The Vall d’Hebron hospital transplants the lungs of a 24-year-old woman for the third time | Science

“I just hope that this time the lungs become friends with my daughter.” In this naive way, Dolors, the mother of Mireia Sitjà, summed up the suffering of this 24-year-old girl. Sitjà has become the first Spanish woman to have had three lung transplants. This Friday, the young woman was full in the corridors of the Vall d’Hebron hospital in Barcelona where, despite the masks, her eyes smiled at the toilets who have achieved this unprecedented medical feat in Spain. The young woman who was diagnosed with cystic fibrosis when she was only months old left the hospital a week ago after the third transplant. He has shown his desire to live, aboard a stationary bicycle installed in one of the hospital corridors. This is the story of a new medical breakthrough and the fight for survival of a 24-year-old from Barcelona addicted to Japanese culture and passionate about the new Korean pop. “Now I start to dance and I don’t get tired,” warns Sitjà.

Dolors – she does not want to reveal her last name, since she understands that the leading role should be her daughter and the hospital center – took Mireia to the hospital when she was only a few months old. “I had a cold that wouldn’t go away,” he recalls. Here began a true medical viacrucis with many moments of despair. The diagnosis was not good. He had cystic fibrosis, a chronic disease that affects the cells that produce mucus, sweat and digestive enzymes. The body’s secretions become thick and instead of acting as a lubricant, they become dangerous plugs that affect the lungs and the pancreas. Sitjà’s disease worsened year after year and in 2016, when she turned 19, the young woman’s only chance of survival was a double-lung transplant. It didn’t go well. The patient’s body rejected the organs and in 2019 she returned to the operating room where she underwent a second transplant of both lungs. Sitjà’s body rejected it again and the Vall d’Hebron team submitted the possibility of a third intervention to the evaluation of several professionals. Days before last New Year’s Eve, the young woman returned to the operating room in an operation that lasted four and a half hours and in which a team of 17 doctors participated, including thoracic surgeons, cardiac surgeons, anesthesiologists, nurses… The boss from the thoracic surgery and lung transplant service at Vall d’Hebron, Alberto Jauregui, admits that doing a second transplant is “very infrequent” and a third is almost “unprecedented”. “We are the first to do it in Spain, there are very few cases in the world and having done it in Vall d’Hebron gives us the possibility of being able to offer this type of transplant to people in the same situation as Mireia. Unfortunately, we do not have enough donors. If we had more donors we could offer it”, says Jauregui. The doctor remembers the dilemma that the health committee debated in Mireia’s case. “It is true that we offered a third chance to a person when there are patients on the waiting list who have not had a chance. Each case must be assessed. Patients are not numbers. There were possibilities that it would not go well, but in the balance there were more possibilities that it would work and we had to try it because, otherwise, there was no other possibility”, confesses Jauregui. “We don’t know if this time it will work or not. Let’s hope that these lungs will last him a lifetime and if the time comes when we will not debate whether a fourth transplant is possible, “he admits.

The pulmonologist at the lung transplant unit Cristina Berastegui accepts that half of transplant recipients develop chronic rejection five years after the medical intervention. “The lung is an organ exposed to the outside and that makes it very peculiar. In the case of Mireia, we evaluated the possibility of a third transplant in order to achieve her survival. This type of intervention is exceptional, even at an international level, because it requires an ethical assessment, since the available organs mean that in each case the chances of survival have to be assessed with the aim of living as long as possible”, warns Berastegui. .

Vall d’Hebron performs about 80 lung transplants a year and is the Spanish health center that performs the most transplants of this type. Once the intervention was over, Sitjà spent a few weeks in the medical center. The supervising nurse, Adela Amat, confesses that her entire team has felt “very close” to the young woman.

“I have always lived with the disease. Now it’s been a week since I got out of the hospital and I see that I can do things that I couldn’t. Before, with any nonsense I would drown. I couldn’t even put my socks on”, ironically, despite everything, Sitjà. “I adapt to what comes. Transplants are complicated and when rejections come I have to adapt to the circumstances as they come. The important thing is to live day by day”, assures the woman to the media. Behind the flashes and cameras, her mother Dolors watches her —who still does not want to be the leading role— and who has been wishing for years and years that this time the lungs want to “be friends” with her daughter.

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