We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
Would you like to know what your stay at Vall d'Hebron will be like? Here you will find all the information.
The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
The goal of treatment is to increase the amount of oxygen that the blood can carry. This is done by increasing the number of red blood cells or the concentration of haemoglobin, a protein in red blood cells that is rich in iron and carries oxygen to the body's cells. In addition, the underlying disease or the cause of the anaemia, where there is one, needs to be treated.
Treatment of anaemia depends on the type, cause and severity of the disease.
It may consist of:
Your doctor may determine the need for a blood transfusion or other more complex procedures.
A transfusion of blood and/or blood products consists of replacing the blood components that are vital for the patient's survival: red blood cells, platelets and plasma, which cannot be replaced by other alternatives.
This treatment is indicated in patients who, at a given time, are lacking in essential blood components and require the balance to be corrected as soon as possible.
Transfusions carry risks and the decision to transfuse must always be taken by a doctor, depending on the patient's condition, test results and an assessment of the situation. Patients will always need to sign a permission document, which is called informed consent.
Blood and blood components are obtained from voluntary donors. Before donating blood, donors are required to complete a questionnaire about their health status and must also undergo a medical examination. All the blood components obtained are then analysed to rule out the existence of diseases that may be transmitted through the blood.
Before the transfusion is performed, it should be checked that the blood product is compatible with the sick person's blood. The relevant medical staff must assess the risks and benefits of the treatment for the patient.
All components are administered through a vein using a venous catheter.
Although blood transfusion is currently very safe, some adverse effects may occur:
Currently, the transmission of blood-related infectious diseases is highly unlikely. All units of blood are tested for their blood type and to prevent the transmission of infectious diseases such as syphilis, hepatitis B, hepatitis C, HIV, Chagas disease and human T-lymphotropic virus infection.
Desensitisation is one of the treatments available for inducing temporary or permanent tolerance by repeatedly administering to patients repeated doses of the allergen causing them problems. It is a commonly used procedure for treating allergies to some medications and foods.
Desensitisation consists of administering, under controlled conditions, increasing doses of the allergen the patient is sensitised to, to make them tolerant of the medication or food that causes them problems.
This usually induces temporary tolerance, which means the patient can receive treatments they were originally allergic to, instead of having to take less effective alternatives. In the case of foods, patients may become completely tolerant to them or gain some protection against accidental ingestion of the allergen.
Patients undergo desensitisation treatment under the care of an allergist, at the hospital.
There is a risk of allergic reactions during the procedure.
Immunotherapy is a long-term, preventive treatment that aims to reduce the symptoms of patients diagnosed with hay fever, allergic asthma, conjunctivitis, or allergies to insect stings.
The objective of immunotherapy with allergens is to change the allergic response by inducing immunological tolerance. A patient with allergies has symptoms when they are exposed to the relevant allergen. Immunotherapy uses a larger quantity of the allergen, in combination with a different route of entry into the body. This modifies the immune system's abnormal response, causing it to develop a tolerance to the allergen instead of inflammation and allergic symptoms.
Immunotherapy was originally administered by subcutaneous injection.There are currently liquids or fast-dissolving tablets that can be used in sublingual immunotherapy for certain allergens.
Subcutaneously injected treatments are administered every 4 or 8 weeks; sublingual treatments must be administered daily. This is generally continued over a period of 3 to 5 years. Many patients experience a prolonged protective effect after that period, so an assessment may be made of stopping the immunotherapy.
Immunotherapy is indicated for patients with allergic rhinoconjunctivitis or allergic asthma who:
Immunotherapy with hymenoptera venom is indicated for individuals who experience a severe generalised reaction to bee or wasp stings.
Immunotherapy is generally safe and well tolerated when used in suitably selected patients. Even so, localised and generalised reactions can occur.
The most frequent reactions are localised ones, such as redness or itching at the injection site. These reactions are most likely to occur during the first administration of the treatment, which is why immunotherapy starts at the Allergology Department and, if well tolerated, can be continued on an outpatient basis.
Electroconvulsive therapy (ECT) consists of producing mild convulsive activity by administering a brief and controlled electric stimulus with variable frequency through electrodes that are placed on the surface of the brain. This convulsive activity produces biochemical changes in the brain that help to improve symptoms or cause them to go into remission.
ECT is a safe and effective medical treatment that is indicated above all in depressive disorders: Severe depression with psychotic symptoms or at high risk of suicide and serious physical deterioration. It is also indicated in certain psychotic disorders, acute mania and severe treatment-resistant mental health issues. ECT is also indicated in non-psychiatric pathologies within neurology, such as; refractory epilepsy, Parkinson's disease, neuroleptic malignant syndrome and late-onset dyskinesia.
Its application has evolved significantly. It is a pain-free technique that is performed under brief anaesthesia with muscle relaxation and artificial ventilation. Electric stimulation is induced with computer-assisted equipment that monitors the effect of a mild convulsion induced using brief-pulse waves on the brain’s electrical activity. This allows the minimum intensity of electrical stimulation to be administered, decreasing cognitive side effects and drastically reducing the complications associated with treatment. Nowadays, the technique is considered to have no contraindications whatsoever.
Some patients with psychiatric disorders that do not respond to conventional treatment have not, however, been treated with ECT despite its high level of safety and therapeutic predictability. This therapeutic inhibition could be due to the stigma based on outdated beliefs about the treatment.
Anticoagulant therapy involves the use of medications that reduce the blood’s ability to clot in order to prevent the formation of thrombi. It is used in thromboembolic diseases and in patients at risk of embolism to protect circulation.
There are different types of anticoagulants: injectable or oral.
Low molecular weight or unfractionated heparin. Should be started at therapeutic doses as soon as thrombosis is suspected, even before the diagnosis is confirmed, or as prophylaxis (prevention), at prophylactic doses, when the person has one or more risk factors that could trigger a venous thromboembolism (such as hip or knee replacement surgery). They are administered at fixed doses according to the patient’s weight, the type of thrombosis being treated or risk factor being controlled.
They are used as maintenance therapy when oral anticoagulants are contraindicated (e.g. pregnancy) or have been ineffective.
They are used as maintenance treatment (longer use) and are given on confirmation of the diagnosis of deep vein thrombosis or pulmonary embolism. There are two types of oral anticoagulants: vitamin K antagonists and direct-acting.
The anticoagulant treatment is controlled with blood tests or capillary blood tests (by pricking the patient's finger). Monitoring of patients on anticoagulant treatment is done by haematology and haemotherapy specialists.
Hematopoietic Stem Cell Transplant (HPSCT) is the definitive treatment for many primary immunodeficiency disorders (PID). It is a total replacement of the blood cells in our body. It is also called a bone marrow transplant (BMT).
The aim of this treatment is to regenerate a haematopoiesis (the process by which the different types of blood cells form, mature, and circulate from stem cells), which has been eliminated by administering drugs or ionizing radiation, followed by the implantation of the donor's immune system, which is able to recognise and attack the malignant cells in the patient.
In this way, the bone marrow stem cells (factory of the defences) are changed for those of a healthy person (the donor). To undergo this process the patient is admitted to hospital for between one and three months.
1st step:
2nd step:
3rd step:
Bone marrow donation has several features that differ from conventional blood donation, given that it involves obtaining the stem cells (haematopoietic progenitors) that give rise to the several types of cells in circulating blood, and which will allow the recipient’s bone marrow to be repopulated.
Haematopoietic progenitors can be donated in two ways:
Peritoneal dialysis is a treatment that replaces kidney function by using the peritoneum as a natural filter to remove waste and excess fluids. It allows continuous blood purification in patients with kidney failure.
The procedure is as follows: a catheter is inserted into the navel for introducing the dialysis fluid. This fluid is left in the peritoneal cavity for some time and then exchanged for new fluid. This is repeated several times.
Peritoneal dialysis can be performed at the patient’s home and also at night, which is an important factor to maintain the patient's quality of life.
Possible complications of peritoneal dialysis are peritonitis or infection of the dialysis fluid which can lead to infection and inflammation of the peritoneum. Treatment with antibiotics is effective for this complication.
Haemodialysis is usually considered to an intermediary step between advanced kidney failure and a kidney transplant.
Hemodialysis is a treatment that replaces kidney function using a machine that filters the blood and removes waste and excess fluids. It is used in people with kidney failure when the kidneys can no longer perform this function properly.
People with kidney failure starting a haemodialysis programme typically have less than 10% of normal kidney function. Above this figure, haemodialysis is usually not necessary.
Haemodialysis must be performed regularly in four-hour sessions, usually three times a week, although the duration and frequency will depend on the patient and their circumstances.
Haemodialysis is based on biophysics in the sense that the blood passes through a filter and exchanges substances with the fluid on the other side of the filter, which is circulated by a machine. The exchange gets rids of the urea, potassium, phosphorus and other waste substances that build up due to lack of kidney function. These substances partly pass through the membrane by themselves, as there are different concentrations of the substances and they tend to equalise, and is also due to the changes in pressure exerted by the haemodialysis machine.
Possible complications of haemodialysis are the infection of the catheter or being unable to find a viable vascular access site in patients who have had dialysis for many years.
Haemodialysis may continue for years, although it is usually an intermediate step between kidney failure and transplant.
Kidney transplantation is the most effective treatment for chronic kidney failure, as it replaces the function of the diseased kidney. Although it involves risks, it significantly improves quality of life and allows a return to near-normal daily activities.
It is very important to consider that people who receive a kidney transplant will have to take medication for the rest of their lives to ensure the body does not reject the transplanted organ. Regular appointments to monitor the functioning of the transplanted kidney and the levels in the blood of medication used to control rejection are also necessary. The medication used partly reduces the body’s defences and can allow opportunistic infections and neoplastic diseases to occur. Strict monitoring of immunosuppression levels must therefore be carried out at all times. A kidney biopsy may be necessary at different stages of the kidney transplant’s evolution in order to determine the condition of the organ, as blood tests only give an indirect indication. The life expectancy of patients who have had a kidney transplant may be similar to that of the general population, but other factors mentioned must be taken into account in addition to cardiovascular health such as weight, blood sugar levels and lipids in the blood in addition to arterial pressure.
Performing a kidney transplant requires careful preparation once the patient is experiencing kidney failure. A kidney donor must be found. This may be a living donor or a kidney from a deceased person. Outcomes are very good in both instances, and the choice of which to use depends on the personal situation of each patient. For example, a kidney from a living donor would be chosen if someone volunteers to donate and if compatibility tests carried out before the transplant are positive. If there is no donor, a kidney from a deceased donor will be considered, providing the compatibility tests are positive.
Diagnostic tests related to kidney transplant include the assessment performed before it is carried out. These are general assessments of the recipient's health to ensure they will be able to recovery from the surgery without any issues and also immunology tests to minimise the risk of organ rejection.Tests to prepare for the transplant include imaging tests (ultrasound and CT scan) to determine the implantation area, compatibility tests, and subsequent follow-up tests for monitoring (ultrasounds and blood tests).
To ensure the success of a transplant, in other words, good initial function that lasts over time:
Over 500 transplants are carried out in Catalonia every year, with very good transplanted kidney survival rates. However, this is variable and cannot be predicted in each case. As advances in knowledge and technology are made, we are increasingly able to accurately monitor and control transplanted kidneys to lengthen their lifespan.
Biotechnology and translational research (which creates a network of different biomedical specialisations) will be able to make important advances over the coming years. The success of kidney transplants nowadays is largely down to the precise nature of the medication used to prevent rejection.
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