Episode 2 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 could 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 are 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.

48-year-old Kim Hodge has cystic fibrosis...

..a debilitating disease with no cure.

SHE COUGHS

She's been admitted to hospital with a chest infection.

SHE COUGHS

Heavy physiotherapy is just one part of the daily routine to keep Kim alive.

Ah, I can breathe a bit now, for a little while.

I haven't been here so much in my entire life.

All the years I've had CF, I've handled it really, really well

and I think in 25 years,

I've probably only had five hospital admissions.

My lungs are really, really tired now.

I'm thinking is it this one, is this one going to kill me?

I still think that, because today there's not a big improvement.

This is a transplant lungs selection form...

..with options.

And once I sign this,

I will probably go on the transplant list within a week.

When I look at this letter, I feel physically sick.

You're not buying a new dress, you're picking someone's lungs.

It's a gamble.

Transplant comes with it...

..other issues.

I'm not going to be cured of CF,

you don't have a transplant and then you're cured of CF.

People seem to think you have a transplant and then you're cured.

You're not.

I've got a very strong feeling that I'm on borrowed time.

He give me a year to live in January...

..and now we're in May and the months are counting down.

Kim's only chance of survival is to have lungs donated to her

by someone after they've died.

For some people in need of a transplant, there is another option.

59-year-old Glyn Lewis has kidney failure.

His daughter Sarah has come forward to donate one of her kidneys to him.

139/89. What is it normally?

Um, yeah, normally, a bit lower than that.

Before the big day, a final chat with transplant surgeon Mike Stevens.

-How are you, Sarah?

-I'm good, thank you.

-Good.

-Nice to meet you.

-And you as well.

Looking through the scans that you've had,

it's the left kidney that we're going to remove. Is that right?

-Yeah.

-OK. And you understand the reason why we are going to take the left kidney out?

The liver's on the other side?

It's partly that.

Probably the main reason is that the kidney on the left side

has a slightly longer vein.

Ah, so it's easier to put in?

It makes the transplant operation a little bit easier for your...

-It's your father you are donating to, isn't it?

-Yes, yeah.

From your side, it doesn't make any difference if it's the left kidney or the right kidney.

You should be able to live perfectly happily with one kidney.

-OK.

-Was there ever any doubt that you would do this for your dad?

Absolutely not. It just seems like the natural thing to do.

So right from day one, you've always said, haven't you,

if there's any doubt in your mind whatsoever, even said this morning,

"You sure you still want to do it now?"

But, yeah, like I said, it feels like the natural thing to do.

Everyone is so supportive, so...

I'm really lucky.

For me, it's Hobson's choice that I've got to go through,

but it's not for them.

It's their own choice. That's brilliant.

You're a lucky man. You've got a lovely daughter there.

I am.

THEY LAUGH

Best look after it now, afterwards!

Absolutely, without a shadow of a doubt.

There are many people out there who need kidney transplants

but don't have anybody who is able to donate for them.

So we are still entirely reliant on the deceased donor pool

to provide kidneys for the rest of the patients.

One of the big aims, of course,

is that the change in legislation will mean we will have more of those kidneys available.

Many of the hospital staff have been instrumental in promoting the change

in the law to presumed consent for organ donation.

Your general views, then, about the change that's happening?

We are talking potentially at least another 45 organs available for

transplant across the UK.

Chris Hingston is a consultant in Cardiff's intensive care unit.

A big part of my job is promoting organ donation and if that involves

interacting with the media, that's an important way to reach the largest number of people.

So, it's not something that we're unused to doing in organ donation.

But it's great that people are so interested in it.

A3 North critical care.

This ward is where the most seriously ill patients are cared for.

Subsequently, it's where the topic of organ donation comes up most frequently.

Tonight, Chris is looking after a patient in his early 40s.

Steven has suffered a brain aneurysm.

Steve came into the hospital earlier today.

He was unconscious and was put onto a ventilator and he's had his head scanned.

And unfortunately, that's shown a devastating head injury which really isn't survivable.

We've had neurosurgical opinion and other experts have seen him.

I've seen him myself now as well and there's no hope really of recovery.

It's a tragic situation - of course it is.

He has a young baby at home as well, five months old -

which, you know, is difficult for all of us looking after him as well,

bearing that in mind and meeting his family this evening.

Steven and his partner Vicky had been together for almost ten years.

They'd recently become parents to a little girl called Zaren.

As soon as she came, he was brilliant.

He was attentive and thoughtful and loving.

I don't think she could have -

I don't think we could have asked for her to have a better dad.

She was the apple of his eye from the moment she came into the world.

I just found him on the floor. He wasn't really breathing.

He was breathing, but he wasn't moving.

I could see that something really terrible had happened,

but I thought he was very ill

because this sort of thing doesn't happen to you -

it happens to other people.

Even when they took him in the ambulance and when we went to A&E,

I was sure they were going to say, you know, "He is very ill, but he is going to recover."

It's such a shock when they tell you, "That's it, he's gone."

It never even entered my head that he would die.

You know, he was 42.

We've just had a baby, who wasn't even six months old.

With no hope of recovery,

the medical team will now assess Steven's suitability for organ donation.

No, I'm not going up the hill, Molls. Come on.

She's a stubborn dog!

Aw! Now my heart's going 100 mile an hour.

For now, Kim's out of hospital.

But living with cystic fibrosis means every day is a struggle for her.

She can't go anywhere without her oxygen pack.

Keeps my lungs breathing, that's for sure.

I think I should have just had a Jack Russell!

But I wouldn't change her for the world now.

Because I love Molly. Aw!

-God...

-You feeling all right?

A little bit out of breath.

Before Molly came into my life,

I was ready to die

and I was going to completely decline the lung transplant.

And I did tell the doctors I was going to decline it.

Because I just...I don't know why, I thought I'd been through enough.

You know - do I want to go through any more?

And then, when I bumped into Molly and got to know Molly, I thought,

"No, I'm going to live my life or I'm going to die trying."

And the thought of somebody who is currently living,

is going to save me and give me the gift of life,

I find quite difficult.

So the person's actually living their life at the moment,

who's going to offer me a chance of life.

And that's difficult for me.

Sadly, as well as living with lungs that have been deteriorating,

Kim lost her mum when she was 21.

This is my gravestone.

This is where I'm going to be if things don't work...

..out right for me.

If I don't get the transplant call in time,

this is where I'm going to be in the family grave with my mother

and the rest of my relatives.

As you can see, my stone is there ready.

Which is difficult - when I come up here and I look at the stone,

I think, "My God, I'm going to be...". I can visualise my name on there.

And the other day I was trying to work out would it be Kimberly or Kim - which would fit?

It's a mad way to think, really.

Not everyone has to wait for somebody to pass away to get their life-changing surgery.

PHONE RINGS

Hello, Cardiff transplant unit.

On the transplant ward, Sarah is about to donate a kidney to her dad Glyn.

Pressure is good, you haven't got a temperature.

-Morning.

-Hello.

-How are you?

-I don't know.

-SHE LAUGHS

The procedure will be performed by surgeon Mike Stevens.

Good, all set?

-Need the loo first.

-OK.

SHE LAUGHS

Fine. Any last-minute questions?

-I don't think so.

-Good.

-Excellent.

-Glad the wait's over now.

Been pondering for about the last three hours, haven't we?

-OK.

-Let's do it.

How you feeling, Glyn?

Apprehensive, but very proud of my girl.

Mind over matter, isn't it?

-Yeah, yeah.

-Yeah.

It's fine. I'm surprised I'm not nervous yet, to be honest.

Come on.

The retrieval of Sarah's kidney will take around three hours.

BACKGROUND CHATTER

Mike and his team perform around four live donations like this each month.

It's still there.

It is the minority of people who have transplants who get kidneys donated from live donors.

That's if everybody who does have a potential donor...

..comes forward and makes use of them -

it kind of expands the deceased donor pool,

which is good for everybody, really.

We do most of it through keyhole surgery,

but we do need a kidney-sized incision to remove the kidney from.

A surgeon, while he's doing the operation,

will have one hand inside the tummy to help.

It's a fairly unusual way of doing surgery.

What we call hand-assisted keyhole.

This is the camera and if we look on the screen now -

slightly strange view.

We've got the surgeon's hand.

So what we need to do is identify all of the structures

that surround the kidney, the blood supply to it.

We need to take all of those safely.

Over on the intensive care unit,

there's been no change in Steven's condition.

I looked earlier...

Doctors Chris Hingston and Matt Morgan are about to perform their final examination.

Shall we just proceed with the test, then?

Tell you what, Matt, if I do,

you watch, and then the other way round for the second set,

-if that's OK with you?

-Yeah.

These checks will confirm the consultant's diagnosis.

No reaction. Happy with that?

There was no movement when the corneas were touched.

No eye movement, no motor response.

So I am satisfied as the observer of that test.

Fine, OK.

What you have seen us doing is a set of tests looking at the basic

reflexes within the head.

As I said, very primary, even basic reflexes that should be present,

but the brain is so badly damaged and the brainstem is dead,

that those reflexes aren't there.

After receiving this news,

the family made the decision to donate Steven's organs to help others.

Even though there is the automatic opt-in,

they still ask you what you want to do.

If you haven't had a discussion and you haven't talked about it,

it's still a tricky decision to make.

It's a difficult decision to make, you know, and at the time,

you don't feel like you want to part with any of him,

but they also tell you that they

kind of need to do it quickly as well.

There's a point where his organs wouldn't be useful to people.

So you know you haven't got all the time in the world to make your

decision, either, so if you've had a conversation, then it does make it easier.

Steven was generous in life - why wouldn't he be generous in death?

If you're...if we needed something, if I was waiting for a liver,

you'd be praying...

..that someone would give it.

So, I think if you are prepared to take it...

..then you kind of need to be prepared to give it as well.

And like I say, he was generous in life -

why wouldn't he be generous in death?

In the transplant theatre,

the team are nearing the end of Sarah's operation.

Very nice kidney.

Nice and slender donor, which makes a difference for us.

A lot of our patients aren't quite as slender as that.

That does make things easier for me.

So, yeah - it went smoothly.

Now, it's dad Glyn's turn to go on the operating table.

A long wait, but as long as she's OK, that's perfect.

-Your bit now?

-Yeah, that's the easy bit!

Surgeon Rafael Chavez will be transplanting Sarah's kidney into Glyn.

At the moment we are starting the connection of the vein of the kidney to the vein of the patient.

Then we have to do the artery.

After that, we perfuse the kidney with blood,

and everything being OK then,

we complete the operation by connecting the urethra to the bladder.

We are just going to reperfuse the kidney now. OK, go.

So, reperfusion time on the board, please.

Can you record the time? Kidney is going pink.

A squirt of...

Look at that.

-Can you see?

-I can.

You can? OK, that is urine and the kidney is looking pretty.

Brilliant.

Nice.

It's an amazing gift to be able to give, isn't it?

It is and it is a gift for the person that receives

and it is a gift for the person that gives.

Back in hospital with another infection is Kim.

And her reluctance to go on the transplant list is concerning her

consultant, Dr Ian Ketchell.

-Hi, Kim.

-Hiya.

-How are we doing?

-I'm all right.

Just thought I'd pop in and see you because I hear you've come in for two days?

Yeah, come for two days.

Just to check your oxygen levels?

Yeah. I'm feeling a little bit tired.

Everybody seeing you will see how well you look.

We know on a bad day you can look very unwell -

potentially life-threatening admissions to hospital,

as you've had already this year.

-Yeah.

-Therefore, we think it's really important that you do actually get the transplant.

-So...

-I've had enough this time.

I have had enough. Because it's very soon from the last time.

Do you think you are ready to sign all the forms?

I'm very, very close now.

The time to go is when you are feeling well enough, feeling OK.

And that's when you probably think, do I really need to go?

-Yeah.

-But then, when you're feeling unwell,

feeling very poorly and everything looks not so good,

then we may say, "You're not good enough to go for one."

It's really difficult and I can't imagine how it must feel.

But, yes, we all think it's the time. So, good luck.

-I'll speak to you soon.

-See you soon.

-Take care.

-Thanks, Dr Ketchell. Bye.

It's a difficult decision for Kim.

You know, you've got to look at the potential of dying on a transplant table,

to how long will she survive without a transplant?

So we make these decisions of, does she need one?

Yes. She is fully aware of the complications,

but it's time to sign and go.

It's quite cold in here, isn't it, Dad?

As Kim's health has been deteriorating,

her dad Jeff is becoming more concerned.

When are you going to sign up for the transplant now?

I'm going to die if I don't sign up.

You'd better hurry up, put your name down now.

-Yeah.

-Why don't you, then?

You've got no life as you are. You're not getting anywhere.

They are not going to do the op

-unless they think there is a good chance of you surviving.

-Mmm.

If you get five years, it's better than five months.

Kim, you've got to do it - you're going to die.

You've just got to do it.

At the moment, you are on one direct line to the cemetery.

SHE LAUGHS

Kim, look at the bloody expense, I've got to hire the Mercs!

SHE LAUGHS

Be cheaper to...!

He's got a sick sense of humour!

One-way direction!

Do you want me to take that for you, or what?

Right state, I am. You can't drive.

-Dad.

-Come on, let's go.

-Push that.

Wait now, because I'm attached to it, Dad.

Right. Go behind, Dad.

Can't go both together. It's too narrow.

Don't worry.

Go slow, Dad.

On the intensive care unit, Steven is being prepared for theatre.

The family have kindly already consented to organ donation.

Thankfully, they've decided that that's what he would have wanted,

so we are very grateful for that and there's a number of people, you know,

who are going to get a call later on today

who will be absolutely delighted with that for them as well, so

it's really just changing lives and one of the few things we can do

to really save lives in a very sort of tangible way, often.

We can help huge numbers of people through Steve's gift today, really,

which, you know - it's fantastic.

No pressure, false bag running. Yeah.

Specialist organ donation nurse Nicky

will be coordinating in theatre.

He's donating his liver and his pancreas and both kidneys and his heart for heart valves.

-It's amazing, isn't it?

-It is amazing, it is, absolutely.

And potentially, his liver might go to two recipients.

So that really is amazing.

Yeah, 540, I've got that.

Liver. Gosh, that's...heavy.

INAUDIBLE CONVERSATION

It's quite big, isn't it?

They've got the organs out.

They're just sorting out the other bits and pieces.

I'll ring you as soon as they're leaving, OK?

One artery, one vein, one ureter.

Number of arterial patches?

-One.

-No damage to anything on the right?

Correct.

Right kidney.

They said they had used both of his kidneys.

Um, one had gone to a lady in her 60s.

The other one had gone to a man, I think in his 40s.

And his liver had gone to a lady,

another lady again in her 60s who would have died without it.

He's changed other people's lives for the better, you know.

When he was here, he was a good person.

So, why wouldn't he be afterwards?

I do think it's a great gift, and I think

the people who received his organs think it was the greatest gift.

And I think their families,

loved ones and friends think it was the greatest gift as well.

It's almost like a legacy.

You know - we've left...

HE'S left something great for someone else.

In Pontardawe, Kim has made a difficult decision.

She's waiting for an important call from Harefield Hospital.

When I went in with that infection two weeks ago,

it was the turning point.

And it frightened me and I realised...

I realised the mess I was in. I mean, I just...

I don't know, it really did scare me.

If I get a flu...

If I get a flu, then I'm a goner.

PHONE RINGS

Here we go. Hello.

Hello?

-Hi, Tom.

-'How you doing?'

Oh, still nervous.

But I've got to bite the bullet.

Yeah, it's time.

Yeah.

Yes, go on, then, please.

Go live.

Give them my number.

So I'm now actually just gone live right now.

Right. I know this is going to sound absolutely ridiculous,

but I've just put fake tan on my arms.

Will that be a problem if I get a call in the next 48 hours?

There will be no problem, because I've only done my arms. My chest is actually white.

Yeah, if I wear a vest, I'll look like Les Battersby off Coronation Street!

All right.

Kim's now live on the waiting list for a double lung transplant.

OK. That's brilliant.

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

there's already been a significant increase in consent

for organs available to change lives.

He is a hero.

And we love him.

I just hope she's proud.