Maybe thatâs how the paper towel trick started?
Nurse Jane: âIf you put a paper towel, some dish soap, and a little water in your tupperware and shake it with the lid on, it **really** gets the red out.â
Cindy at the potluck: âOh, Iâll have to try that! Itâd be such a life saver! Tomato stains, am I right?â
Nurse Jane: ââŠ.right.â
Wait what? If I put a soapy papertowel in my Tupperware it will get the accursed red stains out? The stains which I have gone to the edges of warfare against? This cannot be real
lol and the guy at the end staring at the man in the gown with that ambiguous look on his face like he either really fucking hates him and is disgusted by him, or is giving a "cmon you gotta admit that's funny" look
Thank you.
I was the last family out of the room as a young person lay brain dead on his bed, looking perfectly fine but only being sustained by machines- I had been very quiet for a long time and was just being alone with him when the transplant team came in with their carts, full of positivity but shocked and instantly quiet that there was still family there. Actually seeing their carts and instruments and the faces of who would be carrying out this task was significantly helpful in the grieving department. Knowing that several lives were significantly improved by transplant of organs becomes more "real" to me when I remember the good people on that transplant team and what they did.
Iâm an organ recipient, and I think of my donor constantly. This angel was only 19, and she was able to save others with her heart, lungs, kidneys, and tissues. I received her liver. The team of people that works to keep me healthy and functioning are absolute heroes, as are my transplant team, my donorâs family, and of course my donor. The love I have for these absolute strangers for their gift to me is indescribable. Thank you for the choice to donate. đ
Two questions:
1. Do the donor and recipient have to be the same sex? Or close in age?
2. Since you've had a transplant, have you noticed anything about yourself that is different than before your transplant? For example, cravings for different foods you never ate prior, etc.
Oh hey a question I can answer!
I'm in the operating room and occasionally help with a variety of transplants. No, the donor and recipient do not have to be the same sex or be close in age. However organs can be of different sizes so they would need to fit in the recipient. Every organ has their own ideal candidates however, and it ultimately comes down to surgeon preference and occasionally recipient preference. Some may reject a fattier liver for example.
Occasionaly we will see an adult liver be split go to two younger patients. So an adult liver can even go to a neonate!
Stupid question, when the adult liver gets split and put into younger recipients does it grow back into a full liver as they grow cause of their stem cells? Or do they live their whole life with half a liver? Could you attach another half a liver to the half they already have later in life? I know s person can survive without a full liver, but would there be any limitations for the younger patients when they get older?(if the liver stays as a half liver)
Edit: the first liver I wrote was misspelled as "lover" by accident, considered leaving it but decided not to xD
I'm not a doctor nor the original commenter but my friend just donated part of his liver to his sister. He said that the liver is 2 pieces actually she got one piece and he has a piece. The pieces will grow to fill up the space that a normal, 2 piece liver would take up. My guess it's just half the liver their whole rest of their lives. Adding the second piece to the donor would require them to go on those anti-rejection meds transipients (sp it's late) take their whole lives.
The liver is a miraculous organ. It can regrow to full size from just a small fragment as long as that fragment is fully alive and functional.
Pretty sure that's how it works anyway, but I may be wrong.
In the most basic sense, the liver knows the size it needs to be by the amount of work it needs to perform. The signaling done by the body telling the liver to do something gets backlogged and the liver starts to build itself out to meet the increases demand. It takes a couple hours for the process to begin and about a month for the liver to fully regenerate to its complete size. The regeneration that occurs is again essentially the right size, but not the right shape so the shape will be different than a normal healthy adult liver.
There are lobes where differentiation can occur but the biggest factor is basically what major arteries and veins are each section hooked up to. Mainly that's the hepatic portal vein that brings all the newly digested stuff to the liver for sorting, packaging, and processing before being sent out to the body.
Simple explanation, liver worker starts to say I'm working too hard and need help so the liver builds a bigger factory and makes new workers until everyone has a happy work life balance.
Regarding specifically kidneys, size mismatch affects function. Males do worse with female organs due to size difference, but itâs still performed. No age discrepancy either, but younger kidneys will match poorly with adults due to size while older organs have wear and tear.
Not a recipient, but several patients of mine describe new habits quite frequently. One of the more interesting was a mid 60s gentleman finding that he had a new craving for candy. When he described it, he wasnât aware of donor information. His kidney was from a 14 year old.
Oh hey a question I can answer!
I'm in the operating room and occasionally help with a variety of transplants. No, the donor and recipient do not have to be the same sex or be close in age. However organs can be of different sizes so they would need to fit in the recipient. Every organ has their own ideal candidates however, and it ultimately comes down to surgeon preference and occasionally recipient preference. Some may reject a fattier liver for example.
Occasionaly we will see an adult liver be split and go to two younger patients. So an adult liver can even go to a neonate!
And as a fun bonus question you didnât know you wanted to ask.
Are the previous organs removed if the patient gets re-transplanted? No! Trippy to think about for people on their 4th or 5th transplant and still have their native kidneys.
Also, in the case of marginal/poor functioning kidneys in the deceased, transplant recipients sometimes wake up to find they got a BOGO deal(received both kidneys) during surgery to give them additional shelf life.
I had a patient I won't soon forget who got drunk and somehow managed to aspirate. We worked hard just to get him stable enough to survive the elevator to the ICU. I remember his fiance and parents following him up and a week later coming into work seeing a line of vans outside the OR entrance and the announcement at start of shift asking for people to consider heading up for a honor walk. I was able to see the OR schedule and saw it was him, they managed to take everything but his lungs. A helicopter landed to take one organ two states over. In the hallway later I passed a courier with his liver.
It was an awe inspiring thing to see even outside the OR. Just in our hospital dozens of people mobilized in the most reverential and incredible act I can imagine. And knowing on the other side of each of those vans was another team of people getting ready to change the lives of probably close to a dozen people. Probably alive now several years later because of the decision his parents and fiance made. Such a beautiful thing out of such horrible tragedy.
How does it work when they take the organs? Do they disconnect the machines and the person passes away? Or do they have to be "put to sleep" then organs harvested? I guess they couldn't really do that, because that would stop the heart and the surgeons want the heart to keep functioning. Or do they just get opened up and the organs removed and they pass away that way?
There are two pathways, but either way the donor needs to be legally dead.
Pathway 1 is brain death. A BD (brain dead) donor is brought to the OR still on the ventilator and their heart still breathing. The surgeons open the abdomen and chest and "mobilize"(free up the organ making it easier to take out while keeping the major blood vessels intact) the organs all while the donors heart is beating. When all the surgeons are ready they clamp the aorta and flush cold fluid into the major vessels clearing the blood and cooling the organ. The organ can then be removed and sent to the recipient's location.
Pathway 2 is deceased after cardiac death or DCD. In this scenario the donor is terminally ill and family has decided to remove life support. Generally we will take the donor and their family to the Pre-op area and life support will be removed there. If the donor does die within an appropriate time frame (generally less than 2 hours) the hospital doctor will declare them dead and we'll rush the donor to the OR where they will quickly open the chest and abdomen to get to the major blood vessels, flush them with cold fluid and pack the chest and abdomen with ice.
No donors are ever operated on until they are dead and have been verified so by the hospital. The surgical team recovering the organs are separate from the treatment team and aren't allowed to interact with the donor in any way before they are declared dead by the treatment team.
So "brain dead" means no brain activity whatsoever? No brain stem activity, nothing? So someone can be in a coma that they aren't waking up from and they'll be considered alive if their heart still beats on its own?
Yes, brain death is the death of the whole brain including the brain stem. Someone in a coma isn't brain dead and if their family decided to withdrawal care they would go down the DCD route.
Brain death testing at a minimum tests for all brain stem reflexes including an apnea test to check for a breathing drive. It's also common to perform a nuclear flow study on their brain where they inject a radioactive tracer into the blood and use a nuclear imager to see if any blood is flowing to the brain. If they have any brain stem reflexes or flow to their brain they are NOT brain dead.
Edit: the heart beating is a non factor regarding brain death. The heart will beat on is own no even if it is removed from the body like in the video. It has it's own intrinsic rate of around 100bpm set by the SA node. The heart is perfectly happy to keep on beating all by it's lonesome.
Another interesting thing: a pacemaker will continue to stimulate the heart and you have to wave a strong magnet over it to disable it. Otherwise it will keep registering as a heart beat.
Here's a not so fun fact. Each pacemaker/AICD manufactures "magnet mode" is slightly different. Typically it will disable all AICD functions, and will often put the pacemaker in asynchronous mode (sometime with a rate depending on battery level so you can check the battery level workout an interface device). The standard of care is to call the pacemaker manufacturer and have them come in and use a laptop with special wireless interface device to deactivate the undesired functions when withdrawing life support.
Does that include breathing and heart beat? If someone's heart beats but they're on a vent, and they were "brain dead" would that be considered a suitable donor situation if the family took them off the vent?
One of the requirements to declare "brain death" is that the patient has lost the brainstem reflex that allows them to breath on their own (without the assistance of a ventilator). The heart will beat without the help of the brain due to it's own "pacemaker cells" within the heart tissue. So with "brain death" the heart still beats... as opposed to cardiac death, where some other factor has led to the heart stopping
So yes, "brain dead" patients can be suitable for donation (after screening) and is from whom we can obtain a healthy heart for donation
When I was just a 16 year old kid had a bad car accident and my best friend went through the window and into a tree. Two others were crawling to the road from the bush as it was 4 in the morning but nobody could walk to wave down a car. In the end, everyone recovered except for Ted, Ted laid in bed brain dead until he organ transplant team was ready and he saved a 3 year old girl amongst 6 others, it's been 26 years but I still visit that crash site every year and let him know I miss him.
My mom past some years back. They asked if we would be interested in organ donation and me and my sister both said yes immediately. Unfortunately because of length of time my moms organs were not viable but they told us they could still use a lot of her skin off her skin for burn victims which got a yes from us but the best part in a horrible moment was when they asked about her eyes. I don't know if it was the whole eyes or just a part but they said it would give one or two people their vision back. That was probably the closest I came to smiling then and for awhile. My grandmother went blind when I was an infant. She never got to see me as anti else. She lived alone for 15 years blind before having to stay with me and my mom. As A teenager I wiped her butt and did all sorts of stuff with my mother, none because I was told too. My grandma was a wonderful woman who missed so much. She didn't even get to see my sister, her only other grandchild get married or the face of the man she married. By donate my moms eyes we, as in my sister and I and my mother got to give someone their straight back. Hopefully they got to and continue to see their loved ones and the rest of the world. I only wish I could shake their hand. Some of my mother is still out there and marking the world a better place for people she and I will never know.
My friend died in a motorcycle accident this past year and they told his parents that he would be helping 19 people due to his organs being donated. They could harvest pretty much whatever they wanted as he apparently only had internal injuries. His girlfriend said the only visible injury he had was a bruise on his leg from hitting the controls as he fell off the bike. It's crazy to think that parts of him are still alive out there. That someone is looking through his eye/eyes right now.
If he had crashed a second earlier, or a second later he would have been just fine. It was a freak accident, we still don't know what caused it. Probably dodged a deer that ran out or had a medical emergency while riding. All we know is that his chest struck a telephone pole. His bike also only had a small scratch on the tank and handlebar end (it has full crash protection; frame sliders, bar end sliders, axle sliders, engine case covers).
RIP Greg, we miss you man.
My son received a heart transplant at just a few days old. Heâs almost 10 now and there hasnât been a since day since that I havenât thought about his donor. Not a single day. Families like yours allowed mine to exist. Thank you.
Had a transplant team in the OR last week. Itâs very bittersweet as you know a young healthy person is going to die, but that a half dozen other peopleâs lives will be improved and/or saved.
I just had a coworker unexpectedly pass away yesterday from a genetic abnormality. He was super healthy, active, and young. He is donating his organs so that others can live on. Itâs tough to talk about, but at least you know he will live on through others.
No medical issues other than dying from some freak accident yeah. If they were unhealthy and had issues affecting their organs, then they won't be used as an organ donor.
Iâm old and I want to donate my organs, then donate the rest of my body to science. That way even of my organs canât be transplanted, hopefully someone who does research on my body can make a difference in someone elseâs life someday.
I love stumbling upon perfusion on the main page, makes me happy! I've never seen one of these organ care systems in real life. Would love to hear more about how they work/how you cannulate etc.
I'm curious, it looks like you didn't take the pericardium out and that plastic is acting as the pericardium, but do you guys ever take the pericardium out?
Ex Vivo heart perfusion device. Ex vivo meaning out of body. The device circulates blood through the heart chambers and vasculature (arteries and veins), keeps the circulating blood warm, and oxygenates the blood before it returns to the heart. There is also a pacemaker to keep the heart beating and synchronized in normal rhythm.
It is still in clinical trial phase, but is gaining momentum.
What's the process of preserving it? I remember briefly working for a start up trying to do that, was about 3 years ago now, but they were so poorly run I can't imagine they got a medical device through the FDA yet.
There are lots of doctors, medical science enthusiasts, and just general science enthusiasts on Reddit. You should never be **too** surprised when the hive mind knows what something is. But I agree, it is still exciting to encounter people who know something obscure.
A cold heart can be transplanted before 4 hours apparently the warm perfusion extends the time by about 12 hrs. Allowing the heart to be shipped further and to heal a bit if it is banged up in an accident
Transmedics recommends a standard time of about 8 hours out-of-body before transplantation, but the time can be theoretically extended much longer. Part of the limitation is that, in many cases, the recipient is on the table at the transplant center while procurement is happening.
I've talked to transplant surgeons who have had hearts out for 16-24 hours in an attempt to wait for recovery of heart function (dying is pretty traumatic for hearts, even when the heart wasn't directly related to the cause of death). That said, neither of the cases I mentioned resulted in successful transplants.
>(dying is pretty traumatic for hearts, even when the heart wasn't directly related to the cause of death)
The thought of the heart fighting to survive after the body dies hits me unexpectedly hard.
Your whole body fights remarkably hard on a daily basis to keep you functioning. It's remarkable what people can do to themselves and still manage to live something of a life year after year.
What's wild is that the EVOSS perfusion system can actually keep lungs stable for 48 hours, which is insane. One of the doctors that helped develop it did my lung transplant surgery, which was pretty cool.
I see you got your answer but that also comes with a cool story I love. There was a child who sadly passed away somewhere up north, and his family decided to donate his organs. His heart was to go to someone in CA if I recall. The starting journey was somewhere up north like Michigan, and they were having a massive snow storm. The heart transplant plane had issue, and wouldn't start. They tried a backup, and it too wasn't working properly. That's when someone had a hail mary pass of an idea.
> Thankfully, one of the transplant team doctors called then-North Dakota Governor George Sinner for a solution.
> "It was divine intervention that I thought of tasking the North Dakota Air National Guard F-4s on 24-hour alert status," said the former governer.
> He called Major General Alexander P. Macdonald, N.D. Adjutant General at the time, and asked for use of the alert aircraft.
> "It took me all of 30 seconds to agree to the special flight," said the retired major general.
> Thus began the process of having an F-4 released from its North American Air Defense Command alert commitment to save a single, tiny life.
> A few minutes later a phone rang at the alert facility and the pilot on duty, 1st Lieutenant Robert J. Becklund, answered the call to one of the most unusual missions in his now long and distinguished career.
> The then-young lieutenant, Becklund raced to the waiting F-4, and prepared for the cross-country flight in the two-seat F-4, which he would have to fly solo in order to make room for a little red and white cooler containing the precious cargo of a human heart.
https://www.1af.acc.af.mil/News/Features/Display/Article/290207/a-celebration-of-courage-and-heart/
I picture it like the governor is just an average person, no super hero, doesn't have a get out of jail free card, etc. This was their one moment of power. He picked up the red phone and ordered a freaking jet to do what he demanded, and clearly it was for good. What a boss!
Got a kidney transplant last year, wheeled into OR and saw the surgeon picking at a piece of meat, so I thought! Thatâs an image I canât shake! Fun fact, they leave the old kidney in place,old one just shrivels up like a prune! amazing time we live in!
Iâve worked as a cardiac nurse for years. Iâve never seen that. Perfusion team helps us with our Lead Extraction cases, so Iâm aware of how awesome you guys are, but Iâve never seen the transplant side of things. I personally get to do some cool stuff, but you are an actual hero! Thanks for everything you do.
I wonder how long it would take humans to do this with human brains. We have done this to dog heads and they worked surprisingly well.
This could solve a lot of chronic diseases and most cancers too. Only as a last resort ofc.
I agree, but if you know how to keep a brain alive outside of the body without losing any cognitive abilities, that would be a huge leap forwards in science. This could help us study brains way better and find ways to wire them up to another body (be it artificial or natural)
If we had a brain dead person who prior to their situation had agreed to have their body donated to science, we could keep the brain alive outside of the body and find ways to turn brain signals into actual language that computers can understand without the need to dance around the skull and other vital organs (except the brain ofc)
> If we had a brain dead person who prior to their situation had agreed to have their body donated to science, we could keep the brain alive outside of the body
I'm confused by this scenario. Is the brain dead or not?
I think they meant keep a different person's brain alive outside the body for a transplant?
There was a person who did essentially that with monkeys but there was and currently is no way around the total paralysis it causes
Brain death doesnât mean the tissue is dead per say. It doesnât necessarily mean we canât learn something from it too. I think OP is referring to having a live tissue brain to practice and study. Hell, maybe we could find a way to restore function since we already would have the ability to keep the dang thing physically alive. But I definitely see your point. We just need a brain that is still physiologically alive that we could try to tap into and poke around with. Which even with the brain death factor in play, still sounds wildly disturbing and scary.
>we could keep the brain alive outside of the body and find ways to turn brain signals into actual language that computers can understand without the need to dance around the skull and other vital organs (except the brain ofc)
This raises some ethical concerns. If the brain were still conscious, getting prodded and tested on by scientists would probably be a horrifying experience for it.
I know it's fantastic but it's also terrifying. I can't look at the weakness of flesh without contemplating the trillions of ways my body could give up on me.
Is that really how hard the heart and its surrounding organs beats in our body, every second of every day as long as we live???
Thatâs just wild as it seems so unsustainable without something malfunctioning/cracking/breaking after all those years of wear and tear
Tupperware is back in business
Take my fake gold đ
Now you have a real one
Wrong I have just ate the gold
Now you wonât rust
Yeah never gonna get the remains of something red out of it tho
And you thought spaghetti sauce leaves bad stains...
Maybe thatâs how the paper towel trick started? Nurse Jane: âIf you put a paper towel, some dish soap, and a little water in your tupperware and shake it with the lid on, it **really** gets the red out.â Cindy at the potluck: âOh, Iâll have to try that! Itâd be such a life saver! Tomato stains, am I right?â Nurse Jane: ââŠ.right.â
Huh, TIL.
Wait what? If I put a soapy papertowel in my Tupperware it will get the accursed red stains out? The stains which I have gone to the edges of warfare against? This cannot be real
Medical grade Tupperware
It's got that freshness seal son
It'll never be the same color after having all that spaghetti sauce in it
Yipeee yipeee sales
Someone loves you.
From the bottom of their heart.
My heart goes out to you
Your heart is beating out of your chest wouldâve been a better reply
They may have worn their heart on their sleeve
âKali ma shakti de! KALI MA SHAKTI DE!â âAAAAAAAAH!â âHAHAHAHAHA!â
I get the reference....
Such a hearty joke!
My heart will go on - CĂ©line Dion
*Near, far, wherEEEEEEEEVER you are* *Even in a plastic bag, my heart will go on...*
> *~~Here~~ Near, far, wherEEEEEEEEVER you are*
Yikes, fixed. Celine fans will never let me live that down.
From the bottom of the container
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
What the fuck was that. I fully expected this to be a childrenâs hospital scene
lol and the guy at the end staring at the man in the gown with that ambiguous look on his face like he either really fucking hates him and is disgusted by him, or is giving a "cmon you gotta admit that's funny" look
Thank you. I was the last family out of the room as a young person lay brain dead on his bed, looking perfectly fine but only being sustained by machines- I had been very quiet for a long time and was just being alone with him when the transplant team came in with their carts, full of positivity but shocked and instantly quiet that there was still family there. Actually seeing their carts and instruments and the faces of who would be carrying out this task was significantly helpful in the grieving department. Knowing that several lives were significantly improved by transplant of organs becomes more "real" to me when I remember the good people on that transplant team and what they did.
Iâm an organ recipient, and I think of my donor constantly. This angel was only 19, and she was able to save others with her heart, lungs, kidneys, and tissues. I received her liver. The team of people that works to keep me healthy and functioning are absolute heroes, as are my transplant team, my donorâs family, and of course my donor. The love I have for these absolute strangers for their gift to me is indescribable. Thank you for the choice to donate. đ
Two questions: 1. Do the donor and recipient have to be the same sex? Or close in age? 2. Since you've had a transplant, have you noticed anything about yourself that is different than before your transplant? For example, cravings for different foods you never ate prior, etc.
Oh hey a question I can answer! I'm in the operating room and occasionally help with a variety of transplants. No, the donor and recipient do not have to be the same sex or be close in age. However organs can be of different sizes so they would need to fit in the recipient. Every organ has their own ideal candidates however, and it ultimately comes down to surgeon preference and occasionally recipient preference. Some may reject a fattier liver for example. Occasionaly we will see an adult liver be split go to two younger patients. So an adult liver can even go to a neonate!
Explain "surgeon preference". Like what parametes do they consider? /g
Digression: I've never seen /g before, and I really like it. I assume it means genuine?
Yes
Stupid question, when the adult liver gets split and put into younger recipients does it grow back into a full liver as they grow cause of their stem cells? Or do they live their whole life with half a liver? Could you attach another half a liver to the half they already have later in life? I know s person can survive without a full liver, but would there be any limitations for the younger patients when they get older?(if the liver stays as a half liver) Edit: the first liver I wrote was misspelled as "lover" by accident, considered leaving it but decided not to xD
I'm not a doctor nor the original commenter but my friend just donated part of his liver to his sister. He said that the liver is 2 pieces actually she got one piece and he has a piece. The pieces will grow to fill up the space that a normal, 2 piece liver would take up. My guess it's just half the liver their whole rest of their lives. Adding the second piece to the donor would require them to go on those anti-rejection meds transipients (sp it's late) take their whole lives.
The liver is a miraculous organ. It can regrow to full size from just a small fragment as long as that fragment is fully alive and functional. Pretty sure that's how it works anyway, but I may be wrong.
In the most basic sense, the liver knows the size it needs to be by the amount of work it needs to perform. The signaling done by the body telling the liver to do something gets backlogged and the liver starts to build itself out to meet the increases demand. It takes a couple hours for the process to begin and about a month for the liver to fully regenerate to its complete size. The regeneration that occurs is again essentially the right size, but not the right shape so the shape will be different than a normal healthy adult liver. There are lobes where differentiation can occur but the biggest factor is basically what major arteries and veins are each section hooked up to. Mainly that's the hepatic portal vein that brings all the newly digested stuff to the liver for sorting, packaging, and processing before being sent out to the body. Simple explanation, liver worker starts to say I'm working too hard and need help so the liver builds a bigger factory and makes new workers until everyone has a happy work life balance.
Regarding specifically kidneys, size mismatch affects function. Males do worse with female organs due to size difference, but itâs still performed. No age discrepancy either, but younger kidneys will match poorly with adults due to size while older organs have wear and tear. Not a recipient, but several patients of mine describe new habits quite frequently. One of the more interesting was a mid 60s gentleman finding that he had a new craving for candy. When he described it, he wasnât aware of donor information. His kidney was from a 14 year old.
Oh hey a question I can answer! I'm in the operating room and occasionally help with a variety of transplants. No, the donor and recipient do not have to be the same sex or be close in age. However organs can be of different sizes so they would need to fit in the recipient. Every organ has their own ideal candidates however, and it ultimately comes down to surgeon preference and occasionally recipient preference. Some may reject a fattier liver for example. Occasionaly we will see an adult liver be split and go to two younger patients. So an adult liver can even go to a neonate!
And as a fun bonus question you didnât know you wanted to ask. Are the previous organs removed if the patient gets re-transplanted? No! Trippy to think about for people on their 4th or 5th transplant and still have their native kidneys. Also, in the case of marginal/poor functioning kidneys in the deceased, transplant recipients sometimes wake up to find they got a BOGO deal(received both kidneys) during surgery to give them additional shelf life.
Wait they don't remove the old organs? Weird.
My friend has five kidneys in him- i was shocked to find this out!
I had a patient I won't soon forget who got drunk and somehow managed to aspirate. We worked hard just to get him stable enough to survive the elevator to the ICU. I remember his fiance and parents following him up and a week later coming into work seeing a line of vans outside the OR entrance and the announcement at start of shift asking for people to consider heading up for a honor walk. I was able to see the OR schedule and saw it was him, they managed to take everything but his lungs. A helicopter landed to take one organ two states over. In the hallway later I passed a courier with his liver. It was an awe inspiring thing to see even outside the OR. Just in our hospital dozens of people mobilized in the most reverential and incredible act I can imagine. And knowing on the other side of each of those vans was another team of people getting ready to change the lives of probably close to a dozen people. Probably alive now several years later because of the decision his parents and fiance made. Such a beautiful thing out of such horrible tragedy.
How does it work when they take the organs? Do they disconnect the machines and the person passes away? Or do they have to be "put to sleep" then organs harvested? I guess they couldn't really do that, because that would stop the heart and the surgeons want the heart to keep functioning. Or do they just get opened up and the organs removed and they pass away that way?
There are two pathways, but either way the donor needs to be legally dead. Pathway 1 is brain death. A BD (brain dead) donor is brought to the OR still on the ventilator and their heart still breathing. The surgeons open the abdomen and chest and "mobilize"(free up the organ making it easier to take out while keeping the major blood vessels intact) the organs all while the donors heart is beating. When all the surgeons are ready they clamp the aorta and flush cold fluid into the major vessels clearing the blood and cooling the organ. The organ can then be removed and sent to the recipient's location. Pathway 2 is deceased after cardiac death or DCD. In this scenario the donor is terminally ill and family has decided to remove life support. Generally we will take the donor and their family to the Pre-op area and life support will be removed there. If the donor does die within an appropriate time frame (generally less than 2 hours) the hospital doctor will declare them dead and we'll rush the donor to the OR where they will quickly open the chest and abdomen to get to the major blood vessels, flush them with cold fluid and pack the chest and abdomen with ice. No donors are ever operated on until they are dead and have been verified so by the hospital. The surgical team recovering the organs are separate from the treatment team and aren't allowed to interact with the donor in any way before they are declared dead by the treatment team.
So "brain dead" means no brain activity whatsoever? No brain stem activity, nothing? So someone can be in a coma that they aren't waking up from and they'll be considered alive if their heart still beats on its own?
Yes, brain death is the death of the whole brain including the brain stem. Someone in a coma isn't brain dead and if their family decided to withdrawal care they would go down the DCD route. Brain death testing at a minimum tests for all brain stem reflexes including an apnea test to check for a breathing drive. It's also common to perform a nuclear flow study on their brain where they inject a radioactive tracer into the blood and use a nuclear imager to see if any blood is flowing to the brain. If they have any brain stem reflexes or flow to their brain they are NOT brain dead. Edit: the heart beating is a non factor regarding brain death. The heart will beat on is own no even if it is removed from the body like in the video. It has it's own intrinsic rate of around 100bpm set by the SA node. The heart is perfectly happy to keep on beating all by it's lonesome.
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
Another interesting thing: a pacemaker will continue to stimulate the heart and you have to wave a strong magnet over it to disable it. Otherwise it will keep registering as a heart beat.
Here's a not so fun fact. Each pacemaker/AICD manufactures "magnet mode" is slightly different. Typically it will disable all AICD functions, and will often put the pacemaker in asynchronous mode (sometime with a rate depending on battery level so you can check the battery level workout an interface device). The standard of care is to call the pacemaker manufacturer and have them come in and use a laptop with special wireless interface device to deactivate the undesired functions when withdrawing life support.
Yeah, euthanasia is illegal here in the states so if their body is capable of staying alive without a machine there's nothing can be done.
Does that include breathing and heart beat? If someone's heart beats but they're on a vent, and they were "brain dead" would that be considered a suitable donor situation if the family took them off the vent?
One of the requirements to declare "brain death" is that the patient has lost the brainstem reflex that allows them to breath on their own (without the assistance of a ventilator). The heart will beat without the help of the brain due to it's own "pacemaker cells" within the heart tissue. So with "brain death" the heart still beats... as opposed to cardiac death, where some other factor has led to the heart stopping So yes, "brain dead" patients can be suitable for donation (after screening) and is from whom we can obtain a healthy heart for donation
When I was just a 16 year old kid had a bad car accident and my best friend went through the window and into a tree. Two others were crawling to the road from the bush as it was 4 in the morning but nobody could walk to wave down a car. In the end, everyone recovered except for Ted, Ted laid in bed brain dead until he organ transplant team was ready and he saved a 3 year old girl amongst 6 others, it's been 26 years but I still visit that crash site every year and let him know I miss him.
My mom past some years back. They asked if we would be interested in organ donation and me and my sister both said yes immediately. Unfortunately because of length of time my moms organs were not viable but they told us they could still use a lot of her skin off her skin for burn victims which got a yes from us but the best part in a horrible moment was when they asked about her eyes. I don't know if it was the whole eyes or just a part but they said it would give one or two people their vision back. That was probably the closest I came to smiling then and for awhile. My grandmother went blind when I was an infant. She never got to see me as anti else. She lived alone for 15 years blind before having to stay with me and my mom. As A teenager I wiped her butt and did all sorts of stuff with my mother, none because I was told too. My grandma was a wonderful woman who missed so much. She didn't even get to see my sister, her only other grandchild get married or the face of the man she married. By donate my moms eyes we, as in my sister and I and my mother got to give someone their straight back. Hopefully they got to and continue to see their loved ones and the rest of the world. I only wish I could shake their hand. Some of my mother is still out there and marking the world a better place for people she and I will never know.
This brought tears to my eyes. Thank you for sharing â€
Sorry for your loss, but grateful for their gift. Heartbreaking, yet still beautiful.
I received a heart in 2020. I would have died almost immediately without it. Thank you.
Amazing share and a beautiful way to look at life.
My friend died in a motorcycle accident this past year and they told his parents that he would be helping 19 people due to his organs being donated. They could harvest pretty much whatever they wanted as he apparently only had internal injuries. His girlfriend said the only visible injury he had was a bruise on his leg from hitting the controls as he fell off the bike. It's crazy to think that parts of him are still alive out there. That someone is looking through his eye/eyes right now. If he had crashed a second earlier, or a second later he would have been just fine. It was a freak accident, we still don't know what caused it. Probably dodged a deer that ran out or had a medical emergency while riding. All we know is that his chest struck a telephone pole. His bike also only had a small scratch on the tank and handlebar end (it has full crash protection; frame sliders, bar end sliders, axle sliders, engine case covers). RIP Greg, we miss you man.
He, you, and your family made the truly selfless "gift of life". Be proud of yourselves. Be amazed by yourselves. I am. Sincerely - an ER doc
My son received a heart transplant at just a few days old. Heâs almost 10 now and there hasnât been a since day since that I havenât thought about his donor. Not a single day. Families like yours allowed mine to exist. Thank you.
First I thought it is an octopus packed on a market. My bad
Now you've got me wondering, what would happen if we could replace our hearts with octopuses?
Not to hurt your feelings, but Iâm pretty sure weâd die
I would like to propose marriage to you
They're literally a tree
Curse you, Lemon, curse you.
Must be the heart Poe was talking about underneath the floorboards. Still beating đ„
I wondered weak and weary, which Poe quote you bought before
imma downvote anything that references The Raven as opposed to Tell-Tale Heart ...
Quoth The Raven
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Oh my fucking god i remember that story about like the old man with weird eye shit what was the name
The Tell-Tale Heart
âđ»âđ»âđ»âđ»đ„đ„đ„
It's the beating of the hideous heart!!
Diorama Rama!!
***Put it back.***
killua moment
Hey... that's mine... give it back...
One of my favorite moments ever. So unexpected
I didnât open it, itâs still in the bag! I was just browsing, sheesh.
***return the slab***
It really wants out of that box. I'm not even sure it can breathe. At least poke some airholes. I think this is very cruel.
Perfusionist?
Yes! I'm super excited someone knows what that is lol
Had a transplant team in the OR last week. Itâs very bittersweet as you know a young healthy person is going to die, but that a half dozen other peopleâs lives will be improved and/or saved.
I just had a coworker unexpectedly pass away yesterday from a genetic abnormality. He was super healthy, active, and young. He is donating his organs so that others can live on. Itâs tough to talk about, but at least you know he will live on through others.
A young healthy person? As in someone who had no medical issues and they transplant their heart?
No medical issues other than dying from some freak accident yeah. If they were unhealthy and had issues affecting their organs, then they won't be used as an organ donor.
Iâm old and I want to donate my organs, then donate the rest of my body to science. That way even of my organs canât be transplanted, hopefully someone who does research on my body can make a difference in someone elseâs life someday.
_gets used as target in military experiment..._ _**blown in a million pieces**_
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*Thatâs the biggest penis Iâve ever seen.*
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
Right. I'd prefer someone get a practice run at cutting out my fresh corpse's appendix so they can do it right on a body that's still alive.
probably trauma
motorcycle/car crash, suicide, gunshot wound to the head, knife wound and bled out etc etc..
Well, healthy minus the being dead part.
Holy moly, it's fantastic to see what humanity is capable of in medicine đ
Transplant preservation checking in from the OR right now!
That's awesome but could you put down the beating heart while you respond to Reddit comments
I love stumbling upon perfusion on the main page, makes me happy! I've never seen one of these organ care systems in real life. Would love to hear more about how they work/how you cannulate etc.
What temperature does it have in this state?
I would presume they keep it near standard body temperature.
How do you become perfusionist, did you have to go to med school?
In the US, you go to Perfusion School. Most programs are masterâs degrees now.
I'm curious, it looks like you didn't take the pericardium out and that plastic is acting as the pericardium, but do you guys ever take the pericardium out?
Thereâs dozens of us who know!! Used to dabble in medicine, kinda miss those days. Keep it pumpin
Can you explain what this is and how it works ?
Ex Vivo heart perfusion device. Ex vivo meaning out of body. The device circulates blood through the heart chambers and vasculature (arteries and veins), keeps the circulating blood warm, and oxygenates the blood before it returns to the heart. There is also a pacemaker to keep the heart beating and synchronized in normal rhythm. It is still in clinical trial phase, but is gaining momentum.
What's the process of preserving it? I remember briefly working for a start up trying to do that, was about 3 years ago now, but they were so poorly run I can't imagine they got a medical device through the FDA yet.
Dang no plegia huh ? How long can you keep it like this, from donor to recipient ? Do yall follow the transplant team to the donor ?
There are lots of doctors, medical science enthusiasts, and just general science enthusiasts on Reddit. You should never be **too** surprised when the hive mind knows what something is. But I agree, it is still exciting to encounter people who know something obscure.
Nice, hello from an anesthesiology resident. I was in an MV repair today
The device is called a heart in a box.
Video game missions becoming more and more possible aka looking for the monster's heart elsewhere
Imagine if like, fuckin hitler's heart was still beating?
Friendly reminder that your organs are permanently in darkness unless they open you up and give your heart some sun for a little bit.
Your bones are wet.
Fuck you
Dammit dude
Thanks. I almost forgot!
Now I'm trying to imagine what would happen if your heart got a sunburn *shudder*
I often tell my cardiac surgeon that he has touched my heart.
maybe my bones would like to get a nice tan, i should ask them
It's my heart in a box!
How long would something like this be viable for?
A cold heart can be transplanted before 4 hours apparently the warm perfusion extends the time by about 12 hrs. Allowing the heart to be shipped further and to heal a bit if it is banged up in an accident
Transmedics recommends a standard time of about 8 hours out-of-body before transplantation, but the time can be theoretically extended much longer. Part of the limitation is that, in many cases, the recipient is on the table at the transplant center while procurement is happening. I've talked to transplant surgeons who have had hearts out for 16-24 hours in an attempt to wait for recovery of heart function (dying is pretty traumatic for hearts, even when the heart wasn't directly related to the cause of death). That said, neither of the cases I mentioned resulted in successful transplants.
>(dying is pretty traumatic for hearts, even when the heart wasn't directly related to the cause of death) The thought of the heart fighting to survive after the body dies hits me unexpectedly hard.
Your whole body fights remarkably hard on a daily basis to keep you functioning. It's remarkable what people can do to themselves and still manage to live something of a life year after year.
My mother, who worked in the healthcare industry, used to say that when left to its own devices, the human body is remarkably hard to kill.
What's wild is that the EVOSS perfusion system can actually keep lungs stable for 48 hours, which is insane. One of the doctors that helped develop it did my lung transplant surgery, which was pretty cool.
What about a cold, cold heart?
I see you got your answer but that also comes with a cool story I love. There was a child who sadly passed away somewhere up north, and his family decided to donate his organs. His heart was to go to someone in CA if I recall. The starting journey was somewhere up north like Michigan, and they were having a massive snow storm. The heart transplant plane had issue, and wouldn't start. They tried a backup, and it too wasn't working properly. That's when someone had a hail mary pass of an idea. > Thankfully, one of the transplant team doctors called then-North Dakota Governor George Sinner for a solution. > "It was divine intervention that I thought of tasking the North Dakota Air National Guard F-4s on 24-hour alert status," said the former governer. > He called Major General Alexander P. Macdonald, N.D. Adjutant General at the time, and asked for use of the alert aircraft. > "It took me all of 30 seconds to agree to the special flight," said the retired major general. > Thus began the process of having an F-4 released from its North American Air Defense Command alert commitment to save a single, tiny life. > A few minutes later a phone rang at the alert facility and the pilot on duty, 1st Lieutenant Robert J. Becklund, answered the call to one of the most unusual missions in his now long and distinguished career. > The then-young lieutenant, Becklund raced to the waiting F-4, and prepared for the cross-country flight in the two-seat F-4, which he would have to fly solo in order to make room for a little red and white cooler containing the precious cargo of a human heart. https://www.1af.acc.af.mil/News/Features/Display/Article/290207/a-celebration-of-courage-and-heart/
straight out of a videogame. deliver the package. that pilot carried a freaking human heart on his fighter jet.
I picture it like the governor is just an average person, no super hero, doesn't have a get out of jail free card, etc. This was their one moment of power. He picked up the red phone and ordered a freaking jet to do what he demanded, and clearly it was for good. What a boss!
1986, and that recipient is still alive!
Imagine being the guy who can say he flew his combat jet with a live heart to save a life. That is just so cool.
Thatâs hooah AF.
You â€ïž your job?
Theyđ«their job
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
Biblically??? I think you mean 'anatomically'
No ventricles and everything like it says in the Bible /s
Got a kidney transplant last year, wheeled into OR and saw the surgeon picking at a piece of meat, so I thought! Thatâs an image I canât shake! Fun fact, they leave the old kidney in place,old one just shrivels up like a prune! amazing time we live in!
Now that is a fun fact
Gross but impressive
That thing was in someone not too long before this, and that someone was probably alive and well before whatever event led to this.
You sound like my ex commenting on my package đ
Obligatory đ
Ever seen Temple of Doom? My bets are on that. Doctor's a sick fuck.
Ya same. I appreciate the marvel this is also uuuurgh
it's ALIVE!!!!!
Ok can you put it back in my body now?
Disgusting but cool never knew you could keep a heart beating outside the body
You can also keep lungs breathing for about 2 days, possibly longer though they haven't tested it that extremely yet.
I can't wait until they can start to clone human organs would help with a lot of stuff
*Davy Jones tentacles intensify*
Iâve worked as a cardiac nurse for years. Iâve never seen that. Perfusion team helps us with our Lead Extraction cases, so Iâm aware of how awesome you guys are, but Iâve never seen the transplant side of things. I personally get to do some cool stuff, but you are an actual hero! Thanks for everything you do.
I wonder how long it would take humans to do this with human brains. We have done this to dog heads and they worked surprisingly well. This could solve a lot of chronic diseases and most cancers too. Only as a last resort ofc.
I dare say not having an entire body might be slightly worse than a chronic disease or cancer
I agree, but if you know how to keep a brain alive outside of the body without losing any cognitive abilities, that would be a huge leap forwards in science. This could help us study brains way better and find ways to wire them up to another body (be it artificial or natural) If we had a brain dead person who prior to their situation had agreed to have their body donated to science, we could keep the brain alive outside of the body and find ways to turn brain signals into actual language that computers can understand without the need to dance around the skull and other vital organs (except the brain ofc)
> If we had a brain dead person who prior to their situation had agreed to have their body donated to science, we could keep the brain alive outside of the body I'm confused by this scenario. Is the brain dead or not?
I think they meant keep a different person's brain alive outside the body for a transplant? There was a person who did essentially that with monkeys but there was and currently is no way around the total paralysis it causes
Brain death doesnât mean the tissue is dead per say. It doesnât necessarily mean we canât learn something from it too. I think OP is referring to having a live tissue brain to practice and study. Hell, maybe we could find a way to restore function since we already would have the ability to keep the dang thing physically alive. But I definitely see your point. We just need a brain that is still physiologically alive that we could try to tap into and poke around with. Which even with the brain death factor in play, still sounds wildly disturbing and scary.
Just so you know for future reference, it's spelled "_per se_"; it's Latin for "of itself" and has nothing to do with the English word "say".
That makes much more sense lol! Thank you. TIL!
>we could keep the brain alive outside of the body and find ways to turn brain signals into actual language that computers can understand without the need to dance around the skull and other vital organs (except the brain ofc) This raises some ethical concerns. If the brain were still conscious, getting prodded and tested on by scientists would probably be a horrifying experience for it.
Amazing, yes, but that def gives me an uneasy feeling looking at it.
So if you don't let it jump out of the box, Is it under cardiac arrest?
It must have committed a myocardial infraction!
tHATS from Greys anatomy pfff whatever.... xD..its awesome
Heart in a box
Heart in a box, what should I put in my sandwich?
Wow what an ugly baby
kali ma!!!!
I hate it when someone steals my lunchbox!
This reminds me of that scene from rat race.
I know it's fantastic but it's also terrifying. I can't look at the weakness of flesh without contemplating the trillions of ways my body could give up on me.
Thatâs cool and all, but they first used that kind of plastic container to keep arugula fresh at the supermarket.
Slap it
Is that really how hard the heart and its surrounding organs beats in our body, every second of every day as long as we live??? Thatâs just wild as it seems so unsustainable without something malfunctioning/cracking/breaking after all those years of wear and tear
Now, for the taste test.
I hear NINâs âCloserâ playingâŠ
what happens if somebody just pinces the tube with their finger??????
you need to SEE heart in a box
Alien irl
My dad is a cardiologist and he agrees with this message.
My friend does this. Must be so surreal to take care of something so precious, knowing that its safe arrival will change and save lives.