In collaboration with the
Dr. Massimo Cardillo
Director of the National Transplant Center
When Maria died she was 97 years 6 months and 29 days old, Francesca instead had even exceeded 100 (years) for ten months and 24 hours. Theirs are two invented names but behind them they hide the identities of oldest organ donors in Italy and in the world.
After their death livers they were harvested and implanted in two other patients who had been on the waiting list for months. The choice of Maria and Francesca – or rather, that of their families – has saved my life of these two people.
These interventions have already entered the pages of the scientific literature and certify once again the leading role of the Italian transplant system among the world excellence. One status already witnessed in 2020, when the first uterus transplant in Italy had been completed in the midst of pandemic. The transplant, if you remember, was a success and a few weeks ago the young Albina Verderame managed to give birth to her baby girl.
“Using such an elderly donor means owning a selection ability and of transplant procedure absolutely excellent. It means being able to execute effectively all the donor investigations necessary to assess the suitability and quality of a senior organ and then select a ideal candidate for the surgical procedure” proudly acknowledged Dr Massimo Cardillo, director of the National Transplant Center. But the stories of Maria and Francesca they say more.
They lead to an awareness that not only helps to strengthen the confidence in the donation-transplant system, already certified by the numbers of 2021. The gestures of these two women redefine the contours of what it means “old” in medicine and consolidate a reality that must become one awareness. And that is that sometimes age is really just a number written on a piece of paper. Specially when a life is at stake.
That number says nothing. Of course, it alone is not enough to define whether an organ is “useless” or not. “Some, like the heart hey lungs are more sensitive toaging. Liver and kidneys are organs more resistantespecially the liver because it has a large regenerative ability”. And once transplanted, added the director of the Cnt, the liver finds a way to to renew more easily than the others and to continue to function perfectly despite its “age”.
The two transplants then tell that the years are not a strict and rigid bond not even in the search for a receiving compatible. “Under ordinary conditions one always tries to make a balancing between the age of the donor and that of the recipient. In the case of the liver, however, this is not an absolute criterion because the choices are guided by theurgency of the recipient”.
Liver and kidneys are more resistant organs, especially the liver because it has a great regenerative capacity
Dr. Massimo Cardillo, director Cnt
In short, Dr. Cardillo explained that it would be possible to transplant the liver of a centenarian donor into a young recipient, even of 20-30 years oldif the latter were in immediate danger of life. “In these circumstances the transplant becomes a viable alternative compared to being waitlisted with the risk of dying”.CopyAMP code.
Of course: not all organs taken from an over ninety or even over one hundred year old can be reused. Maria and Francesca donated their liver but also the fabrics or the cornea could have potentially been reused. “The cornea, for example, has asuitability even at a very old age and therefore this too could be donated by people over eighty”.
Before being able to have the green light, then, each organ must pass a very rigid and scrupulous “selection” phase. “There is a procedure of assessment of the donor very accurate, carried out with blood tests And instrumental which they aim to sanction eligibility of the organ being transplanted”. And Maria and Francesca’s livers, of course, were considered to be in perfect condition.
“In recent years the use of perfusion machinesshe said «ex situ», within which an organ removed from a donor can be perfused and maintained in excellent condition” added Dr. Cardillo, underlining that this technique has made it possible to further expand the possibilities of resorting to elderly donors.
The cornea has a good suitability for transplantation even in very old age
Dr. Massimo Cardillo, director Cnt
The stories of Maria and Francesca, as I told you, tell many things. Including the fact that if two women aged 97 and 100 come to donate their organs it means that the quality and life expectancy have increased, and not a little. According to the director of the Cnt, it is not just a great signal on the donation side: “Today, even very elderly patients for whom a contraindication existed before are sent to receive a transplant. Very advanced age was a limittoday, however, even the elderly can undergo these life-saving procedures”.
The organ donation by two such elderly people seems to confirm what the director Cardillo had already explained to us in 2021. That is, when the national system of donation and transplants had reassembled the inversion due to the pandemic registering a increase in donation membership by Italian citizens and therefore the growth of sense of responsibility. And in part it is true.
However, the stories of Maria and Francesca are configured rather as virtuous examples but still a little too isolated. “Curiously, in the manifestation in life, the percentages of opposition to donation rise more in elderly subjects – admitted Cardillo -. While young people give consent more easily, the elderly do it less. We have an overall lifetime percentage of 30% but for the over eighty year olds the percentage doubles. We must learn to better inform this segment of the population. Elderly people need not fear that their organs are no longer usable. It is important that each citizen gives his willingness to donate, regardless of age”.
Mary and Frances thethey demonstrated.
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