Spanish hospital performs first heart transplant on baby with incompatible blood

The life of baby Naiara, two months old, was saved by pioneering surgery in Spain, by doctors at Hospital Gregorio Marañón, in Madrid.

The baby’s young age favored that the operation was possible, despite not being compatible with the blood group of the sender, in an operation of transplantation of the stopped heart of another baby, with an incompatible blood type, so that the girl could survive. Today, she is recovering from surgery.

In a statement published by the Community of Madrid, it is also a case “unique in the world” because the donor and recipient were in different centers and the transplant was carried out after a prolonged period of cold storage during the transfer, which had to be made by air.

According to doctor Juan Jaurena, the hospital in Madrid had already performed, in 2018, the first child transplant in the world among incompatible donors. Now, the news was that the donor baby’s heart was stopped, and had to be revived before it was removed.

These types of transplants, between people with incompatible blood group and with a heart that stopped, were previously “impractical”, but now they help to “significantly increase” the chances of “recovering a heart for the youngest children”, babies of only a few months, for which there are “few donations”, explains the Spanish autonomous community, which has the capacity to decide on health issues.

The head of child cardiac surgery at Hospital Gregorio Marañón, Juan Miguel Gil Jaurena, adds that the complexity lies in “recovering the heartbeat, which is stopped”, and clarifies that, after recovery, the steps to follow are the same as in a traditional extraction.

The doctor Juan Jaurena explained the difference, to the Spanish newspaper “El País”, between Naiara’s transplant and other heart transplants: in a conventional transplant, when there is brain death, the surgeon finds the donor with a beating heart. Then he stops the organ, removes it from the donor, puts it on ice and takes it away.

When the heart is already stopped, it must first be revived – and only then removed from the donor.

For this, the donor baby underwent an extracorporeal circulation procedure, the blood starts to circulate outside the body, in a machine. When the blood then reaches the person’s heart, it beats again on its own.

To ensure that this procedure works, you need a perfusionist – a professional who keeps the cardiopulmonary bypass machine running.

Zamorano and the rest of the hospital staff – which included a surgical nurse technician and surgeons – went to the hospital where the donor baby was admitted to get the organ.

After reviving him, the heart was removed and kept in the so-called “cold ischemia” – without oxygen supply and at a low temperature – to be transported.

Upon being placed in Naiara, the heart needed to be revived again. “The point is not to revive just once, but twice, in this case,” explained Zamorano.

Naiara’s situation before the operation was very complex, because the heart problems that were detected during pregnancy made it necessary to anticipate the birth and then wait for the rest of the organs to “mature enough” to consider the possibility of the girl getting on the list. transplants.

According to the Community of Madrid, this case “gives greater hope” to families with children with very serious illnesses.

For her part, the director-general of the National Transplantation Organization, Beatriz Domínguez-Gil, valued the role of the donor’s family, who, in the worst moments of her life, “did not hesitate to agree to the donation”, at the same time that highlights the cooperation between the teams of the two centers involved.