Puerto rico government

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

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

At 67, Nelson Guzman He is forever grateful to have been the first person to receive this type of transplant on the island.

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

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

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

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

He doesn’t remember many details of the operation, but he spent 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 said.

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

Fatty liver: the main cause

During this time, the Doctor Juan del RioDirector of the Centre, warns that ten years after the creation of the Liver Transplant Unit at Auxilio Mutuo Hospital, 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 connecting online with primary care doctors. Many arrive late or simply do not reach us (on time). For example, when there is already liver cancer, they are not candidates for a transplant,” 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 disease. This disease, he said, is directly associated with obesity, a condition which, according to estimates, affects more than 60% of the population and which 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 done by Lifelink. It is a non-profit organization that provides organ and tissue recovery services and is federally licensed to serve Puerto Rico and the Virgin Islands.

Regarding the recovery of transplant patients, he noted 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 operation went well, after the first seven days (of the transplant), we can already say that (this patient) will be fine for life,” said doctor.

The Auxilio Liver Transplant Center is, according to Dr. del Río, the one that responds most quickly to the needs of patients requiring this intervention in the whole of the United States, because it has the advantage of having greater availability of organs for transplantation. . Spain, meanwhile, remains the number one country for 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 pointed out that the regulations on these processes are very important and said that he was part of the UNOS (United Network for Organ Sharing) committee.

During this time, the Center performed 18 pediatric transplants, nine combined liver and kidney transplants and one liver split. Fatty liver disease, hepatitis C, hepatocellular carcinoma, inflammatory diseases and alcohol abuse are the main factors that lead to liver damage in adult patients requiring liver transplants, Del Río warned. At the pediatric level, the most common conditions are: biliary atresia, familial portal fibrosis, hepatoblastoma and metabolic diseases.

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

“We are here ready to help with a high quality service,” he reiterated, pointing out that Puerto Rico stands out for being among the top ten places in the United States for the highest number of organ donations, in addition to being the transplant center that serves the fastest. patients requiring this surgery.

At a press conference today held on the ninth floor of the Auxilio Mutuo Hospital to celebrate the Centre’s tenth anniversary, the Secretary of Health, Doctor Carlos MelladoHe had only words of praise for the accomplishments 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 limits in terms of access to funds,” said the title in relation with the federal funds disparity. Medicare and Medicaid assigned to the island for medical services.

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

“It’s a multidisciplinary team. Needless to say, they have the support of the Ministry 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 the greatest number (the patients to benefit from it)”, he added. she stated.

The chef also highlighted the availability of the Catastrophe Fund for eligible patients.