By Andrea S. Pineda
Philippine Daily Inquirer
First Posted 16:34:00 02/26/2011
IN the world of organ retrievals, they are called dark angels.
On call 24/7, the work of transplant coordinators (TCs) has long been associated with cadavers, human organs, and of course, death. Their job is crucial in the harvest of healthy organs from deceased donors for patients waiting for a new heart, kidney, a liver: a second life.
One potential multi-organ donor or PMOD can save at least seven lives. And that may be the greatest miracle wrought by the donors’ families who have said yes to giving the ultimate gift of life.
People involved in the Organ Procurement Organizations (OPOs) say the most challenging part is convincing the grieving family of brain dead patients to give away their organs without any condition. It is a job solely assigned to a transplant coordinator – a task they stress is as crucial as the transplant operation itself.
A few moments after the patient has been officially declared brain dead, the TCs come in. Says Grace Suguitan, supervising transplant coordinator of HOPE or Human Organ Preservation Effort of the National Kidney and Transplant Institute: “We do understand that it is not easy for the family members to give their consent, especially when the possible deceased donor is a minor or is at the prime of his or her life at the time of the fatal accident.â€
She has come to expect, and has actually encountered families who became angry or agitated during the process of getting their consent.
“Because death can come unexpectedly, TCs execute difficult steps under great time constraint and intensely emotional circumstances,†describes Don Mejia, a transplant coordinator under HOTTProg or the Human Organ and Tissues for Transplantation Program Network based at the St. Luke’s Medical Center.
Still, Don and Grace believe that it is important for all family members of the brain dead donor to understand the aspects of organ donation to make the right decision.
A fact we all need to know is that once the patient has been certified to be brain dead, it means that the brain has ceased to function, but not necessarily the other vital organs. The patient is also considered legally dead.
“It’s kind of difficult to explain to the relatives that the patient is already gone, particularly when they can still see traces and movement in the cardiac monitor,†says Czarina Sanchez-Bayani, a transplant coordinator from IPOD or Integrated Program on Organ Donation (IPOD) based at the Capitol Medical Center.
“It takes hours just obtaining the consent because we give them time to grieve and be with their loved one,†she adds.
According to Dr. Rosemarie Liquete, transplant surgeon and chief of the HOTTProg Network, it is very important that the patient still has stable vital signs to maintain organ function. This is critical in screening the organs in preparation for the retrieval surgery.
Thus, timing is very crucial. According to Dr. Liquete, “Organ retrieval should be done at the right time, the right place, and with the right people.â€
Aside from being frontliners in securing donor consent, transplant coordinators are key in coordinating the team of surgeons, doctors, nurses, and a network of hospitals for a successful retrieval.
“We are on-call 24/7, so we must always be on our toes. We cannot afford to lose even a single referral,†says Czarina who, with the rest of transplant coordinators from these OPOs respond to referrals all over the country.
They even provide psychological support for the grieving families, adds Dr. Liquete. “TCs help lessen the impact of the loss of loved ones by offering them an opportunity to give the gift of life to others,†shares Dr. Rica San Diego, a Transplant Procurement Manager of the LifeShare program in Medical City.
But as in any other job, there’s not always a happy ending. There are families of donors who turn down the opportunity of donating their kins’ organs due to cultural belief, family influence, and lack of awareness. Sometimes, the organ itself becomes unsuitable due to various circumstances.
“We do feel bad when a kidney [or any organ] goes to waste, because we always exert effort whenever we have a deceased donor referral,†says Grace. She explains that a donor is properly evaluated before he is considered to be eligible. Usually, those with hepatitis, elevated creatinine levels and/or those with sepsis are medically unsuitable.
Likewise, Don feels disappointed when the organs are not medically suitable. “Much more if the relative of the patient did not consent for organ donation. However, we have to respect their decisions and their beliefs about deceased organ donation.â€
This can be doubly disheartening for the expectant recipient who has spent years waiting for a new lease on life.
“Many Filipinos are still not amenable to donating the organs of their loved ones due to the cultural belief that it is not good or acceptable when a body is not complete when buried,†shares Dr. San Diego.
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