0:00:02 > 0:00:04DRILL WHIRRS
0:00:04 > 0:00:08Saving lives doesn't always mean working with the living.
0:00:08 > 0:00:11Skin, shaft, heads, knees.
0:00:11 > 0:00:13OK, left eye is out.
0:00:13 > 0:00:17Every year thousands agree for their loved one's tissues to be donated.
0:00:17 > 0:00:22We rely on the kindness of people
0:00:22 > 0:00:27to understand that once they're gone, they don't need their eyes,
0:00:27 > 0:00:29their meniscus, their skin, their heart valves.
0:00:29 > 0:00:32They help change the lives of thousands of people
0:00:32 > 0:00:33across the country.
0:00:33 > 0:00:36You don't expect it to happen to you.
0:00:36 > 0:00:39I'm just appreciative that someone would donate their eyes
0:00:39 > 0:00:41cos it's going to improve my quality of life.
0:00:41 > 0:00:42This series follows the staff
0:00:42 > 0:00:45of Liverpool's National Human Tissue Bank...
0:00:45 > 0:00:47OK, you ready? Shall we get cracking?
0:00:47 > 0:00:51People expect it to be like middle-aged men.
0:00:51 > 0:00:55Or kind of massively gothic people for some reason.
0:00:55 > 0:00:56My dad always used to say things like,
0:00:56 > 0:00:59"Oh, you'll never get a boyfriend doing that kind of job."
0:00:59 > 0:01:01..as they grapple with death...
0:01:01 > 0:01:03I don't normally ever get upset ever about it all.
0:01:03 > 0:01:05..to help the living.
0:01:05 > 0:01:07I do think what we're doing is incredible.
0:01:07 > 0:01:10This job is really important
0:01:10 > 0:01:13because we're saving people's lives.
0:01:13 > 0:01:17This week the team battle a shortage of tissue supplies.
0:01:17 > 0:01:20We've had two people donate their heart valves.
0:01:20 > 0:01:22That's not really a lot.
0:01:22 > 0:01:24You don't want young, healthy people to die,
0:01:24 > 0:01:26but it is the young and healthy tissue that's most useful.
0:01:26 > 0:01:31And the hunt is on for a new tibia for 19-year-old Morgan.
0:01:31 > 0:01:32I can see, like, the end.
0:01:32 > 0:01:34It's like a giant race.
0:01:34 > 0:01:36It's just not happening quick enough.
0:01:36 > 0:01:39Like it's just out of grasp.
0:01:47 > 0:01:51It's Monday morning at the National Tissue Bank in Liverpool.
0:01:51 > 0:01:54Inside the teams are hard at work maintaining the stocks of the
0:01:54 > 0:01:58nation's life-saving bone, skin and heart valves.
0:01:59 > 0:02:04So every week what we do is we decide what we've got in the tissue bank
0:02:04 > 0:02:05and what we actually need.
0:02:05 > 0:02:08We're still desperate for skin donors,
0:02:08 > 0:02:11male-only meniscus,
0:02:11 > 0:02:14hearts, Achilles, patella tendons, femoral arteries.
0:02:14 > 0:02:19It's younger donors that we really need,
0:02:19 > 0:02:22so people whose tissues haven't basically worn out.
0:02:22 > 0:02:24They're the most transplantable.
0:02:24 > 0:02:27It's a constant battle for the bank to keep up with the demand
0:02:27 > 0:02:30for tissues from hospitals nationwide.
0:02:30 > 0:02:33All right, no problem. Thanks, Chris. Bye-bye.
0:02:33 > 0:02:36Specialist nurse Jo helps families decide whether to donate the
0:02:36 > 0:02:38tissues of their loved ones.
0:02:38 > 0:02:43She's just come off the phone from a family who've agreed to donate.
0:02:43 > 0:02:45I'm just going to hand over the donation to the team
0:02:45 > 0:02:49and explain exactly what they're going out to retrieve.
0:02:49 > 0:02:54- Hello.- Cop a seat.- It's Mel's job to take the tissues from the body.
0:02:54 > 0:02:58- Date and time donor refrigerated? - Within the six hours.
0:02:58 > 0:03:01- Do we have consent?- Yes.- Brilliant. Thank you very much.- No problem.
0:03:04 > 0:03:08OK, so now we need to phone the mortuary and arrange access so we can
0:03:08 > 0:03:11get things done, get things moving so we'll just give them a ring now.
0:03:13 > 0:03:15Oh, hiya, can you put me through to the mortuary, please?
0:03:15 > 0:03:18The tissues need to be taken within 48 hours
0:03:18 > 0:03:20to make sure they're usable.
0:03:20 > 0:03:23Erm, we'll be in and out within two hours. Cheers, bye.
0:03:25 > 0:03:29So basically the funeral directors have just arrived, so we've come down
0:03:29 > 0:03:31to meet them to sign in the donor
0:03:31 > 0:03:33and any personal belongings they may have.
0:03:33 > 0:03:36Because obviously we have to make sure that
0:03:36 > 0:03:38they've brought the right person.
0:03:38 > 0:03:40It's never happened that they haven't,
0:03:40 > 0:03:42but obviously we can't assume so we have to make sure.
0:03:42 > 0:03:46The donor is a middle aged man who's died of a cardiac arrest.
0:03:46 > 0:03:48To preserve the donor's tissues,
0:03:48 > 0:03:50Mel needs to store the body in the fridge
0:03:50 > 0:03:53while she prepares her equipment.
0:03:56 > 0:03:57It's not the tray.
0:03:57 > 0:03:59No, that's fine.
0:03:59 > 0:04:02This is a fine art, this is, getting the fridge,
0:04:02 > 0:04:06getting the tray into the fridge on the runners.
0:04:06 > 0:04:10These trays are just so small.
0:04:10 > 0:04:12There we go.
0:04:17 > 0:04:20At 33, Mel's been doing the job for 12 years
0:04:20 > 0:04:23but started off with ambitions of a very different kind.
0:04:23 > 0:04:26Basically, after my A levels, I went to university to do drama
0:04:26 > 0:04:29and it was combined with art
0:04:29 > 0:04:31and the course was just a bit,
0:04:31 > 0:04:34kind of, rubbish.
0:04:34 > 0:04:36I'd always wanted to be the next Julia Roberts
0:04:36 > 0:04:40but that was a dream from when I was little, so I kind of grew up
0:04:40 > 0:04:43and thought, "Right, OK, I need to get a job. What am I going to do?"
0:04:43 > 0:04:45Mel joined as a donation assistant.
0:04:45 > 0:04:48The job is so unusual that the only training is on the job.
0:04:48 > 0:04:51Skin, shaft, heads, knees.
0:04:51 > 0:04:53OK, erm...
0:04:55 > 0:04:57# The thigh bone's connected to the... #
0:04:57 > 0:04:59Today she's working with assistant Jen.
0:04:59 > 0:05:01Although she's a qualified criminologist,
0:05:01 > 0:05:04Jen worked in a bowling alley before joining the team.
0:05:04 > 0:05:06- JEN SINGS:- # Bur, bur-bur-bur. #
0:05:06 > 0:05:09Don't!
0:05:09 > 0:05:10It's my little tune.
0:05:10 > 0:05:14# Bur-bur, bur-bur, bur-bur, bur. #
0:05:14 > 0:05:19- She hates it. It's when I'm like... - It's because it's addictive.
0:05:19 > 0:05:21Yeah, very addictive.
0:05:21 > 0:05:23'The first time I ever saw a dead body,'
0:05:23 > 0:05:26I literally was looking at the lady
0:05:26 > 0:05:30and I was looking at her chest thinking, "Is it going to move?
0:05:30 > 0:05:32"Is she actually dead?",
0:05:32 > 0:05:34because I'd never seen a dead body before
0:05:34 > 0:05:37and then when I saw one I was just like, "Oh, there you go then."
0:05:42 > 0:05:46We've got a male donor and we're going to take skin,
0:05:46 > 0:05:48so we take it from the back of the body and the front of the legs
0:05:48 > 0:05:51and we're also going to take bone from the legs, so we're going to
0:05:51 > 0:05:54take the femoral head, femoral shaft and the knee joint.
0:05:54 > 0:05:56'We have to look for identifiable features'
0:05:56 > 0:06:00so, for example, a tattoo or a missing toe so, for example,
0:06:00 > 0:06:03if you were expecting to go out and Joe Bloggs had 15 tattoos
0:06:03 > 0:06:06and you got there and there wasn't a single tattoo, you would question
0:06:06 > 0:06:10that because there could be another one in the fridge with the same name.
0:06:11 > 0:06:14So this is one of the most important things, the blood sample.
0:06:14 > 0:06:17We need to make sure that, because everything's for transplant,
0:06:17 > 0:06:19that everything is actually safe to use,
0:06:19 > 0:06:22that there's nothing nasty lying in the blood.
0:06:22 > 0:06:25There are only around 30 people who carry out this extraordinary
0:06:25 > 0:06:27and demanding work in the UK.
0:06:27 > 0:06:30A lot of people think that I drive up to a mortuary,
0:06:30 > 0:06:34I collect a box with tissue in it, already on ice, you know,
0:06:34 > 0:06:38and take it back to the tissue bank, but, no, that doesn't happen.
0:06:38 > 0:06:40OK, you ready? Shall we get cracking?
0:06:40 > 0:06:42DRILL WHIRRS
0:06:46 > 0:06:48So right now we're retrieving bones from the leg,
0:06:48 > 0:06:50so we're taking the knee joints,
0:06:50 > 0:06:55so obviously the bottom of the femur and the top of the tibia.
0:06:55 > 0:06:57And we're taking the femoral shaft
0:06:57 > 0:07:00and then cutting off the femoral head.
0:07:04 > 0:07:06Can I take your name as the contact for the order, please?
0:07:06 > 0:07:10While Mel and Jen concentrate on collecting the vital tissues,
0:07:10 > 0:07:13upstairs is one of the strangest call centres in Britain.
0:07:13 > 0:07:16We're the customer care team for Tissue Services.
0:07:16 > 0:07:18What would you like to order today?
0:07:18 > 0:07:22Dan is part of the front line team taking hundreds of calls every day
0:07:22 > 0:07:24from hospitals around the country
0:07:24 > 0:07:27in need of donated tissue for their patients.
0:07:27 > 0:07:29Most of our calls do relate to orders for products.
0:07:29 > 0:07:32Is that for stock or for use on the day?
0:07:32 > 0:07:35We do provide bone to a lot of hospitals -
0:07:35 > 0:07:38freeze dried fine bone, freeze dried medium bone,
0:07:38 > 0:07:41freeze dried coarse bone, freeze dried struts.
0:07:41 > 0:07:46Freeze dried femoral heads can be done as half or a slice or ground.
0:07:46 > 0:07:48Tissue doesn't require frozen storage.
0:07:48 > 0:07:52Left and right femur, left and right tibia, left and right pelvis,
0:07:52 > 0:07:55patella tendon with the quadriceps attached.
0:07:55 > 0:07:56Do you need this before 9am
0:07:56 > 0:07:59or are you happy for it to come in before noon?
0:07:59 > 0:08:02We also do quite a lot of cryopreserved products
0:08:02 > 0:08:06such as skin as well as heart valves.
0:08:06 > 0:08:10As the national tissue bank for the country, they help thousands
0:08:10 > 0:08:13of people every year waiting for life-changing transplants.
0:08:16 > 0:08:21One person in need of their help is 19-year-old Morgan in Birmingham.
0:08:23 > 0:08:27Oh, look at these little flowers. It's so small it doesn't make sense.
0:08:27 > 0:08:29My grandad likes shirts like these.
0:08:29 > 0:08:33For the last 12 years, Morgan has lived with a tumour in her leg.
0:08:33 > 0:08:37Today it's the January sales today and she's out for a bit of
0:08:37 > 0:08:39retail therapy with her best friend Holly.
0:08:39 > 0:08:42- You look so snazzy.- Thank you.
0:08:42 > 0:08:46I think this is what I'm going to be wearing to college.
0:08:46 > 0:08:50Oh, yeah! I don't think I could take this off ever again.
0:08:53 > 0:08:57When I was about six years old, I fell over in the playground at
0:08:57 > 0:09:03primary school as all children do and this lump just like formed on my leg.
0:09:03 > 0:09:07They took me to the hospital and they said I had fibro dysplasia
0:09:07 > 0:09:10so, yeah, and they think it could be linked to a cancerous
0:09:10 > 0:09:12condition called adenoma.
0:09:12 > 0:09:15Over the last two years, Morgan's tumour has grown.
0:09:15 > 0:09:17She's worried that it could be cancer.
0:09:17 > 0:09:21I just hope to be cancer-free which would be nice, and not
0:09:21 > 0:09:25have the constant worry of not knowing. Like, it's really horrible.
0:09:25 > 0:09:29Today she's having a scan to check the size of the tumour.
0:09:29 > 0:09:30Hey, Morgan, how you doing?
0:09:32 > 0:09:35- Be back with you in just a few minutes.- OK.
0:09:35 > 0:09:38The type of tumour that we're dealing with is a very slow growing
0:09:38 > 0:09:43tumour and it can change to become a more aggressive kind of tumour
0:09:43 > 0:09:46which does send secondary cells off to other parts of the body,
0:09:46 > 0:09:48what we call metastasis.
0:09:48 > 0:09:51Morgan just wants to get back to her teenage life,
0:09:51 > 0:09:53and hopes the surgeon can help her.
0:09:53 > 0:09:57As the symptoms are getting worse and that the tumour seems to be
0:09:57 > 0:10:01getting bigger, we need to try and take that section of bone away
0:10:01 > 0:10:03to remove the tumour to try and stop it from coming back.
0:10:03 > 0:10:07So we're going to try to get a piece of donated bone,
0:10:07 > 0:10:10a bone that's the right size and shape,
0:10:10 > 0:10:14because obviously if it's too big or too small it won't fit as well.
0:10:14 > 0:10:16The bone Morgan needs is a tibia.
0:10:16 > 0:10:19It'll be down to the tissue bank nurses to find the right donor.
0:10:24 > 0:10:26Back at the bank, it's nearly lunch time
0:10:26 > 0:10:30but tissue specialists Mel and Jen are still hard at work.
0:10:30 > 0:10:33It can take a whole day to take bone, skin and other tissues
0:10:33 > 0:10:36from a donor and the girls haven't finished yet.
0:10:36 > 0:10:39So this is the knee joint that we've taken
0:10:39 > 0:10:43and we take off the meniscus which sits here on the tibial plateau.
0:10:43 > 0:10:46And, as you can see, some of the cartilage has worn away.
0:10:46 > 0:10:50This is just because the donor is older and this is how you'd get
0:10:50 > 0:10:54problems with your knee because obviously once the cartilage has worn
0:10:54 > 0:10:56then you get bone on bone and then that's how the bone's worn
0:10:56 > 0:11:00and that's when people need knee replacements.
0:11:00 > 0:11:06It would be amazing to have kind of the whole story for knowing that
0:11:06 > 0:11:09the tissue that you have actually personally retrieved
0:11:09 > 0:11:12to see it getting grafted into somebody just because then
0:11:12 > 0:11:17it kind of becomes real, it puts it into that kind of perspective.
0:11:17 > 0:11:20After every donation, the team use reconstructive techniques
0:11:20 > 0:11:22to replace the tissues taken.
0:11:22 > 0:11:24Basically, we're just going to reconstruct now
0:11:24 > 0:11:29because we couldn't leave the donor with no bones in his legs.
0:11:29 > 0:11:32So we've got the prosthesis which replaces the leg bones.
0:11:32 > 0:11:34Obviously they're not going to bend at the knee any more
0:11:34 > 0:11:38but we have to make sure they look like they did before we started.
0:11:38 > 0:11:41It's just... It's respectful really.
0:11:41 > 0:11:44The parts they've taken are bagged and sent upstairs
0:11:44 > 0:11:46to be prepared for transplant.
0:11:46 > 0:11:48The first thing I do when I get home from a retrieval
0:11:48 > 0:11:51- is jump in the bath.- Yeah, have a shower and then a cup of tea.
0:11:51 > 0:11:53Ooh, yeah, I love a big cup of tea.
0:11:53 > 0:11:57The tissues Mel and Jen have taken will go on to change and save
0:11:57 > 0:11:5950 people's lives.
0:12:01 > 0:12:04For production specialist Reah upstairs, it's a constant battle
0:12:04 > 0:12:06to maintain the supply of tissues.
0:12:06 > 0:12:09Unless every process is followed perfectly,
0:12:09 > 0:12:11the tissues may not be released for transplant.
0:12:11 > 0:12:14I'm just about to get ready now to dissect some bone.
0:12:16 > 0:12:19I need to gown up with an extra layer of clothes to do that.
0:12:23 > 0:12:28When tissue is retrieved and comes to us here at the tissue bank,
0:12:28 > 0:12:33once we have medical release, we then process it
0:12:33 > 0:12:35so dissecting off the soft tissue,
0:12:35 > 0:12:40cleaning it up so that it's at a state where we can wash it
0:12:40 > 0:12:45and decontaminate it and we send it
0:12:45 > 0:12:47for final irradiation at the end.
0:12:47 > 0:12:51The bones are then frozen and stored until they're ordered by surgeons
0:12:51 > 0:12:54through Dan and the team in customer services.
0:12:54 > 0:12:57In here we've got heart valves.
0:12:57 > 0:13:00So I need a stool because I'm really short.
0:13:02 > 0:13:06The tissue bank store thousands of vital body tissues, but many
0:13:06 > 0:13:10are in short supply so they don't stay in the freezers for long.
0:13:11 > 0:13:14There's a constant demand for heart valves
0:13:14 > 0:13:17because they're so size specific.
0:13:17 > 0:13:21If we have a heart valve donated from a small baby
0:13:21 > 0:13:25you'll find that will have been issued as soon as
0:13:25 > 0:13:28it becomes available because there's so few of them.
0:13:28 > 0:13:31In here I have a mixture.
0:13:31 > 0:13:34I think this is an issuable tank so we've got heart valves,
0:13:34 > 0:13:37meniscus, osteochondrols
0:13:37 > 0:13:41and, yep, some pericardiums and even some arteries
0:13:41 > 0:13:44but I can't see anything at the moment.
0:13:44 > 0:13:47You don't want young healthy people to die but it is the young
0:13:47 > 0:13:50and healthy tissue that we need, that is most useful.
0:13:50 > 0:13:53It has the best clinical outcome as well.
0:13:57 > 0:14:01Good afternoon, Tissue Services. Daniel speaking. How can I help?
0:14:01 > 0:14:02Back in customer services,
0:14:02 > 0:14:05Dan has just received the order for Morgan's tibia.
0:14:05 > 0:14:08A full tibia is unusual for the bank.
0:14:08 > 0:14:12It's not actually a product that we usually process or retrieve
0:14:12 > 0:14:16but what I can do is take it as a specialist request.
0:14:16 > 0:14:18Morgan needs a tibia from someone similar to her.
0:14:18 > 0:14:21Young, female and the same height
0:14:21 > 0:14:24so that the bone fits her leg perfectly.
0:14:24 > 0:14:26She needs a whole tibia replacing.
0:14:26 > 0:14:30Now, it's not a product that we routinely retrieve or store.
0:14:30 > 0:14:33There isn't a great need for them.
0:14:33 > 0:14:36So we can take it as a specialist request.
0:14:36 > 0:14:38He has given us a surgery date of April.
0:14:38 > 0:14:42These types of products can take up to six months to retrieve.
0:14:42 > 0:14:44We're just really hoping that we can meet this tight deadline.
0:14:44 > 0:14:47With only a few months to the deadline,
0:14:47 > 0:14:50all the team can do is wait for a suitable donor.
0:14:50 > 0:14:52All right, well, thanks very much for that, Mr Jeys.
0:14:52 > 0:14:56I will be back in touch with you shortly. Thank you, bye-bye.
0:14:57 > 0:15:01It's mid-afternoon and the specialist referral nurses are busy
0:15:01 > 0:15:02making consent calls.
0:15:02 > 0:15:04Are you OK to speak to me at the moment?
0:15:04 > 0:15:06Is now a good time to do this?
0:15:06 > 0:15:09The nurses help families make the difficult decision to agree to
0:15:09 > 0:15:13a donation, often within hours of a loved one dying.
0:15:13 > 0:15:16And had he any reason to visit his GP or the hospital
0:15:16 > 0:15:18in the past two years?
0:15:18 > 0:15:21'Yes, he's been going quite regularly.'
0:15:21 > 0:15:23Referral nurse Simon has just received news
0:15:23 > 0:15:27of a 35-year-old who's died in a road traffic accident.
0:15:27 > 0:15:29He's about to call the young man's father.
0:15:29 > 0:15:33What was he doing? Was he on a bike or walking?
0:15:38 > 0:15:42After a death, family consent must be given to carry out a donation,
0:15:42 > 0:15:44even for registered donors.
0:15:44 > 0:15:45It's awful, isn't it?
0:15:45 > 0:15:47You just don't expect something like that to happen,
0:15:47 > 0:15:50especially in front of your house as well.
0:15:50 > 0:15:51Dear me.
0:15:51 > 0:15:54It's a difficult conversation at an emotional time.
0:15:54 > 0:15:57If I just confirm that you are in agreement for eye donation
0:15:57 > 0:15:59and potentially for skin donation?
0:15:59 > 0:16:01- Yes.- Is that correct, John?
0:16:01 > 0:16:04- And Jackie was comfortable with that as well?- Yes.
0:16:04 > 0:16:07Though the tissue bank need donors of all ages, often the healthiest
0:16:07 > 0:16:09tissues come from young people,
0:16:09 > 0:16:14but in the last year only 51 donors were under 35.
0:16:14 > 0:16:18- Have you got contact details? - I do, yeah.- Got coroner's consent?
0:16:18 > 0:16:22- Yes, we've got coroner's consent. - From?- Mr Oakley, the coroner.
0:16:22 > 0:16:24With young donors in such short supply,
0:16:24 > 0:16:27this is a vital donation for the bank.
0:16:27 > 0:16:30Tissue specialist Adam will be carrying out the donation.
0:16:30 > 0:16:34- Do you want us to take the blood sample?- Yes, please, if that's OK.
0:16:34 > 0:16:37- Can you do the eye donation as well, please?- Yeah.
0:16:37 > 0:16:40Eyes, one of the most in-demand tissues must be retrieved
0:16:40 > 0:16:44within 24 hours of death to preserve their cells,
0:16:44 > 0:16:46so Adam's up against the clock.
0:16:46 > 0:16:48- Safe journey.- Yeah, cheers.
0:16:48 > 0:16:49We're going to Scarborough,
0:16:49 > 0:16:52and we're just looking at the time it's going to take us to get there,
0:16:52 > 0:16:54so it's 2.00pm, 2.05pm now.
0:16:54 > 0:16:58It's going to take us three hours, so that's 5.00pm.
0:16:58 > 0:17:0024 hours is up at half six tonight,
0:17:00 > 0:17:03so if we got stuck in traffic or anything like that
0:17:03 > 0:17:05cos we've got to go through Leeds at rush hour,
0:17:05 > 0:17:09there could be the potential that we'd lose the donation.
0:17:09 > 0:17:13Adam's only 32, but he's been in the job for almost ten years,
0:17:13 > 0:17:16and has been team leader for the last two.
0:17:17 > 0:17:21When I first started I was 22 years old
0:17:21 > 0:17:25and at that sort of age you feel indestructible.
0:17:25 > 0:17:30You sort of live your life based around the fact that you're 22.
0:17:30 > 0:17:32However...
0:17:34 > 0:17:38when you've seen some of the donors
0:17:38 > 0:17:40that are around your age range
0:17:40 > 0:17:45it makes you think well actually you don't have all the time in the world
0:17:45 > 0:17:48or you're not indestructible or you know things can happen
0:17:48 > 0:17:50and you've got really no...
0:17:50 > 0:17:53In a lot of cases, you have no warning of it.
0:18:04 > 0:18:07Adam's hoping that he can take two healthy eyes from the donor
0:18:07 > 0:18:10but he has to be quick otherwise they'll dry out
0:18:10 > 0:18:13and be no good for transplant.
0:18:16 > 0:18:20My main priority at the moment now is to retrieve the eyes.
0:18:20 > 0:18:24So I've got until half six so I've got 35 minutes,
0:18:24 > 0:18:28so that's going to be what I'm going to prioritise now.
0:18:31 > 0:18:34I'm just going to get all my eye stuff ready first
0:18:34 > 0:18:36and all the paper work and stuff.
0:18:36 > 0:18:40- Can you do it in 35 minutes? - We'll see.
0:18:40 > 0:18:46If I don't think I will I won't start but I think I can, just about.
0:18:52 > 0:18:56It is a little bit strange cos you're not used to seeing somebody
0:18:56 > 0:19:01in that way and I can remember like the first donation that I did.
0:19:01 > 0:19:04You're either going to go, "Oh, my God, what am I doing?"
0:19:04 > 0:19:07Feel ill, pass out, go green, go pale.
0:19:07 > 0:19:08Or you're going to be,
0:19:08 > 0:19:11"Whoa, I've never seen anything like this before.
0:19:11 > 0:19:13"I can't stop staring at it"
0:19:13 > 0:19:17and just be fixated by this unusual sight.
0:19:21 > 0:19:23Would you be able to open up
0:19:23 > 0:19:26one of the little bottles of eyewash, please?
0:19:26 > 0:19:30Unlike other tissues, eyes can only be stored for one month after
0:19:30 > 0:19:34retrieval so the tissue bank need a constant supply of eye donations
0:19:34 > 0:19:36to keep up with demand.
0:19:36 > 0:19:40The left eye is done. That was done at quarter-past.
0:19:40 > 0:19:44So I just need to reconstruct and then do the right.
0:19:45 > 0:19:47So hopefully, OK.
0:19:47 > 0:19:49Adam has to take the whole eyeball.
0:19:49 > 0:19:51Afterwards he'll reconstruct,
0:19:51 > 0:19:54so it looks like the eye is still in place.
0:19:56 > 0:20:00Last year 1,700 eyes were collected by the tissue donation team
0:20:00 > 0:20:04helping people to regain their sight.
0:20:04 > 0:20:07Most of them go to people with damaged corneas,
0:20:07 > 0:20:10the transparent lens at the front of the eye.
0:20:12 > 0:20:13400 miles away in Devon,
0:20:13 > 0:20:1824-year-old Tom is on the hospital waiting list for a new cornea.
0:20:18 > 0:20:20When I was 14, 15, I went to the opticians and they kept
0:20:20 > 0:20:24giving me glasses and I kept saying they don't work. Nobody believed me
0:20:24 > 0:20:28and then the optician said "I think you might have keratoconus."
0:20:28 > 0:20:32Tom's cornea bulges outwards, making it difficult for him to see.
0:20:32 > 0:20:33It's a rare disease.
0:20:33 > 0:20:37Only one in 2,000 people suffer from it in the UK.
0:20:37 > 0:20:42It's times like now if he runs away I won't see him because of my eyes.
0:20:42 > 0:20:46I've come to a point now where I'm not allowed to drive any more.
0:20:46 > 0:20:48I can't read the number plates at the right distance.
0:20:48 > 0:20:50I'm a lot more immobile now
0:20:50 > 0:20:54and my vision it narrows the work I can do down quite significantly.
0:20:58 > 0:21:00Studying to be a quantity surveyor
0:21:00 > 0:21:02and a lot of it's looking at construction drawings
0:21:02 > 0:21:05and the and the trouble I've been having recently is that
0:21:05 > 0:21:07I get double vision in my eyes.
0:21:09 > 0:21:13So I'm trying to measure a drawing with a scale ruler.
0:21:14 > 0:21:18I see two lines and I think which one have I got to measure?
0:21:18 > 0:21:21Only with a donated cornea will Tom be able to have
0:21:21 > 0:21:23anything like a normal life.
0:21:23 > 0:21:26I'm just appreciative that someone would donate their eyes.
0:21:26 > 0:21:28Some people get a bit funny about that kind of thing,
0:21:28 > 0:21:30but I don't really think it is, to be honest.
0:21:30 > 0:21:31I don't think there's anything...
0:21:31 > 0:21:33I guess it's cos I'm the one receiving it
0:21:33 > 0:21:37so I've got a different outlook on it, a different perspective,
0:21:37 > 0:21:40cos it's going to improve my quality of life, I guess.
0:21:41 > 0:21:45Back in autumn, Tom's sight got so bad he had to leave university
0:21:45 > 0:21:47and move back in with his parents.
0:21:47 > 0:21:51Er, basically need to clean my lens.
0:21:53 > 0:21:54I'm sorry I can't see.
0:21:54 > 0:21:56Because of his condition,
0:21:56 > 0:21:58Tom needs a cornea from someone of a similar age
0:21:58 > 0:22:00but, because young donors are rare,
0:22:00 > 0:22:04he's having to use a special contact lens to help him see.
0:22:04 > 0:22:07Like now, I wouldn't be able to... The only reason I know it's in there
0:22:07 > 0:22:08is because I can see you a lot better.
0:22:08 > 0:22:11From the side you might be able to see it like bulge.
0:22:14 > 0:22:17When I was growing up I always wanted to be in the armed forces,
0:22:17 > 0:22:19like, specifically, the Royal Marines.
0:22:19 > 0:22:23My twin brother's in the Royal Marines
0:22:23 > 0:22:26but if you've got keratoconus or you've got a corneal transplant,
0:22:26 > 0:22:29you're not allowed to join anyway
0:22:29 > 0:22:31so I've just had to like give up on that idea.
0:22:31 > 0:22:34I'd still like to but...
0:22:34 > 0:22:39it is literally impossible so you don't worry about it really.
0:22:39 > 0:22:41Don't think about it.
0:22:43 > 0:22:45Tom won't be able to return to university
0:22:45 > 0:22:49or move on with his career until the right cornea can be found for him.
0:22:54 > 0:22:56It's Wednesday and back at the tissue bank
0:22:56 > 0:22:59the donation team are having a rare lunch break.
0:22:59 > 0:23:04They all work shifts, seven days a week, 365 days a year.
0:23:06 > 0:23:09- Did you try the Atkins? - Are you on the lumpy sick diet?
0:23:09 > 0:23:14- It looks like it.- That's baby food, isn't it?- Is it nice?- No.
0:23:14 > 0:23:18Looks like you've thrown up the kebab you had on Saturday.
0:23:18 > 0:23:21We do find that if we do a retrieval on an empty stomach we are
0:23:21 > 0:23:25absolutely famished by the end so it is important to at least get
0:23:25 > 0:23:26a snack before we start.
0:23:26 > 0:23:30Obviously it's not always the case because of tight time limits
0:23:30 > 0:23:33and things like that but we do try if we can.
0:23:33 > 0:23:35We're quite lucky today in the fact that we're waiting for
0:23:35 > 0:23:39the donor transfer so we've actually got the time to grab something to eat
0:23:39 > 0:23:40which is a bonus really.
0:23:40 > 0:23:44Today Mel is working with long-time colleague Becky.
0:23:47 > 0:23:50They're heading to Warrington to carry out a skin donation.
0:23:50 > 0:23:54Skin is one of the most in-demand tissues the team take.
0:23:54 > 0:23:57'18 excruciating hairdresser pun names.'
0:23:57 > 0:24:00- Are these all in Britain as well? - Are you ready for this?- Yep.
0:24:00 > 0:24:02'British Hairwaves.'
0:24:02 > 0:24:04LAUGHS
0:24:04 > 0:24:06Oh, that's a good one.
0:24:06 > 0:24:08Oh, this is amazing.
0:24:08 > 0:24:12'Sherlock Combs.'
0:24:12 > 0:24:16So this one specialises in wigs
0:24:16 > 0:24:18otherwise known as...
0:24:18 > 0:24:19- Weaves.- ..weaves.
0:24:19 > 0:24:23- What would it be called? - 'Weave all you need?'
0:24:23 > 0:24:26- No, it's better than that. - Is it? Go on, then.
0:24:26 > 0:24:29'Unbeweavable!'
0:24:38 > 0:24:4229-year-old Becky has been working at the tissue bank for nine years
0:24:42 > 0:24:45after studying anatomy at university.
0:24:45 > 0:24:46So you two don't look like the type
0:24:46 > 0:24:49that should be hanging out in a mortuary.
0:24:49 > 0:24:52Why? What do people that hang in a mortuary look like?
0:24:52 > 0:24:54We always get told this but what?
0:24:54 > 0:24:58To be honest I think people expect it be to like middle-aged men.
0:24:58 > 0:25:01I definitely don't think it's young girls.
0:25:01 > 0:25:03Or kind of massively gothic people for some reason.
0:25:03 > 0:25:05Yeah, like mad professor doctors.
0:25:05 > 0:25:08We look a lot older.
0:25:08 > 0:25:11Well some of us do. I still get ID'd.
0:25:12 > 0:25:15Right, got our wellies, got the greens, got the batteries.
0:25:15 > 0:25:17Got ice. It was missing blades.
0:25:17 > 0:25:20We got blades, we got the paperwork, we got the referral, we got a pen.
0:25:20 > 0:25:22Ready to rock'n'roll.
0:25:26 > 0:25:30So we need to clean the donor and shave them.
0:25:30 > 0:25:33With the skin we have to be really, really careful with contamination
0:25:33 > 0:25:37obviously because the skin's used on burns patients
0:25:37 > 0:25:41who are obviously at great risk of infection.
0:25:41 > 0:25:45The skin they collect will be used as a kind of natural bandage
0:25:45 > 0:25:47for people who've been severely burnt.
0:25:47 > 0:25:49This is the dermatome.
0:25:49 > 0:25:52This is the machine that we use to remove the skin.
0:25:52 > 0:25:54There's a blade that moves side to side
0:25:54 > 0:25:58and that takes off a very thin layer of the skin and it's got different
0:25:58 > 0:26:03settings on the side so you can decide how thick you want the skin.
0:26:12 > 0:26:15It's really beneficial because, you know, like,
0:26:15 > 0:26:18when the July bombings happened down in London,
0:26:18 > 0:26:21all of our skin was wiped out because they needed that skin
0:26:21 > 0:26:23because of all the people that got burnt.
0:26:23 > 0:26:25I've just taken skin off this donor.
0:26:25 > 0:26:27This is going to help to save somebody's life
0:26:27 > 0:26:32so you wouldn't do this job if you didn't believe in that kind of thing.
0:26:32 > 0:26:37UK surgeons ordered 600,000 square centimetres last year.
0:26:37 > 0:26:41The high demand for skin means a need for more donors.
0:26:41 > 0:26:42Hundreds of people die every day
0:26:42 > 0:26:45and the sad thing is that a lot of people will die
0:26:45 > 0:26:47and their families won't know about tissue donation
0:26:47 > 0:26:48so they don't get to make that choice.
0:26:48 > 0:26:50It's not waiting for somebody to die.
0:26:50 > 0:26:53It's waiting for someone to make that decision
0:26:53 > 0:26:56and say they'd like to go ahead for tissue donation.
0:26:56 > 0:27:00I've been really fortunate that I've never had to experience
0:27:00 > 0:27:03losing anybody really close to me.
0:27:03 > 0:27:07If anything, it makes you more kind of...
0:27:07 > 0:27:10It gives you the need to want to live your life more
0:27:10 > 0:27:13because you realise that it could be over like that in like a flash.
0:27:13 > 0:27:19How would I like to die? Quickly, painlessly, in my sleep.
0:27:19 > 0:27:21I would like to be doing something I love,
0:27:21 > 0:27:25so I'd like to be doing something on some wild adventure.
0:27:25 > 0:27:28I've never been particularly religious.
0:27:28 > 0:27:32I've never believed really in heaven or that you go anywhere else
0:27:32 > 0:27:36and then again I think people think after death you transform into
0:27:36 > 0:27:41something completely different and of course you don't, it's just you.
0:27:41 > 0:27:43But you're just, just this bit's gone.
0:27:43 > 0:27:44That's it we're done.
0:27:44 > 0:27:47- We've got quite a lot of skin there as well, haven't we?- Yeah.
0:27:47 > 0:27:48Because the donor's quite large
0:27:48 > 0:27:51we've got quite a good yield of skin which is really nice.
0:27:51 > 0:27:54If you looked at this, not having seen it before,
0:27:54 > 0:27:58you wouldn't necessarily jump to the conclusion that it was a pot of skin.
0:27:58 > 0:28:01This skin will help to save the lives of burns victims
0:28:01 > 0:28:04across the country.
0:28:04 > 0:28:08- Brilliant. That's great. Thanks very much.- See you next time.
0:28:10 > 0:28:13Death doesn't scare me at all.
0:28:13 > 0:28:18I'd say, erm, that actually growing old scares me more.
0:28:20 > 0:28:21Definitely.
0:28:21 > 0:28:25You know, the thought of being, like, 85 and...
0:28:27 > 0:28:31..kind of living in a home and not being able to do things for myself
0:28:31 > 0:28:34and just kind of wasting away, if you like.
0:28:34 > 0:28:36I mean obviously that's generalisation.
0:28:36 > 0:28:39Not all 85-year-olds, you know, do that.
0:28:39 > 0:28:42Look at Hugh Hefner. He's getting on. He's fine, isn't he?
0:28:42 > 0:28:45As Becky and Mel drop off five metres of skin
0:28:45 > 0:28:46to fill up the bank's fridges,
0:28:46 > 0:28:50it's another day's good work done.
0:28:50 > 0:28:53Across the country in Southampton, one patient is about to have
0:28:53 > 0:28:56an operation that could change his life.
0:28:56 > 0:29:00After several months on the hospital waiting list, Tom will finally
0:29:00 > 0:29:02receive a donated cornea.
0:29:02 > 0:29:05I don't think I will feel nervous, to be honest, I'll just,
0:29:05 > 0:29:12I'm like, erm, I trust the doctors, and I'm quite excited really,
0:29:12 > 0:29:14because I want to get it over and done with
0:29:14 > 0:29:18and looking forward to waking up and seeing what I can see, pretty much.
0:29:18 > 0:29:22Tom's new cornea was donated from a 20-year-old male donor.
0:29:22 > 0:29:24Straight ahead, please.
0:29:24 > 0:29:28There's a chance the cornea could be rejected, so the surgeon makes
0:29:28 > 0:29:31sure his eye is clear of infection before the operation.
0:29:31 > 0:29:34I can see the area which has thinned
0:29:34 > 0:29:36and which we need to remove and replace,
0:29:36 > 0:29:41and the rest of his eye looks good.
0:29:41 > 0:29:43- Brilliant.- Do sit back.
0:29:43 > 0:29:46So, Tom's clear to go, we're happy with that,
0:29:46 > 0:29:50one thing we do need to do is pop a little mark on you.
0:29:57 > 0:30:01Got a few good luck messages from my brother and my mates.
0:30:01 > 0:30:05"Good luck today, bruv, strength and honour,"
0:30:05 > 0:30:08and the other one is from my friend's mum.
0:30:08 > 0:30:13In theatre, the surgeon cuts around Tom's damaged cornea before
0:30:13 > 0:30:16removing it and stitching the new one in place.
0:30:16 > 0:30:20So now we've freed the damaged cornea or the thinned cornea,
0:30:20 > 0:30:22we can lift that off,
0:30:22 > 0:30:25and we look after that,
0:30:25 > 0:30:28and then with great care,
0:30:28 > 0:30:31we overlay our corneal transplant.
0:30:35 > 0:30:38I hope Tom will find that even in the first few weeks,
0:30:38 > 0:30:39he can see a difference.
0:30:42 > 0:30:43Thank you.
0:30:43 > 0:30:45That was really good,
0:30:45 > 0:30:47I'm really happy with the outcome of the surgery.
0:30:47 > 0:30:53I think this new transplant has gotten off to a great start,
0:30:53 > 0:31:00and now the real work and rehabilitation begins.
0:31:00 > 0:31:03We're going to transfer you over onto your bed, OK, and then we'll
0:31:03 > 0:31:07get you back into your room, you'll be a bit more comfortable.
0:31:08 > 0:31:12If Tom's lucky, he should start to see with his new cornea
0:31:12 > 0:31:13in a couple of days.
0:31:13 > 0:31:17Back at the tissue bank, the search for a suitable tibia for
0:31:17 > 0:31:22Morgan continues, but now the donations have dried up.
0:31:22 > 0:31:25The new year is normally a busy period, as accidents and elderly
0:31:25 > 0:31:27deaths increase over the winter months.
0:31:27 > 0:31:32But this year, it's the opposite and the team are stuck in the office.
0:31:32 > 0:31:35I've been awarded Employee of the Day.
0:31:35 > 0:31:38I'm going to treasure it and makes sure everybody sees it.
0:31:38 > 0:31:43- Look, Francesca, look what I've got! - Well done, Becky.- Thanks.
0:31:43 > 0:31:47This is Mr Skellington.
0:31:47 > 0:31:49Did I mention my Employee of the Day award?
0:31:49 > 0:31:53This is my Blu-Tack octopus, he sits there, but he's got
0:31:53 > 0:31:57a couple of legs missing now, because we've been in need of Blu-Tack.
0:31:57 > 0:32:00We always say with this job that it's one way or the other.
0:32:00 > 0:32:02We can have three weeks of being really,
0:32:02 > 0:32:06really quiet and not having any donations and then before you know it
0:32:06 > 0:32:08we've got four teams out a day,
0:32:08 > 0:32:11taking tissue from all over the country.
0:32:11 > 0:32:14Did I mention my Employee of the Day award?
0:32:15 > 0:32:18But it's not just the team waiting for donors.
0:32:18 > 0:32:22In Birmingham, it's been six weeks since Morgan was told she would
0:32:22 > 0:32:26need a new tibia, and she's starting to think it might never happen.
0:32:26 > 0:32:31- Ah, it does look interesting, is it dry?- Yes, this one's dry.- Yeah.
0:32:31 > 0:32:35Back at sixth form college studying for her A-levels, she can't get
0:32:35 > 0:32:37the search for the right donor off her mind.
0:32:37 > 0:32:42I've been thinking about, like, the whole donation side of it.
0:32:42 > 0:32:45'It's actually quite sad, really, isn't it?
0:32:45 > 0:32:48'Like, I am really grateful, but for them,
0:32:48 > 0:32:50'it's going to be horrible, like.'
0:32:50 > 0:32:53- What pen are you using at the moment? - Just a marker.
0:32:53 > 0:32:57I know that when I get the phone call saying that they've found
0:32:57 > 0:33:01a matched tibia, that another family's, like, had like the worst
0:33:01 > 0:33:04news that anyone could have ever wanted and I'm going to be
0:33:04 > 0:33:08benefitting from their loss and it's really quite sad, actually.
0:33:08 > 0:33:11At home after college, Morgan shares the news of her up-coming
0:33:11 > 0:33:14operation with best friend Holly.
0:33:14 > 0:33:16What part actually is it? Is it like the front plate?
0:33:16 > 0:33:18Yeah, like the entire front.
0:33:18 > 0:33:21What, the entire thing, or just the front plate?
0:33:21 > 0:33:24The actual affected bone
0:33:24 > 0:33:27starts from, like, under my knee to, like, here.
0:33:27 > 0:33:30It sounds like they're taking your whole leg away,
0:33:30 > 0:33:32but they're not, it's just the front plate, isn't it?
0:33:32 > 0:33:34Yeah, it's just the tibia, so they're leaving the fibula.
0:33:34 > 0:33:38It's like I've had it so long, and it's like I can
0:33:38 > 0:33:41see the end, it's like a giant race that I've ran and I
0:33:41 > 0:33:45can see the last ten metres, and it's just there, but I just,
0:33:45 > 0:33:47it's just not happening quick enough,
0:33:47 > 0:33:50like, it's just out of grasp.
0:33:54 > 0:33:57While Morgan's hopes are on hold, at the tissue bank, they're on
0:33:57 > 0:34:01full alert in the hunt for a suitable tibia.
0:34:01 > 0:34:04But by the end of March, things still haven't picked up.
0:34:04 > 0:34:07It's the 23rd March.
0:34:07 > 0:34:13At the moment, we have a special request for a tibia donor,
0:34:13 > 0:34:20aged 18-30, the height limit is 5ft 9. Ideally female.
0:34:20 > 0:34:22It's hard, because you don't want to then be waiting
0:34:22 > 0:34:26for somebody to die, but obviously, you want to help this person as well.
0:34:26 > 0:34:30But it's not just tibias that are in short supply.
0:34:30 > 0:34:33We've got 80 eye donors so far this month,
0:34:33 > 0:34:38and that's not really a lot - most months are over 100, 180.
0:34:38 > 0:34:42We've had 11 skin donors, that's not really a lot,
0:34:42 > 0:34:44especially when skin is needed.
0:34:44 > 0:34:50Erm, we've had two people donate their heart valves this month,
0:34:50 > 0:34:53that's not a lot either, really.
0:34:53 > 0:34:58But again, you can't set a target, because, you know, you can't
0:34:58 > 0:35:02guarantee who's going to die, when they're going to die.
0:35:02 > 0:35:04Across in East Yorkshire,
0:35:04 > 0:35:07four-year-old Laiela is desperately in need of a donated heart valve.
0:35:07 > 0:35:10Right, I'm just checking Laiela,
0:35:10 > 0:35:13making sure that she's all right and that she's awake yet.
0:35:13 > 0:35:15Her pulmonary artery doesn't work.
0:35:15 > 0:35:19Without a suitable valve being found soon, she'll die.
0:35:19 > 0:35:23- Is it Tashy?- Have you got her?
0:35:23 > 0:35:26Laiela was born with a heart defect, erm...
0:35:26 > 0:35:30Between four and five weeks old she had to have it replaced and
0:35:30 > 0:35:31now she has to have another
0:35:31 > 0:35:34pulmonary artery put in, a bigger size.
0:35:34 > 0:35:39The pulmonary artery has to come from a young person.
0:35:39 > 0:35:42It must be horrible, it must be awful for that parent,
0:35:42 > 0:35:46but we cannot thank them enough, because without it, she could die.
0:35:48 > 0:35:50We look after her between us.
0:35:50 > 0:35:54It's like, when my mum and dad go out I look after her,
0:35:54 > 0:35:57because I'm the eldest.
0:35:57 > 0:35:59It's a bit weird,
0:35:59 > 0:36:02because it's like having another bit of another person inside her,
0:36:02 > 0:36:04but if it will help her live
0:36:04 > 0:36:09and help her do normal things like us, then I'm all for it.
0:36:09 > 0:36:13I would, I would donate.
0:36:13 > 0:36:15When I'm dead, of course.
0:36:15 > 0:36:18So she can grow into it, Laiela needs a valve from someone ten years
0:36:18 > 0:36:22older than her, but last year, the tissue team only took 40
0:36:22 > 0:36:25heart valves, none of them the right size.
0:36:25 > 0:36:27Laiela could be in for a long wait.
0:36:28 > 0:36:30Tonight, Adam's on shift.
0:36:30 > 0:36:34He's been asked to take two heart valves from a young male donor.
0:36:34 > 0:36:36They're too big for Laiela
0:36:36 > 0:36:39but they could go on to save two people's lives.
0:36:40 > 0:36:44We're just draping the donor and what we're going to do is
0:36:44 > 0:36:47we're going to go in and do the heart and do that now.
0:36:47 > 0:36:50Heart valves from young donors are incredibly rare -
0:36:50 > 0:36:52so it's a vital donation for the bank.
0:36:52 > 0:36:54If they are retrieved successfully,
0:36:54 > 0:36:57they won't be in the freezers for long.
0:36:57 > 0:37:04The best outcome would be you get two perfect valves
0:37:04 > 0:37:09that can be transplanted into somebody who needs them.
0:37:09 > 0:37:13First of all, what I don't want to happen is when I retrieve them,
0:37:13 > 0:37:16damage them, which is potential.
0:37:16 > 0:37:20Next worst thing would be that they get damaged when they're being
0:37:20 > 0:37:23processed, and then latterly, which is something that you might have
0:37:23 > 0:37:26no control over, is that they were just never fit for use anyway,
0:37:26 > 0:37:28there was pathology on them.
0:37:28 > 0:37:32Heart valves are in so much demand, because they're quite rare,
0:37:32 > 0:37:35you don't always get them, because there is an age limit.
0:37:35 > 0:37:38An upper age limit of 65.
0:37:38 > 0:37:41So whenever you do get one, you want to retrieve it
0:37:41 > 0:37:43so that it can be processed.
0:37:43 > 0:37:46We've got some blood in here.
0:37:46 > 0:37:48It's never easy taking a heart valve,
0:37:48 > 0:37:52and whilst retrieving it, Adam notices a problem.
0:37:52 > 0:37:55It looks like there's been some bleeding just into the tissue,
0:37:55 > 0:38:00really, erm, from, I don't know, maybe a bit higher up,
0:38:00 > 0:38:05but the vessel itself, the vessel itself looks OK,
0:38:05 > 0:38:07I think it looks, up to the bits
0:38:07 > 0:38:09where I've cut anyway, it looked OK,
0:38:09 > 0:38:13so I think it should be hopefully potentially viable.
0:38:14 > 0:38:18As a heart generally, quite small, not much fat,
0:38:18 > 0:38:24erm... but, yeah, it looked quite good.
0:38:24 > 0:38:29The next morning at the tissue bank, the heart valves Adam has
0:38:29 > 0:38:33taken from the donor are cleaned and inspected.
0:38:34 > 0:38:37We're always looking out for particular kind
0:38:37 > 0:38:40of indications that the valve isn't suitable for use.
0:38:40 > 0:38:44There's an indication that there was striations in the tissue itself.
0:38:44 > 0:38:49A striation is basically just a tear in the tissue,
0:38:49 > 0:38:52so that would mean that there's a weakness in the wall
0:38:52 > 0:38:54that's going to be under extreme pressure
0:38:54 > 0:38:58when it's in the body from the blood flow pumping around, so we checked
0:38:58 > 0:39:02it today and unfortunately we found out that the valve isn't fit for use.
0:39:02 > 0:39:05It's sad, because you've gone to that effort
0:39:05 > 0:39:09and you've gone there to retrieve it, but this is why we need donors.
0:39:09 > 0:39:14This is why you need donations, because you might think,
0:39:14 > 0:39:16well, you've got patient one, two and three,
0:39:16 > 0:39:18they've all donated their heart, that's three hearts,
0:39:18 > 0:39:23that's not necessarily the case, because they might not go through fit for issue, all of those three
0:39:23 > 0:39:28might fail at some point due to any number of circumstances,
0:39:28 > 0:39:32so that's why you need more patients, more donors,
0:39:32 > 0:39:35because you can't always guarantee that every one
0:39:35 > 0:39:37you take is going to be suitable.
0:39:42 > 0:39:46In East Yorkshire, Laiela has been waiting for the right heart valve
0:39:46 > 0:39:48for almost three months.
0:39:48 > 0:39:51Now there's a match from a teenage donor.
0:39:51 > 0:39:56Ooh, very emotional. Look, a wreck. Yeah.
0:39:56 > 0:39:59Today she's on her way to Leeds General Infirmary,
0:39:59 > 0:40:04where surgeons will replace her old valve with a new one.
0:40:04 > 0:40:06Do you want Mr Tumble on?
0:40:06 > 0:40:11I don't normally feel nervous, but I normally take this in my stride.
0:40:11 > 0:40:14It's normally Kerry who's the nervous one, the worrying one.
0:40:14 > 0:40:16I'm the father, and I'm her daddy,
0:40:16 > 0:40:20and I'm meant to be the one that looks after her and protects her.
0:40:21 > 0:40:25For somebody to donate something
0:40:25 > 0:40:31so Laiela can have a better life, erm, is quite overwhelming, really.
0:40:31 > 0:40:35I'd like to think I could do it. I don't know whether I could.
0:40:43 > 0:40:49'We had a letter, and the risks on that letter was endless.'
0:40:49 > 0:40:52It ranged from blood clots to the brain to death.
0:40:55 > 0:40:57I don't think Laiela understands
0:40:57 > 0:41:02that there's anything wrong with her heart. So it is heart-breaking.
0:41:02 > 0:41:05And it's going to start making me cry soon,
0:41:05 > 0:41:07but there's no other alternative.
0:41:09 > 0:41:15We know that she wouldn't, she wouldn't survive, she'd die.
0:41:16 > 0:41:20All the tissue bank's heart valves are frozen at minus 135 degrees.
0:41:20 > 0:41:22Only when the surgeon is ready
0:41:22 > 0:41:25will it be defrosted in a warm water bath.
0:41:27 > 0:41:30The new valve should last Laiela for the next ten years,
0:41:30 > 0:41:34when she'll need it replacing once more.
0:41:36 > 0:41:39Laiela's mum and dad have been waiting anxiously for six hours
0:41:39 > 0:41:41while she's been in surgery.
0:41:45 > 0:41:49Erm, we're very happy with how the operation went.
0:41:49 > 0:41:53We took out that old conduit
0:41:53 > 0:41:59and put a new one in and it's a nice size, it's lying very nicely.
0:41:59 > 0:42:03So I think we're probably OK, shall we pop down and go and see her?
0:42:03 > 0:42:06RELIEVED LAUGHTER
0:42:06 > 0:42:10- She's just starting to surface a little bit.- Hiya, are you OK?
0:42:10 > 0:42:12Come, come and take her hand.
0:42:18 > 0:42:20I am happy crying!
0:42:20 > 0:42:24- The other intensive care ones... - It's such a relief.
0:42:24 > 0:42:27It is, it really is a relief.
0:42:27 > 0:42:30Been hanging on for you a little bit.
0:42:33 > 0:42:35Dummy's still there.
0:42:35 > 0:42:39Carried that around since she's been in, on my finger.
0:42:41 > 0:42:42She'll be all right.
0:42:45 > 0:42:49It's another early Monday morning at the tissue bank and the nurses are
0:42:49 > 0:42:51busy with donor family calls.
0:42:51 > 0:42:53I don't know whether you know much about tissue donation,
0:42:53 > 0:42:55or ever heard of it?
0:42:55 > 0:42:58'No, I didn't even know they did it, love,
0:42:58 > 0:43:00'I just thought it were internal organs.'
0:43:00 > 0:43:01Oh, of course.
0:43:01 > 0:43:04For the last four months, the lack of suitable female donors
0:43:04 > 0:43:08has made it impossible to find a replacement tibia bone for Morgan.
0:43:08 > 0:43:11But as April arrives, the board begins to fill up.
0:43:13 > 0:43:15Has she ever been abroad?
0:43:15 > 0:43:18'She was the cruise queen of Bolton.'
0:43:18 > 0:43:19Was she?
0:43:19 > 0:43:21'Up until about four years ago.'
0:43:21 > 0:43:25Finally, there's a glimmer of hope in the hunt for Morgan.
0:43:25 > 0:43:28Down south there's a potential female donor.
0:43:28 > 0:43:33I'm just going to contact a family of a lady who passed away,
0:43:33 > 0:43:35she was on the organ donor register.
0:43:37 > 0:43:40Oh, hi, my name's Laura, I'm one of the specialist nurses
0:43:40 > 0:43:43from NHS Blood and Transplant calling.
0:43:43 > 0:43:47Hiya. I just first of all want to offer you my condolences.
0:43:49 > 0:43:50OK.
0:43:50 > 0:43:54It looks like there could be some good news for Morgan.
0:43:54 > 0:43:57They've consented to donate her tibia bone,
0:43:57 > 0:44:00so it will be the full bone that will be transplanted into our
0:44:00 > 0:44:03recipient at the moment,
0:44:03 > 0:44:07who's waiting because of a malignancy in her leg.
0:44:07 > 0:44:10Hopefully, we'll just wait on the blood results to come back,
0:44:10 > 0:44:13everything is OK, there's no infection
0:44:13 > 0:44:16and that the suitability of the bone, the structure of the bone is OK.
0:44:16 > 0:44:20And then we can issue that for the recipient.
0:44:20 > 0:44:23It's 5am the next morning.
0:44:23 > 0:44:26- This is too early. - This is your fault!
0:44:26 > 0:44:29- Do I look tired?- You look great.
0:44:29 > 0:44:33Becky and Adam have been called out early for an urgent donation...
0:44:33 > 0:44:35and it's a female donor.
0:44:35 > 0:44:38I don't know. What are we doing with our lives?
0:44:40 > 0:44:43- You've had two hours' sleep? Did you stay in Manchester?- No, I came home.
0:44:43 > 0:44:45Well, why have you only had two hours' sleep?
0:44:45 > 0:44:48- I didn't get home until half one.- Oh, Adam.
0:44:48 > 0:44:51It's a three-hour drive in the early hours to make sure they can
0:44:51 > 0:44:53complete the donation in time.
0:44:53 > 0:44:58Wouldn't we rather be in bed? Separately, yes, we would.
0:44:58 > 0:45:00SHE LAUGHS
0:45:00 > 0:45:03We definitely get more male donors than female donors.
0:45:03 > 0:45:06I've noticed that, definitely.
0:45:06 > 0:45:10More men are donors because usually it's their wife, their spouse
0:45:10 > 0:45:17that we're talking to, and at risk of sounding sexist, I think women are
0:45:17 > 0:45:21more pragmatic and want to be a bit more practical about it,
0:45:21 > 0:45:23whereas if you were talking to a man
0:45:23 > 0:45:27about his wife that's just passed away, I think men would
0:45:27 > 0:45:29be a lot more protective and kind of, "Oh, no, I don't want
0:45:29 > 0:45:34"anyone to touch her now, I just want her to be as she is and at peace."
0:45:34 > 0:45:36So what did you do yesterday, anything nice?
0:45:36 > 0:45:37I went and got lasered.
0:45:38 > 0:45:41I wondered what you were going say then.
0:45:41 > 0:45:44Any particular place?
0:45:44 > 0:45:46Under arms and bikini line.
0:45:46 > 0:45:48Lovely.
0:45:48 > 0:45:54- Is there a fashion with regards to pubic areas?- Got to be.- Really?
0:45:54 > 0:45:56- Got to be.- What fashion are you following at the moment?
0:45:56 > 0:45:58Everyone's got beards at the moment, haven't they?
0:45:58 > 0:46:02I started this, I would like to point out
0:46:02 > 0:46:06that when I came back from travelling, I had a beard.
0:46:06 > 0:46:11No-one else had a beard, apart from old people and Father Christmas.
0:46:11 > 0:46:14Now, everywhere you go,
0:46:14 > 0:46:17everyone's got a... It's socially acceptable now
0:46:17 > 0:46:20for a younger person to have a beard.
0:46:20 > 0:46:22I did this.
0:46:29 > 0:46:32Today, the donor is a 63-year-old woman.
0:46:32 > 0:46:36Her family has agreed to donate her leg bones and eyes.
0:46:36 > 0:46:42Yes, in general, male bones are larger and stronger.
0:46:42 > 0:46:44In general, we would tend to get
0:46:44 > 0:46:48more bone out of the graft than we would for women.
0:46:51 > 0:46:53The bone is made up of two different types of bone,
0:46:53 > 0:46:56so you've got the cortical bone, which is the really thick stuff
0:46:56 > 0:46:59on the outside, and then you've got the cancellous bone,
0:46:59 > 0:47:02which is the more kind of spongy kind of lattice on the inside.
0:47:02 > 0:47:04To make sure we've got a decent pool of tissue that's
0:47:04 > 0:47:09available for people, it's really important that we get both male
0:47:09 > 0:47:11and female donors so we've got enough tissue
0:47:11 > 0:47:14for the need, for the surgeons,
0:47:14 > 0:47:18so it's really important that we get tissue from both, and from all
0:47:18 > 0:47:23ages and sizes, so that we've got a good selection of tissues.
0:47:23 > 0:47:27With the bones taken, Adam makes a start on the eyes.
0:47:28 > 0:47:30I don't mind doing eyes, eyes are all right.
0:47:30 > 0:47:32Compared to some of the other things that we do,
0:47:32 > 0:47:34eyes are pretty straightforward.
0:47:34 > 0:47:38- It's quite, erm... - Therapeutic, isn't it?
0:47:38 > 0:47:41Yeah, I think so, because it's quite intricate dissection
0:47:41 > 0:47:45and you kind of really get involved in it.
0:47:45 > 0:47:49- OK, left eye is out.- What time? - Whatever the time is now.
0:47:49 > 0:47:54- Someone's tired! Do you want me to take your eyes out?- I'm not well.
0:47:54 > 0:47:58He's not well, he's got tonsillitis. Been kissing too much.
0:47:59 > 0:48:04- I'm just run down.- From too much snogging.
0:48:04 > 0:48:07Shut up, Becky!
0:48:07 > 0:48:09With the tissues taken,
0:48:09 > 0:48:12they're bagged up and the body put back in the fridge.
0:48:12 > 0:48:14Watch your hands.
0:48:14 > 0:48:18Because of the donor's age, the tibia is not suitable for Morgan,
0:48:18 > 0:48:22but it seems that the South team's donation is a good match.
0:48:29 > 0:48:33Upstairs in processing, Reah has just received the tibia.
0:48:33 > 0:48:38We've had a donation come in, erm, for a tibia, for a bespoke request.
0:48:41 > 0:48:45This is probably one of the largest grafts that we've issued,
0:48:45 > 0:48:50this is what we class as our massive allograft range,
0:48:50 > 0:48:54and it's a bespoke graft, so we've made this
0:48:54 > 0:48:58specially for a particular patient at the request of a surgeon.
0:48:58 > 0:49:01So that's where your patella tendon would sit, your kneecap, and then
0:49:01 > 0:49:05that's the length of the tibia, so it goes down the front of your leg here.
0:49:05 > 0:49:07This isn't what we normally do.
0:49:07 > 0:49:09This is something out of the ordinary for us,
0:49:09 > 0:49:12and it's nice to be able to have that flexibility in our job.
0:49:12 > 0:49:13Every day is different,
0:49:13 > 0:49:16so you never know what you're going to come in to each day.
0:49:20 > 0:49:24Four months ago, Morgan was told that she needed a donor tibia,
0:49:24 > 0:49:26or risk having her leg surgically removed.
0:49:26 > 0:49:28Finally, her wait is over.
0:49:29 > 0:49:31Yesterday, I was really excited,
0:49:31 > 0:49:33because I thought, "Yeah, it's happening!"
0:49:33 > 0:49:35I was excited.
0:49:35 > 0:49:40I got the call saying that the bone was ready yesterday morning.
0:49:40 > 0:49:44I was really excited because I didn't really expect it to happen.
0:49:44 > 0:49:47Cos waiting, I thought I'd probably be waiting much longer than this.
0:49:47 > 0:49:50So as far as I know, I go in on Sunday night
0:49:50 > 0:49:52which is three days away,
0:49:52 > 0:49:55and then my operation happens on Monday afternoon.
0:49:55 > 0:49:58I've kind of made up my own imagination of how they're
0:49:58 > 0:50:01going to do it, where they'll just, like, open me up,
0:50:01 > 0:50:05nicely take the bone away and then put a new one in and plate it
0:50:05 > 0:50:10and then close me up, and it's going to be as nice as that.
0:50:10 > 0:50:14It's not going to be, cos I did watch student nurses the other day
0:50:14 > 0:50:17and this boy had, like, an accident on his motorbike and severely
0:50:17 > 0:50:20fractured both his legs and then they couldn't do the operation
0:50:20 > 0:50:23that they wanted on him because he had bruising and swelling
0:50:23 > 0:50:26all around his ankle and they just shoved a rod through one side
0:50:26 > 0:50:29of his ankle to the other so they could plate it on the outside instead
0:50:29 > 0:50:33of the inside, and it made my stomach turn, cos they were really rough.
0:50:39 > 0:50:42With the operation tomorrow, Morgan's new tibia is packed up and
0:50:42 > 0:50:47couriered overnight to Birmingham's Royal Orthopaedic Hospital.
0:50:56 > 0:51:01After months of waiting, Morgan's cancerous tibia will be replaced.
0:51:01 > 0:51:06It is an operation that has only been done a few times in the UK.
0:51:08 > 0:51:10I'm just on my way to the hospital,
0:51:10 > 0:51:13to get booked in for the night before my operation.
0:51:14 > 0:51:19I'm feeling pretty nervous, as I think anybody would be.
0:51:19 > 0:51:21It hasn't really quite sunk in yet, so...
0:51:24 > 0:51:27I'm extremely grateful that somebody has made that decision to be
0:51:27 > 0:51:33a donor so that I can have this chance of being, like, I don't know,
0:51:33 > 0:51:38like making sure that nothing ever serious comes from my bone condition.
0:51:38 > 0:51:43And I get to live a nice, happy life and health worry free.
0:51:43 > 0:51:47I think it's probably the smaller things that
0:51:47 > 0:51:50I'm looking forward to the most, rather than the bigger things,
0:51:50 > 0:51:52like being able to go to the gym, that would be fun.
0:51:52 > 0:51:56Running for the bus and not it hurting, that would be lovely.
0:51:56 > 0:52:00Going out dancing with my friends, also lots of fun.
0:52:01 > 0:52:06It wouldn't be long in the past before Morgan may well have had
0:52:06 > 0:52:09to have an amputation for this kind of tumour,
0:52:09 > 0:52:12because the only safe way to remove the tumour would have been
0:52:12 > 0:52:14to cut the bone away at the top and bottom,
0:52:14 > 0:52:18and it's very hard to reconstruct that with metal and it's very high
0:52:18 > 0:52:20risk of infection, and so some people may have chosen
0:52:20 > 0:52:22to have an amputation
0:52:22 > 0:52:26and obviously it's going to make a massive difference to Morgan's life.
0:52:28 > 0:52:31The most important thing is to get rid of the tumour,
0:52:31 > 0:52:34so got to be very careful to make sure that the tumour is
0:52:34 > 0:52:38completely clear, but the good thing about this operation is that
0:52:38 > 0:52:41eventually this bone will turn into Morgan's bone,
0:52:41 > 0:52:45because the cells will grow down from her own bone at the top and
0:52:45 > 0:52:49bottom and the fibula and hopefully this means that it will just
0:52:49 > 0:52:51be one operation and that she'll have
0:52:51 > 0:52:54a completely normal leg, pretty much.
0:52:59 > 0:53:03The two cut surfaces virtually match,
0:53:03 > 0:53:07the whole construct is strong enough at the moment just to stay in place,
0:53:07 > 0:53:09but it's not strong enough to walk on,
0:53:09 > 0:53:12so we've got to put a plate on now.
0:53:12 > 0:53:15DRILL WHIRRS
0:53:18 > 0:53:22So we've now got the screw at the top, screw at the bottom
0:53:22 > 0:53:25and we're just going to fill up a few of these holes now,
0:53:25 > 0:53:29but not all of them, so it just holds everything in place.
0:53:29 > 0:53:32The graft fits beautifully and we're really happy.
0:53:34 > 0:53:38Morgan won't get to try out her new tibia for at least three months
0:53:38 > 0:53:41until it's strong enough for her to walk on.
0:53:49 > 0:53:52This job is really important,
0:53:52 > 0:53:56because we're saving people's lives.
0:53:58 > 0:54:02Often when I've told people what I do, they often say,
0:54:02 > 0:54:08"Oh, someone's got to do it," as if it's like this really negative thing,
0:54:08 > 0:54:13but because of the death aspect in it, people tend to forget
0:54:13 > 0:54:17about the product at the end of it and where that tissue goes,
0:54:17 > 0:54:20and whose lives are being changed and saved, and they just focus
0:54:20 > 0:54:25completely on the dead body aspect of it, and that's a real shame, I think.
0:54:25 > 0:54:29In East Yorkshire, Laiela is back at home and doing well.
0:54:29 > 0:54:32It's been six weeks since Laeila's had her open heart surgery
0:54:32 > 0:54:34in Leeds and she's doing brilliant.
0:54:34 > 0:54:40Really good. She's got more energy, she is back at nursery now.
0:54:40 > 0:54:43Totally different child.
0:54:43 > 0:54:46Without that family, Laeila wouldn't be here today.
0:54:46 > 0:54:49We can't thank them enough for what they've done.
0:54:49 > 0:54:51If the shoe was on the other foot,
0:54:51 > 0:54:53I think I would like to know that
0:54:53 > 0:55:00if we've donated tissues, organs, that they've been used
0:55:00 > 0:55:05and they've gone to somebody that's been able to live a normal life.
0:55:06 > 0:55:08It's been several months since Tom's corneal transplant
0:55:08 > 0:55:11and he's enjoying his improved eyesight.
0:55:13 > 0:55:17At least now I can only see one ball instead of two.
0:55:17 > 0:55:21I've already re-enrolled to start university in September.
0:55:21 > 0:55:24Erm, hopefully just continue
0:55:24 > 0:55:27as I would have done a year ago, to be honest.
0:55:27 > 0:55:32Before I left, I'd have double vision and be a bit blurry,
0:55:32 > 0:55:34so it's obviously hard to make good shots.
0:55:34 > 0:55:38Now, I make all the good shots.
0:55:40 > 0:55:43And in Birmingham, Morgan's back on her feet
0:55:43 > 0:55:45and looking forward to the future.
0:55:45 > 0:55:48It's been seven and a half weeks since I've had my operation.
0:55:48 > 0:55:50I'll have a cinnamon and raisin bagel.
0:55:50 > 0:55:55'I'm super grateful that I had the chance to have this donor bone.'
0:55:55 > 0:55:57I think it's super important that people donate,
0:55:57 > 0:56:00it changes people's lives and for the better.
0:56:00 > 0:56:04So I'm really looking forward to being able to walk again properly one day.
0:56:04 > 0:56:06Yeah, it's changed my life.
0:56:07 > 0:56:12Next time, 18-year-old Reuben needs a life-changing operation.
0:56:12 > 0:56:15I do miss not working, working's my life really. I love it.
0:56:15 > 0:56:21So now, got barely nothing really, even my mum's having to support me.
0:56:21 > 0:56:25And the emotional pressure of the job starts to take its toll.
0:56:25 > 0:56:30I'm hearing someone's died maybe 25 times a day
0:56:30 > 0:56:34and I can't do it for ever, cos I'll, I'll forget
0:56:34 > 0:56:37everything else about nursing isn't just about death, is it?