Two weeks ago, on a Fri night, I enthusiastically signed the transfer papers for a patient to go to the cardiac intensive care unit so that she could receive plasmapheresis treatment before being transplanted with a heart. yes! A new heart! She had been admitted for continuous infusion of milrinone because despite the numerous operations she had received as a child to fix her broken heart, those fixes were but temporary and her heart was giving up. We had bought her 10 years with those operations but it was time for a new fix. The operations meant that she had a lot of antibodies, antibodies that would fight the new heart, so she had to receive plasmapheresis to clear her system for it, and hopefully make a new home for that new heart. I remembered watching her being wheeled into the CICU. She was scared. And crying. And I remembered praying for the family that lost someone so that she could receive this new heart. I knew what the score was. Is. Someone lost their life so that she could get a new one. For 10 years (or hopefully more) anyway.
She got a week.
Her body rejected the new heart. She was awake for maybe 2 days before she coded and was finally on ECMO. Her family made the decision over this past weekend to let her go. I cannot imagine the grief that they must have felt. Their little girl was only 15. She could have lived on the milrinone for at least another 6months. 6 months hooked to an IV. But the heart became available and she had a transplant. One week. That’s all it took for her body to decide whether or not it wanted to live.