There are already 8 human organ procurement organizations in Shanghai, and a team of professional coordinators composed of medical and nursing workers are certified to work.
Organ Donation Coordinator: Facing death and welcoming new life
Our reporter Huang Jianjian
June 11 is the sixth "China Organ Donation Day". Under the epidemic prevention and control, a brief organ donation publicity event was held in the outpatient hall of Shanghai Changhai Hospital.
The human organ donation coordinator of Changhai Hospital told the story of "one basketball team" to the citizens who participated in the activity.
"Ye Sha, a 16-year-old boy, unfortunately died of illness. His parents donated his son's heart, liver, lungs, kidneys and corneas to 7 people who were seriously ill, so that they could be reborn. Ye Sha liked playing basketball the most during his lifetime. , so 5 of these 7 people formed a special basketball team to continue the dream in his place..."
Human organ donation is to advocate citizens to donate useful organs voluntarily and without compensation when their lives cannot be saved, so that life can be continued in another way.
Since 2015, citizens' voluntary donation has become the only legal source of transplant organs in my country.
As of June 9, 2022, the number of registered organ donations in China has exceeded 4.77 million, an increase of more than 100 times compared with more than 25,000 cases in 2015.
However, there are still 300,000 patients in my country who need organ transplantation due to end-stage organ failure every year, of which only 6% of the patients can achieve organ transplantation.
There are currently 8 Organ Procurement Organizations (OPOs) in Shanghai, all of which are affiliated in comprehensive tertiary hospitals, and a team of professional coordinators composed of medical workers with relevant medical backgrounds are certified.
Facing death while welcoming new life is the daily work of a human organ donation coordinator.
powerless
Outside the intensive care unit of Changhai Hospital, 73-year-old Mr. Xu sat in the corner without saying a word.
The wife and daughter-in-law sobbed quietly.
In the ward, Lao Xu's 45-year-old eldest son was in a coma, relying on instruments to maintain his life.
It's been the eighth day since the accident, and the doctor has tried almost everything he can think of.
The vague idea in Lao Xu's heart became clearer.
"What else can I do for my son now?" Lao Xu asked when he first met Gao Xiaogang.
"It has been clinically determined to be brain dead. Next, maybe you can consider organ donation." Gao Xiaogang said the same thing to many family members of patients who are in despair.
Every time, it is very heavy.
At first, everyone was strongly against it.
"How can you treat our child like this!" his wife cried and accused him.
Old Xu was also very reluctant, but watching his son's various indexes drop day by day, he knew that there was not much time to hesitate.
Three days later, Lao Xu made a decision to let his son's life continue in another way.
On that day, a few relatives came to the ward and surrounded the two old people to persuade them, "You can't give up until the last moment!" "Do you always want your child to die without a corpse?" Keep lips closed.
"Families who choose organ donation will be pressured by various public opinions, and many cases will encounter such a situation." At this moment, Gao Xiaogang is also a little worried that the family members will be shaken.
But Lao Xu calmly said to him, "They are just here to visit, and they will leave after a while." The old man firmly believed that organ donation was the only way to "live" his son.
At this moment, however, the patient's heart stopped beating.
There is no chance.
When the heart stops, blood stops flowing, metabolism stops, and organs quickly become inactive.
"From an organ to a transplant, it has to go through strict procedures such as inspection, testing, harvesting, and preservation, and there are still many legal procedures to go through." Gao Xiaogang said, and all this came to an abrupt end when the heart stopped beating.
Dilemma
Gao Xiaogang is an organ transplant surgeon. Since 2015, he has had another identity - human organ donation coordinator. He led three medical workers with relevant medical work backgrounds to form the coordinator team of Changhai Hospital.
During the epidemic, the team did not stop. From the end of March to the end of May this year, Changhai and OPO's human organ donation coordinators successfully achieved 3 organ donations in a closed management environment. The transplanted organs produced by donation saved the lives of 11 patients. .
Potential donors come from the emergency room and intensive care unit of Changhai Hospital and its service area hospitals, mainly patients with neurosurgery, brain trauma and vascular diseases.
Information about patients with brain injuries is reported to the OPO office at any time of the day.
"We just follow the patient's condition and do not interfere in any treatment process. This is the common working standard of OPO in the world."
There are some unwritten rules for coordinating donations.
For example, it is not suitable to talk about donation when family members are still actively working to rescue the patient.
For example, the first contact with family members should help them communicate with the hospital about their condition, and when the condition is determined and the family realizes that the condition is irreversible, it will slowly transfer to the donation process.
When communicating with family members, you cannot sit face-to-face in a negotiating manner, but try to sit side by side to reduce the sense of distance and empathize with your family members...
"At present, there are two main difficulties in promoting organ donation in my country." Gao Xiaogang said that the first resistance comes from understanding the criteria for determining death.
"There are three criteria for determining the death of a patient in my country: brain death, cardiac death and both brain and heart death. When the patient meets the criteria for determining brain death and the family members accept the determination of brain death, the heart of the patient with brain death keeps beating. If the organ is healthy and there is no genetic disease, there is a chance. Become an organ donor. However, due to the different recognition standards for death, some family members will worry that their loved ones will lose the chance to be rescued." The second resistance comes from people's traditional concept of keeping the body of the deceased intact, which is often more difficult than The former is more difficult to break through.
There are a variety of situations that come with organ donation.
"As soon as you hear about organ donation, you will ask how much it will cost, and you will also ask for information on organ recipients, and to go to 'see' during the New Year and festivals. When encountering these situations, we must resolutely avoid them, and we must not exchange benefits. Gao Xiaogang said, "We must make it clear to the families of potential donors that the donor does not die because of donating organs, but only after he dies and agrees to donate. It is an act of great love."
Organ donation has always been free of charge.
This year's National People's Congress, Zhang Baoyan, a deputy to the National People's Congress and founder of Xunzi's "Baby Home", suggested the establishment of a "human organ donation pension system", such as returning the personal medical expenses borne by human organ donors during their lifetimes and exempting funeral expenses for funerals. , as well as appropriate increases in reimbursement benefits or full reimbursement for immediate family members in the process of treating various diseases in the future.
Zhang Baoyan pointed out that many donors were the backbone of the family during their lifetimes, and when they died, the family was in trouble.
In this case, they are also willing to make donations, which is the embodiment of noble values, and the society should give them some compensation.
This is a consolation for the deceased and their families, and it can also encourage more people to donate their organs.
"Last year, Shanghai completed a total of 104 organ donation operations, accounting for 4.18 millionths of Shanghai's 24.87 million permanent residents." The annual donation rate of one million people is an important indicator to measure the popularity of donation.
"At present, although the annual donation rate of one million people in my country has reached 4.1, which is in the middle level in the world, the donation rate of many countries in the world has reached 20 to 30." Gao Xiaogang said.
The coordinator is not a solicitor.
"Our identity is a bit embarrassing. Unpopularity and rejection are common. If a case is not successful, it means that there may be several patients with organ failure who will die while waiting for organ transplantation." Facing death, facing death Newborn; while absorbing a lot of negativity, it provides sunshine guidance and hope to the grieving families of potential donors.
"Some people say that we are always 'staring' at the patient's organs, but this is because organ transplantation is currently a limited method for human beings to fight death and prolong life." And this is why Gao Xiaogang has been able to persevere.
say goodbye
Xiao Xia is a little thin boy. His father died at an early age. He was raised by his mother and lived in his grandparents' house.
One day, Xiaoxia's mother suffered a brain hemorrhage, and the doctor declared her brain dead.
When the human organ donation coordinator first talked to Xiao Xia about whether to donate her mother's organs to save others' lives, he couldn't accept it for a while, "Absolutely not!" The coordinator enlightened him: "Your mother doesn't want to leave you, you Do you want her life to continue?" The boy burst into tears.
After a long time, Gao Xiaogang patted him and said, "The process of growing up is very painful, but you need to walk on your own." He promised Xiaoxia that if his grandparents were sick in the future, they could come to the OPO office of Changhai Hospital, no matter which colleague was there. , will help coordinate the second elder to see a doctor.
"In this way, you can also do something for the family and prove in front of your uncle and aunt that you have grown up and can be on your own..."
After 2 days, Xiaoxia's mother's vital signs were difficult to maintain.
At the last moment, the boy signed the consent form for the donation operation.
The hospital made a special case for Xiao Xia to help him change into the sterile isolation gown and enter the operating room to say goodbye to his mother.
In the operating room, the anesthesiologist, the human organ harvesting team, nurses and family members stood in front of the donor's bed. Witnessed by the coordinator of the Shanghai Red Cross Society, they held a brief farewell ceremony.
The doctor made a death judgment in accordance with the procedures stipulated by the state, the witnesses reviewed the life of the donor, and everyone bowed three times to the donor and observed a moment of silence.
newborn
Organ transplant patients have two birthdays.
In addition to his original birthday, another "birthday" is the day of the transplant.
In the corridor outside Changhai Hospital's organ harvesting office, there's a letter wall with letters from many transplant patients to donors—though they never reach their recipients.
Recently, the mother of a young boy donor frequently came to the hospital to hear about the recipient.
The medical staff were a little worried at first, but the mother repeatedly said that she just wanted to see the child.
The coordinator helped arrange a video meeting.
When the staff arrived at the recipient boy's house, accompanied by the other's mother, they dialed the WeChat video.
At the other end, a little boy shouted to the camera: "How are you, Mommy." The mother at the other end burst into tears...
When the video is closed, the connection between the two parties will remain in the "cloud".
Gao Xiaogang said that many parents will be relieved when they see that their child's organs are alive and healthy in another child.
"The waiting time for children's organ donation is longer, and the transplant operation is more complicated." Gao Xiaogang said of a father who traveled all over the country to seek medical treatment with a 3-year-old child with a congenital ureteral deformity.
During the half year of dialysis at Changhai Hospital, he would come to the OPO office almost every day to see if there were any suitable kidneys for the child.
Not long ago, the father finally got good news.
When it really came to this moment, his heart was very complicated: "If there is hope for his child, it means that another child has unfortunately passed away."
"Now every time I do a transplant, what I think about is that I must do everything possible to save the patient, otherwise I will feel sorry for the deceased and the family who donated this organ." Gao Xiaogang said.
"When people lose their loved ones, they are the most isolated and helpless. I am very fortunate that I can accompany them through this most difficult journey." After the donation, sometimes Gao Xiaogang will keep in touch with some of the family members. time to provide some help.
But some people don't bother anymore.
For example, the boy Xiao Xia, Gao Xiaogang has never contacted him again, but occasionally sees him growing taller, having a girlfriend, and graduating college from his circle of friends...