Photo: Dr. Samuel Weinstein
Once I get that call, everything changes. I might be out with my children, at the movies with my wife, or perhaps sleeping when the call comes: There is a donor for one of our patients on the pediatric cardiac transplant waiting list.
After that, it is hard to think about anything else. Once we accept a heart for transplant, a cascade of events unfolds that will change the lives of many people. Even if I don’t need to be at the hospital for a few hours, mentally I am already there. In my head I am working over the details of the operation, reviewing what our cardiologists think of the donor and evaluating the stability of the recipient.
Heart transplants almost always occur at night. Because hospitals are not reimbursed for organ harvests, operations to remove the donated organ are typically placed at the end of an operating room’s elective schedule, late in the day. The donated organ, which may be hundreds of miles away, must be brought to our medical center. We usually don’t get to start the implant of the donor heart till sometime after midnight.
Coordination and timing of a heart transplant could become an Olympic event, involving at least two teams at two hospitals – a harvest team and a donor team — each with a different set of objectives. I will make at least 10 calls before I get to the hospital. Dozens of people on our transplant team will be alerted: cardiologists, nurses, anesthesiologists, surgeons, intensivists, perfusionists. As is customary, we send our own team of surgeons to pick up the heart. Other transplant teams may also be involved, sending their own sleep-deprived surgeons in to harvest the lungs, liver or kidney.
The donor story is always horrible. The children frequently succumb to trauma, terminal illness or, perhaps most tragic of all, child abuse. The donor stories stay with me, and lately I have stopped asking how the child died. I cannot forget the father who, backing out of his driveway, accidentally ran over his child. My children still don’t understand why, whenever they are playing basketball in our driveway, I make them stop and line up where I can see them before I pull my car out.
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{Register to be an organ,eye and tissue donor. To learn how, www.donatelife.net or www.organdonor.gov}
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