Luiz Perillo, a 35-year-old Brazilian architect, passed away on Tuesday (30) in São Paulo, one week after undergoing a multivisceral transplant, a rare procedure involving the replacement of five organs. The surgery, performed on September 23, was halted due to a generalized infection, which led to complications and a cardiac arrest. Perillo had been waiting for the transplant for four years, a period marked by hospitalizations and intensive treatments. He became known for his struggle and activism for organ donation.
The multivisceral transplant, incorporated into Brazil’s Unified Health System (SUS) in February 2025, is one of the most complex procedures in medicine. Perillo needed a stomach, pancreas, liver, intestine, and kidney, all from the same donor, due to thrombophilia that caused organ failure. Despite initial success in the surgery, the infection prevented its continuation. The family announced his passing on social media without detailing the final cause.
- Only five hospitals in Brazil are equipped to perform multivisceral transplants.
- In 2024, Brazil recorded about 30,000 transplants, but only two were multivisceral.
- Organ donation requires family authorization, registered via the new ID or AEDO website.
Long wait in the queue
Perillo faced four years on the waiting list for a compatible donor. During this time, he suffered complications from thrombophilia, a condition that caused clots and led to multiple organ failures. He was hospitalized for over two years, relying on parenteral nutrition for 13 hours daily and hemodialysis three times a week.
Battle against thrombophilia
Thrombophilia, diagnosed in his youth, compromised Perillo’s portal vein, critical for the digestive system. The condition caused progressive organ failure, necessitating a multivisceral transplant. Weeks before the surgery, he faced an infection that worsened his condition, jeopardizing access for nutrition and hemodialysis. His entry into an emergency phase accelerated the search for a donor, leading to the September 23 surgery.
Organ donation activism
While awaiting the transplant, Perillo stood out as an organ donation activist. He used social media to encourage expressing donation wishes during life, crucial for authorizing donations in Brazil. He also promoted the importance of discussing the decision with family, a key step for donation approval. In Brazil, the decision can be registered on the new ID or via the Electronic Organ Donation Authorization (AEDO). Perillo’s campaign reached thousands, reinforcing awareness about the issue.
A rare procedure
The multivisceral transplant is one of the most complex in medicine, with costs up to ten times higher than conventional transplants. Incorporated into the SUS in 2025, the procedure remains limited to a few specialized centers. Only five hospitals in Brazil are equipped to perform the surgery, which requires high donor-recipient compatibility. In 2024, of over 30,000 transplants in Brazil, only two were multivisceral, highlighting the procedure’s rarity. Perillo’s surgery was halted after the first stage due to an infectious condition that compromised his recovery.
Legacy of hope
Luiz Perillo left a significant legacy in the fight for organ donation. His story inspired patients on waiting lists and underscored the need for donation awareness campaigns. Despite the tragic outcome, his journey highlights the necessity for advances in Brazil’s transplant infrastructure and greater organ donation adherence.
Routine of resilience
Despite his severe condition, Perillo maintained a routine of physical exercise to preserve muscle mass. This practice was crucial for his survival during the years of waiting, according to his family.
Advances in the SUS
The multivisceral transplant was incorporated into the SUS in February 2025, expanding access for patients like Perillo. Before this, the procedure’s high cost restricted it to private hospitals or exceptional cases.
