Organ donor recovery is a way of life

The job's not for everyone.

But Shari Tupac, an organ recovery coordinator at Nevada Donor Network Inc., believes in the work she does. One of five such nurses, she could get a call at any time: Someone in the valley has just been declared brain-dead.

Whether a victim of a car accident, gunshot wound, fall or cardiac arrest, the patient hooked up to the ventilator may be able to share something great value to someone else -- a heart, a kidney, a lung, life.

And Tupac is about to meet the next of kin.

She doesn't deliver a sales pitch or offer a plea for those waiting on the other end. Her job is to provide information to the family.

"Your job begins with someone else's pain -- that's the hard part," Tupac said. "You can't do this job if you don't believe in donation. You have to believe that this is a good thing."

Nevada Donor Network is the only organ recovery organization in the valley, and the delicate work is up to the small staff of coordinating nurses and specially trained technicians.

Federal law requires hospitals to call the organization for every death. The coordinating nurses go to the hospital in cases of brain death.

By the time they arrive, the doctors have informed the family that their loved one is brain-dead and someone from the donor network will be coming to meet with them.

The number of such meetings can fluctuate from none one month to three the next. There is a potential of gaining 75 organ donors a year, yet the group averages only 25 to 30.

Many families are still in shock, Tupac said. Because they see the patient, who is connected to a ventilator, many have trouble comprehending that the person is legally dead.

Gaining family consent is successful only 50 percent of the time, Gerry Phillips, director of organ recovery services, said. Most families are unwilling to consent, mainly because organ donation had never been discussed before.

But when they agree, miracles can happen. Last week in Seattle, an 18-year-old woman who was near death received a life-saving transplant on Christmas Eve. The heart had been donated by a 15-year-old Las Vegas teen who died two days earlier in a car accident.

For the nurses on the front line, who talk to the families and help recover the organs, it's a job like no other.

"With this, someone dies. Even if the family donates, it doesn't take their pain away," she said. "It's a balance between the sadness and pain that you see and that something good can come out of it."

For some, it's too much. Before Tupac joined the network, the average coordinator lasted 18 months on the job. Some have lasted as few as five days.

Tupac is one of three coordinators who have remained in their positions for three years or more.

"Not everybody is cut out to do this job," she said.

Once a family consents, the coordinator's job is just beginning.

The coordinators, all registered nurses with experience in operating rooms, emergency rooms or intensive care units, assist during the recovery process and are responsible for packing kidneys into a cooler then whisking them off to their final destination.

Because the heart and lungs have up to four to six hours to be implanted in a waiting recipient, the surgeon removes and packs the organs.

"The minute the heart is removed, that's when the clock starts ticking," Tupac said.

The liver has up to 12 hours. Kidneys have up to 48 hours.

There are no local transplant locations for heart, lungs and liver transplants. They are shipped out of state, often the University of California, Los Angeles.

In some cases it may take a few days for a patient to progress from injury to brain death. In that time, families may have already discussed the idea of organ donation, meaning their decision to consent may take only 15 to 20 minutes, Tupac said. For others it could take hours.

If and when consent is given, testing begins at the hospital for kidney function, heart function, tissue typing and infectious diseases.

The organs are then entered on a national list of registered donors. Nevada Donor Network is registered with the United Network of Organ Sharing, a nonprofit national organization that provides an initial list of possible recipients in a five-state area -- California, Arizona, New Mexico, Utah and Nevada.

Most recovered kidneys and pancreases stay in Southern Nevada. A kidney with a perfect match in another area of the country will be sent out. But first preference is to keep organs in the area.

Sunrise and UMC share a list of kidney patients. The receiver of a kidney depends on computer matching and cross-matching, in which donor cells and recipient cells are placed together to see if they are compatible.

"We keep a local priority," Ken Richardson, executive director for the organization said.

In Southern Nevada, there are more than 100 people on dialysis waiting for a kidney.

Although most can survive on dialysis, it requires treatment three hours a day, three to four days a week, which can be exhausting.

On the receiving end of kidney donation is Claudia Swift, transplant coordinator for Sunrise Hospitals. While Nevada Donor Network is recovering the kidney, Swift is also working at an increased pace contacting and preparing the patient.

"It's the pleasant side," Swift said. "You're changing someone's life."

Often the receiving family feels guilty. At first they're excited about getting a kidney. Then it sets in that somebody had to die, Swift said.

Part of her job, Swift said, is assuring the family that the patient would have died regardless of the organ donation.

"This is just a way to make something positive come out of a negative situation," Swift said.

Nonvital organs such as cornea, bone, tendon, skin, heart valves and blood vessels are also recovered by Nevada Donor Network.

"The bone and soft tissue from one donor can help 30 to 100 people -- sometimes more, depending on need," said Keith Larson, director of tissue and eye services at Nevada Donor Network.

Corneas, bone and soft tissue are contracted locally or nationally based on need. Richardson said the organization provides well over 100 corneas a year.

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