There are very few things in life more rewarding, yet often more bittersweet, than a career in medicine. That is particularly true when one is a member of a heart transplant team.
Most people have never heard of a cardiovascular perfusionist, let alone know our role in the operating room. To summarize it quickly, we are responsible for operating the heart lung machine that literally takes over the function of the heart and lungs during cardiothoracic surgery, allowing the surgeon to work on a still, empty heart, while the patient’s blood is diverted to the heart lung machine rather than returning to the heart, and subsequently returned to the patient’s aorta, thus the term cardiopulmonary bypass.
It is the perfusionist’s responsibility to provide hemodynamic support and ensure optimal oxygenation, CO2 removal, blood gas and electrolyte management, as well as administering cardioplegia solution to safely arrest and protect the heart for the duration of certain procedures, as is the case with heart transplantation, where we are literally keeping the patient alive while their heart is removed and the new one is implanted.
The saying, “it takes a village” couldn’t be more appropriate than when it comes to organ transplants. A heart transplant team consists of many more members than those present in the operating room. At Phoenix Children’s, we are incredibly lucky to have such a great team consisting of cardiologists, surgeons, anesthesiologists, transplant coordinators, perfusionists, nurses, scrub techs, CVICU intensivists, physical therapists, dieticians, social workers, transport teams consisting of drivers and pilots who take the procurement team to the organ donor sites across the country (often in the middle of the night), and the list goes on. Then, there is the most important member of the transplant team – the donor.
It’s very difficult to put into words the immense gratitude and respect I have for these incredible people and their families. As perfusionists, we have a very unique perspective on heart transplants, as we are involved in both procurement and implantation of the donor heart. During procurement, we are the ones who deliver the medication that literally makes the heart beat for the last time in the donor’s body – an experience we do not take lightly and it certainly has a lasting impact on us. It can be a heavy weight to carry at times. Luckily, the weight gets lifted significantly when we see the heart begin beating on its own once implanted in the recipient – a visual reminder the patient, quite literally, has been given a second chance at life, thanks to the selflessness of one person – the donor - and a team of dedicated individuals who work so hard to make it possible.
It is truly incredible being able to witness the impact a heart transplant can have, not only the patient, but also their family. Watching a child who struggled to walk down the hall of the CVICU prior to transplant walk (sometimes even run) out of the hospital hand-in-hand with their parents after transplant is one of the most incredible, most rewarding and most humbling things I’ve been able to witness not only in my professional career, but in all my life. It is uniquely exhilarating doing something that so few do, and I am truly thankful for the patients who trust us to take their lives in our hands.
With April being Donate Life Month, I feel compelled to thank all who are registered organ donors and encourage those who aren’t to put some thought into it. Currently, there are 114,927 patients on the organ transplant waiting list with an average wait time of 191 days for a donor heart to become available, 185 days for lungs, 239 days for a liver, 679 days for a kidney and 679 days for a pancreas. While they are waiting for these organs, they face serious challenges even beyond their physical health.
Every single donor helps, and everyone matters.