Michele Derbyshire has been an OR nurse for 25 years and has participated in more surgeries than she can remember-but a particular 56-hour period in early summer will stay with her forever.Ê That’s when the transplant team at Capital Health’s University of Alberta Hospital in Edmonton found itself in the middle of an unplanned “transplant marathon.” By the time it was over, the team would have performed a record-breaking 18 organ transplants-more than ten times the usual number-and 15 people would have a second chance at life.
“When we first learned there was an available heart and lung donor, we were excited,” Derbyshire recalls. Although the University of Alberta Hospital does many heart transplants every year, combination heart and lung transplants are rare; they might happen once a year. As one of Canada’s busiest transplant centres, the University of Alberta Hospital and Stollery Children’s Hospital teams typically perform about 250 transplants per year of all organs and all age groups.
So the experienced cardiac transplant team was perfectly prepared for the long night that lay ahead. Cardiothoracic surgeon Dr. John Mullen knew he’d be on his feet for about eight hours.
“Then a few minutes later we learned there was another heart and lung donor,” Derbyshire says. “I don’t think anyone has ever done two heart and double lung transplants back to back. We knew we had our work cut out for us.”
But the marathon had hardly started. “We found out there were two more donors in ICU. I remember wondering what had happened, why were so many people dying? I was afraid there had been some kind of disaster,” Derbyshire says.
In fact, the sudden surge of available organs was simply a highly unusual fluke – four separate tragedies, some from across the country. (To protect donor family privacy, the transplant team is given very little information about donors, not even real names.) “An organ donation truly is a gift from one grieving family to another-one who has lost a loved one and one who is going to lose a loved one. Their gift may spare someone else the same loss,” says Karen Olivier, organ donor coordinator with HOPE (Human Organ Procurement and Exchange Program).
Keeping donors stable in order to maintain the organs can be very complicated-each donor’s chart includes seven pages of doctor’s orders that include multiple requisitions and many hours of intensive care. The process can be emotionally exhausting for nursing and medical staff, especially when heartbroken family members are present. ICU staff don’t usually have many donor patients, but by midnight on May 9th, they had not one such patient-but two and another at Capital Health’s Royal Alexandra Hospital.
Dr. Mullen managed to grab a few hours of sleep after the first successful heart and double lung transplant. Meanwhile, surgeons recovered the heart, lungs, kidneys and liver from the second donor while transplant teams in two other operating rooms prepared for a kidney transplant and a liver transplant. Throughout the entire 56-hour period, at least four operating rooms were in use at any one time.
The third donor went for recovery surgery and teams worked through the night and into the morning to transplant a kidney into one patient, a liver into another, a combination kidney/pancreas into another. At sunrise, Dr. Mullen performed his second heart and double lung transplant.
As the fourth donor went to the OR that morning, urologist Dr. Ron Moore prepared for his third kidney transplant. Before the day was over, he would have performed an unprecedented five kidney transplants in 56 hours.
“We all worked on adrenaline and managed to sleep for a few hours in between patients,” Moore says.
In total, the team performed:
- five kidney transplants
- two double lung transplants
- one combination kidney and pancreas transplant
- three liver transplants
- two heart transplants
- not one but two of the most complicated and rare forms of transplants-combination heart and double lung
“These two days tested the skill and stamina of many, many people, both inside the operating rooms and beyond,” says Dr. Norm Kneteman, clinical director of Capital Health’s regional transplant program and Professor of Surgery at the University of Alberta. “Literally hundreds of people worked around the clock to make this possible, especially in managing the sudden surge of patients needing ICU beds. We’re very proud of our team.”
Deb Gordon, vice president and chief operating officer at Capital Health’s University of Alberta Hospital and Stollery Children’s Hospital adds, “The efforts of the entire Capital Health system in facilitating this transplant activity were outstanding. We are delighted to have been able to meet the needs of so many patients and families.”
After it was all over, the HOPE program coordinators returned to each of the donor families to share the good news that all of the transplant surgeries were successful. “Without exception, these families feel such pride in their loved ones for being able to save someone’s life,” Karen says. “It gives them some comfort to know that despite their tragedy, there is a silver lining. And in this case, it was a shining silver lining-15 people went home to their families.”