[00:00:01] Speaker A: The Michael Hatfield remax team presents real estate and more. Bay Area real estate is different than all of America. And why? What's up with buyers? What's on sellers'minds? How is the market and much, much more. Now here's your host, Michael Hatfield. Welcome to the real estate and more show, and thank you for listening. We have an incredibly interesting topic of discussion this morning with a very special guest, a man who has formerly assisted with lifeguard flight operations, helping to save lives in the organ donor transplant environment. Our show today is about the life saving process of organ transplant, the critical infrastructure ensuring that organs get from location a to location b, the time sensitive nature of it all, and some about the immense changes for a donor recipient's life, a new beginning and when minutes matter on the show this morning, I have Mr. Brad Davis, former transplant coordinator for a midwestern transplant center. Welcome to the show.
[00:01:12] Speaker B: Can I call you Michael?
[00:01:13] Speaker A: Please do.
[00:01:14] Speaker B: All right.
[00:01:14] Speaker A: Absolutely. First of all, we need a little bit of backstory. At a recent social event, Brad and I had an opportunity to compare past history, interests and mutual occupations being involved with lifeguard transplant operations. Brad as a transplant coordinator in the 1990s and myself as a former pilot of lifeguard flights way back in the 1970s. Our mission in the lifeguard flight operation and transplant environment was to ensure human donor organs got from a donor to a recipient as expeditiously as possible. Firstly, for our listeners, can you explain exactly what is a lifeguard flight?
[00:02:01] Speaker B: Yeah, lifeguard flight is used when we need to transport a transplant team to a donor hospital and then return the team with the organ back to the recipient hospital.
The flight may be out of an airport and we use ground transportation then from the airport to the hospitals.
In some situations, we'll use helicopter to get us from the airport to the hospitals, but all of that transportation is.
[00:02:37] Speaker A: Considered lifeguard minutes matter. And in the air traffic control environment, the lifeguard flight is identified in the call sign of the actual flight and its unique elevated priority in the air traffic control system. And they're somewhat immune to ATC delays that most flights endure during normal operations of airline flights, however, without holding patterns for weather. As an example, a lifeguard pilot may have to use his experience to decide whether weather conditions are safe enough in order to proceed. So, Brad, lifeguard flights are only for heart organs or are they for other organs as well?
[00:03:21] Speaker B: They're for any organ that needs to be transported quickly to the recipient facility or even getting the transplant team to the donor hospital quickly.
The donors hearts only beat for a certain amount of time and so often we can be rushed to get to the donor hospital, as well as once we get the organ out, getting back to the recipient hospital as quickly as possible. And I was going to add, you were mentioning the lifeguard status. I remember a number of times when we flew out of JFK, for example, and here we are in this little lear jet passing all these huge. Back then it was 747s waiting to take off, and we didn't go under their wheels or under the planes, but felt like it. We were just right up against them and traveling down the tarmac to get to the Runway.
[00:04:15] Speaker A: Huge priority with a lifeguard flight. Just huge. I can't say enough about how your heart swells to be involved in a life saving operation like a lifeguard flight. And that certainly is integral when minutes matter as part of the transplant operation. Do you know what nation's transplant system saves more lives than any other country in the world in, like, say, 2021?
[00:04:42] Speaker B: Yeah. I haven't been keeping up with the statistics, but I know the United States has led the world in organ transplant. A lot of, in the 90s, we had surgeons come from all over the world to train at the few transplant centers then, and then go back to their countries and start transplant programs.
[00:05:04] Speaker A: Wow. Very interesting. I hear a lot of people ask, they say, what is the difference between a lifeguard flight and an angel flight? Do you know that one?
[00:05:15] Speaker B: Yeah. Well, I think lifeguard flights are not air transportation. They're not only used for organs, but it's also used for patients, as people know, if there's a trauma, that patients are transported as well. So I think those may be angel flights.
So anytime air transportation is used, those are either angel or lifeguard flights.
[00:05:41] Speaker A: And angel flight has requirements that the patient actually is ambulatory and able to travel in a small, unpressurized aircraft.
[00:05:50] Speaker B: Okay.
[00:05:51] Speaker A: Yeah. And these are airplanes that may not have access to lavatory facilities and for the duration of the flight, and they must have a personally signed letter from the physician in order to travel on angel flight. And it's a humanitarian organization that usually operates the angel flight, so to speak. And they're usually volunteer pilots there. Whereas in the operation you and I were involved with, it was lifeguard. That was a different thing altogether.
[00:06:20] Speaker B: Yeah. And I was going to say that oftentimes we had to call our recipients in, organ transplant recipients in from, some of them were stable enough to be at home. And so in some cases, may have needed to have relied on those angel flights to get to the hospital so they could get their transplant while the lifeguard flight goes off and takes the transplant team to and from the donor hospital. So I can see how those two would work together.
[00:06:46] Speaker A: So there is a definite life to the organ once it is ready to be exchanged into the recipient. There's definitely usually on a heart, it's what nowadays?
[00:07:01] Speaker B: Well, I think it's always been about four to 5 hours. So hearts and lungs are more sensitive to the cold ischemic time than the other organs. Liver, pancreas, even small intestine, those are probably still being done.
Require to be implanted within eight to 12 hours. So we always hear the heart teams would always have much more dramatic transportation. They would have the helicopters to and from the airport. They would have the faster jets to get to and from the airports.
The liver team, I would mainly focus on the abdominal organ transportation.
We had a little bit more time so we could actually get away with taking an ambulance to and from the hospital to the airport.
To and from the airport, and then taking air transportation from there.
[00:07:59] Speaker A: Yeah. Isn't there requirements also for that flight to be available?
The pager and all that? I remember this. Maybe you would like to expand on.
[00:08:09] Speaker B: Way, the way the process works is as a transplant coordinator, I would get a call in the middle of the night from our answering service. They would say, brad, we've got an organ donor offer that you need to call the hospital, know, wherever it was. So I would call them, get the information on the donor, call the surgeon, explain what we had. And this is often in the middle of the night, because that's when just the timing of the whole donor process ends up being.
Things start happening in the middle of the night. And the surgeon would then say, make a determination of whether we should go get it. And it was at that point, I'd call someone like you to say, listen, we need to go down to Mississippi, and how quickly can you get a plane on the tarmac for us at the airport? And you may not have your plane at the airport that's closest to our hospital or from where we're leaving. So you'd have to relocate the plane to that FBO and meet us there. And then we would fly from that. But the timing of calling the rest of the team, getting everyone else together, was based on how quickly the pilots could get the plane ready. Because if we don't have a plane, we're not going anywhere. So you guys had to be on call. And I'd like to hear your end of how it felt to be called in the middle of the night and what you had to do to get the plane ready and meet us at the specific time. How much time did you have?
[00:09:53] Speaker A: Actually, the dedicated aircraft was at the airplane at the airport. It was San Jose at the time. This was back in the. This was when some of the first.
[00:10:03] Speaker B: Even before my time, before your time.
[00:10:05] Speaker A: And the airplane was ready, and we had to be able to respond within 20 minutes.
[00:10:11] Speaker B: Wow.
[00:10:12] Speaker A: And so the call would come in from EU, the transport coordinator. We would actually have someone filing the flight plan to go wherever it was going to go while the pilot was launched to the airport. And the airport was dedicated, or the airplane was actually dedicated to be available for those circumstances. But it was an amazing time.
[00:10:40] Speaker B: Yeah. The choreography of getting everything.
You talk about timing things.
My title was a transplant coordinator. Timing was everything. We had to predict when we could get the team to the airport, when we would be into the donor hospital and into the operating room. There they had to have the patient in the operating room ready to go, and then that's on the donor side. And then once the organ is recovered, the clock is ticking on the organ.
We had to predict the time coming back and when the surgeons at the recipient site, recipient, or need to get started, so that there's as little time wasted between the time the organ is taken out and the time the organ is sewn in. And so it all comes down to timing and I would say a choreography of things that had to move at a particular pace and predictable time frame.
[00:11:48] Speaker A: There's only a certain set of parameters where a heart, for example, can be used. And we were talking off the air, when can a donor heart become available? And what is the difference between one that cannot be a donor heart?
[00:12:06] Speaker B: Right.
[00:12:06] Speaker A: Please.
[00:12:07] Speaker B: Yeah. I think a lot of people are asked to sign your driver's license to indicate whether you want to be an organ donor or not. And what a lot of people don't understand or realize is that only a few people, or only a certain percentage of all deaths can be used for organ donation, looking at 20 to 30 years ago. But it's only those patients who have been diagnosed with irreversible brain death. So this is head trauma, gunshot wounds, unimaginable in some cases, circumstances where the head is traumatized enough to stop brain activity irreversibly, but the heart continues to beat, and it's in those rare cases. And I think the percentages back in the 90s probably still the same, was only about 4% of all deaths could result in organ donation.
So it does a couple of things. I mean, it means something to me to say that it's a low likelihood that anyone who dies will become an organ donor. So you really have to take advantage of the few, that 4% that become available for organ donation, and that starts with getting consent from the donor family.
And then everything has to work.
Some of this process that we've already started to talk about all has to come together. The heart has to continue to beat in the donor, even though they're brain dead, for us to ultimately use the organ. And that's one of the reasons, I think, main reason why organs are so scarce and plenty of people die, but not very many people die with an organ that can be used for transplant.
[00:14:01] Speaker A: Very interesting. Now, an organ in an older man, so to speak, it can go into an older woman.
[00:14:10] Speaker B: Yeah.
As you might imagine, the organs are the same between gender, but it's mainly size, blood type, not even age as much. I've seen older people with very healthy organs, and so those organs can be used. So age is not. There are limits, but we're very careful with assessing the viability of the organ.
So it's mainly size. And adults cannot necessarily. Their livers cannot be put into children, for example, because the liver would be, or the heart may be too big.
Although there have been advances, even when I was doing this, there were advances where they would, with livers, at least they were able to take a segment of the liver, an adult liver, and put it in the child. And that technology has progressed dramatically.
[00:15:17] Speaker A: Unbelievable. I recall on the flight end of things being in a jet, and then we get the signal that the helicopter is inbound, and then at that point in time, we get our departure clearance, which was whatever we pretty much needed at the time. And we'd start the engines and they would be ready, and onboard would come a real competent guy like Brad here, as well as the tech people, as well as the organ. Back in the day, I was doing it, the heart organ, which I recall most, only it was like in an ice chest, a thermos ice chest back in the day. But I remember that here come the helicopter. And then as soon as the team was on board, the door was closed, and we'd say, lifeguard Learjet four five one. And they would say, you're cleared.
Forget the taxi clearance. You're cleared for takeoff.
[00:16:15] Speaker B: Right.
[00:16:15] Speaker A: And everybody included, united Delta seven six seven s, would be holding for you because of the priority and the fact that minutes matter when you're carrying a donor heart or essential organs such as that. It gave you a feeling of incredible accomplishment, like you were doing something for others and humanity and so forth.
[00:16:44] Speaker B: Yeah. I mean, you were as much a part of the transplant team as everyone else, because without capable pilots who knew what they were doing in these situations, if that piece falls apart, there's no transplant.
Those who receive a transplant probably appreciate this, but there's a whole multitude of people behind the who are operating behind the scenes to make these transplants happen. And pilots are uniquely responsible for the success of these transplants.
[00:17:23] Speaker A: Kind of interesting weather minimums. You're right at them down to like 300ft of forward visibility on the Runway. And it could be, for airline operations, it could be considered a time to divert, but yet you knew how important that heart had to be. And so at that time, you would take it right down to the minimums in order to ensure the delivery of that organ. It was an incredible time.
[00:17:54] Speaker B: Yeah. There were times when we would. I remember very distinctly coming into a small airport somewhere and the pilots would say, okay, we're going to be landing here and we're still in the clouds. And all of a sudden we feel the Runway underneath us because the ceiling was right on top of the Runway.
[00:18:15] Speaker A: Yeah. Folks, once again, these hearts and organs are not, well, let's say hearts anyway. They're not harvested, so to speak, from people prematurely.
The brain has already went on and the heart is still beating, allowing for the implant of that organ into another worthy individual. And it is like an unbelievable feeling. How did you deal with that emotional side of things, Brad?
[00:18:51] Speaker B: Yeah, I mean, when I first started as a transplant coordinator, it was pretty surreal. I mean, you have to remember that patients who are organ donors, like you said, michael, their hearts are still beating and so they still look alive.
Their color is there, they're warm to the touch.
They're on a mechanical ventilator, so they look like they're breathing, so they don't look like a body or a corpse going into the operating room, they look like a patient who's asleep and going to undergo surgery.
And especially with kids.
Some of my first organ donations were with children. And it's really hard. Especially. There were times when we would arrive a little early, or at least they hadn't gotten the patient to the operating room. And we'd see the family giving, grieving over their lost child in certain circumstances. And it was difficult to see that and who we were going to help save. And I had to put the emotion side away and not let that get into the way. I had a lot of things on my mind because I had to continue to coordinate this transplant. So there was plenty to distract me. But there was one particular story that I shared with you. I tell the story just because it was kind of an interesting juxtaposition between life and death. And in the operating room at a local hospital late at night, all the ors are dark and quiet for the most part, except for the flurry of activity that's going on in our operating room, where I don't remember how many transplant teams were there, but these ors can get pretty crowded with the different personnel working on things. So we had completed all of the preparation that the surgeons need to do and Transplant coordinators need to do to be able to receive the organ. Once it comes off the field, we get everything ready, and then everything stops. This is just the natural process. We stop. We all look at the clock because we need to note the time, because once we start removing the organ, that determines how much time you have to transplant the organ. So the flurry of activity came to a stop, got really quiet, and just as the surgeon began the procedure to remove the organ from the lung, this happened to be a young child donor.
We heard the cries of a baby being born in one of the operating rooms next to us.
Everybody kind of looked at each other, and we all thought, wow, that's pretty amazing. It's kind of the circle of life, this thin barrier between life and death, where obviously the child had already died as brain death. But here you've got a child dying or their organs being recovered, and you've got another patient being born. And with the idea that the organs from the donor will now be able to save more than, you know, in some cases, more than one child's life. So it just illustrates the transplant world where patients are waiting for organs and are about to die. And the question is whether they can get an organ in time and then to experience a birth during that process, or hearing the child coming into the.
[00:22:34] Speaker A: World, it was amazing story. Incidentally, 27,169 transplants were completed in the United States in 2020. 315 thousand, 927 kidneys, 6143 livers, 67 pancreas, 490. Combination of kidney and pancreas, 2671. Heart and lung, 1778. And 93 other amazing. The United States leads the world in these type of transplants. And like I said, for me, it was all about the heart transplant and the excitement that would surround it, because you're doing something of a worthy nature and something, and knowing that something's good is coming out of this operation.
[00:23:36] Speaker B: It's just something good out of a needless tragedy in many cases. I mean, the donors die tragically in many cases. So it's really great that something good can come out of these. I think it's some solace to the donor family to know that while they've lost a loved one. And it's very hard knowing that that death could result in someone else being helped.
And I think it says a lot that the United States leads the world in this area because in many countries, it's presumed consent. In other words, when someone dies, they're just presumed to be an organ donor. They're not voluntarily. They don't make that decision. But many selfless donor families can rise above the grief and the trauma at the time that they're experiencing and be generous enough and rational enough to think about others at a time when their focus is on their lost loved one. So it says a lot for the american culture and the generosity of the american people. Donor world.
[00:24:42] Speaker A: One last thought is that critical organs like the heart are not carried routinely on commercial flights. Why would that be?
[00:24:50] Speaker B: With this type of time frame, we can't take those chances.
[00:24:57] Speaker A: Back in the early 1990s, Nancy and I had a young, very remarkable babysitter who watched over our young two children. It was necessary that an oxygen bottle accompanying her everywhere she went. She was on the heart and lung waitlist at Stanford Transplant center. One day, Nancy and I went for a two day getaway out on the coast. But then we received this call.
They had paged her. Stanford had her a donor. What a wonderful moment that was. And what a remarkable, life giving blessing for her new beginnings. The minutes matter for certain.
I just go back over and I think about the history of the human heart transplants. And they began with Christian Barnard. Dr. Christian Barnard in December of 1967, at the time, his team transplanted the first human heart into a human being. And it lasted for a while. It was successful. But then shortly thereafter, Dr. Norman Shumway with the Stanford team performed the first heart organ transplants in the United States. And that was in January of 1968. And in the early stages of my aviation career, I had the honor of flying some of those lifeguard flights along with the organs accompanying by a tech team such as someone like Brad, as a human being, just be involved in that was such a wonderful, worthy feeling that you were doing something for others. Well, thank you so much for your time of involvement that you did. It's just an incredible, incredible story that you had there about one of the organs that you did.
[00:26:46] Speaker B: My pleasure.
[00:26:47] Speaker A: So this morning, it's brought back emotions I experienced many, many years ago as a lifeguard pilot involved in the transport of life saving organs. Today, we've been graciously honored to have Mr. Brad Davis, former transplant coordinator on the show, to share a side of these critical life saving operations. Thank you, Mr. Davis, for sharing with us your experience.
[00:27:09] Speaker B: Yeah. Thank you for your service and the whole process.
[00:27:14] Speaker A: It's time for a short break. You've been listening to real estate and more show interesting people like Brad Davis, topics like transplant operations and lifeguard flights. And, of course, we talk about Bay Area real estate. Listen to archived real estate and more
[email protected]. Slash radio that's michaelhatfieldhomes.com Slash Radio. The real estate and more show is podcast on demand on Spotify, Amazon, Apple, iHeart, Pandora and most major podcast platforms as well. I'm your host, Michael Hatfield. We'll be right back with our next special guest. Stay tuned.
