Episode 3 Scotland's Superhospital

Glasgow's skyline has changed.

Four of the city's oldest hospitals have closed their doors.

And Scotland's biggest and most talked-about hospital

has taken over.

My name's Davie. I'm going to take you for a wee X-ray, OK? Yeah.

Three-quarters of a million patients are treated here every year

using state-of-the-art technology...

I've got the manoeuvrability down there with the robot.

..cutting-edge operations, and world-class scientific research.

He said it had been grown in a laboratory in America.

I'm going to be one of the first.

That's quite good.

This massive building

is transforming health care in Scotland.

There's nowhere else in Scotland

that could have done everything that we've done.

But is big necessarily better?

I think on average we walk about 20 miles a day, which is a lot.

I'm in an airport or I'm in a hotel. It's a cross between the two.

And in a hospital this size,

are they in danger of losing the human touch?

Can you hear me?

You could go home irredeemably mad

if you spent all your time in a single room.

It's all technology now. I don't like it at all.

The hospital's absolutely wonderful.

The staff can't be praised high enough.

Fantastic.

The Queen Elizabeth University Hospital

is the largest acute hospital in the UK

and home to many of Scotland's specialist services.

The busy renal unit on the fourth floor is the sole provider

of kidney transplants for adults in the West of Scotland.

Staff here perform around 160 of these complex operations every year.

And they care for over 600 patients on dialysis.

Charge nurse Susan Easson moved here

from Glasgow's old Western Infirmary.

Hello, 4C sister.

Dialysis is taking over the job of the kidneys that aren't working

properly. The patient has to be on it for at least four hours,

generally three times a week.

Fully functioning kidneys filter waste products from the blood,

turning them into urine and preventing

the build-up of fluid in the body.

Dialysis is life-saving.

Whenever your kidneys stop working,

the two things that will catch you very quickly are water,

that you can't get rid of because that's what you pee out.

And potassium - a salt in your blood,

that if it gets too high is very dangerous.

And that will end your life very quickly.

Although dialysis keeps patients alive, it takes its toll.

Life on dialysis is brutal, it's absolutely brutal.

You feel rubbish all the time.

You feel drained because you're tired all the time.

It might not sound all that much,

because it's only four hours out your day,

but when you are doing that,

face that every single week in, week out, it's...

You know, you can't live on dialysis forever.

And the only way you can get away from that is with a transplant.

But with over 5,000 people on the UK transplant list

and only 36% of the population signed up to donate,

it can be a long wait.

The unit has just received a kidney from a deceased donor.

It's a potential match for one of the hospital's long-term patients.

Surgeon Karen Stevenson must assess if it's fit for transplant.

This is the kidney that's been delivered to the ward.

It's delivered to the same place every time,

and we have to sign it out of here

and take it down to theatre so that we can prepare it and check it

before we transplant it.

The patient has been called in to wait on standby.

Hello. I'm taking your blood pressure - is that OK?

Yes.

If the kidney is in good shape,

it could be life-changing for 48-year-old Rose Mpofu.

I was diagnosed with polycystic kidney disease

when I was about 22 years old.

And I was basically told that my kidney function,

because the kidneys have got little cysts in them,

my kidney function would eventually deteriorate as I grow older.

And I would need, I would come to a point where I would need dialysis,

no question about it, or a transplant.

Rose, who moved to Scotland from Zimbabwe 14 years ago,

has been on the transplant list for over two years.

I went on the list in April of 2014.

And I got told because of my ethnicity

that it would be difficult - not impossible,

but it would be difficult to get a donor

because there are not that many people, ethnic minorities,

that are, you know, registered donors.

People from the same ethnic background

are more likely to be a close match.

But with a shortage of ethnic minority donors,

patients like Rose will wait an average a year longer

for a kidney transplant.

The longer a kidney is without a blood supply,

the more likely the transplant will fail.

Karen needs to transplant this kidney within 16 hours.

Other organ transplants have to be done more quickly.

Hearts have to be in in a much shorter timeframe.

Kidneys, you've got a little more leeway with them.

But we'll take it down to theatre now,

we'll check it and then she'll come down to theatre

as soon we can make that happen.

It's a long waiting game now.

A new kidney for Rose would transform her husband Gilbert's life, too.

Fingers crossed, fingers crossed.

It's the quality of life, it's a big improvement on your quality of life,

because, if you are living with

kidney failure, it means that three days of your life, every day,

every week, have to be given away to dialysis,

and you have to plan out your life

around the trips to the renal unit

every week. So if something could be done to reduce that

or to eliminate that altogether,

that would be more than she could ever ask for.

As soon as I know, you will know, OK? I promise, all right?

Just hoping that all this waiting is going to be worth it

in the end. So...

Yeah, hang in there, hang in there.

Most dialysis patients have to make their way to the hospital for

treatment. But some have it at home.

20 miles north-west of the hospital in Balloch,

one of the hospital's patients, Maureen Graham,

has converted her spare room into a mini dialysis ward.

This is what keeps me alive, you know.

I'm just so grateful that this is a treatment that I can do, you know.

It's not great, it's not what you want for yourself,

but it keeps me going.

You know, I'm able to lead a normal life...ish.

In between times.

59-year-old Maureen has suffered from kidney disease

for over 20 years, and has been on dialysis for 11.

Being hooked up to a machine makes life difficult enough.

But Maureen must also restrict her fluid intake.

I'm limited to 750 mls per day.

So, 750 mls, that's two cans of Irn-Bru, 660.

You know, so... That includes the milk in my cornflakes.

I've not had soup for two years.

Maureen's husband, David,

helps her with dialysis every other day for four hours each time.

We've more or less got this down to a fine art now.

We've been doing it for awhile.

First we had a few issues.

I think you thought you were hurting me, didn't you?

I found it very stressful... in the early days.

And to some extent it still is.

It's not "poor Maureen" in her eyes.

But let me tell you, what she does and what she goes through, nobody,

even our closest friends don't really know

just what she's subjected to.

Years of dialysis have scarred Maureen's veins.

If she continues with it,

she could soon need major surgery on her blood vessels.

For someone like Maureen, if she did not get a transplant,

then she would die a lot quicker.

And she would have a lot of difficulties in the last few years

of dialysis.

Transplant is the answer.

It's the only way.

It's the only way forward. It's the only way to get our lives

back to normality.

What we do is...

We're existing.

You know, this is an existence, it's not a life.

Maureen's damaged blood vessels

mean she needs a transplant soon.

So a living donor is her best option.

If you go on the waiting list for someone to die to get a kidney,

quite often you'll get called up, brought in

and for one reason or another it's not suitable to transplant,

and you come in and out, in and out, waiting.

And you don't know how long you're going to wait.

If you've got somebody who's going to give you a kidney,

that's what's going to happen, there is a day and a time when it is going to happen.

DOORBELL RINGS

Maureen had to find someone who was willing

to give up one of their own kidneys.

It turned out her perfect match was her lifelong pal, Del.

Hello, are you all right?

You're looking well. So are you, so are you.

We've known each other a long time, Del. We have.

I think about 45 years.

Oh, God, no, it's not that long!

I think this is the

oldest photograph I've got of us both together.

Do you remember that jacket? Yeah, seersucker.

Tartan seersucker. Oh, it was just awful, wasn't it?

I thought I was it. Oh, you were! I was!

And you still are! I still am!

That's great.

For me to be a match was just incredible.

And if anybody was going to do it, I would rather it was me.

So... Oh!

Well... I know, I know.

But... It's still just...

It means so much to both of us, really.

You know, we've been friends for years, through thick and thin.

And for me to be able to do this for Mo, well, it's just confirmation,

you know, of just how dearly I,

you know, I love her, really.

This selfless gift could be life-saving for Maureen.

But Del will be left with just one kidney.

And a small risk that she might need dialysis herself.

Del's like a sister to me.

She's always been like that. We've always been like sisters.

And I try not to get emotional about it.

I try not to think about it and just be matter of fact and,

this is happening, that's happening.

And then sometimes I just...

The enormity of it just washes over me and I think...

What?! What, really.

There are no words.

None.

Anyway...

My pal.

The Accident And Emergency department at the superhospital

is the biggest in Scotland,

seeing around 1,800 patients every week.

One of the biggest changes introduced here

is how emergency patients are treated.

The difference in this hospital is

that there is a separate unit which is called

the Immediate Assessment Unit,

and that is actually where GP referrals go.

Hello, IAU, how can I help you?

And that's been obviously a paradigm shift in terms

of what we see.

So the A department only treats genuine emergencies.

It was hoped this new set-up would reduce waiting times.

But even the new system has struggled to cope.

I think we're seeing that across everywhere in Scotland, England,

Wales, Northern Ireland.

The hospitals especially now are at breaking point,

because the admission rates are much higher,

and patients are unfortunately

getting older and perhaps a wee bit iller,

requiring more and more demand and more and more care.

From road traffic accidents...

He's had a penetrating wound from dashboard glass to his right pectoral.

..to stabbings...

A slash wound to the right side of his face, right the way round,

almost level with his eye.

..and falls...

..the staff here see it all.

Somebody might have stabbed us.

Are you used to dealing with patients like this?

Constantly, especially when it's football season.

There's a team of 58 emergency doctors who work here.

And once in awhile,

they find even classic A cases can take an unexpected turn.

Well, basically after 35, 36 years,

I decided to take up skateboarding again.

And basically gave it a blast this morning,

and everything was going really well.

I thought I'd have one last run before I went home.

And that was the run that didn't work out.

And basically slammed into the concrete from a good few metres.

And it looks like I've broken my ankle.

I don't know why I'm laughing!

Because my wife won't be laughing.

At all.

I think I'm going to have to tell her the good news now.

Hi, it's just me. Hi.

Right, you know how I said I thought I'd just twisted my ankle?

In three places.

I know. I know.

I should have listened to you but...

Hi, I'm Amit, one of the A consultants.

How are you doing? I think you've seen Malcolm as well, so...

We think you've got a fracture across a few of the bones of your ankle.

Right. So you might need an operation to fix it, OK?

Before the operation, Neil's ankle must be manipulated back into place.

This should actually clunk back in fairly quickly.

Right. You just need a good painkiller.

Right. The one that we actually use now more commonly is ketamine.

Ketamine is a fairly powerful anaesthetic drug and it's quite unique.

It works by dissociation.

So the patient may be awake, but not aware of their surroundings.

Rather than being completely under, like some of the other anaesthetics.

So think of somewhere nice.

South Africa, that's where all my friends are.

Brilliant. A nice sunny day.

Think of happy times.

And when you wake up we will have this plaster on for you.

OK?

You'll start to feel your eyes going slightly odd.

Wow!

Ooh! So he's had some ketamine.

It's pretty strong stuff.

So he may scream out in pain or do any of this stuff.

But he's actually unaware of what's going on.

Aaahh! God!

Yee-ha!

Oh, yeah!

Open your eyes for me. Feel the burn.

Feel the burn. Good stuff.

That's cool. Oo-ooh!

As the team manipulates his ankle back into place...

Ooh-ahh!

..Neil is oblivious.

Ahhh!

Woo! Woo!

A cast keeps Neil's ankle stable until his surgery.

OK, Neil... Well done. That's you. That's us.

I'm the man!

This is good!

Yeah! Wow!

Baby! Go for it!

Sshh! Yeah!

OK, Neil. Excellent!

Woo-oo-oo!

That's you. You've got your plaster on, OK?

Already? Yeah.

You did well. Come on.

That's you done, OK?

You had quite a good wee trip there, all right, so we'll leave you to it.

That's the best skate... Here's your goggles back on.

Snake line...

Long roll snake tube ever.

OK. I think he liked it!

Yeah!

Get on board!

So his reaction was probably slightly atypical,

but it was still a positive reaction.

Wipe-out!

But his is a more interesting reaction so far.

Hi. Neil. Is it Neil Buchanan?

Yeah, I'm suffering. Leave me alone.

Can I ask you a couple of questions?

How rad am I? No!

Is your ankle sore? How are you feeling?

I'm feeling like I could probably walk across the ceiling on it.

Dancing on the ceiling? Yeah, Lionel Rich Tea.

# What a feeling! Dancing on the ceiling. #

Neil's wife has come to join the party.

Are you away with it?

Yeah. What are you like?

Feeling a bit woozy? It was brilliant.

It was really good. I'm sure it was.

I just remember it being really bright and colourful,

and everybody just went...

It was something like a cross

between Charlie and the Chocolate Factory

and The Matrix, with skateboards and surfboards.

And it was really cool.

Honest to goodness, what are you like?

This is the one occasion that I wish I wasn't right.

That skateboard is going in the bin.

See you later. All right.

Cheers.

Neil's next trip is up to the ward to wait for his surgery.

Thanks, boys.

The sprawling hospital campus is one of the largest in western Europe,

and equal to the size of 39 football pitches.

It's like a town in itself.

David is trying to navigate his way to the renal and transplant unit.

Tomorrow, Del will give his wife, Maureen, her kidney.

The two couples have travelled from the shores of Loch Lomond

to prepare for the big day.

This is the main entrance to the hotel.

Hotel!

Well, it is like a hotel. They're going on a holiday, these two.

Where is Maureen?

Where is Maureen?

David Kingsmore is one of six permanent transplant surgeons

here in Scotland's busiest renal department.

He has known Maureen for 11 years.

Right, are you decent now? Hello.

Hello. Lovely to see you. And you.

The first thing you know is you will get pushed down to theatre,

probably about 11 o'clock, 11:30, they'll be sending for you.

Really? Yeah, yeah.

It's Mr Clancy doing Del's side.

He's very fast, actually.

Good, right. See you tomorrow.

It's great. I'm glad we are here. Good. Good.

Kind of looking forward to it. More than we are!

See you later then.

See you tomorrow.

Bye-bye. She does dip quite a lot.

Del's kidney will be removed by surgeon Marc Clancy.

He has the unusual job of performing surgery

to remove a perfectly healthy organ.

There is a theoretical risk that if you reduce the amount

of kidney function someone has,

they may run into problems in the long term themselves.

But we make sure the risk of that is absolutely minimised.

We don't want patients donating their kidneys

to have any risk of ending up on dialysis themselves.

We can't make that risk zero.

We have to be honest. But we make that risk very, very small.

I'm going to see Del now,

to say hello. We haven't really met before.

Hello, hello. I'm David Kingsmore.

Hello, hello. Hello, hello, hello, hello, hello.

All set for tomorrow?

Yes, yeah. It's quite a big thing to go through.

Your side is the harder side.

Yeah. It's much harder.

And you'll find it a right hard knock to your system.

Yeah. There are no two ways about it.

Sometimes you may need a blood transfusion,

you get problems with the wounds.

The second, third day you'll feel pretty glum and down.

You'll be sore, your tummy will be all blown up.

And you'll just feel absolutely miserable.

And you have nothing good to show for it.

The only gain you get is that you will actually

have saved somebody's life.

That's a great thing to do.

Thank you. There are not many people sitting in your seat,

you know, stepping up for it.

It's a great thing. I admire people who do it.

Thank you very much.

See you tomorrow then. All right, very nice meeting you.

And you. Thank you. Bye-bye.

It's vastly more stressful to do a live donor transplant

than any other kind.

There are two people putting their lives on the line, not one.

One of them will start off very fit and healthy,

and their life is on the line to make a difference to somebody else.

Not only are you thinking about the person receiving it,

but somebody else has put their life on the line

to give you that opportunity.

You met Mr Kingsmore?

He's lovely.

Yeah. Great guy, isn't he? Yeah,

but he told me just exactly how I was going to be feeling!

You know, I was thinking, you're not really selling this to me!

Did you say that to him? No!

I might not like you for a few days.

But...

That's what I'm worried about.

I know. But so long as it works out for you, that's the main thing, so...

Fingers crossed.

At the superhospital,

it's much more common for a kidney transplants to come

from a deceased donor.

But in Rose's case,

it has taken two years to find a potential match.

Now she is waiting to find out if the kidney is suitable for transplant.

Hi, Rose? Hi.

Hiya.

So, we heard back from the tissue typing lab.

And the crossmatch test is negative,

and that means we can go ahead with the transplant.

Oh, thank you. We will get you sent down to theatre and we will take

things from there. All right?

Any questions for me just now?

No, I'm all questioned out.

All right. No bother.

OK, so we'll see you soon.

All right? Bye-bye. Thank you very much.

SHE SOBS It's hard.

When someone is called in for a transplant,

they go through an absolute mixture.

And they're kind of - they go through a wave.

They feel absolute excitement, trepidation and they are very,

very excited. Thank you.

And then they do, they certainly do hit a wall, and...

..they become...

They start to really start feeling about the donor's family and they

really start

wondering about that person and that family.

I feel so relieved, like a weight

has been...taken off me.

Just feeling emotional right now and again...

I keep on thinking of my donor and...

I'm just so grateful.

Someone's family...

..has been improved by someone's worst nightmare.

And we get to see that.

And it really is, it's life-changing.

And it's incredible.

And it's a gift.

I'm just so, so thankful.

This is going to make such a huge,

huge difference to my life.

At last, Rose has a match, but there's still a long way to go.

There's no guarantee that a kidney transplant will work.

We still have kidneys that we occasionally put in

that either don't work for quite a while,

or, on the very rare occasion, never work.

Overall, it's by far and away the most...

..effective way of treating renal failure.

In terms of people's quality of life, and in terms of the costs,

having a transplant is actually a much cheaper way

to look after someone than having them on dialysis.

It's nearing midnight and Rose has finally been called to surgery.

If everything goes to plan,

the procedure should take no more than four hours.

Can I get a small swab, please?

It takes Karen and the team just over two hours to get to the crucial

moment of sewing in the kidney.

So that is the kidney re-perfused.

So the blood supply is being put back to the kidney.

But almost immediately, Karen notices a problem.

There's actually some bleeding in there.

That's a little unusual.

So I'm just going to sit with my finger on it for a bit,

see if it stops,

before I join the ureter on to the bladder.

I'm just hoping that the operation will be a success.

That's all we are praying for right now.

That something good will come out of what has been going on today.

Can I get some wash, please?

Karen has been able to stop the bleeding.

Now there's one last check to make sure the transplant has worked.

What we'll do know is, once we close the skin,

we will scan it to make sure there is blood going in and out of it,

and round it. And that's all we have to do.

There is blood flow there.

Which is all we need to see.

After almost three hours of surgery, Rose is taken to recovery.

When the old Yorkhill Children's Hospital closed its doors for good

in the summer of 2015,

almost 2,000 members of staff moved south across the river into the new

Royal Hospital for Children.

This centre of excellence is the biggest in Scotland,

treating children of all ages up to 18 years old.

At the heart of the hospital is this huge 70-foot high atrium,

designed to make waiting for appointments much more fun.

Today, it's been turned into an Olympic arena.

Today, we've got the Olympics,

we've brought them to the Royal Hospital For Children in Glasgow.

We've got lots of different sports for the children,

so that they can share the excitement

and enter into the spirit of the Olympics.

CHEERING AND LAUGHTER

As Spider-Man tees off on the roof...

Ooh!

..there's another superhero in the neuroscience ward.

Good shot.

Can you point it at the ten? See the board?

Oh, good shot, well done!

Four-year-old Laurie is recovering from surgery

to remove a brain tumour the size of a golf ball.

Good shot!

Laurie came into the hospital with a brain tumour,

and she had to have that removed about two weeks ago.

And she just turned a corner on Monday, she started speaking again,

and talking and walking.

It was just really, really, really good progress.

We're so excited. It's great.

After her operation, Laurie was in a bad way.

She couldn't talk or walk for ten days.

'Today was the first time she's walked any distance.

'She's only done two or three steps in the room that we've got,

'and at physio.'

Who's my wee champion?

'So today she's walked from her room all the way round to the playroom

'and back again, with a bit of support, which...'

Cloud nine, cloud nine. Couldn't be any better.

You've done such a good job, darling. That was awesome!

Where's my cuddles?

Thank you. Will we phone Daddy and telling that you've

been walking about? Yeah. Yeah? Eh?

Laurie's being cared for in the children's neuroscience ward,

which shares staff with the Institute Of Neurological Sciences,

the largest centre of its kind in Scotland.

It's just one area of medicine that's benefited

from the design of the super hospital.

Because the children's hospital and the adult hospital

are interconnected, medical expertise can be shared.

This has been shown to improve patient outcomes and survival rates.

Neurosurgeon Roddy O'Kane works between both hospitals.

From my viewpoint, it's been brilliant to have the

kids' hospital move over here.

It means that I can be across a corridor

and, essentially, be at the children's hospital,

and then cross back and I'm back at the adult hospital.

And so you find that your ability to see patients that you've been

dealing with on and off over a while,

you can maintain that much better.

Eight-year-old Isla was admitted through children's A yesterday.

She has a genetic condition that causes hydrocephalus,

where fluid accumulates in the brain,

causing debilitating headaches.

It'll give you such a bad headache,

you'll not be able to participate in activities of daily living.

So she will get worse and worse as this goes on.

It'll affect her vision.

And, obviously, if you have very severe headaches,

you're not able to learn. But ultimately it would lead to

coma and then on to death.

The build-up of pressure can become catastrophic within hours,

so Roddy needs to operate today.

If you come in, you're in the main seat.

OK? And Gran's going to take that seat on the side, OK?

That's my brain. That's your brain.

Can you believe it? The next time somebody says to you,

"You don't have a brain," you can say, "Well, I've seen it,"

and I bet they won't have seen theirs. OK?

'Dealing with children is different to dealing with adults,

'there's no doubt about that.'

Dealing with very young children, it's about trying to get them

to understand what they have, why they have it,

why you're going to do things,

why you might do things that mightn't be very pleasant in the

short-term, and try to get them on board.

So it's more time-consuming and a very different way of working.

So, you see this white bit here?

That's fluid that everybody has in their brain.

The brain has a brain water, OK?

And it's kind of made and it's made all the time,

and it gets drained all the time.

So, what happens is sometimes there's a blockage

because the brain water kind of travels from here,

the whole way down, block.

You know the pipes at home?

If they get blocked, you have to get a plumber?

OK. And that's blocked there.

And that's made this one very big, OK?

We can't leave you with that, cos that's what's giving you

the really bad headaches, OK? And it'll affect your vision.

But do you know what? There's a wee layer there

and I can pop a hole through it.

So the water will have a new way of going round your brain,

and it'll get absorbed and your headache will get better.

Does that sound like a good idea?

So I'm kind of like a brain plumber.

Yeah? Except I'll come on time and I won't charge you!

LAUGHTER

Say high-five. High-five for that?

Go on.

I'll follow in a wee second.

If you're operating on children, you're very nervous.

I have my own children, and so...

Isla is the same age as one of my daughters,

so you can't help but transpose that onto your thoughts.

But you have to try and remain objective,

you have to just try and remember what you're there to do,

do your job, try to remove the emotion from it and get on with it.

Can you tell me how you feel about having the operation?

I'm not feeling good about the operation.

Why not? Cos it scares me.

Without the operation, Isla's brain will be under increasing pressure

and she could go into a coma.

But the surgery she needs is not without risk.

Every procedure I do will carry a risk to life,

and I have to let you know that. Yeah, yeah, I know. OK?

And so pardon me for being explicit about it. No, it's fine.

The big risk is there is a big artery that

supplies the brainstem down here, just where we make the hole, OK? OK.

And that's the big danger with it.

So the risk is very small with it.

But it's there and it's obviously very, very serious.

OK? But...

..if she were my daughter... Yeah. ..this is exactly what I would do,

with complete conviction. I'm leaving her in your hands. OK.

Well, I'll look after as if she was my daughter, OK? Yes, right.

That's fine. So we'll get her down there and I'll come

and talk to you afterwards. OK. How long does it take?

The procedure, it takes about an hour to set up the equipment,

and 20 minutes to do the procedure. You're joking me? Yeah.

Within an hour, Isla will be taken for her life-saving surgery.

Back in the adult hospital, Rose,

who received a deceased donor's kidney,

is recovering from her surgery.

She can finally enjoy a glass of water,

after years of fluid restriction.

It's one of those things that people take for granted.

But for me, oh, absolutely pleasure, a fabulous moment.

To be able to be told you can drink as much as you like, oh...

Unbelievable.

Unbelievable. That's all I can tell you.

It just... It's amazing, really.

It's amazing. It's water, but like you've never tasted before.

# Every day

# Every day

# Every hour. #

Rose's friends have come to give thanks for her kidney.

THEY SING IN DIFFERENT LANGUAGE

Rose is like a sister to us,

and we've been with her through the journey.

We've been waiting for a transplant for over two years.

She's a very strong woman.

She's a very good fighter.

And we knew one day it's going to happen,

so we are very, very, very happy.

It's the best thing anyone could ever do, to donate their kidney.

Thank you for everything.

'It's vitally important that people understand

'how important donation is.'

Donation is everything.

There will always be technicians like me to sew things in.

There's not any number of people who will give kidneys.

44% of Scotland's population has signed up to donate

their organs after they die - well above the UK average.

But there are still around 500 people waiting

for a kidney transplant in Scotland.

If only everyone had a friend like Del.

Right, Del. OK. I shall see you...

You shall. ..when you're asleep. Yeah!

Del is taken to surgery first to have her kidney removed.

If all goes to plan, Maureen will take her place in theatre

and have Del's kidney transplanted into her.

Surgeon David will have the job of sewing the kidney in,

but first his colleague, Marc Clancy, must remove it.

It's always very stressful to be operating

on a perfectly well person.

The stakes are very, very high.

It's probably the highest stress operation that I do.

First done in the 1950s, and the surgical operation will be

exactly the same as it was done in Boston way back then.

Sewing the same bits of the kidney to the same places.

It's tried and trusted.

Can I have the table up a bit, Neil, please?

I'm starting.

Marc is using keyhole surgery.

He's made three cuts in her belly

and is using tiny probes and a camera to carry out the procedure.

I'm trying not to put anything hot on the colon.

Del will recover faster, with less pain, after this type of surgery.

So if you scan slightly down into the left, as we look.

'Whilst we've done everything we can to refine the process'

and make it as safe as it can possibly be, we believe

there are still risks to having major surgery

and to having a healthy, functioning part of your body

removed for no benefit to yourself.

Two floors up, Maureen knows she'll only be called for surgery

if Del's kidney is successfully removed.

Quite nervous this morning.

Anxious about what's happening to Del,

wondering if everything's going to plan.

Hoping it is, hoping she's OK.

Just, you know, lots of things going through your head.

She absolutely does not know how amazing this is.

She just doesn't. She just doesn't.

But she wants my life to change, she sees how I struggle.

Right, you see the pale looking stuff beneath?

That's the surface of kidney there, coming into view.

It takes just 90 minutes to prepare Del's kidney for extraction.

Can you please call David to theatre, Val?

I've dissected the kidney on all sides from its surrounding tissues.

It's now attached by a ureter, an artery and a vein.

The most critical part of the operation

is the three minutes or so it takes to divide the two vessels

and remove the kidney, and you'll notice I say a little prayer.

I've got my own special prayer for that situation,

which you'll see in a minute.

OK? Yeah, yeah.

One, two, three,

four, five, six, seven.

All good surgeons go to heaven.

OK?

Scissors.

This kidney is now attached by nothing.

It has no blood supply to it.

It's to all intents and purposes like a person swimming underwater.

And now I have to take it out, and I take it out just here,

and I'm going to give it to David to go and prepare it.

So, that's nice.

Here is the kidney, there's the ureter.

It's lovely, it's really good.

That went smoothly. Beautiful kidney is out, patient is dry.

We've made the minimum cuts that we can really make.

It's a couple of days in hospital, a rapid recovery,

and you remain a healthy person for the rest of your life.

So it's a fantastic gift,

and you come out of it the other end

with your perfect health intact, we hope.

And yet you can give a tremendous amount of good health to your

loved one.

As Marc stitches Del back up...

Scissors, please. ..David checks the kidney is suitable for transplant.

So, that's me wrapping the kidney up in bags.

There's the kidney in there, nice and happy and healthy,

there's a bit of fluid around it, no ice around it.

And then I'll be packing it into a box of ice...

..where we keep it safe till we get Maureen ready to go.

Good luck, David. Hope it all goes smoothly.

Del's kidney is stored on ice while she's taken to recovery.

Good.

But for Maureen, the critical moment is yet to come.

There we go.

Del's operation has taken place in one of the adult hospital's

20 theatres.

Over in the children's hospital,

one of their nine theatres is gearing up for young Isla's surgery.

It's just one hour after she saw neurosurgeon Roddy O'Kane.

Scans are up, equipment's ready.

Lucky socks are on.

Her painful headaches should be relieved

by removing the fluid building up in her brain.

So this medicine sometimes feels a little bit tingly

as it goes up your arm.

LAUGHTER

Isla's condition is commonly treated by implanting a shunt,

a thin plastic tube which drains fluid from the brain into the tummy.

But Roddy is using a more cutting-edge approach,

which should last Isla a lifetime.

The alternative strategy,

and probably a bit more contemporary in terms of neurosurgery,

is where we pass an endoscope into the fluid lakes of the brain

and make a hole so that the fluid can bypass a different way.

OK. Knife again.

Opening a head and manipulating brain or manipulating blood vessels

around brain, there's risks of infection,

there's a risk of causing a stroke.

You could go under a procedure and actually come out worse.

And there's the risk to life.

Roddy has drilled through Isla's skull so that he can release

the fluid putting pressure on her brain.

OK, that's me. You can see the brain water coming out.

There we go. I'd say that's pressure.

Trevi Fountain.

OK, lovely. Top lights down, please.

The pressure has been released, but the most risky part

is still to come.

They need to make a hole in the base of Isla's brain

to divert the fluid permanently.

This delicate procedure requires two surgeons.

OK, that's all you.

Roddy is operating the camera,

while trainee surgeon Paul Fyvie makes the hole which will allow the

blocked fluid to flow freely.

Give us a wee push. Nice and gentle.

It's not the speediest. OK, just gentle back, come back a bit.

OK.

OK, inflate.

OK, and back out.

It's certainly wafting a hell of a lot more.

OK. Top lights on.

It's taken just 20 minutes,

but Roddy won't know if Isla is OK until she comes round.

The sigh of relief doesn't come at that stage when you've

finished the operation. It comes when the patient wakes up

and they're not damaged.

Isla? Time to wake up.

Has she moved stuff yet? Has she moved?

Yeah.

There we go. Are you OK there?

That's your operation all over.

Can you wiggle your toes?

At this stage in the journey,

I'm just kind of glad to be here right now having not damaged her,

now just to see what happens.

We'll see how she progresses over the next few days.

Probably get a scan of her within the next five days

to see if we've got function and...

..flow through the hole we've made.

And see how she progresses.

Isla is back in the children's neuroscience ward.

She's survived the operation,

but Roddy must wait to find out if her headaches have gone.

There are 38 operating theatres across the hospital campus,

and they all need blood on standby.

The haematology and blood transfusions unit

stores and tests blood for every hospital department.

Here they process 10,000 blood samples every day,

using the longest automated tracks in Europe.

Hi, how you doing? How are you doing, all right?

In a year, the blood transfusion unit takes in 18,000 units of blood,

more than any other blood bank in Scotland.

On a daily basis, it could be anything between 50 and 100 units

of various things. Probably more, sometimes.

Getting the blood to where it's needed in a hospital

this size is no mean feat.

This is a big campus. You know, we stretch from one end, neuroscience,

right over to maternity, and both the adult

and children's hospital in between, so we're quite a big area,

quite a bit geography to cover.

So we have a number of blood fridges deployed within the hospital,

so that facilitates the management of blood to the patients.

In theatre block, blood is stored in this automatic blood dispenser.

MACHINE: Enter your personal ID number.

It works like a vending machine,

speeding up getting blood into theatre by 15 minutes,

which can make a significant difference to a patient's chances.

Remove the unit from the tray.

And it could supply blood for Maureen's transplant operation.

Should she need it.

Here we go.

Less than two hours after Del's kidney was removed,

Maureen's being prepared for surgery.

Six scissors. One, two, three, four, five, six.

Right, perfect.

'Whenever you get to know somebody,

'it's nice to be able to close the circle.'

This is, for me, very important, to see it finished.

Although David Kingsmore has performed over 100 transplants,

he never takes it lightly.

So, for me, this is where it starts getting stressful.

I don't sleep the night before doing these things.

Is it all transplants, or...?

No, live donors are very stressful.

Have you got the punch? Thanks.

Just need the tension kept in a very certain way.

As Del recovers upstairs...

..it's finally time for her pal to receive her extraordinary gift.

'This is her last chance.

'You know, she's not getting any younger,

'and the years that she's been on dialysis,

'it does take a toll on your body.'

That's a good view. That's nice.

It's a wee bit awkward, but it looks pretty good.

'This is the start of a new life for her,

'so I'm just dead chuffed I'm able to help her.'

All righty, so that's us sewn the kidney in,

so now's the moment of truth to see how it all does.

Now cut.

So, that's the kidney now open.

See it change colour.

And it's gone that purple colour.

That's it, it's done. That's the kidney in.

We haven't finished off the operation,

but that's the kidney pretty well in,

and nice and healthy and there's nice bleeding

from the surface there. A wee touch there.

So that's it now.

We can relax quite a good bit. That's lovely.

Good.

Good. The job's a good 'un.

We can all wake her up and have a cup of tea.

And that's us, so that's great.

See you all later. See you. Ciao.

I'll still be kind of worried tonight,

and I'll be phoning up two or three times during the night

to see if she's OK.

And if she gets through the next 24-hours without any bleeding

or terrible problems, then I'll be a lot more relaxed.

When she walks out of hospital feeling well, then I'll relax.

It's 16 hours since Isla's surgery to remove fluid from her brain.

Surgeon Roddy O'Kane wants to find out if her debilitating headaches

have gone.

So, Isla, overnight, no temperatures?

No, no problem at all. She's been fine. Been fine.

And no problems with vision or anything like that?

Nope, nothing like that at all. OK.

Hello. Morning. How are we?

I have a question.

When I put my head up and down, it sounds like water.

It sounds like water?

Do you hear a kind of squishing sound?

Yeah, that's just because your brain is getting used to

having drained the water.

Sometimes you'll feel a wee bit of swish-swishy inside your head.

It'll all settle down.

Has the headache gone, sweetie?

Yep. Yeah? OK.

So, all very well from this point of view.

The wound looks nice and dry.

So, fingers crossed!

High-five me. Good, good.

OK.

Early days yet, but every hour you move from surgery,

the more stable the situation gets.

So we've got to watch her closely over the next few days.

We'll want to get a scan on her to check that this procedure

we done is working.

But we're doing well.

This is my balloon that Nan brought.

How are you feeling?

Good.

In the adult hospital, in the renal and transplant ward,

another patient is feeling much better.

Susan is preparing Rose for discharge today.

So you've got the letter to go to your GP, all right?

'We get to see the nice part.'

We get to see these people going home and they're well.

So these are at your anti-rejection medications.

Right, OK. OK?

'Yes, there's the sad times, yes.'

But...

we get to see people with happy stories.

And happy endings.

Thank you for everything, thank you. Love you, gorgeous.

And that's a great part of my job.

Hello, hi, that's me all ready, just waiting for you now.

I only had the one bag when I came in,

eight days ago.

Eight days ago, yeah.

It's amazing what a week can do.

It's completely changed my life.

They don't just come in and go back out again.

You get to know these people.

These people really matter to you.

Where is she? Trouble.

Right, look after yourself, OK? I will try.

Thank you very much, Susan. Thank you for everything.

They're not patients, they're people.

It's just a great part.

It's just 24 hours since Maureen was given her best friend's kidney.

If all has gone to plan, Maureen, like Rose,

should already feel like a new person.

Hello, hello.

Good morning, again. How are you?

I feel well, I feel well.

I just feel good.

Relieved, I'm sure? Relieved. I feel relieved.

I'm going to scan your kidney now.

Right, OK. If that's OK.

So that's your kidney there. Right.

And you see that? Yeah.

That's the vein. Right. So swooshing the blood out.

Oh, I see, right, OK. So the blood's just...

Wow. Coming out all the way back up again.

Yeah. So that's absolutely beautiful. Wow.

So you're quite happy with that? Oh, yeah, yeah, it's perfect.

Oh, that's perfect, yeah, yeah. Great. Yeah, take that any day.

Just a few doors down, Del is also making a good recovery.

But the two pals haven't seen each other since their big operations.

I've not been this well for 20 years.

I haven't been this well for 20 years.

I'd forgotten how this feels.

And she doesn't... She's got no clue.

She's got no clue...

..just how wonderful it is.

She's so kind.

She's absolutely my hero.

Hero.

Hi, pal. Hiya, pal, are you all right?

Don't bend over too much.

You feeling OK? I feel better, aye. Good. I'm definitely feeling good.

How are you feeling? Aye, I'm feeling fine. Are you? Yes.

You look great. So do you. Aye. Oh, aye.

Hopefully get out tomorrow. Oh, brilliant.

That's great, isn't it? That's fantastic news.

Absolutely. Oh, you've done really well. I'm glad. Yeah.

You'll never know what it's like to have a friend like you.

You won't. Oh, no, you would do the same for me.

Oh, I would. I know you would. I would in a heartbeat.

I know that, if I was in that position.

If the positions had been reversed... Yes.

..you would have done it for me. Absolutely, I know that.

But...

I'm going to have a moment now.

That's fantastic. I've had my moment.

You need to get the eyes dry. I know, my eyes are watering already.

Too late now.

I'd expect Del to recover fairly quickly.

I wouldn't expect her to have any consequence

of only having one kidney.

Her blood pressure can sometimes be a bit higher

with only one kidney in the long-term, and you have to be

a wee bit careful, particularly about some of the tablets

and dehydration when you're working off one kidney, rather than two.

But on the whole, she should have absolutely no impact on her health.

Just one week later, and Maureen's going home.

I'm emotional about going home.

I'm excited. But, yeah,

really can't wait to get home to my own surroundings.

It'll be great, yeah.

Together, we've got a new life ahead of us.

Her skin looks different,

her eyes are brighter, she's more alert. She's...

She's actually sparkling, I think.

Thank you. It's been great to see you again.

Right. Right. Ready to go? Off we jolly well.

Every aspect of Maureen's life will be better for

having Del's kidney.

Goodbye, ward.

It's transformative. You go from a life of darkness to sunlight.

I can't say it as any more than living in Glasgow in winter

compared to going to the Bahamas in the summer.

That's what you are asking, what it's like.

It's night and day, the difference.

Bye. Bye, thanks a lot.

Every aspect of her life is now different and better.

From when it opened two years ago,

Glasgow's superhospital has witnessed the transformation

of lives every day,

through the thousands of patients that pass through its doors.

Since her treatment, Isla's headaches have gone.

I'm feeling great.

She's a lot more lively, more chatty than she ever was.

She's passed the headache from her to me.

Rose is enjoying her new lease of life.

Before, I would probably...

Now, I am getting up to go.

Bye.

Don't do that!

And Neil's had surgery to fix his broken ankle.

But he's not been back on the skateboard...yet.

That would have been the other leg.