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A Transplant Success in Panama


Successful heart transplants require an experienced multidisciplinary team – both before and after the surgery. And the complexity of performing transplant surgery and taking care of the patients had not been possible in the country of Panama.

Until now.

Through a cooperative agreement with University of Utah Health Care and ARUP Laboratories, a team of physicians in Panama City was able to complete the country's first heart transplant on March 11 at Punta Pacifica Hospital in collaboration with the Social Security Administration.

A close collaboration between transplant teams at the University of Utah and Punta Pacifica made the milestone possible.

Doctors in Panama drew on the expertise of two Utah doctors, in particular: Transplant cardiologist Jose Nativi-Nicolau, M.D., and pathologist Patricia Revelo, M.D. Nativi-Nicolau worked for two-and-a-half years to bring the international collaboration to fruition—reviewing donor and recipient lists, and double-checking protocols. And Revelo, who works with ARUP Laboratories in Salt Lake City, reviewed the first biopsy samples from the heart transplant patient a few days later.

Another university physician, Omar Wever-Pinzon, M.D., also a transplant cardiologist, assisted with the first heart biopsy.

Without their expertise, the heart transplant program in Panama could not be started. In the first year after surgery, heart transplant patients require as many as 20 biopsies to make certain the donated heart's tissue remains healthy.

Early in March, a donor heart in Panama was matched to a 52-year-old woman with dilated cardiomyopathy who needed a heart transplant. Panamanian President Juan Carlos Varela's plane was used to transport the patient from her rural town to the Panama City hospital while the rest of the country was "paralyzed," Nativi says.

"The whole country was watching and waiting" for the results of the surgery, says Nativi, who grew up in Panama, and flew to Panama City on the day of the transplant to assist with post-surgery care.

He believes the successful operation has bolstered the prospects for future organ donation in Panama. Along with the heart, the donor provided two corneas, two kidneys and a liver to other patients.

"That donor generosity helped six persons," Nativi says. "Before, there was not enough education about donating organs, not enough awareness, no sense of the benefit. That's changed."

University of Utah Health Care mentors and ARUP pathologists will continue to collaborate with doctors in Panama.

The nascent heart transplant program is a result of the University of Utah's active role in global outreach, says Josef Stehlik, M.D., medical director of University of Utah Health Care's heart transplant program. Thirty years after the first heart transplant was performed at University Hospital, Stehlik says, the university has assisted multiple programs around the country advance their expertise in taking care of patients with advanced heart disease. Clinicians and researchers from other states and countries -- including China, Korea, Greece, Jordan, Japan and the Czech Republic, among others -- have collaborated with Utah over the past several years.

"We've invested into international collaboration, and we're seeing results now," he says. "Our program has grown, and we have been able to contribute to advancing care for patients with heart disease in our region and beyond."