NEW TRANSPLANT TOOL: Smartphone images of donor organs can speed critical consultations
Sutures and sponges? Check.
Smartphones may become a must for London surgeons retrieving organs for a transplant after the camera on a BlackBerry Bold was used out-of-town to surgically investigate a problematic liver needed by a patient dying in London.
The clock was ticking when two surgeons and a transplant co-ordinator from London Health Sciences Centre were dispatched to remove a liver from a middle-aged man who was brain dead after a head trauma.
Days earlier, a 56-year-old man with hepatitis C had been taken to a London hospital with his liver failing, joining a waiting list that for some becomes a death sentence because they die before an organ is found.
On a scale of 1 to 40, with 40 being the most severe liver failure, the man rated a 34.
“This was a person who was very sick with significant liver failure. A not insignificant proportion of people die waiting for a transplant,” said Dr. Kris Croome, a surgeon developing expertise transplanting livers, a specialty area for London surgeons who transplant about 70 livers a year.
Croome was joined by a more senior transplant trainee, Dr. Jeff Shum, and a transplant co-ordinator, Michael Bloch.
Back in London, transplant surgeon Roberto Hernandez prepped the hepatitis patient for an operation — the transplant procedure would have to be performed as soon as the liver arrived because a liver is generally useful only within six to eight hours of being removed.
The retrieval team operated on the brain-dead patient, removed his liver, only to find a 6-centimetre lesion that could be cancerous or otherwise make it unsuitable for an organ.
They phoned Hernandez, asking if they should return with the liver or cancel the operation and hope another organ became available.
Had a smartphone not been used, Hernandez would have likely had to cancel the transplant. Instead, he directed Croome and Sum to take a series of photos that were e-mailed back to London. Each image prompted further surgical investigation of the lesion and together they allowed Hernandez to give a green light to the operation.
A year later, the hepatitis patient is alive and doing well.
The work of the London team is garnering attention after an account was recently published in the Journal of Telemedicine and Telecare. And London transplant surgeons are seriously considering making smartphones required equipment for surgery.
“It had worked so well we should put that out there,” Croome said.
A smartphone was also used a month ago to help rule out the use of a liver, saving a patient in London from enduring the start of an operation that would have to be cut short.
“The current case illustrates how smartphone technology can be an invaluable tool in performing real-time consultations,” the London team wrote in the journal.