Inside the Life-and-Death World of BC Organ Transplants

Originally published in The Tyee

Liver, lungs, heart and kidneys. We humans are made up of a great many squishy bits and pieces, all squirrelled away in their rightful places.

What happens when any of these essential parts doesn’t work is the subject of Knowledge Network’s new limited series Transplant Stories. The four-part series begins airing Tuesday.

Director Sheona McDonald brings an extremely human touch to the series, and its many aspects are fascinating: the process of getting an organ from its donor to its new recipient; the long, complex work of installing transplants; the path to recovery.

But the thing that emerges most clearly is the foundational goodness of humans when the chips are truly down.

Wives, husbands, parents, children, caregivers of every stripe come together to provide support.

As much as the series is about medicine, it is also about love.

The opening episode follows a family from Powell River. Brett needs a liver transplant. Diagnosed with primary biliary cholangitis, a chronic liver disease in which his body attacks his own bile duct, he is expected to live only until his late 40s or early 50s. With a young family, he is eager to be put on the transplant list and to await the arrival of a new liver.

Dianne, suffering from fibrosis of the lungs, is forced to rely on supplemental oxygen to do the most basic things. As she and her husband contend with daily life, she explains that she thinks of herself not as a sick person but as someone with a chronic illness. After making more than 84 trips from Langley into Vancouver, the couple enters difficult territory when Dianne’s life expectancy is measured in a matter of months.

Sukinder, waiting for a kidney transplant, does dialysis three times per week. Although he received a kidney in 2001, transplanted organs have a limited window of use. On average, donated organs last about 10 to 12 years.

Since his donated kidney failed in 2012, Sukinder has been on dialysis. His daughter, who is studying to become a doctor, says she chose the career because it was a doctor who saved her dad.

In addition to directing, McDonald is also one of the series’ producers and co-writers. She worked on this series with writer Catharine Parke and producers Giuliana Bertuzzi and David Gullason.

Produced in partnership with BC Transplant, the Provincial Health Services Authority, Vancouver Coastal Health and Providence Health Care, the series is a critical reminder of the need for organ donors.

The unsung art of ‘being there’

You might think it would be difficult to construct a riveting narrative from a process that involves a great deal of waiting, but McDonald knows her way around a story. Some of the most fascinating scenes arise through silent observation.

As the doctors and nurses do their thing in the operating theatre, the details of surgical protocol and the choreographed interdependencies between the many health-care workers in the room stand out.

The series also highlights the “theatrical” aspects of surgery. Not only is there great drama in the act of cutting into a human body, but the people going under the knife are folks that viewers come to know and care about.

Transplant Stories doesn’t soft-pedal the reality of life-or-death situations. Some people live and some don’t. But the heroic work of doctors, nurses and specialists is nothing short of remarkable.

A word of warning for the squeamish: there are a fair number of blood and gut sequences, but if you can get past the gorier stuff, it’s fascinating to watch different organs do their thing.

Life-changing surgeries

The mechanical aspects of the human body are fascinating, as is the process of fixing them. Lungs are a case in point.

The first double lung transplant in B.C. was performed at Vancouver General Hospital in 1989. Since that time, the number of surgeries has soared to more than 60 every year. Even if it is not uncommon, it’s still a lengthy surgery.

When donor lungs arrive, they must be squished into the chest cavity, connected to the new body and reinflated. As the new lungs are being installed in Dianne, it’s somewhat disconcerting to see her exposed heart beating away as the surgeons do their work.

Time is a critical factor in complex surgeries. To illustrate this aspect in the series, a countdown clock runs overtop of the surgery as the doctors determine the best course of action.

The moment of truth comes when the newly implanted lungs are flooded at considerable pressure with oxygen. To watch them take their first breath in their new home is one of the most beautiful moments in medicine, as one of the surgical team says.

It’s not only the big organs, heart, lungs and liver, that are the focus of the show, but also smaller things like corneas.

Marcela, whose corneas never fully developed, has been waiting for a donor as her sight has continued to degenerate. Her family is a key part of her support network.

With eye surgery, the results can be unpredictable, given the state of the optic nerve.

But as Marcela says, although it’s a risk, there is nothing to lose and everything to gain.

Many of the people profiled are from different parts of the province and must travel to Vancouver to access medical services. The travel alone is considerable, but there is a variety of factors at play in organ transplants.

Finding a donor who is the right size and blood type and with healthy organs is also something of a rarity. In the case of Dianne, who needs a rare combination of a small set of lungs with Type O blood, the wait was long.

As this is a documentary series, sometimes you don’t get a happy ending or even a clear resolution. Viewers don’t get to find out what happened to a few of the people profiled. It’s a minor quibble, however, as there is a great deal to be relished.

One of the most interesting spaces of exploration is the territory between life and death, the curious interregnum when neither state is fully in charge.

For the people lingering between these two polarities, family and other support networks are critical. To that end, Transplant Stories focuses not only on the people awaiting organs dealing with health issues, but also on the people who are there to support them.

Nothing makes this clearer than Shelby and her partner, Scott. As a competitive swimmer, her body could do things that regular folk could never dream of. In her teens, she won four medals at the BC Summer Games. But after a meet when she couldn’t even pull herself out of the pool, it was clear that something was very wrong. It was liver failure.

Shelby and her family were informed that unless a donor became available, it was likely that she wouldn’t live more than a few hours. With only hours to go, a match was miraculously found.

Although Shelby recovered enough to win a gold medal, her donor liver eventually failed and she was told to get her affairs in order as she had only a few months to live. But again, another donor liver was found.

As she awaits her third liver donor, she explains that at the outset of her relationship with Scott, she was clear that her health condition was a major factor. In spite of the challenges, the pair seem utterly committed.

It’s another reminder that one of the key elements in a patient’s recovery and ability to contend with ongoing health issues is community: intimate partners and family, but also friends, as is the case with Kevin. Suffering from liver cancer at age 48, he’s accompanied by his friend Gary, who explains that his buddy came of age in an era when men didn’t show emotion or cry.

But it’s OK to let emotion out as the people who have received life-saving organs pay tribute to the donors and their families who made certain that from grief and tragedy, something more hopeful could have new life.

‘Transplant Stories’ airs on Knowledge Network starting Tuesday. To register as an organ donor, you can visit the B.C. Organ Donor Registry.

Originally published in The Tyee