Mar Mesa celebrated its 25th anniversary with magnificence. He is actually 52, but has long given more importance to the day he was born again. He was born again the day his heart was transplanted at Sant Pau hospital in Barcelona, ??where the first successful operation of this kind in Spain took place 40 years ago. On May 9, 1984, a team led by doctors Josep Maria Caralps and Josep Oriol Boní transplanted the heart of a donor into Juan Alarcón, a 29-year-old young man. Since then, around 10,000 transplants of this organ have been registered in Spain and more than 650 at the Barcelona hospital.
When Mar Mesa entered the operating room around Christmas 1998, the average life expectancy of a heart transplant recipient was just over 10 years. “Ten years of gift”, he thought. “Ten years ahead that must be taken advantage of”. 25 have passed and the woman is perfectly fine.
The problems began, apparently, with a flu that left him with sequelae. He suffocated, he woke up in the morning with a “smoker’s” cough when he had never smoked. That seemingly innocuous flu had caused him a dilated cardiomyopathy for which he was treated until the heart said enough, a year and a half after the diagnosis. He was admitted in a very serious condition to Vall d’Hebron, where his parents could not choose an alternative to the transplant but rather the center where it had to be done: Sant Pau or Bellvitge. They opted for the pioneer hospital, but tried to hide the reality from the girl. Fifteen years after the first one, a heart transplant was still a big deal. “My parents thought that I was very young and that I would not take the news of the transplant well. They told me they were taking me for a valve operation,” he recalls. But the lies, even the pious ones, have short legs: “A visiting doctor told me that she was waiting to see if I was put on the waiting list or not because I had to have a heart transplant.”
After the intervention he was left with a great feeling of guilt. “If I was alive it was because someone else had died, although in reality I would have died anyway. I had to overcome that grief”, he recalls. He also had to overcome the transplant’s main adversary, rejection. Specifically, eight rejections in a row, with tests and biopsies until the doctors found the right medication. He was starting a new life: “I have become a different person, but not because my feelings have changed. My first heart was beating a few times which I don’t feel now. I’ve had a lot of desire to live, to do everything I never thought I’d do because I was a much more sedentary person.” Mar Mesa worked, now she spends her time walking, swimming, practicing tai chi, online Egyptology courses, volunteering for the language… She has far exceeded the expiration date that her new heart could have. There is no problem: “Sometimes she beats out of time or makes a series of beats in a row, but I’m used to it and it doesn’t scare me. If anything should happen to me, it’s 25 years of gift, I take it for granted, I don’t live waiting for what has to happen”.
Since May 9, 1984, more than 650 heart transplants have been performed in Sant Pau. Antonino Ginel, director of the cardiac surgery service, highlights the vision of the pioneers: “A person who can see where the future is and convinces you that this is the way and makes people row synergistically in the same direction”.
According to Ginel, who has led around a hundred interventions, the big difference compared to the beginning is that now more complex cases can be addressed. It also highlights the evolution of immunosuppressants and the control of ischemia times (lack of blood supply to the organ). And the future? The doctor hopes for progress in three areas, the product of the work and collaboration of many people in different parts of the world. Advances in immunosuppressants to better control rejection and with fewer side effects. Secondly, mechanical assistance systems, machines that help the function of the heart, developed between doctors and engineers, will be increasingly compatible and with fewer intrinsic problems. Finally, Ginel points to the transplantation of animal organs. “The design of the heart of any mammal is practically the same, although if it is already difficult for one person to accept the heart of another, it will be even more difficult to accept the heart of a mammal, the further away from you from the point of view of the genome”.
Sonia Mirabet, head of the heart failure unit, highlights the radical change in the lives of transplant recipients. “They arrive with an absolute limitation to lead a normal life, there are patients who get tired reading or eating and the transplant allows them to recover a normal life. “They should not focus on things that can happen but try to enjoy what they can have from the transplant.” “The most important thing is that they follow the treatments we tell them.”
Professionals and patients vehemently praise the figure of the donor. “Let it be clear that I am very grateful to my donor, to his family. They were super strong and super brave. Let people be aware that thanks to donations there are many who live” (Mar Mesa). “They are usually relatively young people with an acute cause of death, a cerebral hemorrhage or a traffic accident. The family has not had time to prepare for such a painful moment, and in this emotionally violent context to have the generosity to make the donation is priceless generosity, it is miraculous” (Antonino Ginel).
