In 2017, the Hospital de Clínicas da Unicamp (HC) performed the largest number of annual transplants in its history. Over the past year, 485 transplants of different organs were carried out. In 2016, 351 operations of this type were carried out, representing an increase of 38% in the following year. Since 1984, when the first three kidney transplants were performed, until December 2017, the Hospital de Clínicas performed 6753 procedures on different organs.
Almost all types of surgical procedures involving organ donations performed at Hospital de Clínicas increased between 2016 and 2017. Bone marrow transplants increased from 37 to 43, while kidney transplants increased from 136 to 148. 218 transplants were performed of cornea versus 123 the previous year, and patients who received a new liver jumped from 47 to 70 from one year to the next. In addition to these cases, six more heart transplants were performed. The work of the HC's Organ Procurement Organization (OPO) also surpassed 2016, with 371 notifications made, reaching 132 successful donors.
According to doctor Ilka Boin, coordinator of liver transplants at HC, the 48% increase in the number of liver transplants is a reflection of both the work carried out at the hospital and the possibility of increasing the procurement of organs in the State of São Paulo. “With this increase, we were able to increase the number of transplants, potentially reducing mortality on the waiting list.”
The concern about increasing the number of transplants without losing quality is also highlighted by Professor Marilda Mazzali, responsible for the nephrology area at HC. Liver transplants exceeded the target set for the year with eight more surgeries, 140 of which were from deceased donors, and only eight from living donors. "With this increase in transplants from deceased donors, we have reduced the waiting list by more than 30%. The time on the waiting list was four years, and now the average wait is two years, and in some types of cases the list is empty."
The increase in the number of surgeries also contributes to reducing mortality on the SUS waiting list, both with speed and in being able to offer a better quality of life in the postoperative period for transplant patients. This reflects the reduction in hospitalization time and cases of complications.
Training of professionals
In addition to providing assistance to the population, organ transplants at HC are training spaces for doctors, nurses and other professionals from residency and specialization programs. Most of the professionals trained by Unicamp's HC work in other health services, contributing to the training and carrying out of procedures in hospital units in other cities and states. “Residents are ready to start fundraising, making them have more donors and reaching more distant regions”, explains Ilka Boin.
HC is one of the hospitals that performs the most transplants in Brazil, and the increase is directly linked to the increase in notifications and uptakes. The Organ Procurement Organization stands out as one of the best multidisciplinary teams for evaluating and validating organ donors in São Paulo.
The collection teams evaluate and accompany donors by land up to 300 kilometers away using vehicles provided by the State Department of Health. Above this distance, the movement is carried out by air.
When a healthy donor is located but for some reason cannot be used by HC patients, the organ is sent to other hospital entities linked to the system. In 2017, 22 hearts and 18 lungs were made available for transplants in other hospitals.
Quality of Life
The increase in the number of transplants is also a reflection of greater awareness among family members about the importance of donations. Even so, the number of family refusals of potential donors is still around 40%. "The donation is the starting point of this process, and this starts in society. Society itself is the one who receives back the donation bonus", says neurologist Luiz Antonio da Costa Sardinha, coordinator of the OPO.
For Luiz Antonio Sardinha, the transplant system is an exemplary model within the SUS of social justice, with a single queue and centralized registration. "The recipient knows where they are in the queue, as the transplant system in Brazil is transparent and easily audited. When you celebrate a transplant, you celebrate that society has given itself the right to improve its quality of life.”
One of the cases of recent transplants carried out at HC is that of retired Carlos Roberto de Paiva, aged 55, who is recovering in the hospital ward after his second transplant recently carried out. In 1996 he needed to receive a new kidney, donated by his living brother. . After the surgery carried out at the Hospital de Clínicas itself, Carlos Roberto spent fourteen years living a normal life, until the donated kidney presented complications.
After almost eight years of undergoing treatments to cure hepatitis and other health problems, Carlos Roberto returned to the line and after two months he received a new kidney, from a deceased donor. “I have to thank the family members who authorized the donation, and who continue to do so. Many people will improve their quality of life with transplants.”
