Thursday at UZ Leuven

Today started off without a kidney transplant, as yesterday organs were acquired from a donor (a young girl who had committed suicide). The family of donor had given consent for the girl to be taken off the ventilator that was giving her 'life' ( she was in a coma). I was told that the organs were taken five minutes after the machine was turned off.

During the operation, I had the privilege of standing by the head of the patient (the anaesthesiologists quarters), and was able to see a great deal. An interesting snippet of information was that the 'glue' they used in surgery was made from the clotting factors of cows. I also didn't realise that the pieces of material used in surgery (for absorbing fluids, or providing support) were actually also covered in clotting factors. The patients awakes after surgery, about three minutes after the anaesthesia machine is turned off and its gases removed.

Later I joined the Doctors on a tour of the ward which had held people that had recently undergone any form of abdominal transplant and no longer needed intensive care. Communication between the doctor and patient is two way. The patient gives the doctor a report of his/her day. The doctor has a few follow up questions. And then the doctor gives a report to the patient which I though was great. The reports includes a summary of the blood test results and what the numbers and trends signify. The patients are then informed about the next step of their treatment even if all thats on the cards is taking it easy or trying to sit up for a while. I though such feedback reassures the patients by making every step of the treatment crystal clear and eliminating any sense of doubt that can lead to fear or dismay. 

The doctors also gets report about the patient from the nurses on the ward. The nurses are, I feel, responsible for providing support and comfort to the patients on a more personal level and therefore play an essential role. The patients have more contact with nurses and the nurses know the patients better. They know their preferences and dislikes and are furthermore able to comfort say an elderly women, say during the removal of a drain by holding her hand. 

During the tour the ward I saw an patient whose poor kidneys meant that he needed to use an dialysis machine. On the inner surface of his elbow crease he had an protrusion. I learnt this was where the surgeons fused the artery and vein together, leading to the vein itself thickening like an artery. This was where patient was hooked to the dialysis machine, as if the the machine was continually hooked to a single vein the vein would become damaged. 

After some more desk+document work, we paid a visit to the intensive care unit. Here the patient to doctor ratio is much smaller. The patients get more focused attention. The ward office has monitors the show the vitals such as heart rate of all the occupants. All recent transplants recipients are taken here directly after operation.