Six Hours to Save a Heart

Text by Li Han, Liu Xun & Wang Jiliang Photos by Liu Zhongcan

On the day of December 27, 2018, a breathtaking heart saving race was going on between Wuhan and Liuzhou—two cities separated by over one thousand miles.The precious heart of a young man who had passed away was being transported from Liuzhou to Wuhan to save a dying man.

The heart of the voluntary donor was removed at around 10 am in Liuzhou, Guangxi Autonomous Prefecture and then put into the chest cavity of a patient in Wuhan Union Hospital at 4 pm, which helped save his life.

This operation was successfully executed by the Running Heart Guardians from the Department of Cardiovascular Surgery of Wuhan Union Hospital.

下午1時50分，醫(yī)生在飛機上守護著器官轉(zhuǎn)運箱A doctors guarded the organ transport cooler on the airplane at 1：50 pm

A Heart in Need

“I desperately hope to live and would like to try my best even if there is only one glimpse of hope.” It was on the morning of December 27 when the 49-year-old Han lay abed in the Cardiovascular Surgery Department of Wuhan Union Hospital.He was consistently coughing and his voice became hoarse.His eyes were full of hope as he spoke about the heart transplant surgery to be done later that afternoon.

Han had worked on a construction site for many years.Since January of 2013, he started having coughing f its and often felt short of breath when walking up stairs.He had thought it might be a normal cold, but he didn’t get any better after two months.He had a full examination and was diagnosed with dilated cardiomyopathy (DCM) at Wuhan Union Hospital.By then, his heart had become significantly enlarged and could not pump blood efficiently, which led to a heartbeat of as slow as 30 times per minute.Han’s shortness of breath was temporarily abated with the help of a pacemaker.

Bad news came at the end of 2015 when Han’s health suddenly became worse.He couldn’t stop coughing and couldn’t breathe when lying in bed.He was admitted to Wuhan Union Hospital again and had a detailed examination.It was found that he had heart failure and the pacemaker could no longer work well enough on him.The only hope for him was a heart transplant.

Han suddenly burst into tears upon hearing that he could only survive by receiving a new heart.What’s more, his two-year old son had just been diagnosed with acute lymphocytic leukemia after being admitted to the hospital because of continuous fever.He ignored the doctor’s advice and decided to go home for conservative treatment, while using up all his savings as well as borrowed money for his son.

Han’s illness started to worsen in June of 2018.He had lost over 44 pounds and his skin was yellowing.His legs would become too weak to stand up on after walking several steps.He was referred to Union Hospital on December 3 because of his severe illness.The doctors said he needed a new heart immediately.

Hope From One Thousand Miles Away

It is typically very hard to find a heart donor for a transplant.Luckily, good news came from Liuzhou, Guangxi, on December 26, that there was a matched donor found through the China Organ Transplant Response System.

下午3時33分，器官轉(zhuǎn)運箱被搬上車，準備送往協(xié)和醫(yī)院The organ transport cooler was put in a special car at 3：33 pm and left for Union Hospital

In order to save Han’s life, Dr.Hu Xingjian, Hua Xiaoliang, and Sun Yongfeng, members of the Running Heart Guardians of Union Hospital, set out on the journey to get this life-saving heart back from Liuzhou with the necessary equipment.

Inside the ICU located on the 4th floor of the in-patient department of Liuzhou People’s Hospital, a brain-dead young man lied on a hospital bed.The three doctors were studying his medical record, treatment, and indexes of the body for preoperative assessment.The 22-year-old young man went to the hospital because of headaches in May 2017 and was diagnosed with a serious brain disease.The surgery didn’t work for him and his illness worsened day by day.On the morning of December 16, the young man, who was still lucid, said in tears that he would like to donate his organs to save other people.His parents consternated for a long time and finally decided to sign the Organ Donation Agreement.The young man was announced brain dead on December 25, and his heart, liver, kidneys, and other organs were all donated.

A Non-stop Journey

The heart removal surgery had been scheduled to start at 11 am on December 27, but it had to start an hour ahead because the liver had to be sent to Shanghai for another patient and there was only one flight from Liuzhou to Shanghai during the day, which was scheduled to take off at 12 am.

It was 9:30 am on the morning of December 27, all the medical physicians and staff stood beside the bed and paid silent tribute to the young man for three minutes.Half an hour later, the heart and liver were successfully removed and placed in the white organ transport cooler and sent to Wuhan and Shanghai respectively by doctors.

“The surgery has to be done within six hours after securing the heart so as to have the best effect,” Hu Xingjian said, “the longer the duration of cold ischemia of the organ, the lower the quality will be, and it will be harder to ensure the recipient’s prognostic effect.” The ischemia tolerance for a heart is around six hours, which means the heart for Han had to get to Wuhan Union Hospital before 4 pm on the same day so as to have the best possibility of success.

As it is quite far from Liuzhou to Wuhan, every minute counts.Hu Xingjian and his colleagues went to Liuzhou Bailian Airport immediately after picking up the heart.They also informed their team members in Union Hospital to prepare for the surgery.

The check-in staff at the airport heard about this and provided express service for the three doctors.The doctors boarded the plane with the organ transport cooler at 1:25 pm.

下午4時許，心臟被送到協(xié)和醫(yī)院手術(shù)室 The heart was sent to the Operation Room of Union Hospital at around 4 pm

Successful Surgery

The flight arrived at Wuhan Tianhe Airport at 3:30 pm and the three doctors were led off the plane first.Hu Xingjian got in a special car waiting at the airport with the organ transport cooler and rushed to Union Hospital.

It was drizzling, but there was no serious traffic jam on the way to the hospital.

Hu Xingjian reported the location of the ambulance at 3:50 pm and the medical staff started to anesthetize Han.Eight minutes later, Hu Xingjian lugged the heart into the operation room.The heart was placed into Han’s chest cavity at 4:20 pm and it beat again at 4:52 pm.The surgery was completed at 7:10 pm.It was known that Han’s vital signs were stable now.

救心大戰(zhàn)六小時

文/李晗 劉迅 王繼亮 圖/劉中燦

2018年12月27日，一場緊張的護心大戰(zhàn)在相隔千里的中國中部城市武漢和南部城市柳州之間展開。一顆寶貴的心臟跨越這兩座城市，讓一個不幸逝去的生命，點亮了另一個岌岌可危的生命。

上午10時許，在廣西柳州一位志愿捐獻者遺體中取下的心臟，下午4時許就放進了武漢協(xié)和醫(yī)院一位病人的胸腔，成功挽回了后者的生命。

完成這次生命接力的，是武漢協(xié)和醫(yī)院心臟大血管外科的“護心跑男”團隊。這里記錄的是他們與生命賽跑的全過程。

下午3時30分，武漢天河機場派人引導器官轉(zhuǎn)運箱出機場 A hostess from Wuhan Tianhe Airport facilitated the transport of the organ transport lunch cooler at 3：30 pm

湖北男子須換心保命

“我現(xiàn)在特別渴望活著，哪怕只有一絲希望，我都想試試。”27日上午，在武漢協(xié)和醫(yī)院心臟大血管外科病房，49歲的韓先生躺在病床上，不停地咳嗽，聲音嘶啞，想到下午即將開始的換心手術(shù)，他眼里滿是期待。

韓先生常年在建筑工地打工。2013年1月，他不時咳嗽，爬樓梯就氣喘，當時以為是感冒，但治了兩個月不見好轉(zhuǎn)，后檢查發(fā)現(xiàn)心臟有問題，到武漢協(xié)和醫(yī)院被確診為擴心病。當時他的心臟已顯著增大，心率最慢每分鐘只有30次，泵血能力告急，安裝起搏器后，呼吸困難等癥狀暫時緩解。

2015年年底，壞消息再次傳來。韓先生病情突然加重，每天咳嗽不止，一躺下就喘不上氣。武漢協(xié)和醫(yī)院檢查發(fā)現(xiàn)，他的心臟已經(jīng)衰竭，起搏器逐漸失效，唯一的生機是做心臟移植手術(shù)。

得知要換心才能活下去，韓先生大哭了一場。禍不單行。偏偏就在兩個月前，他兩歲的小兒子連續(xù)高燒不退，被確診為急性淋巴細胞疾病。他不顧醫(yī)生勸說，決定回家保守治療，將全家積蓄和借來的錢用于救孩子。

2018年6月起，韓先生病情再度加重，體重驟降40多斤，全身皮膚嚴重發(fā)黃，走幾步路就累得站不起來。12月3日，他被緊急轉(zhuǎn)到協(xié)和醫(yī)院，病情危重，必須盡快換心臟。

生機來自千里外

心臟移植，供體十分緊缺，幸運的是，經(jīng)過半個多月的等待，12月26日從廣西柳州傳來消息：通過全國器官移植分配與共享系統(tǒng)比對，當?shù)赜幸活w配型成功的供體。

為挽救韓先生的生命，26日下午4時許，協(xié)和醫(yī)院心臟大血管外科“護心跑男”團隊的三名醫(yī)生——胡行建、華曉亮和孫永豐，帶著設備立即前往柳州，準備把這顆救命心臟護送回來。

在柳州市人民醫(yī)院住院部4樓的ICU內(nèi)，一名已經(jīng)腦死亡的男青年躺在病床上，三位醫(yī)生正詳細了解他的治療過程和身體各項指標，認真進行著術(shù)前評估。這名男青年22歲，和父母在南寧打工，2017年5月因頭痛住院檢查，被確診患有嚴重腦部疾病，手術(shù)治療無效，病情逐漸惡化。12月16日上午，尚處于清醒狀態(tài)的他流淚表達了捐獻器官、救治他人的意愿。經(jīng)過激烈的思想斗爭，痛苦的父母在器官捐獻協(xié)議書上簽了字。25日，青年被正式判定腦死亡。心臟、肝、腎等器官全部捐獻救人。

護心奔跑不停蹄

取心臟的手術(shù)原定于27日上午11時進行，由于其肝臟要送往上海救治另一名肝移植患者，而當天從柳州飛往上海只有中午12時許的一趟航班，手術(shù)提前到10時開始。

27日上午9時30分，參與手術(shù)的醫(yī)護人員靜靜站立在男青年病床兩邊，為他默哀3分鐘。半個多小時后，心臟、肝臟被順利摘出，分別裝入白色的器官轉(zhuǎn)運箱中，由醫(yī)生分別送往武漢與上海。

“需要在6小時的黃金時間內(nèi)完成手術(shù)，才能確保手術(shù)最佳效果。”胡行建告訴筆者，“器官離開人體后冷缺血時間越長，其質(zhì)量就會越差，器官移植接受者的預后效果也越難保證。”心臟耐受缺血時間為6小時左右，也就是說，要確保韓先生移植手術(shù)效果最佳，必須在下午4時前將供心從千里之外的柳州送到武漢協(xié)和醫(yī)院。

距離遙遠，時間緊迫。取得心臟供體后，胡行建等三人迅速趕往柳州白蓮機場，同時提前通知協(xié)和醫(yī)院手術(shù)團隊做好各項術(shù)前準備，確保無縫對接。

機場值機人員得知情況，迅速為“護心跑男”團隊的三名醫(yī)生辦理了相關(guān)手續(xù)。下午1時25分，三名醫(yī)生和裝著寶貴心臟的器官轉(zhuǎn)運箱，安全順利地登上了飛機。

手術(shù)順利完成

下午3時30分，飛機抵達武漢天河機場。“護心跑男”團隊的三名醫(yī)生被安排率先下機。胡行建帶著器官轉(zhuǎn)運箱上了早已等候在機場的專車，以最快的速度趕往協(xié)和醫(yī)院。另外兩名醫(yī)生則去取行李。

天下著小雨，所幸一路未出現(xiàn)嚴重擁堵。

下午3時50分，離醫(yī)院不遠時，胡行建報告救護車所在位置，醫(yī)護人員開始為韓先生進行術(shù)前麻醉；8分鐘后，胡行建將心臟供體交到手術(shù)室同事手中……

下午3時58分，器官轉(zhuǎn)運箱在醫(yī)院門口被搬下車The organ transport cooler was taken out of the car at 3：58 pm in front of Union Hospital

下午4時20分，心臟供體植入韓先生胸腔；4時52分，心臟恢復跳動；7時10分，手術(shù)順利結(jié)束。據(jù)了解，韓先生情況平穩(wěn)。