An important task for Transplant surgeons. Helping piece together the picture for every donor organ.

Transplantation involves the surgical removal of the organ(s) from a donor-who is either living or deceased- and then surgically implanting each precious organ into the designated recipient.

Do you know that there are many steps in the organ donation process that are all critical for deciding on whether or not a donor's organ(s) can go on to be transplanted? Transplant surgeons are very much involved in this process of assessing the suitability of the donor organs for transplantation.

Are you aware of instances where individuals were unable to be live kidney donors? Do you know of occasions where organ donation was not able to go ahead from a potential deceased donor (i.e.after death) in hospital, due to there being medical concerns?

Being able to assess each organ donor for their 'medical suitability' to donate one or more organs is one of the essential parts of the downstream transplant process. Although general information on organ donation is available via the Internet for eg, this website from the United States of America more specific information on the In's and out's of organ donation, may not be  easily located unless you know where to find it, eg from the United Kingdom

There are many pieces of information (see below image), that have to be obtained for each and every organ donor as to whether they are suitable to donate an organ (as a live donor) or multiple organs(after death). This whole process is like putting together a jigsaw puzzle, with the final two pieces (bottom right hand of the image), made up of what the surgeons discover at the time of the actual organ retrieval surgery. As most of the pieces of the jigsaw are put together prior to the retrieval surgery, this helps explain why not all donors proceed to the operating room. However, information obtained by surgeons during the retrieval surgery is often critical to the final decision as to whether or not a particular organ can be actually used for transplantation.

Legend- DCD: Donation after Cardio-Circulatory Death; DBD: Donation after Brain Death; NAT: Nucleic Acid Testing

Of note as rates of organ donation do vary between countries as outlined in this report from the WHO Transplant observatory particularly for deceased donors, it is important to place this information into the context of where you live. However, as you can see transplant surgeons are very much involved in the assessing of the donor organs for transplantation!

Image designed by Deb Verran 2012: acknowledgement Presentation magazine 

Ellen Meets a Survivor-Young advocate for Organ Donation

If you want to be inspired by a young advocate for organ donation then watch this video-a conversation between Helene Campbell and Ellen DeGeneres which recently occurred- live on The Ellen Show.

This came about as the result of a twitter campaign via @alungstory with the hashtag #beanorgan donor tweeting up to @TheEllenShow By the way Ellen supports organ donation!

Why should I use Twitter, as a healthcare worker?

How often do I hear comments being made about Twitter including the 'it is for socialising with celebrities' statement. If this was truly the case this blog would not need to be written nor posted! If you know all about Twitter you do nor need to read on, for everyone else here are some facts plus tips.

The use of social media in health care is now very much on the increase as outlined in a recent posting on the popular medical blog KevinMD . So hoping that you can continue to ignore this major trend, is probably no longer useful.

Twitter has become a conduit for relaying information rapidly around the world and is increasingly being used not only by individuals but a number of organisations. Here are some of examples of organisations who all use Twitter- governmental Food and Drug Administration , VicHealth , United Kingdom National Health Service , international organisations World Health Organisation , OECD , professional entities Kings Fund , American College of Surgeon, universities Harvard University , Imperial College , hospitals Mayo Clinic , Kings College Hospital , and medical journals New England Journal of Medicine , Lancet. Also in the public health arena Twitter has been used for 'tweeting' out information on policy Centres for Disease Control , APHA , new developments Johns Hopkins Public Health and evolving health issues CDC Social Media

So what use is this information for you? Well by joining onto Twitter you can elect to follow some of the organisations or entities that relay practical, useful information that you already know about. Look out for the Twitter symbol which is usually a small blue bird icon or a small blue 't' on their web sites and by clicking on that logo, you can then become a follower. Then by checking on your own home page on Twitter you can view all of the tweets of everyone you follow. The information contained in these tweets plus their accompanying links onto web pages may be useful for ongoing learning activities and adding to your knowledge base.

By trial and error you can also find other organisations you may wish to follow by entering relevant words into the Twitter search tool bar. If you find yourself following someone or something that is not particularly useful you can always unfollow! Guides on how to use Twitter are available on the Internet and the Mashable  guide is one of the more popular currently.

How about actually 'tweeting'? Remember what you tweet is immediately in the public global Internet sphere, so anyone can potentially see it. Think before you write and even more importantly before you click on send! One unfortunate tweet can have major, major implications. There are guides available for the use of social media in the health sector. Examples include from the Australian Medical Association , and the British Medical Association . Your employer may also have a social media policy which you need to be fully aware of.

So what now? You can try joining up onto Twitter and start following what interests you. Whether you wish to tweet is up to you and please remember there are rules. Information contained in this recent Cool Info graphic , and the Jeffbullas Blog very much confirm that the use of social media is on the increase. So even if you are currently not accessing Twitter, there is a very good chance that people you know are. Good luck!

     

Robert Redford discusses personal struggle

This video via YouTube features Robert Redford talking about his son who has undergone a liver transplant. As a result Robert Redford is now publicly promoting the benefits of organ donation including it being life saving. Many of you will be aware of the well known Steve Jobs who was also the recipient of a liver transplant and who also publicly advocated for organ donation.

What do Transplant Surgeons Do? We have conversations including about organ donation.

Transplanting organs into recipients is the job of 'Transplant Surgeons', doctors who are trained in the relevant field whether it be for the liver, kidney, pancreas, heart, lung or bowel. More info on transplant surgery can be sourced via the American Society of Transplant Surgeons

So, apart from performing this type of surgery what else do transplant surgeons do in a week?

Transplant surgeons are very much involved in helping assess potential transplant recipients. Once it is clear that someone is suitable to be 'listed' for a transplant then important conversations need to be held with that person and their significant family members. The surgeon communicates the reality of actually receiving the precious often life saving organ, which includes the chance of not receiving the organ in time, how long the actual wait may be and how organ allocation works in practice. During these conversations often there are many more questions that may be asked, all of which the surgeon will need to answer. This is not surprising as undergoing an organ transplant is no small thing for anyone[nor their family]. It is important to clear up any concerns or misunderstandings people may have!

So what are these kind of questions and how can they be answered? Here are some examples-

Q: Doctor, do you travel to the scene of car accidents/car wrecks to get the organs form people who have died?
A: No, because in order for organ donation to be able to occur, you have to have made it into hospital before you die of such major injuries, otherwise your organs will not be good enough to use for transplant.
Q: Members of my family are registered as organ donors, so that means that if any of them were to die then organ donation becomes an automatic process doesn't it?
A: It is important for people to register their intent in advance, however the family are still needed at the time to give the okay for the actual organ donation process to go ahead.
Q: But doesn't being registered as a donor save the family members from the emotional trauma of having to make  decisions at what is such a difficult time for them?
A: The family will not need to decide about  you being a donor if you are registered, but they are still needed to provide information to assist with the donation process. This includes the relevant family member(s), being asked about the donors past medical and social history which is important for checking on the donors back ground.

Finally the one topic where there often seems to be the greatest amount of confusion, anxiety, and misconceptions but for which gaining an understanding is important -

Q: I do not understand at all about 'brain death' what does it mean exactly?
A: 'Brain death' is declared when there is no longer any function of the brain to support you being awake, breathing on your own, plus being able to talk and to move. Also this has become an irreversible state due to there being major brain damage.

You can think about 'brain death' like this. Imagine your computer hard drive ceases to work despite the power being on and the computer from the outside appearing normal. Well, your computer ceases to function and so basically no hard drive, means no function. The same is for us, in that the brain can be seen to act like the hard drive, so no brain function means we cannot function. However unlike your computer where you may be able to replace the hard drive our brains are not replaceable at all. Also once our brain has sustained catastrophic damage it cannot be repaired either. This is why patients who are declared brain dead may 'appear' normal [like the outside of the computer] and the power supply is still on[the heart is still beating], however they can no longer function [which is why the breathing is supported by a ventilator].

So why is it important to understand about organ donation processes and also about 'brain death'? Because more understanding will translate into more people consenting to organ donation. Plus more organs can be transplanted on average from deceased donors post declaration of brain death versus for deceased donors where death has been declared following the heart having stopped beating.  

If you wish to know more, there is general information that can be found via web sites managed by reputable organisations. Here are some examples from Australia Health insite, the United States of America Organ donor gov and India Gift Your Organs Also, if you wish to provide feed back to this blog you are welcome to.

NB: If you or a loved one is undergoing assessment for an organ transplant or are actually on a transplant waiting list, and you are wanting more information then speak to your doctor or members of the team at the Transplant Centre concerned.

On entering the blogosphere

So why you may ask is a Transplant surgeon joining the 'blogosphere'. I am not someone who envisions themself as having large numbers of followers via Twitter or a huge presence on Facebook, let alone being able to manage a dynamic Blog site.

I am here to hopefully add value by informing, clarifying and filling a niche that currently needs to be filled in cyberspace. The healthcare sector is now having to undergo major change, as described in the following link to the Third Healthcare Revolution . Some of this necessary change involves having the appropriate linkages created between the human elements with the tools provided by information technology, such that knowledge can be shared and managed.

In another 5 years, musings via such a blog may no longer be relevant as the appropriate knowledge management networks will be in place, achieved by blending and combining people with technology.