When Esteve Capella talks about his life, he does so with surprising naturalness: ‘I've been living with a transplanted kidney for 50 years and have led a completely normal life.” He says it with a smile, as if this extraordinary event were just a simple anecdote from his day-to-day life. But his story is much more than an exceptional case: it is also the story of the progress of renal transplant medicine and of the pioneering role of the Hospital Clínic Barcelona in this medical revolution in Spain.
A second chance given to him at the Clínic
It all began when he was diagnosed with a serious kidney disease: “They told me I needed a kidney transplant. I was admitted here to the Clínic, they put me on peritoneal dialysis and after five months, my brother donated his kidney to me,” he recalls. It was 1975. Esteve admits he didn't really understand what was happening to him: “I knew nothing about this illness, I didn't even know what a transplant was.” Dr Antoni Caralps, a nephrologist who was one of the key figures in the first kidney transplant performed at the Clínic 60 years ago, was the doctor who admitted him and who explained to him and his family that there was a solution.
The operation marked the beginning of a new life, but the road was not an easy one: “They transplanted the kidney and I was in hospital for 52 days... but in March the following year I went back to work.” That experience, which today would seem unthinkable, given the length of the stay, was the first step.
An unusual combination
Dr Núria Esforzado, a nephrologist at the Hospital Clínic Barcelona, explains why Esteve's case is unique: “The therapeutic regimens of the 1970s were very poor in terms of immunosuppressive power. Many people had a transplant and lost the kidney to rejection.” Nevertheless, in his case, some unusual circumstances arose, especially considering it was half a century ago. Dr Esforzado outlines them: “A brother donor, very young and genetically identical. This has allowed him to reach this point so many years later with the kidney still functioning and even to be able to have another transplant.”
Because Esteve received a second kidney in 2014. The difference from the first experience was night and day: “With the second transplant I was only in hospital for seven days,” he explains, clearly demonstrating the evolution of medicine and surgical techniques.
From open surgery to robotics
Dr Antonio Alcaraz, Head of the Urology Department at the Hospital Clínic Barcelona, points out that the history of kidney transplantation is, in a way, a story of continuity and rupture at the same time: “In the first transplants, like the one in 1965 or Esteve's in 1975, open surgery was performed, meticulous, with vascular surgery and reimplantation of the urinary tract. It was very traditional surgery.”
Despite this classical foundation, there have been two clearly disruptive moments: “The first major change was when the living donor kidney started to be removed laparoscopically. And the second has been robotic kidney transplantation, which was introduced in Europe in 2015 and also to our team.”
These advances have established the Clínic as an international reference centre. “We are history, because in 1965 Dr Gil-Vernet and Dr Caralps performed the first successful transplant in Spain. However, we are also the present and the future: we have already surpassed 6,000 transplants and are the centre with the highest number of procedures of this kind in the country,” highlights Dr Alcaraz.
The future: more organs, more life
Looking ahead, Dr Alcaraz points to two main lines of work: “One avenue is to increase the number of kidneys available for transplantation, even via the genetic manipulation of animal organs, a line of research that is still experimental, such as with pigs. The other is regeneration through cellular engineering, using damaged renal structures to grow new healthy tissue.” This scientific horizon keeps the pioneering spirit of the Clínic alive, but it also challenges society as a whole.
Half a century after his first transplant, Esteve Capella's story remains a testament to a medical, scientific and human success that encourages us to continue advancing in research, donation and the constant improvement of surgical techniques.
