2024-04-01 13:05:05
How many liver transplants were performed in those 24 years? “I remember the names of practically all patients,” says V. Sokolov. And people lying down after the surgeon’s scalpel remain grateful to the doctor for saving their life, the surgeon’s face is not forgotten even 15 years after the operation.
“Yesterday, I was approached by a woman in the corridor of the hospital. It turns out that we performed the transplant on her in 2009, and she still recognizes me,” said V. Sokolov.
He added that not only surgeons, but also gastroenterologists and hematologists are engaged in post-operative patient care.
“Patients are like children to them. Patients send their photos from home, they want to show how they look. The feedback is very strong”, assured V. Sokolov.
The news portal lrytas.lt is preparing the project “Thank you to the doctors”, the accompanying series of publications introduces health care specialists who are sensitive to patients’ problems. You can write a thank you to your favorite doctor in the inviting subpage: Thanks to the doctors.
– You are the most senior transplant specialist at Santara Clinics. How did you get into this field?
– It was 1999, I was already working in abdominal surgery. I saw that there are no liver transplants in Lithuania, only kidney transplants.
We started practically from scratch, but slowly began to develop the idea of liver transplantation. I participated in the first such operation, which was performed by Professor Balys Dainys.
– Why did the liver transplant come later? Are they more complicated to transplant than, for example, kidneys?
– It’s not like you can “sew” an organ and it works. This is a specific area of medicine for which there is not enough surgeons. We also need doctors with a therapeutic profile, as well as anesthesiologists, radiologists, immunologists… You can name them for a long time.
Lithuania is a small country, so you won’t do many transplants. For example, a kidney transplant center for the whole of Latvia was created in Riga. There are not so many operations, they had little work.
Considering the population, it is logical to expect 20 liver transplants per year in Lithuania. Almost one transaction per month is received. Therefore, those specialists who perform transplants are also engaged in the treatment of other patients.
I communicate with colleagues in Latvia. I know liver transplant is difficult there because there are no liver surgeons.
Liver surgery is a complex field. There are many structures that need to be stitched together. A kidney transplant is much simpler because the donor organ is sewn elsewhere, in the iliac region, above the groin.
And in the case of a liver transplant, the old, damaged liver must first be removed. There can be many problems in this phase of the operation. Especially since liver cirrhosis often has poor blood clotting.
Without a liver, a person will not live long – at most 3 days. You do the surgery, but something goes wrong, and then there’s nothing to replace the non-functioning organ.
– You mentioned that the first liver transplants in Lithuania were not very successful. And what are the indicators now?
– Last year, we performed 16 transplants in Santaras clinics – all patients are at home. 100% survive for at least two years. liver recipients.
– in 2022 you started using the donor organ perfusion machine in the spring. What did this innovation change?
– The liver is the only organ for which there is no age limit for transplantation. It is only important that their function is good.
However, there are “marginal” organs where we don’t know if they will work well when transplanted. We can “hang” such a liver to the mentioned machine, for a few hours to see if the function of the explanted liver recovers. If we see that the organ is working well, we can safely transplant it.
When the liver is from a donor and you stop the blood flow, the counter starts. Within 8 hours, it is necessary to connect that liver to the recipient and start the blood flow. This time includes organ transportation. For example, we can connect the liver brought from Riga to that machine and the counter starts again, we have 8 hours again.
– A memorable sight – a photo in which you yourself carry the box with the donor organ from the aircraft. Why do doctors travel to collect it?
– A human donated organ is priceless. We have no right to refuse it. If there is no suitable recipient in the country, the organ can be offered to a patient in a neighboring country. If there is a liver in Riga, but there is no patient for whom it is suitable, Latvians offer that organ to Lithuania.
In such cases, time is of the essence. The Lithuanian army helps very quickly – it raises the helicopter, flies the medics back and forth.
– But all the work is done by the doctors of the country receiving the organ?
– Yes, we travel ourselves, remove the organ, wash it with special mortars, bring it back and transplant it.
The success of the transplant depends to a significant extent on whether the donor organ will be properly prepared. In the case of the liver, it is necessary to look at the blood vessels, various ducts. This requires experience.
Several medical teams are working. I am pleased to say that we have 5-6 experienced surgeons who can participate in any of the transplant circuits. Therefore, if one person is missing, we can still perform an organ transplant.
The police are very helpful when driving around Lithuania. The officers accompany our car in a professional manner – impressive.
– The rush is great. How fast are you driving?
– How much does the car pull (laughs). There have been times when our transport was faster than the police. Then we had to wait for them with beacons to catch up with us. It happens.
– Organ transplants are not scheduled – they take place both late at night and early in the morning. Can your phone ring at any time?
– The transplant process is rigged to the smallest detail. However, it can start at any time of the day.
Then it’s not just my phone that rings, a huge team gets involved: several surgeons, operating room nurses, let’s not forget that some doctors look after the donor and others look after the recipient.
Some get out of bed in the middle of the night, while others get up from the birthday table. It has happened that they call both on Easter and Christmas. The phone rang on the hunter’s turret – I had to go straight to the hospital. The phone can never be turned off.
– And how does the family view those calls?
– Of course, the inconvenience is huge. But this is the specifics of the job – otherwise you won’t be able to do these things. When we started liver transplants, there were only professor Balys Dainys and aa professor Algimantas Bubnys. Then we had to go to remove the donor’s organs ourselves, we would return and perform the operation ourselves.
Now it helps that we can divide those jobs. We have prepared a team of good surgeons.
– During the pandemic, when there were calls for vaccination, it was possible to listen to various conspiracy theories. There are also myths surrounding the topic of organ donation, right?
– You know, it is said that there are 3 million basketball experts in Lithuania. Everyone has advice, knows how to play better. The same applies to vaccinations and organ donation – everyone has an opinion, and based on what? Often – with unclear “facts”.
Fortunately, the National Transplant Office has made a huge breakthrough in communication and shown the public what a transplant is.
Organized actions to sign the consent to become an organ donor. A doctor had to attend them, so I went myself. You sit in the shopping center, you talk to people, you get asked: “Why didn’t you sign?” “Nobody gave it to me,” he replies.
People look for reasons to give up, but they themselves cannot explain what they are afraid of. I am glad that there are fewer such people today.
In the past, less than half of potential organ donors became active.
– You don’t ask the dead. Organ donation is always a family decision…
– Yes, but we notice that consents are increasing, people are beginning to better understand the meaning of this process.
My advice is to take the responsibility off your relatives, talk to them about organ donation. Don’t put off having that conversation. It happens that in the morning a person goes to work, and in the evening he is already a potential organ donor.
Relatives are in shock, it is difficult to suddenly accept the news that your loved one has died. Then they admit, “We don’t know what he was thinking about organ donation.” A quiet conversation would have solved everything.
But the worst thing is when a person signs a consent to become an organ donor after death, and relatives oppose it. A person has expressed his will, and the closest people do not follow it. Hence, we do not respect that relative’s decision.
The public needs to be educated and talked about organ donation. A documentary about transplants recently came out. More movies are needed. There should be a poster about organ donation on every bus stop, on every house. Then maybe people’s thinking will change.
– Some time ago, the heart of a genetically modified pig was transplanted into a living person for the first time in the USA. A few weeks ago, a similar achievement was repeated with the kidney. Donors will soon be unnecessary?
– Medicine is moving forward. Many innovations have already been applied in liver transplantation.
Let’s take how other phones. I remember when I was a kid there was still a corded telephone with a disk dialer. We see that innovation is being implemented at an ever faster pace.
Returning to medicine, we ourselves conduct various experiments, work with liver organoids. The point is that you can take any human cell – even a skin cell – and reprogram it into a liver cell and multiply it. That’s easy to do, but what’s next? Those cells need to be connected, to make a framework out of blood vessels and ducts. Those cells have yet to start functioning. After all, the liver is the laboratory of the human body.
– You have mentioned that when fatigue sets in after long hours in the operating room, you always rush to nature. what are you doing there
– Every year I go on vacation to the north of Norway for a few weeks – to fish. There you can disconnect from all your worries.
However, stress at work is huge. It’s not like you sew up a patient’s belly and walk around calmly. The patient should continue to be monitored until he leaves the hospital.
I’m not talking about those cases where there are complications… After all, deaths are an inevitable part of medicine. It’s not like the doctor just waves his hand and says there will be another patient. You go through it, rewind the tape in your head, analyze whether you could have done something differently.
It is from that nervous tension that I run into the forest. There you sit in the turret, listen to the sounds of nature and switch. For at least an hour, you breathe in the fresh air and look at the animals.
Many people now look at hunters negatively, thinking that they shoot anything. It’s not like that. I’ve seen many animals from the turret, but if you can’t, you don’t hunt that animal.
2024-04-01 13:05:05