Argentina's first pediatric heart transplant in asystole: "May Luca's life be worth it."
In an unprecedented milestone for Argentine and Latin American medicine, one-year-old Felipe Palagani received a new heart in what became the first pediatric heart transplant performed in the country from a controlled asystole donation.
This Tuesday, Pamela, the little boy's mother , spoke with La Voz en Vivo and recounted everything that happened from the beginning.
This medical achievement, carried out by the team at the Italian Hospital, is also a story of solidarity, uniting two Neuquén families: Felipe and Luca Zarragud, a two-year-old boy who, in his farewell, gave his roommate a second chance at life.
"Felipe started with what seemed like bronchiolitis, and that condition worsened to the point where his heart practically stopped beating," she said, confirming that he is just under a year old.
"I absolutely needed a pediatric transplant. In November, we met Luca's family, who was waiting for a liver transplant," he said.
The connection between Felipe and Luca was forged in the wards of the Italian Hospital. Both children, originally from Neuquén, shared not only the same province and the same hospital, but also a room and a melody that became an indestructible bond: "The little ants are marching, bam, bam, bam..."
Luca's mother, Paula, sang to her son and also to Felipe, who was in the next bed connected to an artificial heart. Pamela, Felipe's mother, listened and asked him to sing "louder. Sing it for both of us."
Unfortunately, after they both returned to Neuquén, Luca's condition worsened and he had to return. "That's when his family decided to donate his heart to Felipe," he said. After overcoming all the legal obstacles involved in pediatric donation, they both underwent an unprecedented operation in Latin America: a pediatric heart transplant in asystole.
“The only compatible recipient for Luca's heart was Felipe, incredibly. Luca lives on in Feli's heart. Luca is beating in Feli's heart,” she told La Voz en Vivo emotionally.
“We want you to be part of Felipe’s life,” Pamela emphasized what they told Luca’s parents.
"There may be more donations, we just need to convince families to say yes. That my son has been waiting for eight months, that he has lost eight months of his life, makes no sense," he added.
"And don't let what happened to Luca happen again, let his life be worth living," the woman said emotionally.
Felipe was born healthy, but at five months old he was diagnosed with severe dilated cardiomyopathy, which caused his heart to occupy three-quarters of his chest.
After a long hospital pilgrimage, which included a stroke, cardiac arrest, and connection to an ECMO, Felipe was connected to the Berlin Heart, an artificial heart never before used in such a small patient in Argentina.
However, the Berlin Heart wasn't a permanent solution, and Felipe needed an urgent transplant, joining the country's waiting list of 12 children.
Luca, a “happy, friendly, full of life” boy who “lived singing,” had received a liver transplant just two days before Felipe arrived at the Italian Hospital in November.
Despite their different diagnoses, the families supported each other, sharing their hope, their faith, and their anguish. This bond continued even after Luca was discharged, but his health worsened.
Cytomegalovirus caused irreversible damage to his lungs, and in the absence of medical strategies, his parents, Paula and Nicolás, made the "immense decision" to donate his organs.
Nicolás remembers feeling Luca's strong heartbeat, sensing that it was "the most valuable thing I could give." Although they didn't know if the heart would be viable or if the recipient would be Felipe, they felt the intuition due to "too many coincidences."
Asystole donation, where the donor dies from cardiac arrest and the ablation time is much shorter, is a technique used in countries such as Spain and Australia, but a pediatric heart transplant using this method has never before been performed in Argentina. Carlos Chichero, president of the Buenos Aires City Transplant Institute, emphasized that this is the first case in Argentina and "probably in Latin America" of a pediatric heart transplant with an asystole donor.
In the early hours of June 18th, everything was set in motion. In the waiting room, Pamela, Felipe's mother, received a silent tap on her back from Paula, who said, "We've already been told it's possible." Minutes later, they received official confirmation: "We're in operation." Luca's heart was a match; he came from a family they knew, from the same province, the same hospital, the same room, who had heard the same song.
The unprecedented procedure required the commitment of a multidisciplinary team and the highly complex infrastructure of the Italian Hospital. The donor's heart was stopped for 30 minutes, but was rigorously evaluated and deemed suitable.
Having the transplant performed at the same institution was key to short transfer times. This procedure is covered by Law 27.447 on Organ, Tissue, and Cell Transplantation and was performed under INCUCAI protocols. The coincidence was "totally crazy," Chichero admitted, since Felipe, who had had an artificial heart for five months, was in the same hospital and fit to receive it.
This transplant expands the horizon of possibilities in a limited setting, where between 20 and 30 pediatric heart transplants are performed in Argentina each year.
Luca and Felipe's case is an "incentive" and a message to medical teams to "encourage us a little more," according to Chichero, by showing that a heart that "stopped on its own" can be perfectly viable.
Today, Felipe is recovering, without a pacemaker or drains, and his mother was able to hold him again. Luca's legacy beats in his chest. Felipe's family plans to name him Luca, honoring the "short, intense, luminous" life of a child who "lived with everything" and whose heart allows the "little ants to keep marching" in Feli's chest, "beating for two."
The story of Felipe and Luca, immortalized in a hug between the two families, is a testament to how the most painful thing can give rise to "an immense act of love, capable of giving meaning to an irreparable loss." As Felipe's mother said: "Organs don't go to heaven. They save lives here on earth."
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