (transplantation of different types).

This year, in January, the first transplant of a modified pig heart was performed in the US on a patient with end-stage heart failure. The intervention was successful and the patient lived for two months. The death, which is still under investigation, may be due to porcine cytomegalovirus which was installed in the recipient’s body along with the organ.

Xenotransplantation is an option. From a very young age I was interested in the idea from a theoretical point of view. They are most similar to humans primatesbut they are animals in danger of extinction and humane societies oppose their use. The pig, from a phylogenetic point of view, is very different from the human, but now it is possible to have transgenic pigs, with “knocked out” genes and viruses, so that they do not cause rejection, and this is very encouraging. I am part of an interdepartmental working table that is dedicated to the topic, which is very advanced in our country. I don’t know if it will be final, but since it is under investigation yes, this will go a long way in alleviating the shortage of organs for transplantsDr. Cambarie concluded.

CONTINUE READING:

Why is it important to exercise after a transplant?
Scientific breakthrough for transplants: they managed to change the blood type of the donor kidneys
Transplantation of organs from pigs to humans: how the heart operation went and why it is so hopeful
Donation and transplantation: 10 keys to knowing all aspects of this practice in Argentina

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