Unprecedented transplant in Turin, heart and liver ‘alive’ during transport

It is the first operation of its kind in Italy: organs taken from the Cuneo hospital, transplant performed at the Molinette hospital of the Città della Salute in Turin

First heart and liver transplant in Italy which took place by transporting both organs kept functioning outside the donor’s body. The exceptional operation, performed two days ago, involved the simultaneous removal of the heart, liver and kidneys from a donor in cardiac death at the Cuneo hospital and the subsequent transplantation of the organs at the Molinette hospital of the Città della Salute di Turin.

Because it is a special transplant

Unlike a ‘normal’ multi-organ harvest and transplant, this was an important stage in Italian transplantology, as the particularities are many: the donation method which took place after cardiac arrest, the distance between the donation sites and transplantation, the technologies used for the preservation of organs, the transport of organs not frozen in ice, but kept alive outside the donor’s body in a condition very similar to the physiological one.

The story involves a 62-year-old woman from the Po Valley, hospitalized at the end of December at the Cuneo hospital, who donated her organs after death was confirmed using cardiovascular criteria, and whose organs (heart, liver and two kidneys) were implanted a in four different patients. Immediately after the confirmation of death, the donor’s heart was revitalized by a team made up of cardiac surgeons from Turin and Cuneo who restarted her heart before her removal. The liver was then prepared, and the kidneys were isolated.

Heart and liver ‘alive’, as is possible

Due to the type of donation and the distance between the donation site (Cuneo) and the transplant site (Turin) – the note continues – it was necessary to use sophisticated perfusion machines capable of preventing the organs from being damaged during transport. In particular, the heart is the organ that is most affected by so-called ischemia, or the absence of blood. For this reason, the team of cardiac surgeons and cardiac anesthetists from Turin positioned the heart taken into the Ocs ex-vivo perfusion system to be able to transport it safely to Turin, supplied with its blood and beating outside the human body. Once it arrived in Turin, the organ was successfully transplanted onto a patient suffering from a serious terminal heart disease.

Similarly, the liver was transported to Turin while kept well functioning inside a portable normothermic perfusion machine. The subsequent transplant was then performed on a patient suffering from liver cirrhosis complicated by hepatocellular carcinoma. The two kidneys were also transplanted to two recipients listed for transplant at the Kidney Transplant Center.