IPO Lisbon marks 35 years since the 1st bone marrow transplant in Portugal
PTo mark the National Day of Organ Donation and Transplantation, marked this Wednesday, July 20th, the Portuguese Institute of Oncology of Lisbon Francisco Gentil (IPO Lisboa) recalled the technical and scientific evolution of surgery, 35 years after the first bone marrow transplant in Portugal. This year, the hospital has already carried out 56 interventions.
Despite the clinical and technological evolution, the complexity associated with the treatment remains from the first moment. As explained by doctor Nuno Miranda (UTM) from IPO Lisboa, the length of stay is one of the major factors, in addition to a “long recovery with “regular visits to the hospital”.
“Of the 109 bone marrow transplants performed in 2021, 52 were autologous (that is, the cells were harvested from the patient himself before starting treatment – autotransplantation) and 57 allogeneic (it was necessary to find a donor in the closest family or from the compatible record). international donors). In 20, the IPO also started to do the transplant that the donor can be 50% compatible, soon Lisbon14, the person in charge, in a statement to which the News by the Minute had access.
Although this technique has made it possible to increase the number of patients with their turn, or of the specialist with a completely waiting time, “one of the patients with the first choice”, he indicated.
“Unlike organ transplantation, bone marrow transplantation is not performed in the Operating Room. Patients receive a circulatory system as progenitor cells (or stem cells) through the circulatory system, as if it were a blood transfusion. And these settle in the bone marrow to multiply and give rise to new blood cells. The new cells do not need to be suppressive (graft-versus-host disease), patients and immunosuppression increase the risk of infections, hence the need for care”, he added.
Currently, about 90 patients, some of them with an identified donor, are waiting for a transplant at the unit. However, this need falls short of the needs of professionals. “In terms of human resources, we are obviously lacking. This is a very demanding area, both in terms of the amount of work and motivation”, provoked the doctor.
“In terms of transplants to half Europeans, in terms of transplants similar to our European countries, in terms of transplants similar to the countries that we should not do”, he revealed, adding that another 120 possible others are possible.
“For us, the readmission of a transplant patient is a huge difficulty” confessed Nuno Miranda, noting that, in the short term, “more consultation spaces” and “independent circuits for donors and patients” will be needed.
In addition to the lack of space and staff, the head nurse of the service, Elsa Oliveira, outlines that health professionals are the target of a high “impact” in this service, to which the low levels of resources are qualified when and the need to career review. Since January, ten nurses have left the UTM.
It has brought new treatments, particularly with “CAR cells, which can be used as an individual’s own cells, with modifications to destroy a cell tumor, with repair of own cells in vitro, genetic and innovative” use of hematopoietic progenitor cells thus modified”.
Already 17 people have been the target of this therapy in the unit, although the doctor considers it to be “premature with success rates”.
According to IPO Lisboa, one of the problems associated with treatments with CAR-T cells such as chemotherapy is toxicity. However, Nuno Miranda stressed that, at the moment, priority is given to concern, even though the two factors are “inseparable”.
“It is not capable of increasing efficiency at any cost”, he concluded.
Also Read: Lisbon. CHLC performed the 2,500th liver transplant