The Vall d’Hebron Hospital in Barcelona has carried out for the first time in Spain three lung transplants to the same person. The recipient is Mireia Sitjà, a 24-year-old woman who suffers from cystic fibrosis, a genetic disease that affects the lungs, the digestive system and other organs of the body and that manifested itself in her first months of life.
Cystic fibrosis is a chronic disease that can put patients’ lives at risk and reduce their quality of life: it affects the cells that produce mucus, sweat and digestive enzymes. The body’s secretions, which are normally thin and fluid, become thicker.
As a result of the cystic fibrosis that she suffered from as a disease of origin, the patient received a first double-lung transplant in 2016 after presenting as a complication a pneumothorax.
In 2019 the patient had chronic organ rejection requiring a second transplant of both lungs as it is the only treatment that currently exists, explains Dr. Alberto Jáuregui, head of the Thoracic Surgery and Lung Transplant Service at Hospital Universitari Vall d’Hebron.
Recently, the hospital has performed a third double-lung transplant, since he has again presented rejection of the lungs from the second transplant. It is a “very exceptional situation”, highlighted Dr. Jáuregui.
«Wish to live»
He stressed that it is a very complicated intervention that is only carried out in seven hospitals in Spain but, seeing the patient’s “will to live”, they decided to do it.
For this reason, the medical team previously requested an assessment from the Vall d’Hebron Lung Transplant Committee, made up of professionals from thoracic surgery, pulmonology, anesthesia, rehabilitation, intensive care and nursing.
In this third intervention, which It lasted four and a half hours. A multidisciplinary team of 17 professionals from thoracic surgery, cardiac surgery, anesthesiology, anesthesiology nursing, transplant nursing coordinator, perfusionist nursing, surgical nursing, auxiliaries and caretakers participated.
Jáuregui has detailed that in a second or third lung transplant to the same person increased surgical complications as there is a higher incidence of bleeding and adhesions, immunological complications -the patient has been able to generate antibodies having already been transplanted from a first organ- and infections.
Regarding chronic rejection, Jáuregui explained that it is the main indication for lung retransplantation, a complicated intervention which is carried out because of the patient’s risk of continuing with organs that their body has stopped accepting, not because of the original pathology.
The possibility of retransplantation is raised when the transplanted lungs develop some degree of dysfunction and patients return to develop irreversible respiratory failure.
The doctor has claimed that there are many people who have chronic rejection and with this triple intervention in the same person they have shown that there are alternatives, for which he has encouraged patients to request an assessment: «We want to tell people that this can be do”.