Simultaneous rinse transplants in Porto and Lisbon after “switching” of donors
In question is a practice called “cross-kidney donation” and two interventions that occur simultaneously.
In Lisbon, the case was a father who needed a kidney and a daughter willing to do it, but the two were not. In Porto, the husband would receive his wife’s kidney, but she had the same misfortune in terms of compatibility.
“Thanks to the national cross-donation program, it was possible to cross these two donors [filha de Lisboa e mulher do Porto] and the two receivers [pai de Lisboa e marido do Porto] and carry out the two interventions”, Fernando Rodrigues, director of the São José Hospital’s harvest and transplant coordinator office, explained to the Lusa agency.
The surgeries — four in total, two for organ harvesting and two for implantation — took place throughout the day. Around 19:00, donors and recipients found each other well, Lusa assured sources both from the Centro Hospitalar Universitário Lisboa Central (CHULC), to which the Curry Cabral Hospital belongs, and from the Centro Hospitalar Universitário do Porto (CHUP), which integrates the Saint Anthony.
The transport of the organs was carried out by the Transit Brigade of the Republican National Guard.
The performance of these two transplants was made possible thanks to the National Cross-Renal Donation Program (PNDRC) which is used in the case of people who need a transplant and have a living donor who is not a match.
Thus, using a database that contains other incompatible pairs, a compatible data is sought for each case.
If the system finds one possible, two or more transplants can occur simultaneously through the “exchange” of rinses between the various participating pairs.
The PNDRC dates from 2010, and since 2007 it has been possible in Portugal to perform kidney transplants between donors and recipients without consanguinity, that is, in practice before, a husband could not donate to his wife, but a father could donate to a son and vice versa. .
“What we advocate is a maximization of the cadaveric donor, but this is another way of carrying out the execution and forecasting of the organs. And cross-kidney donation can overcome the limitation because even with living kidney pain and the donor’s intention, they can be incompatible with each other. It is more likely that a person will have access to a document”, Fernando Rodrigues.
The director of the coordinating office for harvesting and transplantation in São José, a hospital that belongs to CHULC, recalled that “when there is no compatibility or risk of rejection of the organ that is transplanted, it is very high”, but that “sometimes there are pairs that are not compatible, but crosswise they do”.
To Lusa, Fernando Rodrigues recalled that “the kidney is the organ that has more people on the waiting list”, a list that in Portugal is over 2,000 patients.
“And the number of organs that has been possible in a possible number of donors does not make it possible to meet the needs”, said the director about a reality that is not only Portuguese, but transversal to the rest of the world.
This practice was carried out for the first time today at CHULC, while CHUP already has other transplants of the kind in its curriculum.
At the same time, Portugal has already joined the International Crossed Kidney Donation Programme, with Spain and Italy being able to do so.
PFT // TDI