I was reading this article which mentions that someone was scheduled for a heart transplant at 1:00 a.m.
Heart transplant surgery last several hours (the article says 4-6 hours, which seems remarkably fast compared to decades past). I understand that there may be multiple teams of surgeons involved, so maybe no one person is performing the surgery for all those hours straight. But still … just for ensuring that the surgeons are at their freshest and readiest, wouldn’t it make more sense for such a surgery to take place during ‘business’ hours?
I do understand that medical staff often works late-night and/or overnight hours. But this question is not about emergency staff, but about surgical staff and the precise scheduling of non-emergency** surgery. Why 1 a.m. and not, say, 9 a.m.?
Two hypotheses I have come up with:
a) There may be some advantages to performing the surgery while the hospital overall is at a low ‘overnight’ activity level – less staff on the floor, maybe less competition for any necessary in-the-moment resources (both labor and materials), etc.
b) a noted ‘rock-star’ surgeon is performing the transplant, and she/he may keep unusual hours. It might be the surgeon that idiosyncratically prefers the late-night surgery, and all the rest of the surgical team and support staff have no say in the matter.
** not to say it’s not serious
You do an organ transplant whenever the organ becomes available. You don’t want that heart just sitting around in a box of ice for six hours while you wait for the medical team to wake up.
This is pure speculation, but that’s probably when the organ became, um… “available.” I suspect you’ll see lots of late night or early morning transplants thanks to drunk drivers.
As noted, I think the answer lies in the limited amount of time a heart can be kept viable before it needs to be transplanted (up to 12 hours according to this article).
For elective surgery, I would personally recommend that people try to be scheduled early in the day (like 8 a.m. or so). You don’t want to be a surgeon’s 4th or 5th prostatectomy of the day, being operated on by a weary crew. Nor do you want to have brain surgery for a tumor in the evening, when all but one pathologist has gone home for the day and intradepartmental consults are not available for frozen sections…but that’s a separate peeve.
and those 12 hours for the heart includes the time it takes to send the heart from the donor to the recipient. Organs are used by region so they don’t send a NY heart to San Fran but the flight could still be a few hours. They use private planes to send organs, not commercial flights.
I’ve often heard this same thing. Apparently surgical outcomes are measurably worse after lunch because the doctors are become fatigued and their circadian rhythm is naturally dropping. I’ve also heard the death rate spikes in the summer, because that’s when the new graduates are starting.
My mom is a retired nurse anesthetist, CRNA. She went into work every morning at 5:45 AM. They had the first patient on the table by 6:45. She got home by 4 if she was lucky. Sometimes it was 6 or later.
She did that for 30 years. Mom did eye surgery exclusively for six years before retirement. The opthalmologist liked to start at 6AM. So she got there at 5:15AM. But they always finished by noon and she came home. The opthalmologist saw patients in the afternoon.
Mom covered call and handled cases at night. But they were considered emergencies.
Understood, but unless I am missing something … this surgery was scheduled at least several days in advance. Maybe I am wrong about that.
EDIT: upon reading the beginning of the article again, and looking at the iPhone image of the texts sent, the patient might actually have only been notified something like 14 or 15 hours in advance of the surgery. The patient texted the journalist at 12:45 p.m. that he would be having the transplant at 1 a.m.
The emergency services will do their very best to get organs to the hospital in time. There’s a video of a police organ transport run here and the militaryhave been known to help too.
Measurably? It sounds like you’ve been listening to some ol’ wives tales. Or you’re confusing surgery with those 50’s, 60’s, 70’s Detroit auto line manufacturing rumors. I’ve also heard the same rumors concerning Harley Davidson motor scooter manufacture. AFAIK, none of these rumors are true.
In the real world, surgical teams are highly trained, highly motivated, and deathly afraid of having to testify in court due to someone’s error. There are hospital surgical procedures in place that require all errors/mistakes/misjudgments be reported, addressed, and corrected in a timely manner.
The recipients surgery may have been scheduled months, or even years, in advance. Each case is different. Donor surgery (or donor organ harvesting) is usually the result of a premature death. Healthy organs are required for transplants. The old, the diseased, those requiring high doses of medication make for poor transplant donors.
Could it also be as simple as getting the most use out of that expensive surgical suite?
Almost every factory runs at least 2 or 3 shifts of workers, because the machinery is so expensive, and there’s no point in letting it sit idle 2/3rds of the day. Well, the equipment in that surgical room is just as expensive, so having both a daytime & a nighttime schedule of surgeries would be most cost effective.
The transplant team might have known for several days that a compatible organ was in a person near death but it wasn’t until Sunday that the donor passed.
Which would presumably be the source of the statistics bordelond heard. I’m not sure how “the statistics exist” is an argument that the statistics are wrong.
No, the correct answer has been given several time already… Most organs for translate have a very short shelf life. At the same time, brain dead donors tend to become increasingly physiologically unstable as time goes on, so one can’t simply retrieve the organs at a convenient time. The recipient may have been informed 12 hours earlier that the transplant team was flying out to another city to retrieve the heart.
