Tag: Transplantation

“You don’t defibrillate asystole…” and other arguments with creatives

It is a favourite pastime of anyone who works in healthcare to scoff at the mistakes we see when medicine is portrayed on film. From the back-to-front chest X-ray on Scrubs to the miraculous success rates of chest compressions in soaps we love to mock. However, for the last four years I have been working with various TV programmes to try to inject a degree of realism without dampening the drama.

This started with Holby City when I helped out on set, making sure that operating scenes looked realistic and that the actors could pass off as surgeons. This was my introduction to the tension between realism and plot. Being a medical drama, Holby had the budget and resources to try and get things right, but even they couldn’t keep viewers interested if they showed a lovely routine list of day cases where nothing goes wrong!

Holby led to me being approached by Eastenders,  which was a different type of work. With 6–8 million viewers every week, this is a show with massive reach. They have a surprising number of storylines involving medicine, ranging from characters with chronic health problems, through to the massive set piece car crashes and explosions. Even with the minor stuff, when they get it wrong they face a slew of complaints from the public and charities. Often Eastenders will want me to come up with injuries or illnesses that fit a story arc. For example, they will want someone stabbed, look like they are going to die, but then get better and be out of the hospital in seven days. This is normally straightforward, apart from making sure they aren’t reusing stuff from previous years!

Working on longer running storylines is more interesting, the most exciting of which was Phil Mitchell’s liver transplant story on Eastenders. They came to me wanting a way to rejuvenate Phil, who had become a belligerent drunk who had lost his sparkle. I suggested a storyline that took him into liver failure and then showed a long climb back to health, with a liver transplant as the final redemption. However, this was a story fraught with public health issues. It was well established that when the famous liver transplant recipient and footballer George Best started drinking again organ donation rates fell. (more…)

Would you give the gift of a kidney to a stranger in need?

 

As far as generous Christmas presents go, donating your kidney seems for many at the extreme end. However, for a few lucky kidney disease patients, this is the gift of a lifetime. Known as unspecified or non-directed altruistic kidney donation, this form of live organ donation is on the rise, and could potentially wipe the waiting list if more stepped forward. I met Frank Dor, a consultant transplant surgeon and Head of Transplantation at Imperial College Healthcare NHS Trust, who has carried out hundreds live organ donations.

The waiting game

Frank receives a phone call notifying him that a kidney from a deceased donor has been allocated to one of the recipients at Imperial. This single kidney is in high-demand as there are around 5,000 people on the UK NHS Blood and Transplant (NHSBT) waiting list for a kidney; some waiting for up to five years. Unfortunately, a few hundred of these will die in the meantime for lack of one.

These patients have chronic kidney disease, meaning they have lost their kidney function so dialysis three times per week becomes the norm. However, life on dialysis is debilitating, difficult and time-consuming. “Dialysis is merely a way of keeping people alive, it’s just a temporary measure that can never fully replace the kidney function,” Frank tells me. “Eventually patients on the waiting list get to a point where they start to lose hope and stop making plans for the future”.

The long-term solution is receiving a kidney transplantation, of which there are two types – living and deceased. Transplantation provides patients with the opportunity for a longer and better quality of life, with patients typically gaining 10-20 years of life compared to dialysis. However, the odds for receiving one are not favourable: there are 1,500 patients on dialysis in Imperial College Healthcare NHS Trust but only around 200 of those get transplanted every year. There is a huge gap between supply and demand nationally and internationally. (more…)