Bellvitge Hospital performs the first heart transplant in controlled asystole in Catalonia with the heart of a donor from another centre

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The heart was extracted at the Germans Trias i Pujol Hospital and the transplant was then performed at the HUB, completing a highly complex procedure.

So far this year, three heart transplants in controlled asystole have been performed at the HUB.

Bellvitge University Hospital (HUB) professionals have performed this June for the first time in Catalonia a heart transplant in controlled asystole with the heart from a multi-organ donation carried out in another hospital.

The heart and liver transplant teams from the HUB moved to the Germans Trias i Pujol Hospital in Badalona with the aim to carry out, together with that centre’s professionals, the multi-organ extraction of the donor and immediately return to Bellvitge Hospital to complete the transplantation. This is the first time a donation under such conditions has been made in Catalonia whereas the fourth in Spain. The procedure requires a great deal of expertise and precision, given that the heart is out of circulation for much longer than in an asystolic transplant performed in the same centre where the donation has been registered.

"We usually complete a transplant in controlled asystole in less than an hour, and in this case it took about 130 minutes to complete the entire process, from the start at Can Ruti to the transplant at the HUB," explains Dr Nicolás Manito, director of the Transplant Programme at Bellvitge Hospital. Heart transplantation in controlled asystole is a fundamental reinforcement for cardiac transplantation. In fact, the three transplants of this type performed at the HUB so far this year already account for 25% of the activity and the projection is for this percentage to reach 30%. Organ donation in asystole occurs from donors who die after cardiorespiratory arrest. This arrest means that the organs deteriorate rapidly due to the lack of blood flow, so the donation process is more complex than it is in the case of death due to encephalic death.

During the extraction of the heart, a perfusion circuit is established that allows the heart to recover its functionality through the supply of oxygenated blood as well as its functional assessment by the medical team. After the year 2020, which was absolutely conditioned by the impact of the pandemic, heart transplantation at the HUB recovered in 2021 the levels of excellence achieved in 2018 and 2019. In this way, up to 25 adult heart transplants were carried out, a figure that only two other centres in Spain recorded. In this way, and thanks to the expertise and coordinated work of the professionals and the donors’ and their families’ generosity, Bellvitge Hospital has consolidated its position as a centre of reference at national level in heart, kidney and liver transplants.