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A Surgeon Reflects On Death, Life And The ‘Incredible Gift’ Of Organ Transplant

Author: Dave Davies / Source: NPR.org

Surgeons performed more than 21,000 kidney transplants and 8,000 liver transplants in 2018, according the United Network for Organ Sharing.

When Joshua Mezrich was a medical student on the first day of surgical rotation, he was called into the operating room to witness a kidney transplant.

What he saw that day changed him.

After the donor kidney came out of ice and the clamps on it were released, he says, “it turned pink and literally, in front of my eyes, this urine just started squirting out onto the field.”

Mezrich was blown away: “I just had this sense like, ‘This is so amazing, what we’re doing, and what an incredible gift. And could I ever do this? Could I ever be part of this exchange, this beautiful thing?’ “

He went on to become a transplant surgeon and has since performed hundreds of kidney, liver and pancreas transplants. He also has assisted in operations involving other organs.

Each organ responds to transplant in a different way.

“The liver will start pouring bile. The lungs start essentially breathing,” Mezrich says. “Maybe the most dramatic organ, of course, is the heart, because you put it in and you kind of hit it like you hit a computer, maybe you give a little shock and it just starts beating, and that’s pretty darn dramatic.”

Mezrich is an associate professor in the division of multiorgan transplantation at the University of Wisconsin School of Medicine and Public Health in Madison. He reflects on his experiences as a transplant surgeon and shares stories from the operating room in his book, When Death Becomes Life.

Interview Highlights

On the different types of organ donors

There are a few different scenarios [where] we take organs from deceased donors, the most common being those that are brain-dead. Those patients have no blood flow to their brain, so they’re considered legally dead, but their heart is still beating, their organs are getting blood flow, and they’re often in a fairly stable situation, so we can take our time.

There’s a second type of donor, which we call “DCD,” or donation after circulatory death. These patients are actually still officially alive, but they’ve reached the point where the decision has been made to withdraw support. And in those patients, we wait to withdraw support until everything has been discussed, and often the family is in the room when that support is withdrawn by their primary doctor, not by us. …

You know, it’s an interesting thing, because you really think about what really is death? How is it defined? Do patients feel the same way as we do? These are kind of some of the really interesting challenging parts of being in this field.

On how transplant takes a long time and requires stamina from doctors

When Death Becomes Life
When Death Becomes Life

I train a lot of people in transplantation, we call them fellows. … These are people who’ve finished their general surgery residency and now they’re getting additional training [in] transplant, and they’re excellent. … Being a surgeon, particularly liver transplant, is all about kind of intestinal fortitude or inner strength. You’ve just gotta keep…

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