Intubated for fifty-eight days, very young, eighteen, Francesco (invented name) when all hope seemed lost, he made it. Back to breathe, to live, thanks to the intuition and gamble of the doctors of the San Raffaele and the Polyclinic of Milan, thanks to the excellence of Health Italian. He survives the worst covid attack ever recorded in such a young boy and survives an operation never attempted in Europe, all the more so in conditions at such a high risk of contagion for the team involved.
Francesco
Francesco is eighteen. It is March 2nd and he begins to have a fever. But it's a different fever. It does not go away. On 6 March Francesco is so serious that he is taken to the San Raffaele. In his region, Lombardy, evil has been raging for two weeks. Two terrible weeks but in which in record time thanks to the crowfunding Fedez-Ferragni a highly efficient intensive care unit has been set up in via Olgettina. Francesco is brought there, immediately. The respirator and ventilation last for seventeen days. But without success. Things go badly and on 23 March it is decided to connect Francesco to an Ecmo, a device that extracts his blood in a continuous cycle, oxygenating it mechanically.
The intervention
Francesco is one of the very rare young patients in Italy and in the world to suffer from such critical conditions. The doctors realize the desperate extraordinary nature of the case and therefore decide to intervene in an extraordinary way. In concert with the team of the Polyclinic they decide to try a risky route only in China, which had never been practiced in Europe at the time (but which will immediately set the standard and will be imitated in Austria). Simultaneous transplantation of both lungs.
An even more complex intervention if we consider the need to protect all operators from the subtle volatility of SARS-CoV-2. The national transplant center approves the request and on April 30 Francesco officially enters the waiting list. Two weeks ago, finally, the arrival of the donation and the start of the intervention.
Francesco's lungs appeared wooden, extremely heavy and in some areas completely destroyed - says Dr. Mario Nosotti, director of the School of Specialization in Thoracic Surgery at the University of Milan, leading the team that operated Francesco - A diffuse damage to the pulmonary alveoli, now unable to perform their function, was then confirmed by microscopic examination, with notes of extensive septal fibrosis.
The future
The desperate conditions described by Dr. Nosotti not only give even more credit to the success of the intervention and the intuition to practice it, but they represent a very important case study for research. The organs explanted and so badly compromised will constitute a precious map for the analysis of the aggressive dynamics of the virus.
Nosotti is understandably satisfied and grateful: In addition to the technical skills, I must underline the stubbornness and courage of the San Raffaele colleagues who, instead of giving up, involved us in a solution never attempted before in the Western world. Our experience is inspired by that of Professor Jing-Yu Chen of the Wuxi hospital in China, whom we personally know and with which we discussed some technical aspects, since for obvious reasons he found himself facing the problem before us.
Thanks to Nosotti, Chen and the expertise of a highly trained scientific community, Francesco made it. Today he is awake and is planning a careful physiotherapy that will be able to release him gradually from the respirator. The worst seems to be behind us, but rehabilitation will certainly take its time and prudence. A huge good luck from all of us.
Featured photo by Luis Melendez on Unsplash
