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Guanajuato #1 State in Organ Donations

cBy Jesús Aguado

The taboos of the past regarding organ donations have been overcome, and that is why Guanajuato occupies first place in national donations, according to State Center of Transplants (CETRA) director Rodrígo López in a recent interview with Atención.

López also commented that the process of transplants in the state is transparent, because “people question what they do not know, and in this state we let people know all the benefits of the program. I have worked here for eight years, and in the past, people thought that the organs were transplanted to wealthy and very important people, but those misconceptions have been defeated with the information that we provide.”

CETRA is located in León.

Dr. López also remarked that if somebody wants to know who received on organ, they can have access to the information by following protocols. “It is very sensitive information, but there is access to it,” he said.

Testimony could be given by more than 3,000 people who have received transplants, he said.

Jesús Aguado: How do you define a transplant?

Rodrigo López: It is the substitution of a healthy organ for a sick one in order to reestablish functioning.

JA: When was the first transplant performed in the state?

RL: It was from a living donor. It was a kidney in 1989. It was performed by the Hospital of the IMSS. Ten years later, the first transplant from a dead donor was also performed by the IMSS. Since 2000, the activity has been more constant, and it keeps growing.

JA: What is the reason for the increase in transplants?

RL: The factors are many, but it is mainly because the hospitals can now perform the surgeries. In 2000, 25 kidney transplants were performed, and that was because the relatives of those in need donated their organs. That was an act of love among families. Now the donations also come from dead people, and the campaigns are better to get relatives to donate the organs of the deceased.

JA: Besides kidneys, what else can be donated by a living person?

RL: Obviously a kidney and, although this is not well known by people, liver segments. Blood also, but for practical issues, kidneys. Due to the sociodemographic characteristics of Guanajuato, kidney problems are very common.

JA: Who pays for the transplants?

RL: The relatives of a donor will never pay for the extraction of an organ. Taking into account the helicopters and ambulances, as well as the solutions that we use (at 4,000 pesos per liter), everything is covered by the Secretariat. The same Secretariat conducts socioeconomic studies of those patients on waiting lists, and there are six different levels—from one to six. Sometimes those who cannot pay for the surgery still receive it. Those who are in the sixth level, which is the highest, do not pay more than 150,000 pesos.

JA: When a person dies, what can be donated?

RL: Organs (heart, liver, lungs, kidneys, pancreas, intestines). In Mexico there are no programs for transplanting lungs. There is no experience, not even in the Mexico City hospitals. The heart transplant is very common, as well as liver and kidneys. Several pancreases have been successfully transplanted. Talking about tissues: corneas can be donated, as well as long bones from legs and arms. Many people think that when a bone is donated the whole part of the body is taken, but that is not true. Only the bone is taken. The body is given back to the relatives with a prosthesis and in perfect condition.

JA: How many people can benefit from just one bone?

RL: When the bones are donated, these are processed, and we get sub-products that can benefit more than 70 people. When the bones are not donated, only six or seven people can receive an organ, and in addition, that will depend on the condition of the organs.

JA: Is the donation of bones and tissue common?

RL: It is a common topic. In San Miguel 8 people out of 23 have donated everything. But it depends also on the condition of the person, and it is not asked of everybody. For example, those who had drug or alcohol problems are not candidates for donating, and children cannot donate.

JA: Although it is common, is it easy to get the donation of bones?

RL: Of course it is very complicated and intense work. It is a very emotional moment for the family and asking them to think of helping others without receiving a benefit makes things even more difficult. But we provide them with all the information requested, and the donation also helps them to endure their mourning because they can feel that part of their relative still lives. They can also have access to the information about who received the donation. We do not recommend that, because there are cases of people who have been obsessed with the beneficiary and want to be close to him or her, and that is not healthy for anybody.

JA: What is the maximum age for donating corneas?

RL: We do have a microscope that helps us to analyze the quality of the corneas now. In the past we received corneas from 60-year-old people, but now we can receive from 70-year-old people.

JA: What about the black market for organs?

RL: That does not happen. To perform a transplant, very expensive compatibility studies are needed, and they are conducted at very specialized hospitals. Also, a transplant requires a team of more than 30 people. With so many people involved, it is just impossible.

JA: What are hospitals that perform transplants in Guanajuato, and what is the destination of the donated organs?

RL: Hospital General de Alta Especialidad del Bajío, Hospital Regional del ISSTE, Unidad Médica de Alta Especialidad del IMSS, and the Hospital General de Irapuato are the only public hospitals authorized for transplants. The authorized private hospitals are Hospital Aranda de la Parra and Hospital Ángeles. We have to be notified of any donation, even if it is from a private hospital. Each hospital has a donation committee that respects the law and decides the final destination of the organs. I can tell you that all the donations we have had from public hospitals have ended up in public hospitals.

JA: Are the organs exported?

RL: Exporting or importing organs in Mexico is forbidden by law. Only corneas can be imported and they are brought from San Diego or Miami. In this state, there is a clinic that imports its corneas from there.

JA: What is the protocol for getting the cadaver organs?

RL: We arrive at the scene when the medical group trying to save the life of somebody says that there is nothing more to do and the patient is brain dead. We explain the process to the family, and we try to make them understand that their relative will not come back. People are never forced to donate. Currently, there is not a single family with regrets for the donation, because their tragedy is turned into life, and that helps with the mourning.

JA: Is there something else that you want to say?

RL: Since 2009, the negativity about donating has decreased. That year, 6 of every 10 families said no to donation, and now it is only 2 of every 10—80 percent say yes. I also want to say thank you to all the donors who generate good news. I want to invite everybody to take part in the donation. There are 1,250 people waiting for a kidney transplant in Guanajuato.

Finally, for those on the waiting list, waking up every morning in despair and with the uncertainty of when a transplant will be available, I want to let them know that the CETRA team wakes up daily with the sole mission of working hard to get the organ. We do not know when it will arrive. Unfortunately, it depends on accidents. I want them to stay tranquil, because there is somebody looking out for them.


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