Blog / Why have I decided to become a donor? / For Many Other Cases as Vladan’s and Uroš’s
03/06/2019
Why have I decided to become a donor?
For Many Other Cases as Vladan’s and Uroš’s
Emilija Nestorović, Head of the Ward for Heart Transplantation and Mechanical Cardiac Support of the Clinical Centre of Serbia
For Many Other Cases as Vladan’s and Uroš’s
I have been the Head of the Ward for Heart Transplantation and Mechanical Cardiac Support since its foundation in 2013 when the heart transplantation programme was restored in Serbia and mechanical cardiac support established as the integral part of this programme.

The date September 21, 2013 represents the date that nobody of us at the Ward will certainly forget, because we turned something that seemed as the far away dream into reality. Not just into reality, but we turned it into a new life. That was a day when my team and me performed the first heart transplantation and gave Vladan a possibility for the new beginning and future. Today, he is a grandfather and lives his sixth year with a new heart and he is here for his family and friends.

We have performed 40 more transplantations since then. Although our job means following strictly established medical protocols for each patient, we are still only humans, regardless of the high degree of professionalism, and we live the story of each of them over and over again. Maybe we don’t know them as long as their families do, but going through some of the most traumatic situations in life with them, we become a part of all of it.

Apart from being hard and complex and time-consuming job, it also entails a high degree of emotional burden and empathy. Since you spend large amount of time with patients treating them and waiting for that, for them the most important call in life, when they get it, you share fear and concern whether you will end this long-term fight as a winner. They must not see our fear, but we hide it behind a smile, encouragement and hope that everything will be all right, because this smile is the last thing that sets the patients to this last battle for a new life.

Although we care for all our patients, the biggest care is nevertheless for the youngest ones. They always remind you that life is not fair and that it is a constant fight.

Memories of the most difficult moments remind you of the battles that you lost, whether in case of young people who were not lucky enough to live for a transplantation, or those who underwent it, but not completed it as winners.

Although it happens rarely, the worst feeling is when the whole team waits in the operating room with excitement and anxiety for the transplanted heart to start working and it stands still. Immune system of the recipient is sometimes above us and you can expect such situations, although you know that you have done everything by the medical protocol.

It is equally painful when you succeed with all possible efforts to keep the patient alive until an organ for him has been provided and when happiness because you have a potential donor is replaced by despair, because the family has not given the consent for donation, and you lose him eventually.

It is hard to fight things that you cannot influence directly, and our every day is full of such fights. I remember a girl who waited for a long time for a heart transplantation, especially because she was of smaller figure that makes finding of an adequate donor a great challenge. The day when we received a call that we have the potential donor who matched her according to all the characteristics and the knowledge that the family has given its consent brought joy into the hearts of all of us. However, the moment of joy was interrupted by a call in which we were told that the family changed its mind after talking to a priest and decided to cancel its decision. The girl died in several months’ time.

It is hard to understand that young people can be so sick that the heart transplantation is their only salvation. However, disease can happen to anyone of us, not only to the ones that do not take care of their health, but also to the sportsmen. And to children. In the first place, the cause of heart disease is ischemic disease, resulting from an inadequate lifestyle (obesity, smoking, elevated arterial pressure, diabetes, stress), then heart muscle inflammation, which usually affects healthy young people, largely athletes, and congenital heart muscle disease at the third place.

Number of donors in Serbia is critically low. Although we have the state of the art technology, and are able to help certain patients while they are waiting for a new heart by installing heart pumps, neither technology nor we are omnipotent. Sick heart cannot tick forever. We are proud of every transplantation, of every saved life. One heart transplantation a month is a progress, but it is not sufficient. Currently, 39 patients are waiting for a heart transplantation in Serbia, the youngest of them is 18.

The development of transplantation programme reflects the degree of humanity development of a society. When I think of how it all looked like six years ago, when the first heart transplantation was done in Serbia, I have to admit that we have made progress, and that people's awareness of the importance of donating organs is changing. So far, 41 families have assured me that there are people who have shown willingness to help and prolong someone's life, people who have shown the act of the greatest humanity, the ability to raise above the worst situation that their loved ones are facing and make somebody else happy. This is the best definition of humanity.

Small number of performed transplantations concerns me and makes me think whether we failed as a society, whether we are aware what humanity means. Although lack of knowledge and lack of information are main reasons for numerous prejudices, we as a society must not allow that this should be the justification for making wrong conclusions and decisions.

We must set the example for our children, because unfortunately, they too are witnessing that life is not fair and that even the youngest ones are not protected and that the disease can happen to anyone. They should be the incentive for us to do everything we can to prolong someone’s life and preserve someone’s family.

Through our actions and care for health of somebody who is not close to us we demonstrate the essence of humanity. Humanity is not helping the loved ones because it is natural, but it is the ability to develop compassion and helping people who are not related to us in any way. You do not waive anything in this fight, but you donate something, which does not mean anything to your loved one at that point.

Although fights are not over yet, the ones that we won are our light at the end of tunnel. Victory is every life that we managed to prolong and every family that we managed to make happy by saving the life of their loved ones. My light and something which makes me still believe in what I do is hope that there will be more boys like Uroš, who lived to celebrate his 18th birthday with his family and friends and only a couple months before he was a little frightened boy of merely 40 kilograms, who was waiting for his new heart and whom you could get smiling only for a moment by giving him chocolates.

People who decided that day that they wanted to save the life of little Uroš, give hope that as a society we will become mature enough and realize the importance of donating organs to those who cannot move forward without our help. I want to believe that in Serbia the number of human people is significantly higher than the current results show us.
AUTHOR
Emilija Nestorović,
Head of the Ward for Heart Transplantation and Mechanical Cardiac Support of the Clinical Centre of Serbia