Chris Kelly gives a fascinating account of his recent task to get to Surrey in time to collect an important eye donation. We need ten eye donors every day to meet UK demand. Chris is a Lead Tissue Donation Practitioner for our Tissue & Eye Service, and this is Chris’s day:
Today, I am on our eye donation retrieval shift or, what in the team we refer to as an ‘eye only’, to distinguish from our other multi-tissue retrievals. This means I will be working solo today; I’ll be stationed in our Colindale office awaiting a call from our On Duty Manager to advise me on any donors in our region to attend.
I start at 10am, which gives me time to go for a swim before work. Our retrieval shifts can sometimes involve some long drives and late finishes, so I’ve found that mornings are best to fit this in.
When I arrive in the office I’m greeted with a familiar sense of urgency from our Team Leader – no time to sit down, there is already a donor waiting and it is one with time pressures. I need to get down to a hospital in Surrey and the mortuary manager wants me in and out by 1pm.
“The mortuary manager wants me in and out by 1pm”
This is a common scenario we face: The vast majority of our donations take place in hospital mortuaries which, at many sites, are extremely busy departments. Their priority is to assist families and funeral directors, as well as pathologists working on post mortems, so when we call to arrange access it is usually a juggling act for them.
The donation alert coming in to our team is one of the latter stages of a process that began the day before following the patient’s death. Our dedicated team of specialist nurses in the National Referral Centre were notified that this patient had made known their wishes for donation by signing up to the Organ Donation Register. Then started a process of gaining consent from next of kin, ensuring there is clearance from the coroner, close revision of the donor’s medical history, checking with the hospital for a blood sample, and then completing it all to send to Colindale so we can arrange access to the mortuary.
So within 20 minutes of coming in the door I’m back out again, along with the consent form, paperwork, and all the kit and PPE I will need for the donation. Out comes the trusted sat nav and, surprise, the M25 is very slow by Heathrow (an in-depth knowledge of motorways and alternative routes is quickly acquired in this role!). But the ETA is just after midday, so barring any more delays, I’m getting there just in time.
Which I do – phew! The mortuary staff have finished their morning post mortems and are now busy assisting funeral directors. But I know this site well – I’ve been here twice this past few weeks – so I’m able to set up my kit, complete the not-small amount of paperwork, and then proceed with collecting a blood sample and eye donation.
“I pay close attention not to damage the cornea”
The retrieval process itself is not very complicated but I pay close attention not to damage the cornea. Once retrieved, I then spend some time reconstructing; we ensure the eye area retains a natural curve and use a special cap with very small ridges the keep the eyelid closed over. This is probably the most delicate part of what we do as we have to make sure that the donor’s appearance is what the family would expect – it all goes smoothly.
And within an hour, I’m saying thank you and goodbye and loading the tissue into the van, and it’s M25 time again. Lunch on the road and soon I am back at base ready to dispatch the donation. This donation will arrive at NHSBT Manchester Eye Bank within a few hours and the tissue processing will begin. Within 28 days, two new corneas should be available for transplantation and provide a patient somewhere with restored eye sight – what a gift for Christmas!
But we need at least 10 donors every single day in order to meet the clinical need of UK patients. So tomorrow our team will hopefully be busy, and the next day, and the next…
If Chris’s blog prompts you to sign up, please visit the Organ Donor Register and sign up today.