Week 7 GOL (July 17-July 21)

 Hi Friends! I am back this week with some more incredible updates! I was able to go to the Eurofins serology testing lab, volunteer at Howie's House, become a Donation Chamption, and round some more at Temple University Hospital! See below for outlined details! 

Monday (July 17): Today we spent time at the Eurofins serology testing lab where they test blood and tissue for infectious diseases prior to transplantation. Because tissue is regulated by the FDA, it is important to ensure that these donors are "clean". Meaning they are free from the general infectious diseases that would prevent you from giving blood (hep a-c, HIV, syphillis, zika, west nile, etc). For organ donation, you do not need to be "clean" given that these are life saving gifts, however, it is just as important for transplant surgeons to know what diseases the organs could be carrying so they might treat their recipient properly. We were able to see their most recent machine run. This machine can test for most of the infectious diseases within 30 minutes, whereas before these test would've had to be done painstakingly by hand. We also saw the Panther machines which conduct the Nucleic Acid Testing (NAT) which tests specifically for HIV. After seeing the machines loaded, we were able to see the computer run blood-typing and also the tube method.

This required loading a sample of plasma and blood into wells that either agglutination or did not. If the blood aglutinated in response to the antibodies, that signified that was not that specific blood type. For more detailed/understanding, I have a link for you to watch which explains/shows you a bit better than I can explain. 

https://www.youtube.com/watch?v=gXIBAWiUBV0

Tuesday (July 18): Today was really cool! We worked our way over to Howies House today. Howies House is a model built off the Ronald McDonald house where transplant recipients, families, and people awaiting transplant can stay for a reduced cost ($40/night and even then can be adjusted based off of peoples abilities). There is food in the pantry for guests to make at any time of the day and dinner is cooked each night, either by volunteer groups or the House itself. They have a small fitness center, library, family room, patio, and lounges for families to recover during their stay. We met with the son of a recent heart recipient and was able to hear his story and the support his family receives from Gift of Life and Howie's house in his fathers time of recovery. We also rode the shuttle which provides a no-cost ride to and from hospitals so that families can be taken to their doctors appointments without worrying about city driving, parking, and navigating the many roads surrounding the large hospitals. On the shuttle we spoke at length with the wife of a recent lung recipient and the wife of a recent liver recipient. Both were traveling to the hospital to visit their husbands and had been staying in the house for a little over a week. We talked to them about their experiences as caretakers, mothers, and wives and received a different perspective to the transplant process given that we've mostly been focusing on the donation/deceased side of the process. On the way back from the hospital we picked up a couple who had been staying on and off at the house for over a year. They came from Iowa, fought insurance companies and moved to Philadelphia so that he could receive a heart transplant. We then joined a Case Review meeting where Howie's House, some nurses, doctors, and Transplant coordinators spoke about what went right/wrong for a number of specific cases. I then finished the day off by meeting with GOL data department and reviewing the graphs I've created for the allocation portion of my project. Overall today was really amazing, educational, and touching. 

Wednesday (July 19): Today I volunteered at Howie's House again. Today we started by having Tom and Alice, the couple who had been staying at the house for over a year ring the Chimes of Hope. Finally, after a year of being away from home, this week they are able to return home. After the incredible ringing of the chims ceremony, we talked to a fourteen year old double lung recipient. He had been struggling with Cystic Fibrosis for the majority of his life until he recieved his transplant this past April. He has been recovering at the house with his mom, attending doctors appointments, and overall just making everyone laugh. I was impressed by his character and how uplifting, funny, and positive he was. After our meeting with him, he even asked me to help him make his mac n cheese which was really touching to me (As silly as that may sound). We then spoke to Tom and Alice in more detail about their life leading up to illness, receiving the L-VAD, and then finally their process of moving to Philadelphia. One quote that really stood out to me was when Tom said, "I didn't see the L-VAD as a destination. I saw it as a bridge". They are truly an incredible couple and I am excited that they have the opportunity to now live and enjoy life for longer then they would have had. Overall today was an amazing experience. 

Thursday (July 20): Today was super interesting. I attended an all day Donation Champion training. We heard from transplant recipients, a donor family, people waiting for transplant, nurses, doctors, and Transplant Coordinators about donation and the impact/importance of donation. The Donation Champion training is a course held multiple times a year that educate nurses and physicians on their roles and how important their role is in helping donation and transplantation happen. The course also serves to destigmatize donation within the Health Care community so that they can better understand what Gift of Life does and why Gift of Life does the things that they do. The Donation Champion training really is a way to bridge the gap between Gift of Life and the Heathcare professionals within GOL's service area. Another part of the training focuses on explaining Brain Death and provided advice on how we can work better to explain brain death to families. We also focused on DCD (Donation after Cardiac Death) information and how careful GOL has to be with planning these cases and having Health Care teams assist in creating a successful donation process. Donation after Cardiac death occurs when a patient is not brain dead, however they do suffer from a non-recoverable injury or illness in which they cannot live without being on a ventillator or on the ECHMO machine described in my last post. A part of the course went through the history of organ donation and transplantation. In 2019 the very first DCD heart transplant case occurred at Duke University. This was lifechanging in the organ donation and transplantation community as it is very difficult to allocate a heart and lungs to recipients given how quick blood stops flowing to organs after the heart stops. There have also been developments with technology where they have designed an Organ Care System (Shown Below). This Organ Care System is a portable machine that mimics the human body by warming and pumping the organ with recirculating blood through the organ. These machines have been developed for heart, lung, and liver allocation, which allow organs to travel further then they ever could before which increase overall utilization of these life saving organs. I also learned that in certain DCD cases, the family may choose to be present in the OR when the machines are turned off. If this does happen to be the case, the patient is draped differently and has a blanket covering them so they do not look as if they're laying in an OR room. In addition, all surgical tools are covered, lights are lowered, and the transplant teams are in the other room out of sight. The family can say their final goodbyes and are informed prior that they must leave within five minutes of their loved ones heart stopping or the opportunity for donation may not be possible. This training was really important and overall I can see how this can be beneficial to bringing healthcare teams, families, and gift of life closer.

After the training, I also attended a zoom meeting with Public Affairs about getting involved in the community and volunteering. Francesca and I are planning on running a huge Donate Life Event this Fall at Juniata College so meeting with Public Affairs was really important.

Friday (July 21): Today I did rounds at Temple University Hospital with Joe Paparo, the Hospital Services Coordinator at Temple. We were following-up with the two DCD cases done at Temple earlier this week and just thanking the nurses, physicians, and attendings involved in the patient's care and thanking them for allowing donation to happen. With those two cases, the donor, their family, the Health care team, and gift of life successfully transplanted four kidneys and saved four lives by doing so. We created a recognition letter that those healthcare teams can hang up in their breakrooms or wherever else they may want to keep those letters stating what their patient had donated and who they had helped. We then ate lunch and joined a zoom with the Donation council made up of doctors, nurses, community leaders, and social services who spoke about the upcoming National Minority Donor Awareness Month starting on August 1st and how we can educate and make connections with those communities. 

Overall this week was kind of all over the place and all in the same place at the same time. I learned so much this week and I am excited for this upcoming week with the Transplant Coordinators. I will be on-call again and observing cases as they come through the referral door. Thank you for reading this segment and I hope you all have a wonderful week! 

Thanks! 

-Rachael Triglia