They perform the first liver transplant from a donor with covid-19 in Mexico


Mexico.- A 16-year-old boy with brain death was the liver donor for a 12-year-old girl whose life expectancy was no more than 72 hours.

Specialists from the Mexican Institute of Social Security (IMSS) performed the first transplant at the national level from a covid-19 positive donor in a hospital in Nuevo León.

The case of the minor was classified as “National Urgency”, by the National Transplant Center (Cenatra), due to the critical state in which the minor, called Sofía, was found.

And that is how hope appeared for her when the existence of a donor was notified, however, he had tested positive for covid-19, which represented an obstacle.

“UMAE No. 25 was facing a new challenge: the multidisciplinary team of specialists analyzed the international protocol to determine the feasibility of placing in the girl an organ donated by a patient with brain death, but with a positive SARS test. -CoV-2”, reported the IMSS in a statement.

Little Sofía suffers from Alagille syndrome, a rare hereditary disease that causes multiple conditions, mainly to the liver, where cirrhosis occurs, which leads to liver failure.

On March 27 of this year, the little girl received a first liver transplant at the same IMSS hospital in Nuevo León, “but on the fifth day of surgery she presented a complication due to hepatic artery thrombosis, which required surgical intervention for reconstruction. of the glass, which was failed”.

On April 4, an emergency was declared for Sofia’s case, so the next liver donation from any place or institution in the country would be for her.

That same day, a 16-year-old donor was notified in Irapuato, Guanajuato, who presented brain death.

“In the donor’s tests, a positive diagnosis for COVID-19 appeared, but the characteristics of weight, height and even blood group were compatible with the recipient.”

“We knew that we were not going to find another opportunity like this,” commented Dr. Luna López, indicating that the patient was expected to have a maximum of 72 hours to live.

Although the donor had tested positive for covid-19, he had been asymptomatic, so his viral load was not highly contagious and his death was for a different reason: a serious neurological injury.

After taking the organ from Irapuato to Nuevo León, transplant surgeons worked for six hours to place the liver in the minor who was already waiting for him to continue living.

“The head of the Transplant Division of the Specialty Hospital No. 25 explained that liver transplantation is a highly complex surgical process, since there are four structures that must be connected to the recipient’s body: the hepatic artery, the portal, suprahepatic veins and the bile duct, all of them with millimeter calibers that require extreme precision to fit and function properly.

Despite the complications, the surgery was a success because it left no evidence of viral infection in the recipient or in the surgeons, and it set a precedent in the history of IMSS throughout the country.

After 72 critical hours in intensive care, and on April 21, Sofía returned home with a good prognosis.

For Dr. José Manuel Pavón Sánchez, a Pediatric Intensive Care physician, the coordination of all the medical disciplines that interact in this type of case was very important.

“I feel very proud to be part of the institution, of this great health team, to know that we have great support from our bosses, from our directors. I am proud to know that through my work, we were able to change Sofia’s life. This, for one as a professional, is very encouraging, it is gasoline to continue doing things better and better”, Dr. Pavón Sánchez shared with emotion.

For his part, the general director of UMAE No. 25, Dr. José María Sepúlveda Núñez, assured that these are the results of the work of all categories of the hospital that assume the challenges that are necessary in the care process.

“As director of this hospital, it is a great honor and pride for me to have a great work team. The first transplant to be performed with a liver from a patient with a positive covid-19 test was a great challenge that a great work team took on and, fortunately, it was successful,” said Sepúlveda Núñez.

He confirmed that Sofía was discharged and, both he and the entire medical team that participated in the intervention, hope that she will continue to evolve positively.


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