A heart arriving in the operating room transformed into a block of ice. This is the dramatic scenario that emerges from the technical report signed by Guido Oppido, cardiac surgeon of theMonaldi Hospital, called to operate on little Domenico in one of the most delicate and desperate moments in transplant medicine. A document described by experts as shocking, now under the attention of the Ministry of Health, which clearly shows an error in the chain of transport of the organ intended for the child.
According to the reconstruction, it all began in the early afternoon, when the thermal container from Bolzano was opened in the operating room in Naples. Inside, the bucket containing the heart was not simply refrigerated, but completely encased in a solid mass of ice. A surreal and dramatic sight, caused—according to the report—by the use of dry ice, solid carbon dioxide, instead of the traditional ice required by protocols.
The result was an organ that initially became inextractable. The team spent about twenty minutes, using large quantities of water, attempting to partially thaw and free the heart. An infinite amount of time, while in the operating room, the child's life hung in limbo. Meanwhile, the procedure had already entered its most irreversible phase: the surgeons had begun the cardiectomy only after confirmation of the successful removal in Bolzano, unaware that something was going terribly wrong.
Once the gravity of the situation became clear, there was no longer any choice. Domenico's diseased heart had already been removed. "Lacking alternatives," Oppido writes in the report, the team was forced to proceed with the implantation of the new organ, despite "strong suspicion of severe frostbite damage" to the cardiac tissue. An extreme decision, made in a race against time, aware of the enormous risks it entailed.
The document raises serious questions about the management of the so-called cold chain. Dry ice, which reaches temperatures of approximately minus 78 degrees Celsius, is incompatible with the transport of organs, which must be kept cold but not frozen. This gross error will now have to be attributed to specific responsibilities along the route between Bolzano and Naples.
Source EDITORIAL TEAM
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