The journey of the heart： the heart transplant operation connecting two lives is carried out by relay
In the central operating room of Zhongshan People’s Hospital, heart transplantation is under intense pressure. More than a dozen medical staff participated in this operation. Nanfang Daily reporter Ye Zhiwen photo
Regain "mind" life
overall process
He woke up. Two hours after the successful heart transplant, my father and sister were at the bedside, and the indicators on the monitor had returned to normal.
"Did I take off my defibrillator?" He opened his dry lips slightly and asked urgently.
"Don’t worry, take it off." The doctor held up his mobile phone and showed him the photos of the defibrillator. His mouth trembled slightly, and then he closed his eyes, and the amount of anesthetic was not completely consumed. He has just undergone a "heart-changing" operation, and he looks pale and tired.
On August 3rd, he underwent a heart transplant in Zhongshan People’s Hospital. Three days later, all the postoperative monitoring indexes of the recipient met the requirements and were sent back to the general ward of cardiothoracic surgery. Finally, he got rid of the defibrillator and was reborn. He was full of expectations for a new life.
Goodbye, defibrillator!
This transplant is his last shot at his young life. Since 2013, he learned that he had dilated cardiomyopathy. In 2017, due to the sudden aggravation of his condition, he had to install a defibrillator to help maintain a normal heart rhythm. "My brother is a sensitive person, who can feel his heartbeat all the time, as if there is only the topic of heart in his life. This sensitivity began in April this year and is rooted in fear. " The sister of the heart transplant recipient told the reporter that since April this year, after the parameters of the defibrillator in my brother’s body were adjusted, the number of times the defibrillator discharged into his body increased significantly, up to 39 times a day! Every time you discharge electricity, you can make people who are lying quietly bounce out of bed. She still remembers that in the middle of the night when her brother was in the hospital, he suddenly bounced out of bed and often scared the patients on the side. Everyone did not expect that a heart patient would have such "horrible" behavior.
He’s had enough! For three months, he lived in fear every day. I don’t know when the whole body will be electrified again. I don’t know when the defibrillator will shock his chopsticks to the ground at dinner. A young life, however, can’t run and jump, can’t walk on its own for a long distance, can’t fall in love like other young people, and commute to work by bus … … He can only bear the changeable illness and uncontrollable ups and downs. After years of taking cordarone, his blood vessels have hardened, and a pair of white swollen arms often embarrass the nurses who take injections.
In July this year, after two consecutive radiofrequency ablation operations, he completely fell into despair. Two operations made his heart, which was already black and blue, even more vulnerable. The arrhythmia that still occurred from time to time after the operation moved his conservative heart. He remembered the "ultimate kit" that the doctor told him in May — — Heart transplant. "For more than two months, his thoughts have not been firm and he has been holding a wait-and-see attitude towards transplant surgery." The recipient’s sister said that it was not until my brother met those who were reborn because of the transplant operation in the hospital and saw that they lived a normal life that he added some confidence to the operation.
"My brother’s desire for survival has always been very strong. After six years of illness, all the opportunities to treat diseases have been tried. I ran to many hospitals and tried various treatment methods. It is really the last fight to go to the transplant step." The recipient’s sister said.
They are "heart protectors"
"Giving everyone who is eager to survive a second chance is the biggest mission of transplant surgery and the source of a sense of accomplishment for a cardiothoracic surgeon." Liang Yi, director of cardiothoracic surgery department of People’s Hospital, described heart transplantation. He was both the chief surgeon and the commander-in-chief of the whole transplant operation on August 3. Since the recipient was pushed into the operating room at 7: 43 in the morning, Liang Yi has been busy all the time. The cardiothoracic surgery team is not only responsible for organ transplantation, but also for organ acquisition.
From the moment I opened the chest for the donor, everyone’s heart was touched by the transplanted heart, "heartbeat — Stop jumping — "Rebound" runs through the whole transplant operation. Cardiothoracic surgery sent medical staff to protect the heart carefully. Just after 7 o’clock on the morning of the 3rd, Huang Weizhen was ready to change clothes in the ICU of the hospital internal medicine department. He is the "heart catcher" who is often responsible for obtaining the heart by the cardiothoracic surgery team. "Although the deceased has passed away, I always feel that taking out the heart will also cause damage to it, especially when the heart stops by perfusion. Just seeing it gradually stop in a few minutes, I can only do so." For all the operations of the deceased, Huang Weizhao was cautious, as if it were an ordinary surgical patient. When he closed his chest, he would sew up his wound exquisitely as usual and dress the donor — — Although, these actions have lost their practical significance.
Wei Xu, the "heart giver", carefully put the transplanted heart into the physiological saline mixed with ice and water. He couldn’t remember which heart he had given since he entered the business. From nervous to calm, he participated in organ transplantation in Corey, and he also went through a mental journey of his own. "When I started working in the organ harvesting team, I felt uncomfortable. I felt like a ‘ Vulture ’ 。” Wei Xu fell into memories of the past, and didn’t begin to accept his job until he saw those people who were reborn because of heart transplantation, and he felt its significance.
2 minutes and 31 seconds! On the 3rd, the delivery distance was more than 200 meters. Wei Xu walked more than 300 steps in an incubator with a transplanted heart and a box full of ice, which was not his fastest time. The pace is quick and steady, and he knows that the small suitcase in his hand is related to another person’s life. When he arrived at the operating room, he was relieved. Liang Yi was standing in front of the operating table waiting for him. The recipient had opened his chest, tracheal intubation was completed, and cardiopulmonary bypass was established and ready.
Operating table No.3 in the central operating room of People’s Hospital is often used for transplant operation, because "3" in Cantonese has the homonym of "health". Liang Yi quickly removed the diseased heart and put it in a container. After leaving the recipient, the diseased heart didn’t stop beating immediately. At the same time, Liang Yi took out the defibrillator for the donor.
"After I got on the operating table, my heart seemed to be affected by the transplanted heart. When I was fully involved in the operation, my heart seemed to temporarily stop beating until the ascending aorta was opened again, and blood flowed into the new heart of the recipient. At the moment when I saw this heart restart, my heart followed." After so many transplant operations, Liang Yi sweated for each donor, and he sweated for himself. The operation lasted nearly 4 hours, and the chest was successfully closed at 12: 30. This ordinary and special heart transplant operation was completed.
Connect two lives
"I hope my lover will not disappear because of the termination of life. Through organ donation, my lover can continue to live in other people’s bodies." The donor’s spouse told reporters.
This time, the source of mind was found by Chen Miaolian and Ning Liqing. Just two days before the operation, Ning Liqing, coordinator of OPO (Human Organ Acquisition Organization), suddenly received a phone call from Chen Miaolian, assistant director of the ICU of the hospital internal medicine department, and learned that a potential donor’s family agreed to sign the Consent Form for Human Organ Donation. Ning Liqing immediately put down his work and met his family, and signed the Consent Form for Donation with him in less than half an hour to help the recipient who had been waiting for more than two months find the heart.
This time, Ning Liqing signed the Consent for Human Organ Donation without any effort. "The donor’s family members are very open-minded and very cooperative. They not only agreed to donate their hearts, livers and kidneys, but also handed over all relevant legal proof materials within one hour after signing the consent form." Her words were full of gratitude. Before the transplant operation started, Ning Liqing stayed at the donor’s bedside and wanted to do her best to help her family. "Organ donation is by no means a moment. The OPO coordinator will follow up the follow-up living conditions of the donor’s family and help them as much as possible." She said.
In fact, the job of an OPO coordinator is quite complicated and challenging, and Ning Liqing is not so lucky every time. At about 11 o’clock one night in May this year, Ning Liqing received a phone call from the intensive care unit of Xiaolan People’s Hospital in Zhongshan City, and provided her with information about potential donors. Without saying anything, she went straight to Xiaolan Hospital from home, and her husband and son followed her without worrying about her safety. "At first, it was very smooth. The family members agreed to sign the Consent of Human Organ Donation, and the person was transported to the Municipal People’s Hospital that night. Who knows that the family members changed their minds the next day? This kind of thing is entirely voluntary. We always respect the opinions of our families. " Organ transplantation is full of variables, and now Ning Liqing is much more peaceful.
As early as 2005, Ning Liqing began to coordinate organ donation as a volunteer of the Red Cross, which was just in its infancy in China. Xie Xi, Pi Juan, Ning Liqing and Li Cuiping are the earliest people in People’s Hospital who are engaged in organ donation coordination part-time and the first batch of organ donation coordinators in China. Now the OPO team in the hospital has grown to 11 people, including 3 newly recruited full-time employees. "In addition to communicating with family members, the coordinator is also responsible for collecting legal materials for organ donation and helping family members go through the formalities. For those families who lost contact, we should also contact the public security, civil affairs and other departments to find them together. " Pi Juan believes that the coordinator’s job tests a person’s overall coordination ability and communication and analysis ability, which is quite different from the professional position of the hospital.
As a veteran member of hospital OPO, Pi Juan has explored a set of her own working methods. "Without a strong purpose, things can often be done better." This is her experience. Pi Juan believes that OPO coordinator is not a "take" role, but a person who helps organ donors fulfill their wishes. The trust of family members determines the success or failure of donation coordination. She often took the initiative to understand the difficulties of her family members. When she learned that the donor’s daughter’s family had differences because of the children left behind in her hometown, she shared her parenting concept with them. Finally, the husband and wife reached an agreement to take the children to Zhongshan. So far, the donor’s daughter has often communicated with Pi Juan about children’s education.
"The work of the coordinator is long-lasting, and it cannot be measured only by whether the family members agree to sign the consent form for organ donation. These families have made contributions to society, and we should pay more attention and return." Pi Juan said.
■ Close-up
It has been 15 years since the first heart transplant in Zhongshan was born again.
"Install a Ferrari motor in a Xiali car." Li Qiangfan humorously described his transplant operation. He was the first heart transplant patient in Zhongshan. Fifteen years ago, Li Qiangfan had a heart transplant because of dilated cardiomyopathy and became the "first person to eat crabs". He still remembers the scene of lying on the operating table: "Before the operation, the doctor asked me if I was afraid, so I smiled and said, What am I afraid of if you all dare to do it?"
On June 28th, 2019, it coincided with the 15th anniversary of heart transplantation in Zhongshan People’s Hospital. Li Qiangfan also returned to the hospital to celebrate his "15th birthday". In a blink of an eye, he has gone through 15 years of his life. Su Jianwei, head nurse of cardiothoracic surgery in People’s Hospital, said that every year, the hospital holds a party for the reborn people who have received heart transplants to celebrate their life course. Everyone gets together to exchange postoperative experience, and Su Jianwei sees a sense of satisfaction from their gratitude. "Li Qiangfan is not the oldest person, but we are ‘ Rebirth ’ The person who has the longest life among patients is the benchmark for everyone. " Su Jianwei introduced that Li Qiangfan has always been the image ambassador of the hospital to promote organ donation, and he has been actively running for patients for many years.
After 15 years and 88 cases of heart transplantation, Zhongshan People’s Hospital ranked second in Guangdong Province. Jiang Haiming, vice president, said that this is the result of the hospital’s differentiated development strategy. As a prefecture-level hospital with OPO (Human Organ Acquisition Organization) in the province, Jiang Haiming hopes that organ transplantation can continue to be a "boutique" medical service project of the hospital, and at the same time continuously expand its social benefits to promote the promotion of the hospital brand. (Nanfang Daily reporter Lang Hui correspondent Lin Ruzhu)