As many as 3/4 of Poles agree that their organs be removed after their death. However, as many do not know if their loved ones would like their organs to be donated in the event of death. Meanwhile, the value of such a gift for hundreds of terminally ill people is known only to those who have already had one foot in that world.
Anna only found out that she was suffering from autoimmune liver disease in high school. Frequent stays in the hospital, and deteriorating well-being, successively excluded her from normal life. Despite this, after graduating from high school she got into English and began her studies. The disease, however, developed at a fairly rapid pace. Anna was getting weaker and weaker, her stomach was still aching. Her legs swelled so much that she could not put on her shoes. Side effects of the medications were depression and excessive weight gain. She interrupted her studies. She stayed home alone all day. Her whole world was the Internet.
Lot and March
The doctor told the parents that their daughter’s body was destroying her liver on its own, and medicine could not stop it. It was difficult for them to accept it. They decided to fight. At all costs. They searched for information about this disease, visited many doctors. Over time, the child’s illness changed their relationship with each other. Anna’s mother resented her husband that instead of making her daughter’s life more joyful, she wasted all her energy fighting against a stronger enemy. Father blamed his wife for giving up. They argued more and more often. Anna heard their conversation once. Mother said they had to be ready for anything, that no one would bury them when they died, because they would be alone.
One of the doctors who consulted Anna during her next stay in the hospital mentioned a transplant. The girl, however, did not take it into account. She did not believe that such a complicated operation could be successful. A liver transplant seemed to her and her parents as dangerous and terrifying as a flight to Mars.
Meanwhile, the girl’s health deteriorated day by day. She was unable to walk. Her parents brought her to Warsaw to the General, Transplant and Liver Surgery Clinic. There she met patients who suffered just like her. She also met people who had already had a liver transplant. What had so far seemed only science fiction to her has gained a human face. She became friends with a peer who was coming for a check-up after a liver transplant and she was feeling really good. She told Annie that she had started a new life. A light of hope lit up in her head. After the qualifying tests, she was put on the waiting list for a transplant.
Hope and fear
Anna was afraid of the operation. However, only she gave hope that she would live. Her parents were informed that they could receive a phone call at any time with the information that a donor had arrived. Then they must go to Warsaw immediately. From that moment on, the whole family waited. The ringing of the telephone made everyone feel on their feet. The car had to be refueled at all times, the suitcase was packed. Mixed feelings tugged at them. On the one hand, they wanted to get it over with, knowing it was the only chance. On the other hand, they were paralyzed with fear when they thought about surgery. After three months, they got a call from the clinic.
About 160 people are waiting for a liver transplant in Poland. On average, a patient qualified for the procedure waits about 6 months. Last year, 336 of them were made.
The results of organ transplantation are getting better, therefore the indications for this method are expanding. As a consequence, the number of people waiting for an operation increases and the waiting time for this operation is longer, which poses a threat to the lives of these patients. Public awareness of the value of organ transplantation for hundreds of terminally ill patients is still insufficient. The opposition to organ donation expressed by the family of the deceased makes it impossible to save many sick people’s lives.
On the way to Warsaw, in the car, Anna told her parents that if the operation was unsuccessful, they would send an email to her friend from England, whom she had met on the Internet and with whom she often spoke on Skype. Parents tried to keep her spirits up, even tried to joke. However, they were all scared to death. Doctors told parents that the operation could take eight hours.
Eight hours
The liver removed for transplantation, cut off from the structures of the entire body, looks dead when cooled, but when implanted, it turns pink and begins to produce bile. – It is really fascinating – says prof. Marek Krawczyk, head of the General, Transplant and Liver Surgery Clinic of the Medical University of Warsaw, where Anna found herself. The professor first saw an organ transplant operation with his own eyes right after graduation during a two-week stay on a scholarship at a clinic in Cambridge. He participated in two procedures performed by the pioneer of liver transplantation in Europe, prof. Roy Calne. – I took part as the third assistant, that is, I was involved in the preparation of the operating field, holding the hooks. But it was a great experience and a priceless lesson anyway, she recalls. In 1994, the first successful liver transplant in Poland was performed at the clinic in Warsaw. Before, however, the team in which prof. Krawczyk worked, he was successful, he had to face failure. The first transplant performed was unsuccessful. – The patient’s condition was serious and it was known that she would die without an organ transplant. However, as it turned out, her condition was too severe for the operation to be successful. Today I know that it was a mistake to qualify this patient for surgery. However, although we failed, we did not give up. We analyzed everything and we were ready for the next transplant – he says. The implantation of a new liver must be preceded by the removal of the damaged organ, which is not a simple procedure at all. In the liver affected by cirrhosis, blood flow is often blocked and therefore circulates collaterally. Vessels cut off during the procedure, dilated as a result, may lead to haemorrhage that is difficult to control. In addition, the inflammation that has arisen around it requires removal. When implanting a new liver, the veins and the artery must be fused. It is a very precise procedure, considering that their diameter is sometimes only 3 mm. The average operation takes about 8 hours, of which the damaged liver is removed for 4 hours, and a new one is implanted for the next 4 hours. There are also 15-hour surgeries. In addition to the main operator, 7 or 8 surgeons participate in the procedure – some for excision and some for implantation. Prof. Krawczyk says that when you stand at the operating table for 8 hours, you do not feel tired, because all your attention is focused on the procedure. – Only after the surgery does the air come out of me. The legs are like cotton wool and a person remembers that he also has a bladder – he says.
Consent to live
In Poland, the so-called the principle of tacit consent. This means that the hospital may perform the collection if the person has not objected during his lifetime in the form of an entry in the central register or a written or oral declaration made in the presence of at least two witnesses and confirmed in writing by them. However, the doctor asks the family if it is known that the deceased objected during his lifetime. As many as ¾ Poles agree that their organs should be removed after their death. It is almost 30 million potential donors. At the same time, of us do not know if our relatives would like to donate their organs for transplant after death. This means that almost 30 million Poles would not be able to answer the doctor’s question: “Would the deceased want his organs to be transplanted in the event of death?”
– It is a great joy when a patient, sometimes even unconscious and close to death, starts talking to a doctor after receiving a new organ. When I get a letter from a patient whom I had a liver transplant two years ago, and he writes that his son has just been born and wants to thank him for the opportunity to have such happy moments, I always read it to the other doctors on the team at the briefing. I know it’s important to them too. This gives meaning to our work – says prof. Krawczyk.
Anna does not know to whom she owes her life and a new liver. But she is happy. Already a few days after the transplant, she changed beyond recognition. The water that her body was collecting is gone. Her body took its normal shape. She was in a euphoric state. The spectacular effect that you feel right after the surgery gives you hope that you can live a normal life. Until the transplant, she did not remember what it was like when a person was not in pain. Life after the transplant was a new world for her without pain, without fear and with a future. Before that, she had no plans or even motivation to get out of bed in the morning.
Anna returned to college. Her friend from England visited her. Now she’s going to see him.