Episode 1 The Human Tissue Squad

DRILL WHIRRS

Saving lives doesn't always mean working with the living.

Skin, shaft, heads, knees.

OK, left eye is out.

Every year thousands agree for their loved one's tissues to be donated.

We rely on the kindness of people

to understand that once they're gone, they don't need their eyes,

their meniscus, their skin, their heart valves.

They help change the lives of thousands of people

across the country.

You don't expect it to happen to you.

I'm just appreciative that someone would donate their eyes

cos it's going to improve my quality of life.

This series follows the staff

of Liverpool's National Human Tissue Bank...

OK, you ready? Shall we get cracking?

People expect it to be like middle-aged men.

Or kind of massively gothic people for some reason.

My dad always used to say things like,

"Oh, you'll never get a boyfriend doing that kind of job."

..as they grapple with death...

I don't normally ever get upset ever about it all.

..to help the living.

I do think what we're doing is incredible.

This job is really important

because we're saving people's lives.

This week the team battle a shortage of tissue supplies.

We've had two people donate their heart valves.

That's not really a lot.

You don't want young, healthy people to die,

but it is the young and healthy tissue that's most useful.

And the hunt is on for a new tibia for 19-year-old Morgan.

I can see, like, the end.

It's like a giant race.

It's just not happening quick enough.

Like it's just out of grasp.

It's Monday morning at the National Tissue Bank in Liverpool.

Inside the teams are hard at work maintaining the stocks of the

nation's life-saving bone, skin and heart valves.

So every week what we do is we decide what we've got in the tissue bank

and what we actually need.

We're still desperate for skin donors,

male-only meniscus,

hearts, Achilles, patella tendons, femoral arteries.

It's younger donors that we really need,

so people whose tissues haven't basically worn out.

They're the most transplantable.

It's a constant battle for the bank to keep up with the demand

for tissues from hospitals nationwide.

All right, no problem. Thanks, Chris. Bye-bye.

Specialist nurse Jo helps families decide whether to donate the

tissues of their loved ones.

She's just come off the phone from a family who've agreed to donate.

I'm just going to hand over the donation to the team

and explain exactly what they're going out to retrieve.

-Hello.

-Cop a seat.

-It's Mel's job to take the tissues from the body.

-Date and time donor refrigerated?

-Within the six hours.

-Do we have consent?

-Yes.

-Brilliant. Thank you very much.

-No problem.

OK, so now we need to phone the mortuary and arrange access so we can

get things done, get things moving so we'll just give them a ring now.

Oh, hiya, can you put me through to the mortuary, please?

The tissues need to be taken within 48 hours

to make sure they're usable.

Erm, we'll be in and out within two hours. Cheers, bye.

So basically the funeral directors have just arrived, so we've come down

to meet them to sign in the donor

and any personal belongings they may have.

Because obviously we have to make sure that

they've brought the right person.

It's never happened that they haven't,

but obviously we can't assume so we have to make sure.

The donor is a middle aged man who's died of a cardiac arrest.

To preserve the donor's tissues,

Mel needs to store the body in the fridge

while she prepares her equipment.

It's not the tray.

No, that's fine.

This is a fine art, this is, getting the fridge,

getting the tray into the fridge on the runners.

These trays are just so small.

There we go.

At 33, Mel's been doing the job for 12 years

but started off with ambitions of a very different kind.

Basically, after my A levels, I went to university to do drama

and it was combined with art

and the course was just a bit,

kind of, rubbish.

I'd always wanted to be the next Julia Roberts

but that was a dream from when I was little, so I kind of grew up

and thought, "Right, OK, I need to get a job. What am I going to do?"

Mel joined as a donation assistant.

The job is so unusual that the only training is on the job.

Skin, shaft, heads, knees.

OK, erm...

# The thigh bone's connected to the... #

Today she's working with assistant Jen.

Although she's a qualified criminologist,

Jen worked in a bowling alley before joining the team.

-JEN SINGS:

-# Bur, bur-bur-bur. #

Don't!

It's my little tune.

# Bur-bur, bur-bur, bur-bur, bur. #

-She hates it. It's when I'm like...

-It's because it's addictive.

Yeah, very addictive.

'The first time I ever saw a dead body,'

I literally was looking at the lady

and I was looking at her chest thinking, "Is it going to move?

"Is she actually dead?",

because I'd never seen a dead body before

and then when I saw one I was just like, "Oh, there you go then."

We've got a male donor and we're going to take skin,

so we take it from the back of the body and the front of the legs

and we're also going to take bone from the legs, so we're going to

take the femoral head, femoral shaft and the knee joint.

'We have to look for identifiable features'

so, for example, a tattoo or a missing toe so, for example,

if you were expecting to go out and Joe Bloggs had 15 tattoos

and you got there and there wasn't a single tattoo, you would question

that because there could be another one in the fridge with the same name.

So this is one of the most important things, the blood sample.

We need to make sure that, because everything's for transplant,

that everything is actually safe to use,

that there's nothing nasty lying in the blood.

There are only around 30 people who carry out this extraordinary

and demanding work in the UK.

A lot of people think that I drive up to a mortuary,

I collect a box with tissue in it, already on ice, you know,

and take it back to the tissue bank, but, no, that doesn't happen.

OK, you ready? Shall we get cracking?

DRILL WHIRRS

So right now we're retrieving bones from the leg,

so we're taking the knee joints,

so obviously the bottom of the femur and the top of the tibia.

And we're taking the femoral shaft

and then cutting off the femoral head.

Can I take your name as the contact for the order, please?

While Mel and Jen concentrate on collecting the vital tissues,

upstairs is one of the strangest call centres in Britain.

We're the customer care team for Tissue Services.

What would you like to order today?

Dan is part of the front line team taking hundreds of calls every day

from hospitals around the country

in need of donated tissue for their patients.

Most of our calls do relate to orders for products.

Is that for stock or for use on the day?

We do provide bone to a lot of hospitals -

freeze dried fine bone, freeze dried medium bone,

freeze dried coarse bone, freeze dried struts.

Freeze dried femoral heads can be done as half or a slice or ground.

Tissue doesn't require frozen storage.

Left and right femur, left and right tibia, left and right pelvis,

patella tendon with the quadriceps attached.

Do you need this before 9am

or are you happy for it to come in before noon?

We also do quite a lot of cryopreserved products

such as skin as well as heart valves.

As the national tissue bank for the country, they help thousands

of people every year waiting for life-changing transplants.

One person in need of their help is 19-year-old Morgan in Birmingham.

Oh, look at these little flowers. It's so small it doesn't make sense.

My grandad likes shirts like these.

For the last 12 years, Morgan has lived with a tumour in her leg.

Today it's the January sales today and she's out for a bit of

retail therapy with her best friend Holly.

-You look so snazzy.

-Thank you.

I think this is what I'm going to be wearing to college.

Oh, yeah! I don't think I could take this off ever again.

When I was about six years old, I fell over in the playground at

primary school as all children do and this lump just like formed on my leg.

They took me to the hospital and they said I had fibro dysplasia

so, yeah, and they think it could be linked to a cancerous

condition called adenoma.

Over the last two years, Morgan's tumour has grown.

She's worried that it could be cancer.

I just hope to be cancer-free which would be nice, and not

have the constant worry of not knowing. Like, it's really horrible.

Today she's having a scan to check the size of the tumour.

Hey, Morgan, how you doing?

-Be back with you in just a few minutes.

-OK.

The type of tumour that we're dealing with is a very slow growing

tumour and it can change to become a more aggressive kind of tumour

which does send secondary cells off to other parts of the body,

what we call metastasis.

Morgan just wants to get back to her teenage life,

and hopes the surgeon can help her.

As the symptoms are getting worse and that the tumour seems to be

getting bigger, we need to try and take that section of bone away

to remove the tumour to try and stop it from coming back.

So we're going to try to get a piece of donated bone,

a bone that's the right size and shape,

because obviously if it's too big or too small it won't fit as well.

The bone Morgan needs is a tibia.

It'll be down to the tissue bank nurses to find the right donor.

Back at the bank, it's nearly lunch time

but tissue specialists Mel and Jen are still hard at work.

It can take a whole day to take bone, skin and other tissues

from a donor and the girls haven't finished yet.

So this is the knee joint that we've taken

and we take off the meniscus which sits here on the tibial plateau.

And, as you can see, some of the cartilage has worn away.

This is just because the donor is older and this is how you'd get

problems with your knee because obviously once the cartilage has worn

then you get bone on bone and then that's how the bone's worn

and that's when people need knee replacements.

It would be amazing to have kind of the whole story for knowing that

the tissue that you have actually personally retrieved

to see it getting grafted into somebody just because then

it kind of becomes real, it puts it into that kind of perspective.

After every donation, the team use reconstructive techniques

to replace the tissues taken.

Basically, we're just going to reconstruct now

because we couldn't leave the donor with no bones in his legs.

So we've got the prosthesis which replaces the leg bones.

Obviously they're not going to bend at the knee any more

but we have to make sure they look like they did before we started.

It's just... It's respectful really.

The parts they've taken are bagged and sent upstairs

to be prepared for transplant.

The first thing I do when I get home from a retrieval

-is jump in the bath.

-Yeah, have a shower and then a cup of tea.

Ooh, yeah, I love a big cup of tea.

The tissues Mel and Jen have taken will go on to change and save

50 people's lives.

For production specialist Reah upstairs, it's a constant battle

to maintain the supply of tissues.

Unless every process is followed perfectly,

the tissues may not be released for transplant.

I'm just about to get ready now to dissect some bone.

I need to gown up with an extra layer of clothes to do that.

When tissue is retrieved and comes to us here at the tissue bank,

once we have medical release, we then process it

so dissecting off the soft tissue,

cleaning it up so that it's at a state where we can wash it

and decontaminate it and we send it

for final irradiation at the end.

The bones are then frozen and stored until they're ordered by surgeons

through Dan and the team in customer services.

In here we've got heart valves.

So I need a stool because I'm really short.

The tissue bank store thousands of vital body tissues, but many

are in short supply so they don't stay in the freezers for long.

There's a constant demand for heart valves

because they're so size specific.

If we have a heart valve donated from a small baby

you'll find that will have been issued as soon as

it becomes available because there's so few of them.

In here I have a mixture.

I think this is an issuable tank so we've got heart valves,

meniscus, osteochondrols

and, yep, some pericardiums and even some arteries

but I can't see anything at the moment.

You don't want young healthy people to die but it is the young

and healthy tissue that we need, that is most useful.

It has the best clinical outcome as well.

Good afternoon, Tissue Services. Daniel speaking. How can I help?

Back in customer services,

Dan has just received the order for Morgan's tibia.

A full tibia is unusual for the bank.

It's not actually a product that we usually process or retrieve

but what I can do is take it as a specialist request.

Morgan needs a tibia from someone similar to her.

Young, female and the same height

so that the bone fits her leg perfectly.

She needs a whole tibia replacing.

Now, it's not a product that we routinely retrieve or store.

There isn't a great need for them.

So we can take it as a specialist request.

He has given us a surgery date of April.

These types of products can take up to six months to retrieve.

We're just really hoping that we can meet this tight deadline.

With only a few months to the deadline,

all the team can do is wait for a suitable donor.

All right, well, thanks very much for that, Mr Jeys.

I will be back in touch with you shortly. Thank you, bye-bye.

It's mid-afternoon and the specialist referral nurses are busy

making consent calls.

Are you OK to speak to me at the moment?

Is now a good time to do this?

The nurses help families make the difficult decision to agree to

a donation, often within hours of a loved one dying.

And had he any reason to visit his GP or the hospital

in the past two years?

'Yes, he's been going quite regularly.'

Referral nurse Simon has just received news

of a 35-year-old who's died in a road traffic accident.

He's about to call the young man's father.

What was he doing? Was he on a bike or walking?

After a death, family consent must be given to carry out a donation,

even for registered donors.

It's awful, isn't it?

You just don't expect something like that to happen,

especially in front of your house as well.

Dear me.

It's a difficult conversation at an emotional time.

If I just confirm that you are in agreement for eye donation

and potentially for skin donation?

-Yes.

-Is that correct, John?

-And Jackie was comfortable with that as well?

-Yes.

Though the tissue bank need donors of all ages, often the healthiest

tissues come from young people,

but in the last year only 51 donors were under 35.

-Have you got contact details?

-I do, yeah.

-Got coroner's consent?

-Yes, we've got coroner's consent.

-From?

-Mr Oakley, the coroner.

With young donors in such short supply,

this is a vital donation for the bank.

Tissue specialist Adam will be carrying out the donation.

-Do you want us to take the blood sample?

-Yes, please, if that's OK.

-Can you do the eye donation as well, please?

-Yeah.

Eyes, one of the most in-demand tissues must be retrieved

within 24 hours of death to preserve their cells,

so Adam's up against the clock.

-Safe journey.

-Yeah, cheers.

We're going to Scarborough,

and we're just looking at the time it's going to take us to get there,

so it's 2.00pm, 2.05pm now.

It's going to take us three hours, so that's 5.00pm.

24 hours is up at half six tonight,

so if we got stuck in traffic or anything like that

cos we've got to go through Leeds at rush hour,

there could be the potential that we'd lose the donation.

Adam's only 32, but he's been in the job for almost ten years,

and has been team leader for the last two.

When I first started I was 22 years old

and at that sort of age you feel indestructible.

You sort of live your life based around the fact that you're 22.

However...

when you've seen some of the donors

that are around your age range

it makes you think well actually you don't have all the time in the world

or you're not indestructible or you know things can happen

and you've got really no...

In a lot of cases, you have no warning of it.

Adam's hoping that he can take two healthy eyes from the donor

but he has to be quick otherwise they'll dry out

and be no good for transplant.

My main priority at the moment now is to retrieve the eyes.

So I've got until half six so I've got 35 minutes,

so that's going to be what I'm going to prioritise now.

I'm just going to get all my eye stuff ready first

and all the paper work and stuff.

-Can you do it in 35 minutes?

-We'll see.

If I don't think I will I won't start but I think I can, just about.

It is a little bit strange cos you're not used to seeing somebody

in that way and I can remember like the first donation that I did.

You're either going to go, "Oh, my God, what am I doing?"

Feel ill, pass out, go green, go pale.

Or you're going to be,

"Whoa, I've never seen anything like this before.

"I can't stop staring at it"

and just be fixated by this unusual sight.

Would you be able to open up

one of the little bottles of eyewash, please?

Unlike other tissues, eyes can only be stored for one month after

retrieval so the tissue bank need a constant supply of eye donations

to keep up with demand.

The left eye is done. That was done at quarter-past.

So I just need to reconstruct and then do the right.

So hopefully, OK.

Adam has to take the whole eyeball.

Afterwards he'll reconstruct,

so it looks like the eye is still in place.

Last year 1,700 eyes were collected by the tissue donation team

helping people to regain their sight.

Most of them go to people with damaged corneas,

the transparent lens at the front of the eye.

400 miles away in Devon,

24-year-old Tom is on the hospital waiting list for a new cornea.

When I was 14, 15, I went to the opticians and they kept

giving me glasses and I kept saying they don't work. Nobody believed me

and then the optician said "I think you might have keratoconus."

Tom's cornea bulges outwards, making it difficult for him to see.

It's a rare disease.

Only one in 2,000 people suffer from it in the UK.

It's times like now if he runs away I won't see him because of my eyes.

I've come to a point now where I'm not allowed to drive any more.

I can't read the number plates at the right distance.

I'm a lot more immobile now

and my vision it narrows the work I can do down quite significantly.

Studying to be a quantity surveyor

and a lot of it's looking at construction drawings

and the and the trouble I've been having recently is that

I get double vision in my eyes.

So I'm trying to measure a drawing with a scale ruler.

I see two lines and I think which one have I got to measure?

Only with a donated cornea will Tom be able to have

anything like a normal life.

I'm just appreciative that someone would donate their eyes.

Some people get a bit funny about that kind of thing,

but I don't really think it is, to be honest.

I don't think there's anything...

I guess it's cos I'm the one receiving it

so I've got a different outlook on it, a different perspective,

cos it's going to improve my quality of life, I guess.

Back in autumn, Tom's sight got so bad he had to leave university

and move back in with his parents.

Er, basically need to clean my lens.

I'm sorry I can't see.

Because of his condition,

Tom needs a cornea from someone of a similar age

but, because young donors are rare,

he's having to use a special contact lens to help him see.

Like now, I wouldn't be able to... The only reason I know it's in there

is because I can see you a lot better.

From the side you might be able to see it like bulge.

When I was growing up I always wanted to be in the armed forces,

like, specifically, the Royal Marines.

My twin brother's in the Royal Marines

but if you've got keratoconus or you've got a corneal transplant,

you're not allowed to join anyway

so I've just had to like give up on that idea.

I'd still like to but...

it is literally impossible so you don't worry about it really.

Don't think about it.

Tom won't be able to return to university

or move on with his career until the right cornea can be found for him.

It's Wednesday and back at the tissue bank

the donation team are having a rare lunch break.

They all work shifts, seven days a week, 365 days a year.

-Did you try the Atkins?

-Are you on the lumpy sick diet?

-It looks like it.

-That's baby food, isn't it?

-Is it nice?

-No.

Looks like you've thrown up the kebab you had on Saturday.

We do find that if we do a retrieval on an empty stomach we are

absolutely famished by the end so it is important to at least get

a snack before we start.

Obviously it's not always the case because of tight time limits

and things like that but we do try if we can.

We're quite lucky today in the fact that we're waiting for

the donor transfer so we've actually got the time to grab something to eat

which is a bonus really.

Today Mel is working with long-time colleague Becky.

They're heading to Warrington to carry out a skin donation.

Skin is one of the most in-demand tissues the team take.

'18 excruciating hairdresser pun names.'

-Are these all in Britain as well?

-Are you ready for this?

-Yep.

'British Hairwaves.'

LAUGHS

Oh, that's a good one.

Oh, this is amazing.

'Sherlock Combs.'

So this one specialises in wigs

otherwise known as...

-Weaves.

-..weaves.

-What would it be called?

-'Weave all you need?'

-No, it's better than that.

-Is it? Go on, then.

'Unbeweavable!'

29-year-old Becky has been working at the tissue bank for nine years

after studying anatomy at university.

So you two don't look like the type

that should be hanging out in a mortuary.

Why? What do people that hang in a mortuary look like?

We always get told this but what?

To be honest I think people expect it be to like middle-aged men.

I definitely don't think it's young girls.

Or kind of massively gothic people for some reason.

Yeah, like mad professor doctors.

We look a lot older.

Well some of us do. I still get ID'd.

Right, got our wellies, got the greens, got the batteries.

Got ice. It was missing blades.

We got blades, we got the paperwork, we got the referral, we got a pen.

Ready to rock'n'roll.

So we need to clean the donor and shave them.

With the skin we have to be really, really careful with contamination

obviously because the skin's used on burns patients

who are obviously at great risk of infection.

The skin they collect will be used as a kind of natural bandage

for people who've been severely burnt.

This is the dermatome.

This is the machine that we use to remove the skin.

There's a blade that moves side to side

and that takes off a very thin layer of the skin and it's got different

settings on the side so you can decide how thick you want the skin.

It's really beneficial because, you know, like,

when the July bombings happened down in London,

all of our skin was wiped out because they needed that skin

because of all the people that got burnt.

I've just taken skin off this donor.

This is going to help to save somebody's life

so you wouldn't do this job if you didn't believe in that kind of thing.

UK surgeons ordered 600,000 square centimetres last year.

The high demand for skin means a need for more donors.

Hundreds of people die every day

and the sad thing is that a lot of people will die

and their families won't know about tissue donation

so they don't get to make that choice.

It's not waiting for somebody to die.

It's waiting for someone to make that decision

and say they'd like to go ahead for tissue donation.

I've been really fortunate that I've never had to experience

losing anybody really close to me.

If anything, it makes you more kind of...

It gives you the need to want to live your life more

because you realise that it could be over like that in like a flash.

How would I like to die? Quickly, painlessly, in my sleep.

I would like to be doing something I love,

so I'd like to be doing something on some wild adventure.

I've never been particularly religious.

I've never believed really in heaven or that you go anywhere else

and then again I think people think after death you transform into

something completely different and of course you don't, it's just you.

But you're just, just this bit's gone.

That's it we're done.

-We've got quite a lot of skin there as well, haven't we?

-Yeah.

Because the donor's quite large

we've got quite a good yield of skin which is really nice.

If you looked at this, not having seen it before,

you wouldn't necessarily jump to the conclusion that it was a pot of skin.

This skin will help to save the lives of burns victims

across the country.

-Brilliant. That's great. Thanks very much.

-See you next time.

Death doesn't scare me at all.

I'd say, erm, that actually growing old scares me more.

Definitely.

You know, the thought of being, like, 85 and...

..kind of living in a home and not being able to do things for myself

and just kind of wasting away, if you like.

I mean obviously that's generalisation.

Not all 85-year-olds, you know, do that.

Look at Hugh Hefner. He's getting on. He's fine, isn't he?

As Becky and Mel drop off five metres of skin

to fill up the bank's fridges,

it's another day's good work done.

Across the country in Southampton, one patient is about to have

an operation that could change his life.

After several months on the hospital waiting list, Tom will finally

receive a donated cornea.

I don't think I will feel nervous, to be honest, I'll just,

I'm like, erm, I trust the doctors, and I'm quite excited really,

because I want to get it over and done with

and looking forward to waking up and seeing what I can see, pretty much.

Tom's new cornea was donated from a 20-year-old male donor.

Straight ahead, please.

There's a chance the cornea could be rejected, so the surgeon makes

sure his eye is clear of infection before the operation.

I can see the area which has thinned

and which we need to remove and replace,

and the rest of his eye looks good.

-Brilliant.

-Do sit back.

So, Tom's clear to go, we're happy with that,

one thing we do need to do is pop a little mark on you.

Got a few good luck messages from my brother and my mates.

"Good luck today, bruv, strength and honour,"

and the other one is from my friend's mum.

In theatre, the surgeon cuts around Tom's damaged cornea before

removing it and stitching the new one in place.

So now we've freed the damaged cornea or the thinned cornea,

we can lift that off,

and we look after that,

and then with great care,

we overlay our corneal transplant.

I hope Tom will find that even in the first few weeks,

he can see a difference.

Thank you.

That was really good,

I'm really happy with the outcome of the surgery.

I think this new transplant has gotten off to a great start,

and now the real work and rehabilitation begins.

We're going to transfer you over onto your bed, OK, and then we'll

get you back into your room, you'll be a bit more comfortable.

If Tom's lucky, he should start to see with his new cornea

in a couple of days.

Back at the tissue bank, the search for a suitable tibia for

Morgan continues, but now the donations have dried up.

The new year is normally a busy period, as accidents and elderly

deaths increase over the winter months.

But this year, it's the opposite and the team are stuck in the office.

I've been awarded Employee of the Day.

I'm going to treasure it and makes sure everybody sees it.

-Look, Francesca, look what I've got!

-Well done, Becky.

-Thanks.

This is Mr Skellington.

Did I mention my Employee of the Day award?

This is my Blu-Tack octopus, he sits there, but he's got

a couple of legs missing now, because we've been in need of Blu-Tack.

We always say with this job that it's one way or the other.

We can have three weeks of being really,

really quiet and not having any donations and then before you know it

we've got four teams out a day,

taking tissue from all over the country.

Did I mention my Employee of the Day award?

But it's not just the team waiting for donors.

In Birmingham, it's been six weeks since Morgan was told she would

need a new tibia, and she's starting to think it might never happen.

-Ah, it does look interesting, is it dry?

-Yes, this one's dry.

-Yeah.

Back at sixth form college studying for her A-levels, she can't get

the search for the right donor off her mind.

I've been thinking about, like, the whole donation side of it.

'It's actually quite sad, really, isn't it?

'Like, I am really grateful, but for them,

'it's going to be horrible, like.'

-What pen are you using at the moment?

-Just a marker.

I know that when I get the phone call saying that they've found

a matched tibia, that another family's, like, had like the worst

news that anyone could have ever wanted and I'm going to be

benefitting from their loss and it's really quite sad, actually.

At home after college, Morgan shares the news of her up-coming

operation with best friend Holly.

What part actually is it? Is it like the front plate?

Yeah, like the entire front.

What, the entire thing, or just the front plate?

The actual affected bone

starts from, like, under my knee to, like, here.

It sounds like they're taking your whole leg away,

but they're not, it's just the front plate, isn't it?

Yeah, it's just the tibia, so they're leaving the fibula.

It's like I've had it so long, and it's like I can

see the end, it's like a giant race that I've ran and I

can see the last ten metres, and it's just there, but I just,

it's just not happening quick enough,

like, it's just out of grasp.

While Morgan's hopes are on hold, at the tissue bank, they're on

full alert in the hunt for a suitable tibia.

But by the end of March, things still haven't picked up.

It's the 23rd March.

At the moment, we have a special request for a tibia donor,

aged 18-30, the height limit is 5ft 9. Ideally female.

It's hard, because you don't want to then be waiting

for somebody to die, but obviously, you want to help this person as well.

But it's not just tibias that are in short supply.

We've got 80 eye donors so far this month,

and that's not really a lot - most months are over 100, 180.

We've had 11 skin donors, that's not really a lot,

especially when skin is needed.

Erm, we've had two people donate their heart valves this month,

that's not a lot either, really.

But again, you can't set a target, because, you know, you can't

guarantee who's going to die, when they're going to die.

Across in East Yorkshire,

four-year-old Laiela is desperately in need of a donated heart valve.

Right, I'm just checking Laiela,

making sure that she's all right and that she's awake yet.

Her pulmonary artery doesn't work.

Without a suitable valve being found soon, she'll die.

-Is it Tashy?

-Have you got her?

Laiela was born with a heart defect, erm...

Between four and five weeks old she had to have it replaced and

now she has to have another

pulmonary artery put in, a bigger size.

The pulmonary artery has to come from a young person.

It must be horrible, it must be awful for that parent,

but we cannot thank them enough, because without it, she could die.

We look after her between us.

It's like, when my mum and dad go out I look after her,

because I'm the eldest.

It's a bit weird,

because it's like having another bit of another person inside her,

but if it will help her live

and help her do normal things like us, then I'm all for it.

I would, I would donate.

When I'm dead, of course.

So she can grow into it, Laiela needs a valve from someone ten years

older than her, but last year, the tissue team only took 40

heart valves, none of them the right size.

Laiela could be in for a long wait.

Tonight, Adam's on shift.

He's been asked to take two heart valves from a young male donor.

They're too big for Laiela

but they could go on to save two people's lives.

We're just draping the donor and what we're going to do is

we're going to go in and do the heart and do that now.

Heart valves from young donors are incredibly rare -

so it's a vital donation for the bank.

If they are retrieved successfully,

they won't be in the freezers for long.

The best outcome would be you get two perfect valves

that can be transplanted into somebody who needs them.

First of all, what I don't want to happen is when I retrieve them,

damage them, which is potential.

Next worst thing would be that they get damaged when they're being

processed, and then latterly, which is something that you might have

no control over, is that they were just never fit for use anyway,

there was pathology on them.

Heart valves are in so much demand, because they're quite rare,

you don't always get them, because there is an age limit.

An upper age limit of 65.

So whenever you do get one, you want to retrieve it

so that it can be processed.

We've got some blood in here.

It's never easy taking a heart valve,

and whilst retrieving it, Adam notices a problem.

It looks like there's been some bleeding just into the tissue,

really, erm, from, I don't know, maybe a bit higher up,

but the vessel itself, the vessel itself looks OK,

I think it looks, up to the bits

where I've cut anyway, it looked OK,

so I think it should be hopefully potentially viable.

As a heart generally, quite small, not much fat,

erm... but, yeah, it looked quite good.

The next morning at the tissue bank, the heart valves Adam has

taken from the donor are cleaned and inspected.

We're always looking out for particular kind

of indications that the valve isn't suitable for use.

There's an indication that there was striations in the tissue itself.

A striation is basically just a tear in the tissue,

so that would mean that there's a weakness in the wall

that's going to be under extreme pressure

when it's in the body from the blood flow pumping around, so we checked

it today and unfortunately we found out that the valve isn't fit for use.

It's sad, because you've gone to that effort

and you've gone there to retrieve it, but this is why we need donors.

This is why you need donations, because you might think,

well, you've got patient one, two and three,

they've all donated their heart, that's three hearts,

that's not necessarily the case, because they might not go through fit for issue, all of those three

might fail at some point due to any number of circumstances,

so that's why you need more patients, more donors,

because you can't always guarantee that every one

you take is going to be suitable.

In East Yorkshire, Laiela has been waiting for the right heart valve

for almost three months.

Now there's a match from a teenage donor.

Ooh, very emotional. Look, a wreck. Yeah.

Today she's on her way to Leeds General Infirmary,

where surgeons will replace her old valve with a new one.

Do you want Mr Tumble on?

I don't normally feel nervous, but I normally take this in my stride.

It's normally Kerry who's the nervous one, the worrying one.

I'm the father, and I'm her daddy,

and I'm meant to be the one that looks after her and protects her.

For somebody to donate something

so Laiela can have a better life, erm, is quite overwhelming, really.

I'd like to think I could do it. I don't know whether I could.

'We had a letter, and the risks on that letter was endless.'

It ranged from blood clots to the brain to death.

I don't think Laiela understands

that there's anything wrong with her heart. So it is heart-breaking.

And it's going to start making me cry soon,

but there's no other alternative.

We know that she wouldn't, she wouldn't survive, she'd die.

All the tissue bank's heart valves are frozen at minus 135 degrees.

Only when the surgeon is ready

will it be defrosted in a warm water bath.

The new valve should last Laiela for the next ten years,

when she'll need it replacing once more.

Laiela's mum and dad have been waiting anxiously for six hours

while she's been in surgery.

Erm, we're very happy with how the operation went.

We took out that old conduit

and put a new one in and it's a nice size, it's lying very nicely.

So I think we're probably OK, shall we pop down and go and see her?

RELIEVED LAUGHTER

-She's just starting to surface a little bit.

-Hiya, are you OK?

Come, come and take her hand.

I am happy crying!

-The other intensive care ones...

-It's such a relief.

It is, it really is a relief.

Been hanging on for you a little bit.

Dummy's still there.

Carried that around since she's been in, on my finger.

She'll be all right.

It's another early Monday morning at the tissue bank and the nurses are

busy with donor family calls.

I don't know whether you know much about tissue donation,

or ever heard of it?

'No, I didn't even know they did it, love,

'I just thought it were internal organs.'

Oh, of course.

For the last four months, the lack of suitable female donors

has made it impossible to find a replacement tibia bone for Morgan.

But as April arrives, the board begins to fill up.

Has she ever been abroad?

'She was the cruise queen of Bolton.'

Was she?

'Up until about four years ago.'

Finally, there's a glimmer of hope in the hunt for Morgan.

Down south there's a potential female donor.

I'm just going to contact a family of a lady who passed away,

she was on the organ donor register.

Oh, hi, my name's Laura, I'm one of the specialist nurses

from NHS Blood and Transplant calling.

Hiya. I just first of all want to offer you my condolences.

OK.

It looks like there could be some good news for Morgan.

They've consented to donate her tibia bone,

so it will be the full bone that will be transplanted into our

recipient at the moment,

who's waiting because of a malignancy in her leg.

Hopefully, we'll just wait on the blood results to come back,

everything is OK, there's no infection

and that the suitability of the bone, the structure of the bone is OK.

And then we can issue that for the recipient.

It's 5am the next morning.

-This is too early.

-This is your fault!

-Do I look tired?

-You look great.

Becky and Adam have been called out early for an urgent donation...

and it's a female donor.

I don't know. What are we doing with our lives?

-You've had two hours' sleep? Did you stay in Manchester?

-No, I came home.

Well, why have you only had two hours' sleep?

-I didn't get home until half one.

-Oh, Adam.

It's a three-hour drive in the early hours to make sure they can

complete the donation in time.

Wouldn't we rather be in bed? Separately, yes, we would.

SHE LAUGHS

We definitely get more male donors than female donors.

I've noticed that, definitely.

More men are donors because usually it's their wife, their spouse

that we're talking to, and at risk of sounding sexist, I think women are

more pragmatic and want to be a bit more practical about it,

whereas if you were talking to a man

about his wife that's just passed away, I think men would

be a lot more protective and kind of, "Oh, no, I don't want

"anyone to touch her now, I just want her to be as she is and at peace."

So what did you do yesterday, anything nice?

I went and got lasered.

I wondered what you were going say then.

Any particular place?

Under arms and bikini line.

Lovely.

-Is there a fashion with regards to pubic areas?

-Got to be.

-Really?

-Got to be.

-What fashion are you following at the moment?

Everyone's got beards at the moment, haven't they?

I started this, I would like to point out

that when I came back from travelling, I had a beard.

No-one else had a beard, apart from old people and Father Christmas.

Now, everywhere you go,

everyone's got a... It's socially acceptable now

for a younger person to have a beard.

I did this.

Today, the donor is a 63-year-old woman.

Her family has agreed to donate her leg bones and eyes.

Yes, in general, male bones are larger and stronger.

In general, we would tend to get

more bone out of the graft than we would for women.

The bone is made up of two different types of bone,

so you've got the cortical bone, which is the really thick stuff

on the outside, and then you've got the cancellous bone,

which is the more kind of spongy kind of lattice on the inside.

To make sure we've got a decent pool of tissue that's

available for people, it's really important that we get both male

and female donors so we've got enough tissue

for the need, for the surgeons,

so it's really important that we get tissue from both, and from all

ages and sizes, so that we've got a good selection of tissues.

With the bones taken, Adam makes a start on the eyes.

I don't mind doing eyes, eyes are all right.

Compared to some of the other things that we do,

eyes are pretty straightforward.

-It's quite, erm...

-Therapeutic, isn't it?

Yeah, I think so, because it's quite intricate dissection

and you kind of really get involved in it.

-OK, left eye is out.

-What time?

-Whatever the time is now.

-Someone's tired! Do you want me to take your eyes out?

-I'm not well.

He's not well, he's got tonsillitis. Been kissing too much.

-I'm just run down.

-From too much snogging.

Shut up, Becky!

With the tissues taken,

they're bagged up and the body put back in the fridge.

Watch your hands.

Because of the donor's age, the tibia is not suitable for Morgan,

but it seems that the South team's donation is a good match.

Upstairs in processing, Reah has just received the tibia.

We've had a donation come in, erm, for a tibia, for a bespoke request.

This is probably one of the largest grafts that we've issued,

this is what we class as our massive allograft range,

and it's a bespoke graft, so we've made this

specially for a particular patient at the request of a surgeon.

So that's where your patella tendon would sit, your kneecap, and then

that's the length of the tibia, so it goes down the front of your leg here.

This isn't what we normally do.

This is something out of the ordinary for us,

and it's nice to be able to have that flexibility in our job.

Every day is different,

so you never know what you're going to come in to each day.

Four months ago, Morgan was told that she needed a donor tibia,

or risk having her leg surgically removed.

Finally, her wait is over.

Yesterday, I was really excited,

because I thought, "Yeah, it's happening!"

I was excited.

I got the call saying that the bone was ready yesterday morning.

I was really excited because I didn't really expect it to happen.

Cos waiting, I thought I'd probably be waiting much longer than this.

So as far as I know, I go in on Sunday night

which is three days away,

and then my operation happens on Monday afternoon.

I've kind of made up my own imagination of how they're

going to do it, where they'll just, like, open me up,

nicely take the bone away and then put a new one in and plate it

and then close me up, and it's going to be as nice as that.

It's not going to be, cos I did watch student nurses the other day

and this boy had, like, an accident on his motorbike and severely

fractured both his legs and then they couldn't do the operation

that they wanted on him because he had bruising and swelling

all around his ankle and they just shoved a rod through one side

of his ankle to the other so they could plate it on the outside instead

of the inside, and it made my stomach turn, cos they were really rough.

With the operation tomorrow, Morgan's new tibia is packed up and

couriered overnight to Birmingham's Royal Orthopaedic Hospital.

After months of waiting, Morgan's cancerous tibia will be replaced.

It is an operation that has only been done a few times in the UK.

I'm just on my way to the hospital,

to get booked in for the night before my operation.

I'm feeling pretty nervous, as I think anybody would be.

It hasn't really quite sunk in yet, so...

I'm extremely grateful that somebody has made that decision to be

a donor so that I can have this chance of being, like, I don't know,

like making sure that nothing ever serious comes from my bone condition.

And I get to live a nice, happy life and health worry free.

I think it's probably the smaller things that

I'm looking forward to the most, rather than the bigger things,

like being able to go to the gym, that would be fun.

Running for the bus and not it hurting, that would be lovely.

Going out dancing with my friends, also lots of fun.

It wouldn't be long in the past before Morgan may well have had

to have an amputation for this kind of tumour,

because the only safe way to remove the tumour would have been

to cut the bone away at the top and bottom,

and it's very hard to reconstruct that with metal and it's very high

risk of infection, and so some people may have chosen

to have an amputation

and obviously it's going to make a massive difference to Morgan's life.

The most important thing is to get rid of the tumour,

so got to be very careful to make sure that the tumour is

completely clear, but the good thing about this operation is that

eventually this bone will turn into Morgan's bone,

because the cells will grow down from her own bone at the top and

bottom and the fibula and hopefully this means that it will just

be one operation and that she'll have

a completely normal leg, pretty much.

The two cut surfaces virtually match,

the whole construct is strong enough at the moment just to stay in place,

but it's not strong enough to walk on,

so we've got to put a plate on now.

DRILL WHIRRS

So we've now got the screw at the top, screw at the bottom

and we're just going to fill up a few of these holes now,

but not all of them, so it just holds everything in place.

The graft fits beautifully and we're really happy.

Morgan won't get to try out her new tibia for at least three months

until it's strong enough for her to walk on.

This job is really important,

because we're saving people's lives.

Often when I've told people what I do, they often say,

"Oh, someone's got to do it," as if it's like this really negative thing,

but because of the death aspect in it, people tend to forget

about the product at the end of it and where that tissue goes,

and whose lives are being changed and saved, and they just focus

completely on the dead body aspect of it, and that's a real shame, I think.

In East Yorkshire, Laiela is back at home and doing well.

It's been six weeks since Laeila's had her open heart surgery

in Leeds and she's doing brilliant.

Really good. She's got more energy, she is back at nursery now.

Totally different child.

Without that family, Laeila wouldn't be here today.

We can't thank them enough for what they've done.

If the shoe was on the other foot,

I think I would like to know that

if we've donated tissues, organs, that they've been used

and they've gone to somebody that's been able to live a normal life.

It's been several months since Tom's corneal transplant

and he's enjoying his improved eyesight.

At least now I can only see one ball instead of two.

I've already re-enrolled to start university in September.

Erm, hopefully just continue

as I would have done a year ago, to be honest.

Before I left, I'd have double vision and be a bit blurry,

so it's obviously hard to make good shots.

Now, I make all the good shots.

And in Birmingham, Morgan's back on her feet

and looking forward to the future.

It's been seven and a half weeks since I've had my operation.

I'll have a cinnamon and raisin bagel.

'I'm super grateful that I had the chance to have this donor bone.'

I think it's super important that people donate,

it changes people's lives and for the better.

So I'm really looking forward to being able to walk again properly one day.

Yeah, it's changed my life.

Next time, 18-year-old Reuben needs a life-changing operation.

I do miss not working, working's my life really. I love it.

So now, got barely nothing really, even my mum's having to support me.

And the emotional pressure of the job starts to take its toll.

I'm hearing someone's died maybe 25 times a day

and I can't do it for ever, cos I'll, I'll forget

everything else about nursing isn't just about death, is it?