“They extended my life”: ten years after the first liver transplant in Puerto Rico

In the last ten years, 369 liver transplants have been performed in Puerto Rico, which represents about 35 to 40 per year. All these patients have undergone surgery at the Liver Transplant Center of the Auxilio Mutuo Hospital, an institution that celebrated its tenth anniversary on February 24.

At 67 years old, Nelson Guzman He is eternally grateful to have been the first person to have received this type of transplant on the island.

“They extended my life” told the father of three children and grandfather of four grandchildren.

Visibly moved, the man recounted that he used to make a living driving trucks for a well-known department store on the island. His belly, he said, began to swell for no apparent reason and one day he vomited blood.

It was at the Carolina Area Hospital where he was initially evaluated, but due to the apparent severity of his symptoms, he was transferred to the Medical Center. There, he recalled, doctors Rafael Pastrana and Iván Antúnez recommended that he go to the Auxilio Liver Transplant Center, since, due to the apparent damage to his organ, he was a candidate for a transplant.

“A psychologist interviewed me and told me: ‘It’s life or death.’ And I chose life. They sent me to Aid and I already knew that I had to have a (liver) transplant. I feel very proud to be the first (in Puerto Rico to receive that transplant). I say it and sometimes you can’t believe me”said.

He does not remember many details of the surgery, but he does spend about two months in the intensive care unit.

“I am very grateful, first to God and also to the doctors, nurses and everyone who treated me at the Auxilio. I have evolved and I feel much better, ”he maintained.

Based on his experience, Guzmán called on other patients in need of a liver transplant to trust in the process.

Fatty liver: the main cause

Meanwhile, the doctor Juan del Riodirector of the Center, warns that ten years after the creation of the Hospital Auxilio Mutuo Liver Transplant Unit, there are still communication problems with basic doctors in the early identification of potential transplant candidates.

“We could do more, but we continue to suffer from the problem of line connection with primary care physicians. Many arrive late or simply do not reach us (on time). For example, when there is already liver cancer, they are not candidates for transplantation, ”she lamented.

Another concern, said the Spanish surgeon, is that the clinical picture of patients has evolved and hepatitis C is no longer the most common cause of liver disease, but rather fatty liver. This disease, he said, is directly associated with obesity, a condition that is estimated to affect more than 60% of the population and that also leads to other diseases.

However, Del Río warned that the volume of organ donations on the island is very good, as well as the work that Lifelink does. This is a non-profit organization that offers organ and tissue recovery services and is authorized by the federal government to serve Puerto Rico and the Virgin Islands.

Regarding the recovery of transplant patients, he commented that, in adults, survival after one year is over 90%.

“In liver transplantation, the surgical procedure is very important. If the (transplanted) liver is of good quality and the surgery went well, after the first seven days (of the transplant) it can already be said that (that patient) will be fine for life”, said the doctor.

The Auxilio Liver Transplant Center is, according to Dr. del Río, the one that most quickly attends to the needs of patients in need of this intervention in the entire United States, since it has the advantage of having a greater availability of organs for transplantation. Spain, meanwhile, remains the number one country in transplants and donations, he said.

Since February 2020, he explained, a change in the rules on the distribution of organs favors the island since it allows Puerto Rico to be the first option where the organ will be used. Del Río commented that the regulations on these processes are very important and commented that he is part of the UNOS (United Network for Organ Sharing) committee.

Meanwhile, the Center has performed 18 pediatric transplants, nine combined liver and kidney transplants and one liver split. Fatty liver, hepatitis C, hepatocarcinoma, inflammatory diseases and alcohol abuse are the main factors that lead to liver damage in adult patients in need of a liver transplant, Del Río warned. At the pediatric level, meanwhile, the most common conditions are: biliary atresia, familial portal fibrosis, hepatoblastoma, and metabolic diseases.

Meanwhile, Del Río called on citizens to donate blood since, as he explained, a healthy blood bank is needed to support this type of surgery. The blood banks on the island, he said, face limitations due to insufficient donations. The doctor also commented that there is always a need for more human resources to strengthen the program, especially nursing.

“We are here willing to help with a high-quality service,” he reiterated, highlighting that Puerto Rico stands out for being among the top ten places in the United States for the most organ donations, as well as being the transplant center that serves the fastest. patients in need of this surgery.

During a press conference held today on the ninth floor of the Auxilio Mutuo Hospital to celebrate the tenth anniversary of the Center, the Secretary of Health, Dr Carlos MelladoHe only had words of praise for the achievements made there.

“These ten years since the (first) liver transplant in Puerto Rico should be a source of pride, because in Puerto Rico we know that we have limitations in terms of access to funds,” said the headline in relation to the disparity of federal funds Medicare and Medicaid assigned to the island for medical services.

Therefore, the official warned that building this Center, even with these “vicissitudes”, is something “admirable”.

“This is a multidisciplinary team. Needless to say, they have the support of the Department of Health. What we expressly want is to transform and support all these initiatives and find a way for the patient (to access this service) and for many (patients to benefit)”, she said.

The head also highlighted the availability of the Catastrophic Fund for eligible patients.

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