Bergamo Hospital, sleepless night for transplant and surgery: "So save two lives"

Go back to work in the middle of the night because the available colleagues are already busy? It is not obvious or due, but this also happens when the emergency knocks twice on the same hospital ward. This is what happened on the evening of Monday 7 October in the Cardiac surgery of the Pope John XXIII hospital in Bergamo.

It is 19 and Amedeo Terzi, head of the heart transplant center, is contacted by the national transplant center for the availability of a heart. It is the call that a patient admitted for 3 months in intensive care, a 63-year-old man suffering from severe heart failure, had been waiting for a long time.

This is how the broken-down machine of sampling and transplanting is set up, almost a practice in the Bergamo hospital. The team of cardiac surgery that will carry out the transplant and the collection team, composed by the cardiac surgeon, is alerted. Diego Cugola and by the nurse coordinator of the cardiovascular block operating rooms Maria Berardelli, with departure scheduled at 11pm and the transplant surgery scheduled for 2:30 on Tuesday.

At the same time, around 10:30 pm, a patient in a red code, a 67-year-old man, appears in the emergency room and is diagnosed in record time by the operators of the highly specialized emergency center of Pope John (the emergency doctor is present Federica Damini, the cardiologist Paola Ferrari, the anesthesiologist Francesca Pagan and the nurse Alessandro Belfiore) a dissection of the ascending aorta, a situation that must be dealt with in a sudden manner. The team that intervenes is made up of cardiac surgeons Samuele Bichi is Samuele Pentiricci, by the anesthesiologist Rita Sonzogni, by the instrumentalist Severine Dormont, by the nurse Sara Bolazzi, from the OSS Maria Zampaglione and the perfusion technician Gabriele Micci. The group starts working at 1am to finish at 6am.

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"The patient's clinical instability required immediate intervention. We were forced to start the surgery immediately, knowing that the duration would be incompatible with the scheduled transplant time – explains Terzi -. The alternative of delaying the time of collection and delaying the transplant for a few hours was not feasible because by now we had agreed with the colleagues at the hospital where the donor was and accordingly organized ".

The alternative to this point is only one: to contact Maria Berardelli, traveling to another Italian hospital for heart collection, and to understand if it was possible to recall the operators needed to organize a second team to carry out the transplant, given that those available were already engaged in the case of aorta dissection.

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"It was just after midnight. I called four operators home and asked them to go to the hospital within a short time. There were two lives to be saved. They immediately gave me a positive response, leaving their families in the middle of the night – remembers Maria Berardelli – So at half past midnight we managed to organize a new team for transplantation ".

This is the instrumentalist Elisabetta Salvi, of the nurse Cristina Salvi, the OSS Claudia Comensoli and the perfusion technician Vincenzo Bruno, entered the operating room for the transplant at 3 am on Tuesday 8 October, just before the patient's entrance to the hall to receive a new heart, which occurred around 4 am. The contribution of Anesthesia and Resuscitation 2, which has reorganized shifts to make an anesthesiologist available to the transplant, Francesca Pagan. To perform the transplant Amedeo Terzi and his cardiac surgeons Francesco Innocente, Samuele Bichi is Simone Carulli. Shortly after 7 am, the anesthesiologist came to give the change Federica Pellicioli, the nurse Roberto Mazzotta, the perfusion technician Andrea Ariano and the OSS Nicola Carratu.

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Both patients are now hospitalized in intensive cardiac surgery with a post-operative course judged good by clinicians.

"In one night we were able to solve the patient's problem with aortic dissection and to do the transplant for the patient who had been in intensive care for three months – he commented Fabio Pezzoli, medical director of ASST Pope John XXIII -. I would like to thank all the operators who, with their availability and professionalism, have allowed us to save two lives. This company can count on people who roll up their sleeves and know how to make the difference with uncommon dedication and a spirit of sacrifice ”.