Bergamo, the child who had received the lung from his father was discharged

Little Mario (the name is fictitious) has left the hospital. Last week it was the child was discharged and, thanks to the lung donated by his father, he was able to breathe again. The lung transplant from a living donor, the first in Italy for this organ, was performed on January 17 at Pope John XXIII in Bergamo.

Ánduel, the donor father, is a 34-year-old construction engineer from Albania. Little Mario had moved to Italy with his mother Ornella in the summer of 2018, when he was one year old and, a few months after their arrival, his father also joined them. The year following their arrival in Italy, the parents took their son to the Meyer hospital in Florence for some signs of illness. After exams, he arrives there diagnosis of thalassemia or Mediterranean anemia, a blood disorderwhich requires a bone marrow transplant.

However, the donation of marrow from the father, with the consequent “transfer” of the parent’s immune system to the child, has generated the so-called “Graft Versus Host Disease”a serious complication whereby the transplanted cells from the donor “attack” the recipient’s organs and tissues, which the new immune system fails to recognize as its own.

This disease damages Mario’s lungs, who was completely losing the ability to breathe independently. His only hope of survival is a lung transplant: in the autumn of 2022 the specialists of the Meyer hospital in Florence contact Pope John XXIII of Bergamo to evaluate and possibly put the child on the list for a lung transplant. On December 1, 2022, the family arrives in Bergamo. The child is hospitalized in the Pediatrics department, directed by Lorenzo D’Antiga, who is Director of the Integrated Pediatric Pathways Department at the Bergamo hospital. The baby needs continuous high flow oxygeni.e. a non-invasive respiratory support system.

During the discussion of the multidisciplinary team of pediatric transplants, Michele Colledan, director of the Department of Organ Failure and Transplantation and of the General Surgery Unit 3 – Abdominal Transplants and Professor of Surgery at the University of Milano-Bicocca, highlights the enormous advantage represented by a transplant with an organ donated by the father, who has already donated marrow and thus transferred his immunity to his son. This would have eliminated the risk of rejection.

Although this strategy was already adopted for liver transplantation by Pope John, in the case of the lung this intervention had never been done in Italy and had very few precedents in Europe, due to the great technical difficulty and the rarity of the situation. After a detailed discussion, the whole team agrees for this type of approach.

Parents immediately give their availability. The transplant was performed on Tuesday January 17 in two adjacent surgical rooms, which worked in parallel. The operation is guided and coordinated by Michele Colledan, who performs the transplant on the child, while Alessandro Lucianetti, director of General Surgery 1 – Abdominal Thoracic, performs the removal of the right lung lobe from the donor father.

Immediately after the operation, the father was hospitalized on the first day in the adult intensive care unit, and when he woke up from the sedation he immediately asked his wife for news on his son’s health. The child is hospitalized for two weeks in the Pediatric Intensive Care Unit: eight days after the transplant Mario reaches respiratory autonomy with suspension of invasive ventilation. Once the sedation is suspended, the mother has the opportunity to stay with her child day and night. The father was able to see his son again after about a week, that is, after recovering from the operation.

The child is transferred to ordinary hospitalization on February 1st in Pediatrics. It is in excellent general condition and resume your normal activities without the need for any respiratory support, thanks to his new lung donated by his father, fully functional. The child’s resignation arrives on Tuesday 21 February, just over a month after the operation. Mario will stay in Bergamo for some time to undergo post-transplant checks. Then he will be able to go home and start a normal life again.

«Seeing a child breathe independently again after a transplant and see him leave the hospital it’s what makes our work truly unique. It is significant that this happened precisely in Bergamo, exactly three years after the outbreak of a pandemic that took the breath away from many of our loved ones», explains Fabio Pezzoli, ASST health director Pope John XXIII. “Mario’s is certainly a special case, having received a special gift from his living father. But his story is testimony to how important it is to choose to donate one’s organs after death ».

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