'Privilege' To Save Lives

A new Kiwi TV series, which began on Wednesday October 27, tells the heartfelt stories of New Zealanders in need of organ transplants.

Situation Critical also highlights families who have lost loved ones and those who have donated a family member's organs in order to give the ultimate gift of live. Good Living spoke to one of the transplant surgeons whose work is showcased on the show - Adam Bartlett (pictured).

How did you get involved in Situation Critical? What persuaded you to be a part of the show?

I work as a transplant surgeon at Auckland City Hospital where the programme is based. During my surgical training I was fortunate enough to be exposed to transplantation, and saw patients, many of whom were terminally ill, have a second chance in life, as a result of undergoing a transplant. There are very few situations in medicine when you see such a dramatic change in a person from one minute being bed-bound and dependent on others 24/7, to within weeks becoming independent and able to contribute to the community. Through being involved in programmes such as Situation Critical I hope that people can have the opportunity to experience how a family's tragedy can be lifesaving for many people.

How did you become a transplant surgeon? What did that involve? Was it something you always wanted to do as a career?

Training as a doctor was never a childhood aspiration. I applied for medical school as I thought it was a challenge, given that many of my colleagues at school had submitted their applications. Having been accepted, I took the advice of a career adviser and enrolled in medicine as it was the longest course, and I could always cross-credit papers to another degree that was shorter if I did not like it. The first time that I ever stepped foot into a hospital was as a fourth-year medical student, and it took some time to acclimatise to the environment. Having been bought up with a father who was a builder I was attracted to surgery by the practical aspect of "fixing" a problem. However, unlike building, surgery had the distinct advantage that biology often corrected any misalignment. It was during my resident that I had the opportunity to undertake a PhD investigating novel aspects of the immune response to transplanted organs, and saw first hand the effect of transplantation. I then completed my general surgical training and went on to train in liver surgery and transplantation in Kings College in London.

What are the best and worst parts of the job?

Like anyone I fantasise about other vocations, but I feel lucky that I have had the opportunity to have trained in surgery and would not want to do anything else. Also, it has taken me so long, that I'm now too old to consider retraining. Through being a surgeon I have met some amazing people and have been fortunate enough to have shared intimate aspects of their life. There are very few jobs outside of medicine which give you that privilege. I am fortunate that I love what I do, and it excited me enough that I prefer it to playing golf. If that ever changes, then I will move on, as surgery is more than a job, it is a vocation. At times it interferes with other things in your life, but the person didn't often choose to become sick either, so you have to keep it in perspective.

How many transplants would you carry out in a year? Are they on the increase and if so, why? How long does a typical transplant surgery last?

Liver, kidney, pancreas, heart and lungs are transplantated at Auckland City Hospital. We perform approximately 40 liver transplants in adults and children each year. As the outcome of transplantation has improved, a greater number of patients are being considered. However, we are dependant upon donor organs, which limits the number of transplants that can be performed. As a consequence of therebeing far fewer deceased donor organs than patients listed for transplantation, patients are dying on the waiting list. An alternative is to use living donors, to donate part of their liver, however only a small minority of patients have a suitable family member that can be considered.

The transplant operation is a game of two halves - the donor operation is performed by surgeons from Auckland City Hospital who travel to the donor hospital. Depending upon the distance, this can take up to 12 hours, including the three to four hours for the procurement of the organs. The recipient operation is performed at Auckland City Hospital and takes six to eight hours depending upon how unwell the recipient is.

Why would you encourage someone to become a donor and how would you persuade them?

The most important reason to consider being a donor is that you could potentially save a person's life. For patients with end-stage liver, heart or lung disease there is no alternative to replacing the damaged organ. Unfortunately the demand for organs far exceeds the supply; consequently patients die because they are unable to get organs.

Situation Critical screens on TV one on Wednesday nights at 8pm.

Good Living, The Press.