Saturday 8.6.2024
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Recognized by the Legislature of the City of Buenos Aires in 2017, Vogelfang analyzes in an exclusive interview how awareness about organ donation has evolved in recent decades and the importance of awareness campaigns to save lives.
Horacio Vogelfang is an icon of pediatric transplantation. In 2000 he created the Garrahan Heart Transplant program. There he performed more than 60 children’s heart transplants until June 2019. Currently he continues to perform transplants at the Obra Social de Empleados de Comercio sanatorium. In 2017, the Legislature of the City of Buenos Aires declared him an outstanding personality in Medical Sciences. In dialogue with this medium, he analyzes how organ donation has evolved in recent decades.
—How do you evaluate awareness in relation to organ donation?
—I notice that in recent times, taking out the pediatric age of very low weight, there is an increase in donation. It seems to me that what has the most influence is the dissemination of the topic. Because I think people are becoming more aware of organ donation. And, as they say now, we are going through a cultural change. I think the issue has stopped being dramatized so much that when people lose a family member or loved one they know that donation is an alternative that accompanies death.
—How to deepen this awareness?
—We have to continue spreading the word… As it is something that depends on an altruistic, humanitarian gesture, I think that awareness is essential. There must be permanent campaigns. I consider that it is important to disseminate not so much a dramatic request for organs, but rather that there is a patient who is seriously ill and needs it. This request in general is always accompanied by a feeling of guilt. On the other hand, it is important to disseminate the transplants performed and the good quality of life that transplant patients have. This is the international paradigm. In countries like Spain, with a very high rate of donors, campaigns are fundamental and constant.
—Campaigns help to consider the decision in difficult times…
—When a person loses a loved one due to an abrupt event, the degree of sadness means that, if there is not a strong awareness about organ donation, the potential donor is lost. A donor is someone who is brain dead, which means that the body continues to function for a few hours with intensive therapy measures. This can extend to one, two days, but not much longer. Then the deterioration removes the possibility of a donation.
—Is it more complex in the case of boys and girls?
—It is a universe of patients with very special characteristics. Boys and girls require a donor that matches their weight and body surface area. It is true that in heart diseases that require a transplant, the heart usually dilates greatly and creates its own space that then allows it to accommodate a larger heart than would normally correspond to a patient of that size. But always the smaller the patient, the fewer donors there are. In pediatrics, the diseases that patients dream of leading to death are diseases that in themselves contraindicate being a donor. Therefore, in general, to be a donor, a child must suffer brain death as a result of an accident and not from a chronic illness.
An important detail in the case of pediatrics and heart transplants is that today there are devices, such as the so-called artificial hearts, that allow the patient to survive with assistance for months. This extends the time in which they can wait for a suitable donor to arrive.
—How do you feel when you hear about families who, in moments of pain, decide to donate the organs of a deceased person?
—There are two very emotional moments for me. One is when the organ donation is accepted. There is a truly enormous gesture of community solidarity. Transplantation, to frame it in scientific terms, is a medical, technical, scientific activity. But if there is a miracle it is that: that a mother or father, upon losing a child, accepts that the organs can be used so that another can continue living.
Vogelfang performed more than 60 childhood heart transplants until June 2019 at Garraham.
Every May 30 in Argentina is Organ Donation Day, a day in which we are invited to reflect on this altruistic gesture that helps save and improve lives. What happened on May 30?
That date, in 1997, María Obaya gave birth to her son Dante and it was the first time that a woman transplanted in a public hospital became a mother. “It is proof that donating organs not only saves lives, but also creates new ones,” the woman, who died in 2021, repeated numerous times.
María had suffered from autoimmune hepatitis for a decade and received a liver transplant at the Argerich Hospital in the City of Buenos Aires. The donor was a 19-year-old young man who had died in a traffic accident. His family’s decision to donate also allowed for a heart, corneal, and two-lung transplant.
Today in Argentina there are 7,152 people on the waiting list who need a transplant. Every year there are more than 300 donors. But the number needs to increase.
Along these lines, the Justina Law marked a great advance, since any person of legal age is a donor unless the contrary decision is made explicit. In any case, expressing the desire to donate to loved ones while alive helps ensure that those organs can actually be used for transplants.
