Recently, I had the rare chance to step into an operating room and witness one life’s end become another’s new beginning. Observing an organ donation recovery up close is a privilege few are granted, and while words can’t fully capture it, this is my account of the powerful intersection of life and loss.
Prior to taking a job with HonorBridge, my limited knowledge about the world of organ donation was exactly that: limited. My motivation for joining HonorBridge was to write for something bigger than me, for something bigger than all of us—so I familiarized myself with the statistics. Every eight minutes another person is added to the national waiting list, and every day, 16 people die while waiting for a lifesaving transplant. These “16 people” are children, mothers and fathers, brothers and sisters, dear friends, and individuals with hopes, dreams, and a deep desire to live. You might not have met anyone on the waiting list, but maybe you are meant to. You might not be impacted yet, but maybe you will be. On paper, these lives might sound like statistics that organizations use to make you press a button—but in reality, these are our loved ones. Even if we haven’t had the chance to love them yet.
As a non-clinical HonorBridge employee, I work out of our Chapel Hill office. It’s a beautiful place to be productive and attend a meeting, but you would never know what is happening on the ground level, past the double doors, just by looking. The HonorBridge Donor Care Center (DCC) is a state-of-the-art medical facility, similar to a small hospital, that gives us the opportunity to recover organs and tissue for transplantation. Donors are transported to our Donor Care Unit (DCU), cared for and prepped by nurses, and sent to our operating room to have their organs and/or tissues recovered by a team of surgeons.
The DCU is a world that no one besides doctors and nurses are familiar with, quietly out of view—and never in a million years did I think that my job credentials/badge security would get me through that second set of double doors. I had suggested a “behind the scenes” article to share on our blog, and to my surprise, I was invited to attend an organ recovery in the operating room (OR), starting at 9 p.m.
After downing a cup of coffee on my way in (us non-clinicals aren’t equipped for all-nighters), I texted the DCU manager, Jennifer Buchanan, because my key card would only get me so far. Upon arrival, I was asked to don a bunny suit, shoe coverings, gloves, a hair net, and protective glasses. I was in the ICU when I first saw the donor, who had been declared brain dead two days earlier, meaning they had permanently lost all brain function and had been legally and medically declared dead by a hospital physician. I followed as the donor was wheeled into the operating room, surrounded by HonorBridge team members, including organ donation coordinator Matt Woodard, who guided me through every step of the process.
It wasn’t until we reached the OR that I caught a glimpse of the surgical teams, who had all come from different states to procure different organs. This was a surprise to me—I had assumed that one surgeon did all of the organs, but this particular recovery had brought in teams from SC (heart) and Ohio (lungs). Dr. Black, a transplant surgeon from ECU Health, was there to procure a pancreas as well as the liver and a kidney on behalf of the University of Maryland Medical Center. Jonathan “JT” Neff, HonorBridge’s Physician’s Assistant Surgeon, was assisting.
The room was much more crowded than I anticipated. I watched as HonorBridge team members, who had been caring for the donor all day, handed the reins to the heart team and transitioned into more of a surgical support role. It was a well-oiled machine as they began prepping the donor, covering them from the neck up for the surgery and coating the chest/abdomen in a yellow antiseptic solution. Although the brain had permanently stopped working, the donor’s body was kept on a ventilator to keep the heart beating, allowing oxygenated blood to flow through the organs so they remained viable for transplant. A tray of surgical tools was positioned near the feet, sterilized and ready to hand off. A table of blue basins, all awaiting organs, lined one side of the room.
Matt told me that anything draped in a blue sheet was not to be touched. “If it’s blue, it’s not for you,” he joked, but I had never taken words so seriously.
Before recovery officially began, Surgical Recovery Coordinator Soorya Vasan announced the moment of honor, and a team member began to speak.
“From our first breath to our last, each of us tells a unique story with our lives. Today, we honor our donor and this opportunity to save the life of another person.”
A statement from the family was read, followed by a moment of silence. Despite the number of people in the room, and the magnitude of what was about to happen, you could have heard a pin drop.
After that, the process of recovery began. I was never able to determine exactly when the first incision was made to the chest, as surgeons crowded around the table in billowy blue surgeon coats.
“You are in the room with top tier medical professionals,” said Matt, as we looked on. “These people are literally doing things that nobody else can do.”
In the chaos of that moment, when the surgeons were opening the donor up and the smell of cauterization filled the air, Matt’s words settled deep. The brilliant people before me were saving lives—and the honor of having a front row seat wasn’t lost on me.
As things progressed, I watched as all the teams—lungs, heart, and abdominals—worked side by side, simultaneously. The liver, which was biopsied onsite, required constant updates, as well as pictures—and after a small mass was discovered elsewhere in the body, a waiver to continue recovery prior to receiving biopsy results was required, as well. When the doctors couldn’t hold a phone, our staff held them up and placed them on speaker. As Matt told me, there are two things that can never be transplanted: cancer and an unknown infection. Prior to removing organs, the surgical teams were constantly evaluating their designated organs and keeping their receiving centers in the loop.
Prep work took hours, and multiple things were happening at once, but I’ll never forget the moment someone called out, “the heart has been accepted!” I didn’t need Matt to tell me what that meant, because I knew: The heart that I was staring at, still pumping in the chest of the donor, was about to save the life of someone in South Carolina. The hair on the back of my neck stood up at the realization. It was such a simple thing to say, yet it changed everything for someone else.
From there, things happened fast. Ohio had a recipient who needed a bilateral lung transplant, or both lungs, but only one of the lungs was good for transplant. Despite the fact that Ohio passed on the lungs, the team stayed in good faith to assist, which I found touching.
Before the heart was recovered around midnight, someone called out, “we’re good to cross clamp!” This essentially stops blood flow to an organ prior to heart removal—and, unbelievably, I was invited to the “head of the bed” to witness it firsthand. The moment the heart stopped beating, ice water was poured on top of it, and the surgeon called for pressure to keep the heart valves open. At the same time, ice was being packed around the abdominals as the preservation process began. From there, everyone moved with quick precision.
The heart was taken out of the body and wrapped in a sterile bag and then transferred into a cooler, surrounded by ice. Once it was packaged, the heart team quickly removed their protective gear (PPE) and ran it down the hallway and out of the building. After that, Dr. Black removed the liver, which was much larger than I expected, and it was placed into a big blue bowl, followed by the pancreas and kidneys. By the end of the recovery, both lungs were recovered for research, and the heart, liver, pancreas, and kidneys were delivered to waiting patients.
In the marketing department, we always ask people to refrain from using the word “harvesting” and use the word “recovery” instead. Now that I’ve seen it in person, I can’t stress this enough. There was no “harvesting” going on—each organ that was removed represented the recovery of someone on the other end, and no one in the room ever lost sight of that.
I will never forget the donor, and immortalizing their gift with words has been an honor. As I stood at the head of the bed and saw a tuft of hair that never had the opportunity to turn gray, I quietly thanked and held space for them. It was the end for one person, but the beginning for someone else. Their family had already said goodbye, but because of their decision, someone else didn’t have to. I walked out of those double doors in the early morning hours, but that experience will always stay with me—and I hope it stays with you, too.
One organ, eye, and tissue donor can save and heal up to 75 lives. Register your decision today!
