The first living lung transplant in Italy performed in Bergamo. The protagonist of the operation, carried out yesterday 17 January at the Papa Giovanni XXIII hospital, is a 5-year-old boy from another region, who received the organ from his father. After donating marrow to his son to treat the thalassemia that afflicts the child since birth, the father chose to deprive himself of a part of his lung to save the child’s life. “It is a very rare case, with very few precedents in Europe”, they underline from the Bergamo Asst.
The child – explains a note from ‘Pope John’ – suffers from thalassemia or Mediterranean anemia, a blood disease which made it necessary to undergo a bone marrow transplant, performed in another Italian hospital. However, the marrow donation from the father, with the consequent transfer of the parent’s immune system to the child, has produced the so-called graft versus host disease (GvHD), a serious complication that is observed in patients undergoing transplantation allogeneic. In summary, the donor’s cells ‘attack’ the recipient’s organs and tissues because the new immune system does not recognize them as its own. A form of rejection that caused the child extremely serious and irreversible damage to lung function, so much so that he required a lung transplant.
Father and son remain hospitalized and their prognosis is still reserved. However, the doctors say they are “confident about the post-operative course, also because in this case the risk of rejection, particularly high for a cadaveric lung transplant, is very low when the immune system recognizes the new organ as its own”. It is above all for this reason that, when a hospital from outside the region asked for Pope John’s willingness to accept the child for a lung transplant, the surgeons of Bergamo proposed the living donation to the family.
“The extreme rarity of these cases, and the technical limitations of living transplants, in the case of the lung do not make it an easy-to-apply therapeutic option – explains Michele Colledan, director of the Organ Failure and Transplantation Department and of the General surgery 3, abdominal transplants by Pope John XXIII Asst – For this reason, unlike what happens for other organs, it is not usually considered an option within everyone’s reach, capable of effectively contributing to the reduction of waiting lists. However, the operation marks an important step for our hospital in an almost forty-year growth path in transplantation activity.A path undertaken thanks to the pioneering work of Lucio Parenzan in pediatric cardiac surgery and which has led us, also thanks to Giuseppe Locatelli, to the specialization in congenital and acquired pathologies of the child and which, in the last 20 years, has strengthened aiming at a clinical activity of high level on the lung, even in the adult”.