Episode 1 The Greatest Gift

In Wales, around 200 people

are currently waiting for an organ transplant.

If I stop dialysis, I'd probably last a fortnight

before I possibly die.

On average, someone dies every 11 days on the waiting list.

You'll have to go for the op, you've got to do it, you're going to die.

Last year, Wales led the way in the UK

and changed the law to presumed consent.

It's a landmark day for Wales but it's a landmark day for people

who are waiting for transplants.

Now, it's assumed that we're all potential donors when we die...

..unless we opt out or express such wishes to our loved ones.

A single donor can change the lives of so many

who are waiting for the call for the gift of life.

Unless something drastic happens, I'm going to have my transplant.

With unprecedented access to the transplant teams

at the University Hospital of Wales,

this series follows the incredible journey from one person's death,

to others receiving the greatest gift.

SHE COUGHS

32-year-old Kimberly Chard has cystic fibrosis,

a life-limiting condition which affects her lungs.

SHE COUGHS

She's currently on the waiting list for a double lung transplant.

There you go, I'll finish that later.

INTERVIEWER: How often do you have to do that?

I do a couple of different nebulisers a day,

so I do it about six times a day,

including antibiotics that help me get the mucus off my chest.

It's...it's pretty much exhausting.

It's just knackering and every day's a chore.

But, hopefully, I'm going to have a transplant,

and I'll be able to breathe again.

We just need that call, now.

What if, you know, I don't make it, or I get taken off the list?

We've had to talk about all that.

It's not easy, but you have to do it.

I don't want to be able to talk about that,

I'd would rather plan things, I'd rather plan my future.

But...

I'm not in the position of just thinking about that, right now.

So...it's vital that we get the call for a transplant

as soon as possible.

Kimberly's been on the waiting list for ten months.

In order for her transplants to go ahead,

someone has To donate their organs after they die.

A year ago, organ donation in Wales changed.

By law, we're now all potential donors unless we opt out.

In the countdown to the change in legislation,

the Welsh Government organised road shows across the country

to help spread the message.

Are you aware of the change in the organ donation law?

-Yes.

-Good.

-Can I give you one of these?

It's information on the new Organ Donation Act that's coming through

next week on the new opt out system.

-OK.

-It gives you all the information there.

For Robin Simpson, this is more than just publicity.

I actually had a thought.

I could be giving a leaflet to someone -

I could have their kidney.

Bizarre.

I'm on a kidney transplant waiting list.

-Are you?

-Yes. And I work for the health department,

so I volunteered to get involved.

-Oh, right, yeah.

-Yeah.

Give my bit back.

-Yeah. My son donated...

-Did he?!

..his organs when he died, so...

Richard's heart recipient received a gold medal in the Transplant Games.

-Did he?!

-Yeah.

Good God! Fantastic!

So, how long have you been on the transplant list?

Two and a half years on the waiting list.

You're lucky in a way, if you're going to have an organ failure,

kidney's the one to have because you've got the dialysis...

-You've got two.

-Yeah, and you've got dialysis to keep you going.

With a heart, lung, or liver, there is no alternative.

No.

Hi, can I give you one of these?

With presumed consent now law,

everyone nearing death in a hospital environment in Wales

is a potential organ donor.

Critical care.

The most seriously ill patients will inevitably spend time

on the critical care unit.

Bed one, now, 52-year-old man, traumatic head injury,

no more seizure activity...

Consultant intensivist Chris Hinkston

is the regional clinical lead for organ donation in Wales.

OK, so we should be able to wake him up today then?

-Should be able to wake him up today, no problems at all.

-OK, fine.

A lot of our patients get better, but one in five of them,

they won't survive their intensive care stay,

and that's really where organ donation comes in

as a part of usual, rather than unusual, end of life care.

So it's really our job to approach all patients about organ donation.

201 over...

Diastolic at 80...

This is last time. 35...

67-year-old Bill has been admitted to the ward following a stroke.

His daughter, Karen, and family are with him.

They're not 100% sure what happened,

whether there was a bleed to the brain, first, before the fall,

or whether the bleed to the brain caused the fall,

but he fell backwards and...

..cracked his head.

And...

didn't really regain consciousness from that point.

-Clever bird!

-You got it?

-Yeah.

My dad, he was funny, he was kind,

he had budgies when I was growing up and liked yo-yos.

Since his admission, Bill's condition has worsened.

The doctor showed us an X-ray of a normal brain

and then they showed...

..then they showed an X-ray of my dad's.

And you could see the damage.

And you could see it wasn't going to get better.

Whilst Bill continues to be cared for on the unit,

the medical team will find out what his end of life wishes are.

Harefield Hospital, Middlesex...

..and cystic fibrosis patient Kimberly

has had an early Christmas present.

We had a call from the transplant coordinators

at nine...nice o'clock last night

to come to the hospital because they found a matching donor.

It's a good match and, unless something drastic happens,

I'm going to have my transplant!

Kimberly's lung transplant took the surgeons ten hours to complete.

Without it, she may only have had months to live.

-You feeling dizzy at all? OK to carry on?

-Yeah.

Kimberly's now undergoing intensive physiotherapy

and husband Luke has been by her side throughout her recovery.

On the first day, she could do ten, 15 steps.

She did 45, so...!

Yeah.

She's doing all right, yeah.

The lung transplant has transformed the young couple's lives.

'I just can't believe it.

'Just can't believe...'

Sorry.

-You OK?

-Yeah.

-Come here.

-That feels like a lifetime ago.

-I know, and...

you know, just gasping, wasn't it?

Gasping for breath.

Just seeing myself, hoping it would happen...

..and the relief that it has happened, so...

Crying both times.

Everything I've been through, all the pain and everything,

it's all worth the future I'm going to have.

Yeah.

A person deciding to...

..to give such a gift when they're gone is just...

..just such a selfless gift.

It means the world to me and to other people

that lives have been saved, too.

Someone who's still waiting for his life to change is Robin.

He has kidney failure

and has been waiting almost three years for a transplant.

Robin's treatment involves dialysis to remove the toxins from his body.

He's able to manage this himself - even at work.

Do you want to see the actual...

That's where the catheter goes into my peritoneum,

and it ends up over here somewhere.

And that's where it drains in and out, and nice little...

..port, they call it, where they put the tube in.

Just take that off.

And that's it.

That goes all the way into my peritoneum.

Just add that...

All right, that's the drain bag. That's where all the...

..previous two litres I put in this morning comes out, and...

..that's it, now, for 25 minutes.

All the usual toxins that your kidneys would eject through urine

is going into that.

So, I carry my spare kidney round on a rucksack.

So it's extremely restrictive.

But it's keeping me alive, so...

The alternative doesn't bear thinking about.

And I can't go far, anyway,

cos I've got to remain within an hour of the hospital

in case I get the call, so...

Yeah, every time, I say it's tedious, boring, gets on my nerves,

but it's saving my life, so...

But it is tedious.

You know, my whole day revolves around,

you know, doing the dialysis.

On the critical care ward, Bill is showing no signs of recovery.

It's now time for the medical team

to raise the subject of organ donation with his family.

I've had a look at him today, had a look at the scans.

Given the extent of the brain injury that he's got,

he wouldn't wanted to have... survived in that condition.

I think, actually, there's no chance of him surviving,

but, unusually, you've obviously approached us

about the fact that he had very clear wishes about organ donation,

you approached us about that.

I know... I'd obviously like to introduce you to Michelle

who's our specialist nurse for organ donation.

She'll be able to answer all your questions I'm sure you have.

-Is that the letter that you have?

-Yeah, he registered the other week.

The letter came this week.

Oh, bless him.

He wanted to do this, it was important to him.

-Yeah.

-That's all that matters.

And what we'd be looking at, being able to donate,

which would be liver,

which, obviously, is going to save somebody's life,

and kidneys, which would take two people off dialysis,

so they're amazing gifts.

I think it's a wonderful thing, though,

in that he wanted to help others. I really do.

It's the best thing, the best outcome under the circumstances.

-Mm-hm.

-He'd be thrilled.

Dad had talked about organ donation.

It was the last serious conversation that we'd had.

Not knowing that, in a few weeks' time,

that was going to have to happen.

It was his decision, and...

..I wasn't going to challenge it because it was his decision.

Specialist nurse Emma will be overseeing the process.

-All right?

-He's ready.

-He's ready, I think.

So...when everything is ready, and we're ready to stop,

one of the doctors will come in

and they'll take the breathing tube out of his mouth. OK?

When his heart stops, OK, we'll tell you.

-If at any point you want us to stop...

-No.

I know that you don't, but I just have to make you...

-You know, this is still...

-It's what he wants.

It is what he wants.

And you're doing a very amazing, brave thing for him.

-He's doing it. Not me.

-I know. But you're helping him.

-Is that all right?

-Yeah.

INAUDIBLE

'It was OK until they turned all the machines off.'

I think I would have coped with it a lot...

..a lot worse if I hadn't have had the transplant to focus on.

It's like he still had a job to do even though he couldn't do anything.

He was still doing something, he was looking after those organs

until they could be given to somebody else.

Someone who received such a generous gift

from an anonymous donor is Kimberly.

-Hi!

-Hi.

-How are you?

She's about to undergo a test to check

how well her newly transplanted lungs are working.

Just nice and gentle breathing for me.

When you're ready, sharp breath all the way in...

Blast it out. Keep it going, keep it going,

keep it going, keep it going, keep it going...

When you're empty, breathe in. Well done.

Kimberly's cystic fibrosis has meant

she's rarely had a lung capacity of more than 30%.

It's looking good.

There's definitely a good increase compared to last time.

That was you...

..in August.

What percent lung function have I got now, then?

So, you're working with 71...

and 67%.

Oh, my God! That's a massive change.

-I'm happy that you've got your transplant.

-Thank you.

All right, lovely, that's you all done.

Can't ever remember having a lung function that good.

I don't think I have.

So...I'm in shock!

Really shocked.

-INTERVIEWER: Are you pleased?

-Yeah, so pleased.

-All right, lovely.

-Pretty much amazed.

-I'm happy for you.

-Thank you.

Time to check in with her consultant, Dr Martin Carby.

There's a chest X-ray before your operation.

There are lots of shadows in this X-ray,

there are lines, and there are rings here,

and there's some mottled shadowing,

which are all indications of widened airways,

which have clogged with mucus,

which is the problem that you've had before your transplant.

And if you compare that to...

your CT scan that you've just had of your new lungs,

the appearance of those lungs is much more uniformly black,

filled with air without great big holes in them.

That's crazy.

But it's much more healthy-looking lung tissue

as opposed to looking a bit like Swiss cheese,

which your old lungs did.

-OK?

-Yeah.

-I'm really happy for you.

-Thank you.

-Yeah.

-OK. I'll leave you to have some time together.

-I'll see you before you go again.

-OK, thanks.

-All right. Bye-bye for now.

-See you.

God. That's crazy, isn't it?

-You OK?

-Yeah.

She's just done fantastically, really. I'm so happy for her.

She's, you know, just a few weeks after her operation

and she's going home,

and hopefully this is just the start of a new life for her.

I think the change in arrangements for organ donation in Wales

will potentially have a very positive effect,

and hopefully we'll see a continuing increase in organ donation,

which will allow my team to carry on

giving people the benefits that we've seen for Kim.

THEY CHUCKLE

After her life-changing surgery, Kimberly is finally leaving hospital

and will continue her rehabilitation at home.

At the University Hospital of Wales, a special delivery has arrived.

It's a donor kidney for transplantation.

Looks reasonable.

I understand it had a very good function in the donor, so...

This kidney has been best matched to a recipient.

And it's good news for Robin.

I was just about to go to lunch

and I stood up, tightening my shoelaces up,

and the phone went and told me, "We may have a kidney for you."

I went straight into panic mode and literally just logged off from work

and told my colleagues, "I'll see you either tomorrow,

"if it doesn't go...go ahead,

"or in two months' time," so...

I'm going to have my normality back in my life.

You know, not tied to dialysis,

going back and forward every four hours.

So, yeah, mixed emotions.

Blind panic, mainly.

Performing the transplant today is consultant surgeon Mike Stevens.

Won't be long, we'll just get back downstairs

to just set one or two things up.

-Right.

-And then we'll come up for you, so...

-OK.

-Ten minutes or so, I suspect.

-OK.

-All right?

-OK.

And we'll have a chat with you afterwards.

-OK. No gin and tonic before?

-Best not. For me, or you?

Both!

Probably best not for me.

-Yeah. OK, thanks, Mike.

-See you a bit later, then, OK?

Yeah, OK. Cheers.

He was similar to what we usually see with transplant patients,

that sort of mix of apprehension and excitement.

Always tends to be very nervous.

Most of the time been waiting quite a long time for this day to come.

One generous benefactor can save and transform up to nine lives

through the gift of organ donation.

It's a decision that Bill's family have made,

and the surgical team are now in place for retrieval.

Fusion's on. OK, it's running well.

Specialist nurse Emma will be coordinating in theatre.

His kidneys have been accepted.

I think his family are just happy that he can do anything, so...

that's...that's good.

I just spoke to her, so she knows that.

Left kidney's out.

Ureters?

Branches tied?

No branches tied...

OK. Left kidney.

Knowing somebody else is going to get help, as well, you know,

and they're going to receive a kidney,

just makes it all, all the...

you know, the work that we do, it makes it worth it.

Right kidney.

Right kidney.

In the UK, there are around 6,500 patients

on waiting lists for organs.

Today, two of them will receive some incredible news.

They probably would've been getting a phone call

first thing this morning to say, "Come to hospital."

You know, "We've found you a kidney donor."

And so, yeah, life-changing for these people,

absolutely life-changing.

Two bags.

The kidneys will now travel to the recipients

and be transplanted within a few hours.

It's all only possible because of Bill's gift.

It's made losing him easier because it's like...

..something good has come out of it.

And I can't think of any other circumstance

where someone dies that something good comes out of it.

It's quite a negative final thing,

whereas for Dad,

it still doesn't feel final

because parts of him are living on in someone else.

DRUMBEATS

That's my alarm. "Take your meds!"

In Bargoed, Kimberly's getting used to life at home

with her new lungs and drugs regime.

-Just find them all!

-SHE CHUCKLES

Going to dedicate an hour or two to do it.

Organise everything.

Lost the next one. Oh, there we go.

I'm diabetic through cystic fibrosis as well.

My liver disease hasn't changed since I was a kid, luckily.

And then we've got the anti-rejections.

So, every day I take my anti-rejections at 10am and 10pm.

It's important to make sure that you take them at regular times.

And that's all of them.

Well, that's all of the tablets, anyway.

-INTERVIEWER: Is that just for today?

-Yeah, that's just today's.

I think a lot of people, when I've had my transplant,

have just thought, "Oh, so you're cured now?"

And it's not that. You've got to maintain...

you've got to maintain yourself and you've got to keep yourself well,

you've got to keep doing the treatments,

and take care of yourself, really.

It's not just...it's not just an easy fix -

it's a lot of hard work.

But you go into its knowing that you've got to do that.

It's the simple joys of life that you miss out on, and...

..you only realise when you're feeling well enough that,

"God, I couldn't have done this before."

And it does hit you a bit hard, so... Yeah.

Morris, please?

Consultant surgeon Mike Stevens is an hour into

transplanting Robin's new kidney.

Forceps.

What we've done so far, we've just prepared the vessels

that we're going to put this onto, essentially, and...

we...we'll get the kidney we prepared earlier and...

It's like a cooking show, isn't it?

Try and keep the timing short as we can.

So we stitched the vein to the vein to begin with,

and then the kidney artery onto Robin's artery.

And once we've done that, we'll release the blood into the kidney,

so we'll perfuse the kidney again, we'll see how it looks.

-OK, time down, time of reperfusion.

-8:45.

-I'll hold it.

It looks quite nice.

So we like to see a nice sort of uniform pink colour

all way around the kidney, which we've got here.

Looks pretty good so far.

So the kidney's now got a blood supply.

The last bit for us to do is to join the ureter,

the water pipe up to the bladder.

May have a bit of urine there, actually, which is a good sign.

Often a bit sleepy to begin with, these types of kidneys, but...

..in the longer term it should function well.

It's going to make a big difference to Robin.

This is what organ donation is about.

I think it's really difficult for people to understand...

the difference that it makes until you see people like Robin,

and you see the difference that it makes to them,

and you see what life looks like for them before

and then how it changes afterwards.

And you can only appreciate that really

by seeing the other half of the story, so...

Since the change in the law a year ago in Wales,

there has already been a significant increase in the consent rate

for organs available to change lives.

Nothing's going to make up for losing my dad.

He's always been my hero.

Even more so now.