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Weight loss, swollen belly, weakness and fainting were very common symptoms for Maria Raimunda da Silva. "I was practically dead," he says, remembering the number of times he's been hospitalized without consciousness. The diagnosis of cirrhosis of the liver came quickly, as well as the referral to a specialized unit.
Daily visits to the doctor have become routine. Maria, a mother of two, began treatment at the transplant hospital of the state of São Paulo, in the state capital, where she learned that her liver had stopped working . One procedure could save his life: a transplant.
"They saw that there was no way," he says. Terrified and frightened, she registered in the state's transplant queue and only a matched donor could end this suffering. It was then that a liver appeared and on May 21, 2017, performed the transplant. The cure was not the best, but in 15 days, Maria Raimunda had resumed a new life
"The profile of this patient is that it's not just the sick liver." it is malnourished (since other organs have also been affected) .Every transplant is a surprise, each case varies in recovery, "reports the hepatologist at the Transplant Hospital, Mirella Medeiros Monteiro
Today, at 58, Maria Raimunda has no words to thank the family members of the donor and emphasizes the need for everyone to become potential donors "It was a feeling of relief. I feel 20 years old again, I am much more energetic than before. I therefore advise my children and all my family to donate. If it was important to me, it is important for others as well. "
Central reguladora
Today, thousands of Brazilians have similar trajectories like this one, but many of them are still lost along the way. leave behind stories, families and a chance for survival.To reverse this scenario, it is imperative to create a society increasingly aware of the importance of becoming an organ donor.
In the state of São Paulo, there is an agency responsible for administering and regulating all donation and transplantation procedures Since 1997, the Transplant Center, attached to the State Department of Health, makes the distribution of captured organs more equitable and transparent, so criteria for waiting times, compatibility and severity of patients are established.
Since then, the Central Bureau has recorded a balance of 101,300 São donors Paulo and more than 117,000 transplants performed. There was a 916% increase in the number of cadaveric donors (those who had brain death), reaching the historic mark of 844 only in 2017.
Click here to see an infographic on the subject. 19659002] These achievements are the result of integrated work between several teams scattered throughout the state who perform organ capture, transplantation and constant monitoring of the patient. Because of this volume, the Center has a very robust structure.
Based on agreements with public and private institutions, the entity has air and land transport responsible for the regional distribution of organs by the state (except). "We need a quick mechanism to inform donors and prepare the patient for transplantation," said Marizete Medeiros, coordinator of the Transplant Center, which operates 24 hours a day.
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Hospital units that have intensive care units and emergency rooms must have a transplantation commission directed to the hospital, which identifies patients who have suffered head trauma or stroke. With this, he must notify the Center to certify the possibility of a donor. After confirmation of brain death, the family must authorize the donation.
Meanwhile, patients waiting for an organ are enrolled on a waiting list of the Center. When a donor appears, this system crosses the information and indicates who the potential recipients are. Criteria such as blood type, severity of the patient and waiting time are essential for the administration of this organ.
"We always send a laboratory to take samples of both people and do the last test.After these procedures, the transplant can be performed," says Marizete.C is based on these strategies that today São Paulo holds half of the country's transplants and is an international reference in several modalities of the procedure.
São Paulo at the top
The State of São Paulo It is not at the forefront of domestic transplants only by their number of inhabitants.Today, Paulistas receives patients from all over Brazil, who are on the waiting list. in São Paulo, to perform the procedure.
This is what happens with lung transplants, which puts the state forward in relation to several countries. The Heart Institute (Incor), linked to the Hospital das Clínicas of the Faculty of Medicine of the One University of São Paulo, is one of the only ones trained for this practice.
This is a rather complex logistics compared to other organs, since the chances of damage are greater and require further evaluation. For this reason, Dr. Paulo Pêgo Fernandes director of the Thoracic Surgery Division of the entity, explains that the great difficulty is to keep a motivated team to do the work
"This is longer surgery Most of the time, they are four in one, because we have to take both lungs and put both donated.Therefore, a large hospital structure with multidisciplinary follow-up is required. is not easy to find. "
Last year, the Fernandes team performed more than 50 transplants. "It is a challenge that we have been seeking for decades and that we can offer today, with this differentiated service it is our duty to serve the people."
Say "yes" "to the gift
In Brazil, it is the family that authorizes donations. It is therefore important to clarify to all members at this stage the desire to donate organs. This is undoubtedly the biggest challenge not only for the Transplant Center, but also for the whole country.
For many families, it's hard to understand brain death. However, brain failure invalidates any chance of a patient's life, yet the heart still pumps blood into the body. "There is a caption about" turning off devices. "If that possibility exists, it's because it has no more prognoses," says Mirella.
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