For those who need it, a transplant can feel like a new lease of life. In Mexico, 48 patients need a new heart, but the Covid-19 pandemic is slowing down the pace of transplants.
During the first half of 2020, donors have decreased due to numerous SARS-CoV-2 cases. In the last decade, heart transplants averaged 17 operations for the first half of each year. At the end of June, only six such operations had been performed, according to figures from the National Transplant Center (Cenatra).
On July 21, 1988, the first heart transplant was performed at the Mexican Social Security Institute (IMSS). But there’s still a big waiting list. There are 23,322 Mexican patients who need hearts and other organs.
A new plan
Since June 29th, the Ministry of Health and Cenatra have published a plan for donation and transplantation reactivation programs to continue their work in this area.
Their goal is to promote the reactivation of donation and transplantation programs, keeping all involved safe. The plan considers performing these surgeries according to health alert levels in each state.
“The federal government has begun programs for hospitals that are free of Covid-19 to begin the heart, kidney, and liver transplant program. We are at a stage of the pandemic when we can have patients in non-Covid hospitals. We hope to not slow down the transplant system anymore,” says Victor Córdova, an internal medicine specialist and founder of the Science in Obesity Movement.
At the beginning of the lockdown, Cenatra and Mexican health institutions recommended a pause on all donation and transplantation programs to prevent further infection. The only exceptions were emergency liver and heart cases.
The story of the first heart transplant
The first heart transplant was performed on July 21, 1988, at the IMSS La Raza National Medical Center. Since then, 630 heart transplants have been performed, according to Cenatra figures.
Rubén Argüero Sánchez was the surgeon in charge. The process, which began with the confirmation of a female donor in the early morning of July 21, 1988, culminated at 10 p.m.
The donor, Eloísa Pacheco, suffered brain death. After evaluating her case and asking her family for authorization, doctors began testing potential recipients. Of the three candidates, Mr. José Fernando Tafoya Chávez (then 45 years old) was the right candidate.
“After the transplant, the research continued. We participated with eight other countries in the world to perform cardiomyoplasty and initiate the implantation of stem cells to the heart. There’s only one institution in the world that has had 108 implant cases, and that was this Institute,” says Argüero.
On Argüero Sánchez’s team was Dr. Guillermo Careaga Reyna, who is currently Director of the Advanced Medical Unit (UMAE) at La Raza National Medical Center, located in Mexico City.
On a typical day, the unit has 530 appointments, more than 6,000 laboratory studies, approximately 170 patients are treated in the ER, and 1.5 transplants are performed.
One in three transplants of this organ are performed at La Raza. IMSS has taken advantage of technological advances that benefit this type of procedure, such as:
- The placement of two ventricular support systems, better known as the artificial heart.
- In conventional heart transplants, there is an extracorporeal circulation pump.
- A new preservation solution extends the time between extraction and transplantation from three to six hours.
- The transplant staff at La Raza have the opportunity to train in the United States, Spain, and Colombia.
- Thanks to these aspects, the average survival rate of patients is greater than 85% one year after receiving a transplant.
- Recommendations for patients waiting for a heart transplant
There is a before and after for patients who receive a heart transplant. Here are some recommendations that Córdova gives to those on a waiting list:
- Remain calm, as the transplant success rate in Mexico is over 80%, in both the public and private sectors.
- Strictly and rigorously comply with all medical indications.
- Follow a diet low in carbohydrates and high in protein, as indicated by your doctor.
- Have frequent checkups with a dentist and ear, nose, and throat specialist to prevent infections.
- If you take any medications to control any disease, let the surgeon know about them.
- 70% of a surgery is in the hands of doctors and hospitals, but 30% of the surgery is the patient’s responsibility. This should include immunological treatments and not putting on weight.