I first discussed the possibility of a heart transplant in 2001 with my GP – Doctor Jeremy Martin. It was not until August 2005 that I was finally listed for a transplant. The medical mantra for a heart, lung or liver transplant is:

“Ill enough to die, yet strong enough to survive.”

The years between 2001 and 2006 when I finally came through the double transplant were very difficult to navigate, especially for friends and family who can only watch as your health deteriorates. If you are a heart, lung or liver patient on a transplant list you virtually have to earn the right for a transplant by proving that you are dying! By the time I was physically stable enough to be listed for a heart transplant the oxygen supply to the rest of my body had become so low that I had a stroke and my kidneys decided to go on strike. The photo to the left shows me on dialysis. This is an experience that is best to be avoided. If I had received a heart transplant within 90 days of being listed I would have been spared the dubious and risky pleasures of haemodialysis. Not to mention the huge expense of this procedure. Dialysis costs in the region of £30,000 per year - the net cost of a kidney transplant is a lot lower year on year.

The shortage of suitable organs and the trauma of a major organ transplant operation force the health system to restrict access to this high risk procedure. A form of rationing exists which is actually in the best interests of the patient, but it does not feel that way at the time. If the rationing procedure continues for too long the patient dies. The idea of 'rationing' is not to deprive the patient of a more efficiently functioning organ, but to ensure that the scarce organs are allocated to maximise the benefits to the recipient. It is a difficult decision for all concerned. I have spoken to many patients on waiting lists. Understandably many of them are very afraid of the actual operation. Control over their own lives has transferred to a medical team and an unknown donor. Trust and belief in the system has to be solid. The emotional and psychological strains are as difficult to endure as the physical punishment that many patients experience.

The period of waiting can be brief or very prolonged.

One young girl I met caught a cold infection one weekend. Her immune system did not deal with it effectively. By the following weekend her heart had gone haywire and she received a heart transplant. Her window of opportunity gave her a very brief journey into a transplant and then successfully out the other side. Considerable good fortune has to occur for such a smooth transition to take place. The coincidence of various factors has to take place. I would like to say that the factors are ‘managed’. ‘Management’ is possible to a certain extent, but certain variables remain beyond the control of the key individuals involved.

What factors must come together?

The medical assessment has to be carried out quickly and decisively to establish whether the patient cannot live without a transplant. The medical team need to confirm that the patient has every chance of coming through the procedure successfully and will be able to make the most of the replacement organ. This boils down to a judgement as to whether the transplant would give the patient an improved quality of life.

To be continued

TRANSPLANTS SAVE LIVES, MONEY and MISERY.