Completed a few days ago 45 years from the first transplant kidney in an adult made at Hippocrates General Hospital of Thessaloniki. During these 45 years, a total of 2,716 transplants were performed at the Hippocrates Surgery Clinic, according to the Director of the Clinic, George Tsoulfas.

In a report, Mr Tsulfas talked about what happened in the clinic during this time, about the increase in organ donors in our country, about waiting lists, the problems of the lack of anesthesiologists and the future of transplants in Greece and internationally.

The transplants with numbers

The first adult kidney transplant in Hippocrates took place on 2/6/1980 and the first kidney transplantation on 8/10/1980. Stations were the successful liver, adult and child transplants, first in Thessaloniki by Professor Antonios Antoniadis on 30/05/1990 on a 42 -year recipient and on 01/07/2022 to a child just 6 months, respectively. The first pancreas transplant was followed on 16/02/1990, islet on the pancreas on 30/05/1999 by Professor Vassilios Papanikolaou, as well as the 1st combined liver transplantation on 16/11/1996.

As Mr Tsulfas notes, 2,716 transplants were carried out in Hippocrates within 45 years, 747 of which were liver transplants, 1,092 bodily kidney, 859 kidney from living donors, 6 combined liver-bright and 12 combined kidney. “In 2024 102 transplants-29 liver, 37 kidney barrier, 34 kidney living, a combined liver and a combined kidney-pancreas-and this year, slightly shorter than six months, 54 transplants, 28, 28, 28 kidney-pancreas. We see that this year the number of liver transplants made in less than six months is very close to the number of liver transplants made last year. This is due to the awareness of the citizens and the media also contribute to it. It is also important that the system has been better organized by both the new law and with transplant coordinators so that people know that the gift of life it offers will be properly exploited. A very important factor is to make people feel confident in the system. One had said that transplantation is the mirror of society, and that is true, “Mr Tsulfas said.

The waiting lists for a transplant

Waiting for liver transplantation is clearly much less than waiting for kidney transplantation, which can reach 8-10 years. According to figures presented by Mr Tsulfas, at the end of 2024, 27 patients were waiting for a liver transplant (in the national list the number was 41) and the percentage of transplants on the Hippocrates list was 36.3% (37.8%). In the list of the Hippocrates for kidney transplantation, 330 patients expected (1,198 on the national list).

“For liver transplantation, waiting periods are not long. Usually in a semester, perhaps less, a heavy condition will be transplanted. Unfortunately, unfortunately, the wait can reach 8 to 10 years. This is because for the end -stage kidneys there is dialysis, so they can wait. For the liver there is no such alternative, so the patient cannot wait long. “

Developments in Hippocrates Transplantation Clinic

“In recent years we have had difficult situations with the pandemic. Hippocrates, which is the largest reference center and the largest in northern Greece, played a leading role in the pandemic and managed to keep the transplant alive. In the midst of Covid we did transplants thanks to the efforts of all: surgeons, anesthesiologists, intensive care, hepatologists, nursing service, administration. All of them, in fact, exceeding the duty, did everything to keep the transplant in difficult times, “notes Mr Tsulfas, adding:” Also the new law on transplantation in Greece came to Greece, who brought the coordinators to the hospitals and the hospitals. In Greece we had not many years ago three to four donors per million population, which was one of the lowest in Europe, if not worldwide, and we have now reached 8-10 donors per million population. It’s a frightening change. And this is due to a coordinated effort by both EOM and everyone. In the midst of developments was the Center for Research and Innovation in the Transplantation of Symphony Organs, because it is a area that is constantly needing new ideas, new research to proceed. It is not only the surgical, it is also the immune, to improve the quality of the grafts, to benefit more people with protocols such as, for example, for incompatible transplants, living donors. Even in techniques it has progressed; e.g. In living donors, removing the cuttings mostly is now laparoscopic. What until a few years ago it seemed impossible to do is now possible. “

Anesthesiologists and transplants

Anesthesiologists are a problem that all public hospitals in the country face. At the Hippocrates Transplantation Clinic, existing anesthesiologists are making superhuman effort. “The problem with transplantation-and especially in liver transplantation-is that a specialized anesthesiologist needs and in Greece there are 5-6 anesthesiologists who can give anesthesia to such a surgery. There are two in Hippocrates, so as you understand these colleagues are valuable, because without them the transplant is not progressed. Hippocrates has issues for anesthesiologists, it is a difficult hospital, because the number is 10 to 12 at the moment. Very small for the whole hospital, ”notes Mr. Tsulfas.

The applications of artificial intelligence and the future of transplants

The evolution of technology and the applications of artificial intelligence contribute and will contribute even more to transplants, Mr Tsulfas points out. “Artificial intelligence enables us to be able to appreciate the cuttings better and, to a certain extent, is important to be able to evaluate and prioritize patients better in an objective way. Artificial intelligence has the ability to gather a plethora of data and has the computational capacity and algorithms to exploit this data much better and much faster than the human mind, ”adds Tsulfas.

Regarding the future of transplants, he says: “I believe that in many different areas there will be evolution. That is, it will be the best exploitation of grafts through maintenance pumps, which are machines where a graft can be installed after being removed by the donor to assess its quality. This helps to use cuttings that otherwise we wouldn’t know if they are right. Secondly, artificial intelligence will help both prioritize and in the whole process. Also, one area that will develop a lot of things is xenophobia, that is, pig transplantation. They are already running protocols in America and this is because the problems that existed with the immune system, the quality of the grafts, the compatibility have begun to solve, as technology now allows us to change the donor’s gene profile. These are research protocols currently running in America, but the results are optimistic. “

At the same time, Mr Tsulfas notes that it is not science fiction to create stem cell organs to be transplanted to patients, as three -dimensional printing studies are already underway. “We at our center have started a 3D print protocol in collaboration with the Department of Surveyors of the Polytechnic of the Aristotle University of Thessaloniki. This protocol was for liver cancers, where printing was done to have the map. The next step is bio -prostation, where instead of using the plastic material that will print the liver to see geography, we use e.g. Stem cells and with these special printers can slowly print tissue. These are very early stages, but the truth is that technology is going very quickly and impressive. I believe they are going very quickly and the messages are optimistic in many areas, ”concludes Mr Tsulfas.