The Desperate Hunt for Life
Two weeks ago a congressional committee opened hearings on a bill that would help set up a federally sponsored clearinghouse to match potential organ donors with recipients. But the hearings drew less attention than the dramatic event that unfolded as they opened. Mrs. Billie Hall, 38, of Walnut, Miss, had traveled to Washington to testify in favor of the bill, and shortly after she arrived at the Capitol, she heard the news she had been waiting months for. Her 13-month-old son, Brandon, had just been given a chance to live. Because the parents of a 9-month-old Virginia girl killed in a car crash had consented, the child's liver could be transplanted into the body of Brandon—who had been born with a liver defect that would have killed him within weeks. Shortly after Mrs. Hall presented her emotional testimony, Brandon received his new lease on life—and offered a dramatic underscoring of the usefulness of organ clearinghouses.
Brandon got his new liver at the University of Tennessee's William F. Bowld Hospital in Memphis, one of only four facilities in the country that perform the difficult surgery. But the liver had come from Richmond, where an organ procurement specialist had reported its availability to a privately funded network called NATCO (North American Transplant Coordinators Organization).
Some 300 organ procurement coordinators around the country belong to NATCO, and through it match donors of livers, kidneys, pancreases, hearts, lungs and corneas to recipients whose lives can be saved or transformed by these organs. PEOPLE recently tracked a typical case of one of those life-saving specialists.
Last Dec. 7 organ procurement coordinator Brian Broznick was driving home from a TV studio in Pittsburgh, where he had just appeared on an evening talk show, when his electronic pocket beeper alerted him to an urgent call: A liver, 559 miles away in Nashville, Tenn., was available for transplant. Broznick, 31, rushed home to set in motion an elaborate plan that cost $65,000 and eventually involved dozens of doctors, nurses and medical technicians. Twenty-four hours later a dying man had a new liver. Broznick had helped save his life.
In the two years since he joined the University of Pittsburgh Transplant Foundation, the nation's largest and busiest transplant center, Broznick has retrieved hundreds of organs. But most of his work involves livers. Ninety percent of the nation's liver transplants are performed in Pittsburgh, since Dr. Thomas Starzl—who pioneered the surgery in Colorado in 1963—joined the Pittsburgh staff in 1981. Last year alone, the foundation's three organ procurers obtained 80 livers for the surgeons, and Broznick, who was involved in more than half of the procurements, proved himself indispensable to the phenomenal process of organ transplants. "I play a major role in what goes on," he says. "All of us who do this work are a tightly knit group."
They have to be, primarily because of the scarcity of organs. Fewer than 1 percent of all Americans die under circumstances favorable enough to render their organs viable for transplant. Almost all donors succumb to brain death, and since livers become unusable 10 minutes after the heart stops, their organs must be kept alive on life-support systems. Adding to the problem, grieving families are often unwilling to donate organs from their loved ones, and doctors seldom initiate the recovery of organs. Explains Broznick "When a physician loses a patient, maybe he thinks he's failed. He wants to wash his hands of the matter and get it over with."
Consequently, Broznick must travel more than 100,000 miles a year in pursuit of available livers. The work is physically exhausting—he's on call 24 hours a day, seven days a week—and emotionally draining. When he arrives to pick up a liver, he sometimes spends hours with the donor family to explain the need for organs. "I really live this job," he says. "People depend on me for their very life."
That was clearly the case on Dec. 8 when Broznick left to retrieve the liver in Nashville from a 23-year-old accident victim named Victor Brock. An auto mechanic who suffered severe head injuries when his motorcycle crashed into a tree, Brock was brain dead. But doctors at Vanderbilt University Hospital kept blood coursing through his veins and maintained a strong heartbeat while Broznick's team was summoned. Meanwhile two potential recipients, chosen from a waiting list of 60 for their similarity to Brock's body type and weight, were alerted. One, a 21-year-old New Jersey man, had advanced liver cancer; the other, a 33-year-old Arkansas history teacher, had severe hepatitis. Both immediately flew to Pittsburgh.
Five years ago these patients could not have expected to live more than a year, even with transplanted livers. Now, with a new antirejection drug, cyclosporine, transplant recipients have a 72 percent survival rate for one year. (So far the longest a liver transplant patient has survived is 13 years.)
While the dying men flew to Pittsburgh, Broznick began his own dramatic journey. At 8 p.m. on Dec. 8 Brian and two surgeons, Drs. Thomas Hakala and Marshall Orloff, boarded a chartered Learjet. Arriving in Nashville 80 minutes later, they headed for Vanderbilt University Hospital, where they encountered a frustrating delay. Doctors in New York had called to say they needed Brock's heart for a transplant at Columbia-Presbyterian Medical Center. It would take them three hours to get to Tennessee.
Broznick was unhappy. Time is crucial in all transplants—a brain-dead donor's organs cannot be kept "alive" indefinitely. But finally the New York surgeons changed their minds, and the operation began. Freshly scrubbed and wrapped in a blue gown, Broznick took his place at the operating table with Hakala, Orloff and a roomful of Vanderbilt doctors and nurses. Brock's chest was seared open with a scalding electric knife, and the surgeons began the painstaking three-hour-and-20-minute process of harvesting. Broznick helped the surgeons rinse blood out of the liver and administer a preserving solution. Then Dr. Hakala removed it from Brock's body.
It was now 5 p.m., but Broznick's work had just begun. After packing the liver into a picnic cooler filled with ice, he was raced to the airport. The Learjet's engines were already humming as Broznick and the surgeons scrambled on board. Within 85 minutes they were home. Meanwhile Vanderbilt surgeons were removing Brock's heart, kidneys and corneas—as he had stipulated on a form attached to his Tennessee driver's license—in the hope that they could be used for transplants.
Back at Presbyterian-University Hospital in Pittsburgh, doctors had already determined, after exploratory surgery, that the New Jersey man's cancer was hopelessly advanced, and he was later sent home. Jerry Lessley, the Arkansas teacher, was then prepared to receive the liver. When Broznick reached the operating floor, he put the cooler on a counter just out side the emergency room. "Is this it?" asked an anesthesiologist. Broznick answered, "Yes," and the doctor took the organ inside. It was 7:20 p.m.
In the OR the surgeons went to work. First they broke three of Lessley's ribs to make room for the football-size liver. Then they slid the organ into place and began to connect it to the teacher's own tissues. After 12 hours of surgery, blood coursed through Lessley's new liver. He would live. His color gradually turned from deep gold (a sure sign of liver disease) to healthy pink.
For Broznick, healing is a family tradition. The son of a hospital administrator and a housewife, he grew up in Pittsburgh, the older brother of twin sisters. He earned an associate's degree in biology at hometown Duquesne University in 1972. His first marriage ended in 1975 and he is now married to an administrator at a local VA hospital. His schedule leaves little time for family pleasure—holiday dinners and movie dates with wife Rosemary are often interrupted by Broznick's beeper.
The hardest part of his job is encouraging reluctant families to donate their relatives' organs. If a potential donor is within 150 miles of Pittsburgh, Brian approaches the family himself. Otherwise, they will be approached by an organ procurer in their own region. "I try to get the family to discuss their feelings, to vent their grief. If I have to sit with them for 10 hours, that's fine," says Broznick. "Sometimes the donor family gets angry. They think I'm there to take something away from them." In the case of Victor Brock, the organ procurer from the Nashville Transplant Program had an easy job. Brock's father, the Rev. Roy Brock Jr., a Baptist minister, consented immediately. "They tried to put a sales job on us, but we didn't need to be sold," the Rev. Brock remembers. "We had once talked to our son about organ donation. He'd be very pleased."
Jerry Lessley hopes to return to teaching in 1984, after eight years as an invalid. "For the first time in years I wake up feeling fine," he says. "It's kind of scary to be normal after so long." For that unexpected new life, Lessley knows he can thank the generosity of Victor Brock and his parents. And, of course, the dedication of Brian Broznick.
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