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In Peru there is only one organ donor per million inhabitants due to the Covid-19 pandemic

Peru is one of the countries with the fewest organ donors in Latin America, ranking second to last after Paraguay and Bolivia. This situation worsened with the onset of the Covid-19 pandemic, further reducing its donation rate from three to one donor per million inhabitants this year.

Currently, one of the most requested organs is the lung, a transplant carried out by the Guillermo Almenara Irigoyen National Hospital. “It is one of the transplant centers with the highest demand. In their history of more than five years in transplantation, they are doing an average of 40 transplanted patients ”, recalls Dr. Mary Díaz, Procurator and Transplant Manager of EsSalud’s Central Operations Management.

So far in 2019, in our country, 663 organ and tissue transplants have been performed. According to the Ministry of Health, of this figure 135 are kidney transplants, 39 liver, 12 heart, as well as 365 corneal transplants, 109 bone marrow and only one, read well, a lung transplant.

Despite its high demand, it is not common in Peru to have lung donors. One of the factors is the special requirements that are needed for your procedure. “It has to be a lung from a young donor, that it is well cared for, that it does not have many days of hospitalization because it may have been contaminated with other intrahospital germs.”

For Dr. Díaz, finding an ideal lung donor is not easy, either in Peru or in other countries around the world.

Situation suffered by Eloy Espinosa-Saldaña, magistrate of the Constitutional Court (TC), who is waiting for a lung donor. “I have pulmonary fibrosis that has tended to worsen and the only way to reverse it is a lung transplant.”, He told Tv Peru.

Through his Facebook account, Saldaña encourages people to donate. “Please donate your organs. I have seen and lived in my own flesh the tragedy of people who literally die at the door of a hospital or a clinic for lack of the necessary organs, with doctors, nurses and technicians powerless help”.

At present, only 13% of Peruvians are registered with Reniec as voluntary donors, but when the person dies and the family member is consulted, he or she refuses and does not allow the organ donation to be made. “We have a high family refusal rate that is around 70%, that is, of every 10 Peruvians who are consulted about accessing the organ donation of their deceased relative, only three accept,” recalls Dr. Díaz.

While 40% say they will not donate and the rest say nothing. “This is an important factor that we have to evaluate and analyze, because the population is not informed about what organ donation is, what are the aspects of donation, how does one decide to be a donor and what is the impact of deciding being a donor, which is saving lives ”.

For this reason, Dr. Díaz recommends that regardless of whether you place yes or no on the DNI of wanting to be a donor, the most important thing is that this decision is communicated in life. And also talk with your family that when the time comes, they respect your decision to donate.

What organs can be donated?

One person can donate up to nine organs and save lives. For example, the most demanding organ in Peru and the world is the kidney and it has about 13 thousand patients on dialysis “who no longer have kidney function and who are the subjects to be transplanted”, with respect to solid organs.

While the most demanding tissue is the cornea, there are between 3,000 to 4,000 patients waiting for a corneal transplant to improve their vision, according to EsSalud.

Then there’s the heart, with a waiting list of three young patients. One is under the age of 50 and the other is a minor. Lungs follow, performing two transplants in 2020 and one this year. Followed by the liver, pancreas, and tissues like skin and bone.

Organ donor decline

The donation rate has dropped considerably. Before the pandemic, there was a rate of three donors per million inhabitants in 2019, which implied 93 deceased donors, with 534 transplants in that year.

While this year there have been more than 160 transplants between organs and tissues. To date, there are 26 registered multi-organ donors. “This has already improved in relation to the year 2020, when only 145 transplants were performed.”

For Dr. Díaz, it is important to understand that the donation rate is based on three important factors: country policies that allow the promotion of organ donation, where all Peruvians have access to transplantation; a population that believes and has confidence in its health system; and the organization and financing of all the procurement and transplantation network systems as a country.

In that sense, the list of consent certificates to be donors, according to the Ministry of Health: more than 10 million Peruvians do not even reach 200 thousand positive certificates of donation. This means that it is not a known topic, it is not a topic that can be discussed in the family, in the entire community and in society. Therefore, “the way we decide to be donors is not positive for improving donation rates.”

More than half a century has passed since the first transplant was performed in Peru, which was carried out at the Edgardo Rebagliati Martins Hospital, where a kidney was transplanted. It was the young Hugo García Gonzáles Prada, who received the vital organ from his father José García Aguilar. The young man suffered from chronic kidney failure. The operation was carried out thanks to a team of 26 professionals, led by Dr. Marino Molina Schippa.

Today there are only two effective donors for every million people, that is, 66 people who donate and around seven thousand people on the waiting list for an organ or tissue nationwide.

Organ transfer

The lifespan of a heart is four hours, a liver six hours, a lung two hours, a kidney may have 12 or 24 hours and corneas three days, from when it is extracted until it is put into another organism. At least one hundred people participate in the operation, including surgeons, anesthesiologists, pathologists, nurses, psychologists, among others. When the patient is brain dead, it is communicated to the transplant team, it is sent to the ´transplant proctors´ (who verify that everything is in order) so that they can then ask the family for a donation and carry out the corresponding tests on both the donor as the donor. “Transplantation is not only a medical issue, society, the MTC, the PNP, the Ministry of Defense, FAP and the media participate. It is a coordinated and intersectoral work. ”, Mentions Juan Almeyda, director of DIGDOT.

All the transplants that are done in the hospitals of Peru are completely free; there is no profit intention. However, liver transplantation can cost between S / 180 to 200 thousand soles, similar to heart and bone marrow transplantation, which is S / 250 thousand soles.

Abroad, the cost of this operation can reach S / 850 thousand soles, even more; But the social security already has the human resources trained and trained to be able to offer this type of transplants in the country.

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