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12 Years of a Lifesaving Mission

AATB Vice President & Chief Science Officer, Roman Hitchev, MD, returned to the AATB home office last month after completing a successful pediatric scoliosis surgery mission trip in his home country of Bulgaria. Dr. Hitchev regularly participates in these trips as part of a charitable program that he co-founded in 2007. This year marks the 12-year anniversary of that program, the Euro-Atlantic Transplant Alliance (EATA)-Scoliosis Research Society (SRS) Mission. The Mission was founded with the intent to provide surgical care to disadvantaged children with advanced spinal deformities in Bulgaria.​

The concept for this program was developed by Dr. Hitchev after his successful development of a tissue donation and procurement program in Bulgaria. At that time, the program was yielding over 700 multiple tissue donors per year, which were then processed in France for clinical use throughout the EU. As scoliosis surgery requires a substantial supply of bone allografts, the Mission was created as a way to develop a local end-user sector able to provide modern surgical care to disadvantaged children with advanced spinal deformities free of charge.

The program was launched in March 2007 and is based at Tokuda Hospital in Sofia, Bulgaria, although it has relied on the ongoing collaboration of multiple professional teams and institutions across several countries in order to successfully implement the Mission. Over the past 12 years, with key input and the participation of leading orthopedic surgeons from the United States, Spain, Bulgaria, and Turkey, the Mission has managed to build a world-class school of pediatric spinal surgery in Bulgaria, completely from scratch.​​​

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Traveling teams of primary care physicians were formed with the funding and administrative support of EATA to visit underserved regions of the country on a quarterly basis to provide medical care and referral services to underprivileged children.

Children identified with spinal deformities undergo physical examinations and various laboratory and imaging tests to determine if surgical treatment is appropriate. Cases screened for surgical treatment are then referred for specialized pre-op evaluation by a team of spinal surgeons led by Vasco Yablanski MD, Associate Professor of orthopedic surgery and Director of Orthopedics at Tokuda Hospital in Sofia, Bulgaria.​

The most recent Mission tour occurred this past March and included three U.S. surgeons, one surgeon from Spain and one from Turkey, in addition to the two local surgical teams. There were five pediatric cases that were completed, all of which presented extremely rare and complicated advanced spinal deformities. All five surgeries went smoothly, and the children are all recovering well. The 2019 Mission tours were wrapped up with the presentation of Mission Certificates to the U.S. and European surgeons who performed these lifesaving surgeries. Dr. Hitchev had the honor of awarding these certificates to the visiting surgeons.​

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To date, the Mission has performed over 125 complex life-saving surgeries and has a 100% success rate. Substantial use of allograft bone donated by the local tissue bank has made these successes possible. Some of the first children operated on in past missions are now adolescents and young adults who are able to enjoy a better quality of life thanks to this incredible program and the charitable contributions of professionals like Dr. Hitchev and the organizations that support them.​

Thank you to the mission team! The team of U.S. and European surgeons is as follows:

  • Team leader: Steven Mardjetko MD, FAAP, Director of Spinal Surgery at the Illinois Bone & Joint Institute. Dr. Mardjetko is a clinical professor of orthopedic surgery and is a fellow in the American Academy of Pediatrics and the Scoliosis Research Society where he has served on its Board of Directors. He is an active lecturer at many professional meetings and conferences where he teaches the latest surgical techniques to spine surgeons worldwide.
  • David Clements MD, Clinical Professor of Orthopedics & Spinal Surgery, Director of Spine & Scoliosis, Cooper University Bone & Joint Institute, Camden, NJ
  • Munish Gupta MD, Mildred Simon Distinguished Professor of Orthopedic Surgery, Professor of neurological surgery, Director of pediatric and adult spinal deformity surgery, Washington University, Center for Advanced Medicine, Shriners Hospital for Children, St. Louis, MO
  • Dherra Anathakrisnan MD, clinical professor of orthopedic and spinal surgery, Emory Clinic, Atlanta, GA
  • Peter Sturm MD, clinical professor of orthopedic surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
  • Purnendu Gupta MD, clinical professor of orthopedic and pediatric spine surgery, Chief of Staff, Shriners Hospital for Children, Chicago, IL
  • Francisco Sanchez-Perezp Gruezo MD, clinical professor and Chair, Orthopedic and Spinal Surgery, University Hospital of Madrid, Spain
  • Ahmed Alaney MD, clinical professor of orthopedic and spinal surgery, Acibadem University Hospital, Istanbul, Turkey
  • Salim Aziz MD, clinical professor of cardiovascular and thoracic surgery, George Washington University Hospital, Washington D.C.

Local Surgeons:

  • Vasil Yablonski MD, Director of Orthopedic & Pediatric Spine Surgery, Tokuda Hospital, Sofia, Bulgaria, Host Medical Director of the SRS-EATA Bulgaria Program
  • Ivan Ivanoff MD, Orthopedic Surgeon, Tokuda Hospital, Sofia, Bulgaria
  • D. Dimitrov MD, Orthopedic Surgeon
  • Ivo Vlaev MD, Orthopedic Surgeon
  • P. Pashov MD, Orthopedic Surgeon

Host Anesthesiologists:

  • Biliana Kamenova MD, Anesthesia & Spinal Monitoring
  • Victor Stefanoff MD
  • S. Simionov MD
  • D. Morev MD

Tokuda Hospital Head Nurse:

  • Vinia Runinska RN

Local Surgeon Visitors:

  • Kalin Mihoff MD, Chair, Orthopedic Surgery, St. Marina Hospital, Varna, Bulgaria
  • Martin Petroff MD, Orthopedic Surgeon, St. Marina Hospital, Varna, Bulgaria

Instrument Reps:

  • Leighton Wells, Innotek-DePuy, Chicago, IL

SC Monitoring Tech/s:

  • Alexandra Marchese, Biotronics Corporation, Ann Arbor, Michigan, Chicago Division, USA
  • Ruthann Leo, Biotronics Corporation, Ann Arbor, Michigan, Chicago, IL, USA

Support Staff:

  • Euro-Atlantic Transplant Alliance Foundation (EATA)
  • Tissue Bank Osteocentre Bulgaria (OCBG)
  • Medtronic Spine Corporation (MDT)
  • Curt Cooper, Innotek-DePuy, Chicago, IL
  • Sylvia Gutierrez, DePuy Europe, Madrid, Spain
  • Patrick Pilcher, Allosource Corporation