After a catastrophic brain event, the death of a Virginian teenager created seven life-saving opportunities and a logistical challenge for Virginia Beach-based Medical Transport, LLC. Later the same day, another seven-organ donor led to high praise from LifeNet Health, a non-profit organ procurement agency also based in Virginia Beach.
“With (Medical Transport’s) help, we saved 14 people’s lives that day,” wrote the transplant coordinator for LifeNet Health, Andrew Shunk, BSHS, NREMT-P, who is also a volunteer paramedic with the Davis Corner Rescue Squad in Virginia Beach. “We had two seven-organ donors in 24 hours and utilized 15 ambulances.”
With 80+ ambulances on the road throughout Virginia and a dispatch room resembling a 9-1-1 center, Medical Transport is the transport of choice for LifeNet Health.
“We’re blessed to have the resources to respond to requests like this,” says Andy McMahan, CC/EMT-P, operations supervisor for Medical Transport in the Richmond area. “We enjoy it and we rise to it.”
Some organ runs are more urgent than others. Kidneys, for instance, are viable up to 48 hours after removal from a donor whether living or deceased, while hearts have a window of just four hours. While new technologies and preservatives to extend organ viability are coming into use, time still remains critical in moving organs from donor hospitals to recipients, who may be hundreds of miles away. This process usually starts with a phone call from LifeNet Health to the Medical Transport dispatch center.
“Sometimes, it’s incremental,” says Aimee Moore, senior dispatcher. “They’ll give us a heads-up that they have a multi-organ donor and then they’ll keep calling us back as they locate recipients for the organs.”
“They are a major factor in carrying out our process,” says Shunk. “They know the best routes to all the hospitals. They are very reliable and we are reliant on them.”
Since no attendant is required, standard two-person crews are often split up to drive two trucks for organ runs. Instead of using a SUV, which becomes crowded easily, ambulances are used because of their ability to load/unload people and equipment quickly. The crews pick up organ recovery teams from charter flights at general aviation airports and drive them to donor hospitals to recover the designated organs. The teams often consist of four surgeons and nurses laden with boxes of surgical tools, wheeled coolers and other gear.
Recovery teams are organ-specific. There might be a heart team, a lung team, a liver team, kidney teams and others converging on a donor hospital from all points. Each gets an ambulance. Once the organ leaves the hospital, the clock is ticking. The driver usually waits to do the return trip to the airport as a hot run with lights and siren. On rare occasions, weather will ground these urgent flights and the ambulance will make the run to the receiving hospital; that's a process that works well in Virginia. With the lights and siren, only three or four hours separate each of the transplant centers LifeNet Health serves at in Sentara Norfolk General Hospital, Medical College of Virginia in Richmond, Henrico Doctors’ Hospital in Richmond and the University of Virginia in Charlottesville.
Triage is an issue for dispatchers when organ runs interrupt the daily transport routine. “LifeNet Health trumps everything,” says Moore. “It’s like a stat call, but we still have other patients. Dialysis patients are a priority because they’re tightly scheduled and they have to be on the machines for hours. If we’re short on trucks, I’ll page for staff willing to take an organ run.
“They try to give us at least an hour’s notice to get to an airport or a hospital, but sometimes we have to be quicker than that and I try to get crews where they need to be at least 15 minutes early.”