There are a lot of things that need to be looked at when reviewing an offer. We just don’t give an organ to somebody because they are the first one on the list. The size is a very important matter. Would you put a lawnmower engine in a big truck? I didn’t think so. Neither will the opposite work. It is the same thing with humans. The size has to be right or really similar. The same rule applies for lung, heart, liver or kidney transplant. For lung transplant it may be even trickier because the doctor has to account for the disease. Some disease, like pulmonary fibrosis, kind of makes the lungs shrink so smaller lungs are needed. Other disease, like chronic obstructive pulmonary disease (COPD) makes the chest cavity larger so bigger lungs can fit. It is always up to the surgeon to make the final call since he is the one putting them in.
The physician also has to review the social and medical history of the donor along with some test results (Xray, echocardiography, blood work, etc). Once everything seems to be a good match, the organ offer is officially accepted by the physician. This is when it really gets my adrenaline pumping as a transplant coordinator because I do the rest (minus doing the surgery¦ you would not want that). It becomes a race against the clock to call the patient in (aka recipient) and contact everybody else in the hospital that helps make the transplant happens. It goes from registering the patient with admission, informing the blood bank for the anticipated need, the hospital bed coordinator so we can find a bed and most importantly the operating room. The OR charge nurse gets really mad if she happens to learn about the transplant before you officially call! I hear sometimes: “Were you gonna call me today?” You just have to play the game and be nice even if they don’t understand I have to call a million people and a million people are calling me! So I am always on the phone. Everything is worth it though because we are doing it to save a patient’s life. You really have that feeling of mission accomplished when you see the patient after the transplant and they are doing well.