By Joel Warner
By Michael Roberts
By Alan Prendergast
By Michael Roberts
By Michael Roberts
By Amber Taufen
By Patricia Calhoun
By William Breathes
Rather than being off-putting, the imperious bearing of the surgeon was reassuring to Kathy. Since the transplant program's reincarnation at University Hospital in 1988, more than 500 livers had been transplanted, and, Kam noted, he'd done "most of them." Now he was going to get her boy to the other side.
Kam announced that he had done a visual inspection of the donor liver, and the team was ready to proceed. Chris was getting sleepy, but he wanted more reassurances. "Does it look perfect?" he asked again. But Kam would say only that it looked fine, and then he was gone to scrub up for the operation.
More nurses arrived to wheel Chris off to the operating room. Up to this point, he'd appeared nonchalant. Now he struggled not to cry as he looked up at his mother. "Am I ready for this?" he asked her.
Kathy Klug smiled at her son. She thought about all the times she had looked down on him lying in a hospital bed. Her infant with his pneumonia. The ten-year-old with asthma whom she'd willed to breathe in, breathe out. The young man who was told he might never walk normally again. What do you love, Chris? I love the starting gate, Mom. I love the possibilities. She thought about the people who'd gotten him through the bad times: his family, who made sure he knew he was loved, and the doctors who had cared for him and, as he'd once told his pediatrician, "took away the fear." He'd always shown such determination in the face of adversity, whether it was his health, injuries or disappointments and, with the help of those people, he'd always come back stronger than ever. The Bounce-Back Kid.It was as if he'd been in training for this greatest test of his will and courage.
Yes, she'd thought about his question a lot and knew how to answer him. "Chris," she said, "your whole life has prepared you for this."
Chris's eyes were shiny with tears, but he managed a smile. "I'm ready," he said quietly as the nurses wheeled him away.
"We love you, Chris," his family and girlfriend called after him as his gurney was pushed through the doors.
Missy stifled a sob as she and the family got on the elevator. Kathy, her voice wavering, cautioned, "The floodgates, Missy. The floodgates."
When the thirteen-year-old victim's mother gave her consent to Donor Alliance, the care of his body was taken over by one of the agency's coordinators, all of whom are registered nurses. The boy's vital statistics, such as age and blood type, were fed into the UNOS computer, and a regional list was run. There were no Status Level 2A or Status 1 patients who qualified for the liver, so the computer began ranking the patients on Status Level 2B. Chris's name had popped up at the top of the roster, thanks to the three years he'd spent on the waiting list.
Once a heart recipient was located, the other organs could be removed, and the procurement teams moved in. There were two main teams: One would enter the chest cavity for the heart and lungs; the other -- the solid-organ team -- would open the abdomen for the liver, kidneys and pancreas. After the major organs were removed, others would come for the corneas and skin.
The two main teams worked in stages. The first opened the donor's chest but left everything in place -- the heart beating, the lungs rising and falling with the whooshing aid of a ventilator. The abdominal team then moved in, opened the abdominal cavity and got their three organs ready to remove but left them hooked up to the blood supply. The victim was beyond help, but the teams were as precise in their surgery as the transplant surgeons would be. They had to leave large enough segments of arteries and veins for other surgeons to attach to reciprocal places in their new bodies.
When the abdominal team finished its preparatory work, the first team returned to remove the lungs, and, finally, the heart. With that organ no longer supplying blood, the second team quickly removed the kidneys, pancreas and liver. The entire procedure took about two hours.
Once removed, the organs were immediately flushed with a preservative solution and placed on ice. Each of them was then rushed off to a recipient -- the liver to University Hospital and down to the operating room where Chris had been brought.
Chris lay naked on a steel table. His head and shoulders were shrouded beneath a blue half-tent, his face visible only to the anesthesiologist. Electrodes had been placed on his chest to monitor his heart rate; other electrodes were attached to his head to measure his brain waves, which would let Henthorn assess his level of consciousness. Under his careful ministrations, Chris slept.
On the other side of the blue tent was the rest of Chris's body. He was covered from his hips to his feet with another blue sheet, but his torso, from his rib cage to his hips, had been wrapped in a thin, yellow plastic covering called Ioband, which was impregnated with iodine to cut down on the risk of infection. The blue sheets represented areas that were not to be touched by anyone or anything that was not sterile; the yellow was where the surgeons would operate.