The hopes of a new heart transplant for Domenico, the two year and four month old boy hospitalized at the Monaldi Hospital in Naples, have been dashed. The committee of experts gathered to evaluate the feasibility of a new intervention has unfortunately given a negative opinion. The little boy, who is currently in Intensive Care, had undergone a transplant last December with a dramatic outcome: the donated heart had been damaged during transport.
The Heart team, convened by the main Italian structures dedicated to pediatric transplantation, carefully assessed Domenico’s clinical conditions, examining the latest instrumental tests and the chances of success of the operation. The unanimous decision was clear: the child’s condition is not compatible with a new transplant.
The Heart team’s decision
The team of experts included Professor Lorenzo Galletti and Doctor Rachele Adorisio from Bambino Gesù in Rome, Professor Giuseppe Toscano from the University of Padua, Doctor Amedeo Terzi from the Papa Giovanni XXIII hospital in Bergamo and Carlo Pace Napoleone, director of pediatric cardiac surgery at Regina Margherita in Turin.
In the meantime, the available heart will be allocated to other compatible patients, while the little one remains on ECMO support, to temporarily support cardiac function. The Colli Hospital Company announced in a note:
The consultation between experts from the main healthcare facilities in the country dealing with pediatric heart transplants has concluded. A collegial discussion that allowed for a shared evaluation that was as complete and broad as possible. In light of the assessments carried out at the patient’s bedside and on the basis of the latest instrumental tests, it was established that the child’s conditions are not compatible with a new transplant.
Investigations on the damaged heart
The investigators of the NAS of Naples and Trento, coordinated by the prosecutor Giuseppe Tittaferrante and the deputy Antonio Ricci, have started a detailed investigation to clarify the responsibilities. The objective is to reconstruct every phase of transport and implantation, from collection to arrival in the operating room. The first checks concerned the path of the heart: transport by ambulance to the helicopter, flight to Verona and transfer to Naples. We are evaluating whether the instrumentation and procedures adopted comply with the standards established by the pediatric transplant protocols. The suspects include six people, including two cardiac surgeons and their respective teams involved in the sampling and implantation. The investigation aims to establish any negligence or operational errors that have compromised the vitality of the heart.
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