Articles

Liver Transplant Donor Run

In Inspiration, Medical Musings on April 6, 2011 by David Tagged: , , ,

Sunday night, I had the rare opportunity to go on a donor run. We flew into Fresno and I got to scrub in to help in a liver and kidney procurement. It was an amazing experience – awe-inspiring to realize what was happening and overwhelming in knowing what a rare and unique opportunity this was. Out of the tragedy of one person’s loss, multiple individuals are helped – in this particular case, the heart, liver, and kidneys were collected. It is truly an amazing system, where the anonymous generosity of one individual can galvanize an entire support network and bring together physicians from all over the country to most efficiently help people in need.

On the scientific and medical level, transplant is just as amazing.The very idea of transplant, the practice of moving and implant another individual’s organ to help prolong another individual’s life, underscores a deep fundamental understanding of physiology, cell biology, and biochemistry. Physicians build upon a tremendous body of knowledge of physiology – an understanding of how each organ functions and what purpose each tissue serves. For a successful transplant, physicians need to identify the signs of what organ is failing, surgeons need to perfect the technique of resecting an organ while minimizing ischemia and preventing blood clots, and a large body of knowledge must be available to understand how to perfuse the organ and minimize the immune response of a foreign organ.

The play-by-play:
At around 8:30PM, I got a call from Alexandra. I did not have the pager and she had just gone to a procurement earlier that day, so she asked if I wanted to go. I had just gotten home from preceptorship and was making dinner. Having been in the ED the entire day, I was rather tired, but really excited for this opportunity – particularly when I heard that it would be in Fresno.9:45PM, I got into an unmarked van in front of Moffitt Circle. I met up with Alex, the transplant coordinator, Stephen, R3 from Fresno on transplant rotation here at UCSF, and Ingo, the transplant fellow. We drove to SFO and got on a private jet to Fresno. An anesthesiologist from the transplant network met us at the airport and we headed off.

11:45PM We got to Community Medical Center, changed into their scrubs, and began preparing for the surgery.  There was a little bit of downtime, where we got some coffee (bad idea, I was trembling a little when closing) and the fellow went through all the paperwork.

12:15AM. The surgery began. The nurses were super helpful – I don’t have too much experience scrubbing in, but they were really nice in helping me pick out gloves and put on the gown and gloves.

It was an amazing process, with the cardiac team working in parallel with the abdominal team. I won’t go into too many details, but it always astounds me the amount of finesse involved in surgery. Great delicacy is used to maintain the blood supply of the organs, and I could tell the

3:00AM The surgery began to wind down. The R3 and I got to close up the donor, while the fellow focused on the actual organs. I helped tear down the surgical field and package the organs.

4:00AM Back to the Fresno airport, which was then only a skip, hop, and a leap back to SF. I couldn’t sleep the rest of the night, and stayed away the rest of the time until I got back home.

This was truly an amazing experience, and really highlighted the joys of surgery. Through finesse and technique, there is an unparalleled opportunity to make a great impact and impact someone’s life. The task before you is directly tangible and the responsibility is directly on your shoulders. It is truly a different experience, and I really felt the rush of adrenaline in helping out and knowing what I was doing would make a difference.

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