Death and Transplanting Life

For many, the heart is synonymous with passion, personality which is literally at the heart of a person. We even carelessly use the phrase “broke my heart”, however, what does happen when our thick- muscular pump of an organ truly breaks down? The assumed answer would be death; no heart beat=no longer living…right? Well, in reality, a stopped heart can restart, there is no true universal rule in death determination. You are dead when the doctor says you are dead.

Of course we humans like setting rules to end ambiguity and so we have put forward the concept of clinical death which is the cessation of blood circulation and breathing. This sounds probable but in fact, our other organs can survive, including the brain. So delving a little deeper, what happens when the brain dies? First of all, great question and this is an area which we are surer of. Proposed in 1968 by a committee at Harvard Medical school, brain death results from a blockage of blood supply is the complete halting of all brain function and cannot be reversed. This is a significantly improved indicator of death compare to clinical death as the brain no longer controls breathing.  The person will not be aware of anything and never will. The passing of a loved one is unbearable the one thing we cannot forget and some families remain in self-denial at the moment of ‘death’. Some go as far as requesting the deceased to be plugged into a ventilator to prevent decomposition, pumping air in and out of the lungs like a giant bellow beating the heart with it. Miraculously the individual cells and organs are kept alive and growing, hair nails and even urination. From a medical view, without any form of movement the deceased’s muscles will atrophy and thereby shrink. All the (Dare-I-say) symptoms which occur to a directly buried non-ventilated body will occur, only above ground on a hospital bed.

“1 donor, saves 8 lives”

Though life, as we know it, has ended for this particular person. Their organs are the seeds for the growth of another in transplantation. This was of significant importance to the new Welsh system which stipulated adult Welsh citizens are automatically considered to be organ donors after death unless the individual decides to opt out so far only 6% have chosen to do so.  This combats the continual shortage of organ donors. In nearly all countries around the world, the number of donors has remained relatively constant whilst the number of patients waiting to receive an organ has skyrocketed due to the ageing population and accumulation of diabetes, obesity and heart disease. One in every five patients on the transplant waiting list die whilst waiting for an organ. There is a simpler and more obvious solution to this, we should discard our outdated notions of organ transplant. In truth we are superficial, we all believe in the good of organ transplantation as it saves millions of lives. But do we tick the box for opting in? No, controversially, we are too sentimental. A large proportion of families do not donate their loved one’s organ even though the person had opted in previously. We have no need for our organs when we pass away, would it not be better to donate and increase the chance of living of another patient in need in the future?

“Jesus has gone to work”- Dr Christiaan Barnard

Groote Schuur Hospital, Cape Town, Sunday, Dec 3, 1967, 6 am, after nearly 5 hours in the operating room, Dr Barnard along with all his talented team performed the world’s first human to human heart transplant. After a fatal car accident, a day prior, a young woman named Denise Darvall suffered serious brain damage and was subsequently declared brain dead. Permission for organ donation was received from Denise’s Father to be transplanted into the body of Louis Washkansky. The 34-year old greengrocer gained back the ability to walk and talk. Sadly, Washkansky died 18 days later from pneumonia, nonetheless, it was a huge technical surgical success and paved the paths for the transplant of an array of human organs.

Incidentally a mere three days later in Brooklyn New York at the Maimonides Medical Centre, a heart transplant was performed between two newborn babies. Again, the patients survived the gruelling operation but passed away 16.5 hours later.

“We should think of our organs to be borrowed, not owned”- organ donor

There is no doubt the two operations were the epitome of human achievement, making real of man’s theoretical ideas. However, did they achieve medical success? By the astounding height of Barnard’s international fame, it can be argued the transplants were a race. For Barnard and his team, 10 years of preparation had won them sweet, sweet victory. The fact that both teams were able to complete the operation despite the less advanced technology such as lack of current immunosuppression drugs and knowledge in the last century defied all odds. We are moving to a future where entire organs can be grown from the patients own cells.

Author – Jiangmin Hou
Jiangmin is a 5th year high school student currently studying five STEM subjects at Scottish Higher level-Mathematics, Physics, Biology, Computer Science and Chemistry. She is interested in pursuing a degree in Medicine after completion of Secondary Education.