Puerta de Hierro Majadahonda Hospital performs the first cardiopulmonary transplant in Spain involving a resuscitated heart and lung.

Nieves didn't have time to think about it or prepare much. In the middle of one of her routine visits to Puerta de Hierro Majadahonda Hospital , Dr. Manuel Gómez Bueno, head of the Advanced Heart Failure and Heart Transplant Section, received a call. On the other end of the phone, someone said: "There's a heart and lungs for Nieves." The doctor was standing right in front of her in the consulting room: "Nieves, you're not leaving because we have organs for you today." "But I'll have to go home first to tell my family!" she replied. "Well, you'll call them," the doctor replied. Everything has to be that fast when an organ becomes available. In the end, Nieves didn't have to go until the next day, at 7:00 a.m., because the donor's family asked for time to say goodbye to their loved one.

This could be just another story about Spain's successful transplant system , but it also has another unique feature. Nieves is the first patient in our country to receive a heart-lung transplant , an extremely complex surgery, from a donor in asystole (who died of cardiorespiratory arrest, not brain death), a circumstance that makes the procedure even more complicated. And it was a team from Puerta de Hierro Hospital, where the first heart transplant from a donor in asystole was performed in Spain in 2020, that accomplished this feat.

The Regional Minister of Health, Fátima Matute, presented this operation on Monday, on the eve of National Organ, Tissue, and Cell Donor Day, celebrated on the first Wednesday of June. She expressed her pride in the "magnificent professionals who have written another page of excellence" in Madrid's public healthcare system. She also highlighted the act of generosity that was "unparalleled, which reveals the best in human beings," and that it served as the starting point for another person to have "a new opportunity."

Nieves, 54, dressed in a red suit jacket, matching her very outgoing personality, was also present at the event. She was accompanied by her family, some of whom were visibly moved. Also present were the doctors responsible for this historic operation: Manuel Gómez Bueno , head of the Advanced Heart Failure and Heart Transplant Section; Carlos Martín , head of the Cardiac Surgery Service; Silvana Crowley , surgeon in the Thoracic Surgery Service; and Mayte Lázaro , pulmonologist in the Lung Transplant Unit.

Dr. Gómez Bueno explained that the patient was born with a rare but very serious congenital heart disease known as truncus arteriosus . Nieves's heart has only one blood vessel, instead of two, which causes oxygenated and deoxygenated blood to mix, resulting in low oxygen levels and the heart and lungs failing. Despite this, she has led a more or less normal life: "They've let me do everything, but I had to stop to catch my breath." She enrolled in medicine but didn't finish; she is quite adventurous and got a tattoo of her heart disease. A couple of years ago, the disease progressed, and there came a point where her quality of life was already seriously affected. A transplant was the only therapeutic option she had.

It's been four months since the operation, and her life has changed. She spent a month and a half in the hospital learning to live with her new organs, and now she seems to be making a great recovery, although she still has to go for checkups. "I'm grateful to the donor's family for everything because, without them, I wouldn't be here. I thank them from the bottom of my heart, from the bottom of my lungs, from everything. Donors are exceptional people," she said.

Nieves now dreams of traveling again, although this summer, on doctor's advice, she will only be able to do so within Spain; and also of resuming her medical studies or even exploring other options such as psychology or architecture.

Until now, these types of surgeries were performed using organs from brain-dead donors , with few cases of asystole donors worldwide. Furthermore, replacing both the heart and lungs in a single operation is a very complex process. In fact, Puerta de Hierro is one of only two healthcare centers in Spain accredited to perform this procedure.

Professionals from the Heart and Lung Transplant Units of Cardiac Surgery, Cardiology, Thoracic Surgery, Pulmonology, Radiodiagnosis, Anesthesia, Nursing staff, Transplant Coordination, and many other key services participated in this procedure.

Puerta de Hierro pioneered the controlled asystole donation program in 2012, which is implemented in many hospitals across the country and has led to a significant increase in the number of available organs. In fact, in 2024, 51% of donations were in asystole. With a total of 1,316 asystole donors (25% more than in 2023), this type of donation now represents more than half of all donors in our country.

Asystole donation is performed in 25 other countries around the world, but Spain not only has the highest number of organs in this category, but remains the only country that successfully transplants all types of organs from these donors.