Teamwork delivers trio of transplants

6 February 2018

Three life-saving operations were carried out in the space of 18 hours at the Royal Free Hospital – a record for the liver transplant team.

Off-duty surgical staff showed their dedication and compassion by coming to work to ensure the patients had the eight to 12 hour procedures quickly after donors became available. All three patients are now recovering well.

Two of the cases were emergencies and designated as ‘super urgent’ which meant it was essential that the patients received the new livers immediately before their condition deteriorated further. 
The other transplant was for a patient who had been on the list for some time and the team had to operate quickly when a suitable match was identified. 

Time, in all cases, was of the essence.

Elaine Burrell and Katie Quist were the liver transplant co-ordinators who worked closely with the hospital’s theatre team to find the additional staff to enable the transplants to go ahead. They liaised with the consultant anaesthetist Sally Harrison and theatre co-ordinator Angeline Showniwa, to ensure another theatre and anaesthetic team would be available for all potential scenarios. 

Elaine said: “We had to be on the ball constantly. Timings are absolutely crucial because you can’t accept the offer of a donation unless the staff, theatres and intensive care beds are available. Timings invariably change throughout the process, making it vital the team are updated regularly and you have planned for each scenario carefully – such as simultaneous or back to back transplants. 

“Always at the forefront of everything we do is patient safety. Alongside coordinating the transplants you are usually still receiving further offers, setting up further potential transplants and managing patient and relative queries. I took over from Katie, who had set up the first transplant and this was my busiest ever on-call. My bleep was almost on fire.”

Consultant surgeon, Professor Massimo Malago, consultant anaesthetist Jackie Cooper and surgical registrars, Bettina Buchholz and Tom Hana, all answered Elaine’s request for them to come to work, despite not being on-call.

Behind the scenes transfusion staff ensured that blood was ready for the operations and the porter on duty, Anthony Enrique, was transporting blood products and the patients to theatres.
Professor Joerg-Matthias Pollok, clinical lead for hepato pancreato biliary (HPB) surgery and liver transplantation at Royal Free Hospital and the consultant surgeon for the second operation, said: “I would like to express my pride in what we achieved for our patients and their families, who put their trust in us.

“Many have given their best and joined the team, even though they weren’t on call. This has truly been a team effort from all disciplines involved in transplantation; co-ordinators, hepatology, theatre, anaesthetic, surgical and intensive care teams. It feels good to be part of a team with such tremendous spirit.”

Mr Dinesh Sharma, the consultant who carried out the first transplant, said: “To do three liver transplants in 18 hours – two of them in sick super-urgent listed patients - is to my mind a heroic and unprecedented effort on behalf of the unit.  A sincere and big ‘thanks’ for everyone who made this possible. It’s teamwork like this that has been responsible for us being the fastest growing liver transplant programme in the country.”

Dr Doug Thorburn, clinical director for liver transplantation, HPB and hepatology, said: “Our achievements have been reached through demonstrable cohesion across the whole transplant multi-disciplinary team. Enormous credit for this goes to the whole team.

“Our contribution to UK transplantation has not gone unnoticed. To me it is an honour to work with such an enthusiastic and committed team who put the patient at the centre of what we do and consistently exhibit world class values.”

(Picture: Members of the liver transplant teams including surgeons pictured front from left to right - Mr Dinesh Sharma, Professor Massimo Malago and Professor Joerg-Matthias Pollok)