Giving Life

  

DonateLife Victoria Donation Specialist Nursing Coordinators, Nicole Gauthier and Sarah Hawthorne ensure the final logistics are in place before all treatments are removed and the patient and potential donor dies.   An estimated 100-120 people are involved in any one donation case. Intensive Care staff tenderly care for a patient in the final stages of her life. Great care is taken to ensure patients and their families wishes are respected.   Amongst immense sadness, organ and tissue donation provides hope for those on the transplant waiting list.Donation after circulatory death (DCD) must be conducted under tight timeframes. Here, surgeons and theatre staff wait for confirmation about the donor.A very human and intimate moment captured in the final moments of life in the ICU.   Only one per cent of people who die in a hospital are suitable medically for organ donation. Tissue donation has a wider criteria.  For donation after circulatory death (DCD), timing for donation is crucial because oxygenated blood is no longer flowing to the organs.   Here, staff are preparing to take the patient down for surgery soon after death.Captured through the curtains - A Intensive Care Nurse monitors the progress of the patient whilst providing comfort in the final minutes of the patient's life.Members of the Victoria Police Transport Unit quickly usher an organ, packed in ice, to a waiting police car. With sirens on, they will escort the organ to the airport where it will be flown interstate for transplant.  Once outside the body, organs have a limited lifespan, a matter of hours before they are no longer suitable for transplantation.Work carried out at the Victorian Transplantation 26 Immunological Service, helping to match recipient and donor tissue samples. Each circular tab represents one micro droplet from an organ waiting list patient. These tabs are used to cross match the donor organ with a suitable recipient. Scientists from the Victorian Transplantation and Immunogenetics Service look for positive reactions were antibodies attack the cells. A negative result is needed to indicate a suitable match.   The VTIS transplant laboratory stores frozen blood samples from all patients waiting for a transplant. These samples are ready to be tested when the donor blood arrives to check if there is a match.After receiving the call there could be a suitable donor liver, potential recipient Nick waits anxiously for news that the transplant is going ahead.  Significant blood and tissue testing is conducted before transplant to ensure the donor organ is the best match for the recipient and is healthy. Nick and his mum Carole wait for news from the medical team that the liver transplant will go ahead.   Sometimes waiting list patients will be called in, but because of medical constraints the donor organ may not be suitable for transplant.  Anaesthetist Louise Ellard monitors the patients vitals as theatre staff prepare for the liver transplant surgery.A sample of some of the surgical instruments used as part of the transplant surgery.Professor Bob Jones (right) is a study of concentration as he leads liver transparent surgery at The Austin Hospital, Melbourne. The donor liver is carefully wheeled into the theatre rooms before surgeons will remove it from the esky and prepare it for transplant.Over a period of 10 plus hours surgeons and the theatre team work almost continuously with very fine detail and concentration to ensure the surgery is a success.  Midway through a liver transplant, surgeons and theatre staff keep a close watch on the progress of the surgery.Surgeons work on the major veins of the donor liver, preparing it for the recipient so it is ready as soon as the recipient's original liver is removed.This image shows the removal of the recipient's original liver. Surgeons have detached all the arteries and veins from the adjacent organs.  As of May 2016 there were 141 Australians on the waiting list for a liver. There were 1034 Australians waiting for a kidney.   Here surgeons are inspecting the donor organ before transplanting it into the recipient.Inserting a new donor liver during a transplant at The Austin Hospital.A wider image of the activity throughout the liver transplant surgery.   Theatre staff are surrounding the table on the left which has the sterilised instruments, with the table on the right the already used equipment.Surgeons use many different finely placed stitchers to transplant the donor liver into the recipient. Lead surgeon, Professor Bob Jones, works on the donor liver during surgery at The Austin Hospital's Liver Transplant Unit.Roughly three-quarters of the way through the transplant procedure, Professor Bob Jones overlooks his surgical team as they continue the process of attaching the veins and arteries of the liver to the patient. The finer details of the surgery can be seen in the television behind. The process of stitching the recipient begins after many hours of surgery. The lead surgeon is Professor Bob Jones, the head of the hospital's Liver Transplant Unit.The finishing touches are applied to another succesful liver transplant. Over 1100 liver transplants have been performed at Melbourne's Austin Hospital.Louise Ellard and Anaesthetics team prepare to move Nick back to intensive care (ICU) post liver surgery.4.30am. After working a full day and then through the night, Anaesthetist Louise Ellard accompanies the liver transplant patient back to the Intensive Care Unit to handover to ICU staff and begin the long recovery from surgery.    A surgeon briefs Nicks parents, Carol and Phil, about the successful out come of their sons liver transplant.36 hours post surgery, 34 year old Nick is well enough to sit up in bed in ICU and eat his first meal.Fiona received a new liver 7 years ago. She is having her regular checkup at the Liver Clinic at The Austin Hospital.Elaine and her daughter Nacelle get a pre transplant briefing from Professor Bob Jones in the Liver Clinic at The Austin Hospital.Preparing for a partial Corneal Eye Transplant at the Royal Victorian Eye and Ear Hospital. After the recipient is wheeled into surgery, doctors and surgical staff cross check the paperwork before starting the procedure.A donor cornea is kept in a preserving solution before being transplanted.Only a thin layer of the cornea is needed for the transplant, with the cut cornea shown in this photograph. The less tissue that is used the better chance the recipient will have for the graft to take.  Eyes are one of the most complex organs in the body.   Dr Bruno Trindade's sharp eyes, powers of concentration and steady hands ensure the delicate surgery is performed smoothly.When Dr Trindade has removed the recipient's own corneal layer he is ready to transfer the donor layer to the surgical site.   He positions it, keeps it under appropriate conditions and then secures it to position.When surgery is complete, the theatre team allow the cornea to settle and keep it moist.   Eye surgery is performed in sterile conditions in highly technical environments.About two hours after surgery, when the recipient's anaesthetic has started to wear off, Dr Bruno Trindade examines the eye to check it is recovering as planned.   Recipients are monitored periodically over a 12 month period to make sure the tissue has been accepted by the recipient's own body and not rejected.Giving Life
You can register to donate at www.donatelife.gov.au and most importantly, when you do it, make sure that you let your nearest and dearest know of your intentions. Don’t put it off, do it NOW!!!!

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