An operation to reconstruct the anterior cruciate ligament of the knee, using living donation for the transplant, was performed for the first time in Italy on a 14-year-old boy, with the donor father. It happened in Pinerolo (Turin), in the orthopedic structure directed by Sergio Ronco.
With this technique, already used in Australia and Spain and in particular in Barcelona, the Orthopedics team is now developing a protocol on the procedure, submitted to the National Transplant Center, so that it can be shared with other specialized centers, to be adopted nationwide.
The operation was performed by Mario Formagnana, from the Pinerolo hospital and Simone Perelli from Icatme, the Catalan Institute of Sports Traumatology in Barcelona, with the coordination of Dr. Ronco, together with the teams from the Pinerolo operating theatres. All in collaboration with the Regional Transplant Center.
“We performed the surgery simultaneously in two rooms – says Formagnana -. In one we took the tendons from the father and in the other we used them to reconstruct the cruciate ligament of the son”. Until now in Italy, either autologous tendons, i.e. own tendons, or tendons from deceased donors and distributed by tissue banks have been used for reconstruction. The latter in adult patients allow an excellent result, while in pediatric patients they have shown a high failure rate, which often makes their use not recommended. An autotransplant is therefore better, but “in pediatric patients – adds Formagnana – the tendons are often too small. Our patient was a 14-year-old boy still in the growth phase, the surgery had to be performed with a pediatric technique, but the boy showed anthropometric characteristics such as to predict that a tendon autotransplant would have been insufficient in size. For this reason, we decided to use the father’s tendons”.
Living donor tendons, if carefully selected, behave like their own, in terms of effectiveness, and coming from an adult male, they are larger and of a suitable size to ensure a successful outcome of the operation.
The follow up is confirming the success of the surgery: the donor is completely healed, without any type of outcome or consequence, and the boy walks without crutches and is fine, as in a normal ligament reconstruction post-operative.