10 June 2021 15:15
A compatible heart from a Covid-19 positive donor. The recipient, a 15-year-old with an artificial heart for a year, negative for the virus but who needs this transplant to survive. And here, with a multidisciplinary work and comparison between doctors, at the Bambino Gesù pediatric hospital in Rome, an organ transplant from a Sars-CoV-2 positive donor was performed for the first time in the world in the pediatric field. negative patient.
“In the pediatric field – explains Professor Antonio Amodeo, responsible for the complex structure of heart failure, transplantation and cardio-respiratory mechanical assistance at the hospital – finding a compatible heart for a transplant is more difficult than in adults. In the last year, then, due to the pandemic and the restrictions adopted to combat it, these difficulties have further increased. Finding a compatible heart for a transplant is often a more unique than rare occasion. So we did everything possible so that the guy on the waiting list could get the organ he was waiting for. A choice that can make the difference between life and death “.
The 15-year-old boy, who received a new heart, was treated with monoclonal antibodies to eliminate the risk of developing Covid-19. The intervention required special authorizations from both the National Transplant Center (CNT) and the Italian Medicines Agency (AIFA). In 2 weeks, from 4 to 19 May, the professionals of the Department of Cardiac Surgery, Cardiology and Heart-Lung Transplantation of the hospital carried out a total of 6 heart transplants. “In order to assess the risk of transmission of the Sars-CoV-2 virus, numerous researches were carried out in the respiratory system, on the blood and on the heart of the donor, using rather sophisticated techniques, which, taken together, showed a risk of very low viral transmission – says Professor Carlo Federico Perno, head of Microbiology and Immunology Diagnostics of the Child Jesus -. This made it possible to give the green light to the transplant ”. A derogation from the current protocol was therefore requested from the Italian Medicines Agency to use monoclonal antibodies on the recipient boy, in order to further reduce the already low risk of infection. In fact, the protocol allows its use only on patients already sick with Covid-19 and under certain conditions.
“The operation is the result of a multidisciplinary process in which the increase of tools for the treatment of SARS-SoV-2, such as the vaccine, monoclonal therapies and antiviral therapies – explains Professor Paolo Palma, head of Clinical Immunology and Hospital Vaccinology – has led to the development of a series of tools, both research and clinical, which have opened up hitherto unthinkable perspectives “.