Celebrating a thousand transplants

It was 1985 when La Paz University Hospital, in Madrid, performed its first pediatric transplant. This week, the medical center celebrated the fact that it has reached the landmark number of 1,000 transplants.

Parents and former patients - some of whom are now adults - attended the event to share their personal stories, as well as to thank doctors, surgeons, living donors and the families of deceased donors for their help. "Angels of life" is how one father called them all. The head of the transplant coordination team, Santiago Yus, admits that "a tear rolled down my cheek when I heard about their experiences."

The first organ that was transplanted into a child in La Paz was a kidney. A year later, the first liver transplant was performed, followed by the first heart transplant in 1994 and, in 2003, the first multivisceral transplant - the most complicated surgery of all, which is only performed at 20 centers in the entire world. So far, La Paz has performed 21 of these procedures, or five percent of the global total.

For hospital professionals, the main goal is to achieve "a good quality of life for the children," says Paloma Jara, one of the coordinators of the pediatric liver-transplant program. And Adrián Rodríguez, aged 11, certainly looks like he has a good quality of life. The heart he was given at the age of just 12 months gave him the strength to become the world champion at a special competition for athletes with transplants.

Julio Bogeat, 35, had a liver transplant at age 10. Today, besides being a psychologist, he is the father of a 14-month-old boy named Hugo.

The transplant program works with the motto: "It's everyone's job to make it possible," and Manuel López Santamaría, head of the pediatric surgery department, explains that the entire team is vital. "If you appoint the best surgeon in the world to a bad hospital, the results will be bad."

How many people are involved in a transplant? "A great many," says Santamaría. "Surgeons, physicians, anesthetists, nurses... but also lab personnel to make real-time analyses of the blood banks, and so on."

Diego Gil, a 15-year-old patient, has spent the last three weeks with one of his father's kidneys. The fact that they were operated on simultaneously served as the inspiration for his drawing "My father and I" inside the operating room, which won the drawing contest held on the occasion of the commemorative event. Diego had already received two earlier transplants, but both had failed. A new operation did not seem to scare him.

"Rather than worry about myself, I was worried about what might happen to my father when they removed his kidney," he says, speaking from behind the face mask he wears to keep infections at bay. The teen looks healthy and optimistic. But he does have the sensation that he is carrying an adult organ inside. "It's big and it feels heavy," he notes. His father, meanwhile, hopes to be discharged sometime next week.

All the health professionals at the celebration underscored the importance of the experience they have accumulated over the past 26 years. And that expertise is reflected in the numbers: survival rates at La Paz are the same, and often better, than at the most prestigious centers in Britain, France and the United States. "In the field of transplants, it's the rest of the world that looks up to us," says Antonio Burgueño, director general of hospitals for the Madrid region. In liver transplants, for instance, La Paz has achieved a survival rate of 90 percent, 12 years after surgery. Burgueño insists on the importance of continuing to invest in research.

"If we stop researching because of budget cuts, if that halted our ability to move forward, it would be ridiculous," he says, adding that he hopes that "the Madrid government will know that it cannot afford to stop investing in research."

Some of the next 1,000 transplants that lie ahead will surely be lung transplants, an operation that has not yet been attempted at La Paz. "We received accreditation to do them this year, and we already have a patient who needs one," says Francisco Cobas, deputy managing director at La Paz.

As for future challenges, there is an obvious one, on everybody's mind: to achieve a survival rate of 100 percent," says Cobas. "For this hospital not to lose a single patient."