Six Hours to Save a Heart

Text by Li Han, Liu Xun & Wang Jiliang Photos by Liu Zhongcan

On the day of December 27, 2018, a breathtaking heart saving race was going on between Wuhan and Liuzhou—two cities separated by over one thousand miles.The precious heart of a young man who had passed away was being transported from Liuzhou to Wuhan to save a dying man.

The heart of the voluntary donor was removed at around 10 am in Liuzhou, Guangxi Autonomous Prefecture and then put into the chest cavity of a patient in Wuhan Union Hospital at 4 pm, which helped save his life.

This operation was successfully executed by the Running Heart Guardians from the Department of Cardiovascular Surgery of Wuhan Union Hospital.

下午1时50分，医生在飞机上守护着器官转运箱A doctors guarded the organ transport cooler on the airplane at 1：50 pm

A Heart in Need

“I desperately hope to live and would like to try my best even if there is only one glimpse of hope.” It was on the morning of December 27 when the 49-year-old Han lay abed in the Cardiovascular Surgery Department of Wuhan Union Hospital.He was consistently coughing and his voice became hoarse.His eyes were full of hope as he spoke about the heart transplant surgery to be done later that afternoon.

Han had worked on a construction site for many years.Since January of 2013, he started having coughing f its and often felt short of breath when walking up stairs.He had thought it might be a normal cold, but he didn’t get any better after two months.He had a full examination and was diagnosed with dilated cardiomyopathy (DCM) at Wuhan Union Hospital.By then, his heart had become significantly enlarged and could not pump blood efficiently, which led to a heartbeat of as slow as 30 times per minute.Han’s shortness of breath was temporarily abated with the help of a pacemaker.

Bad news came at the end of 2015 when Han’s health suddenly became worse.He couldn’t stop coughing and couldn’t breathe when lying in bed.He was admitted to Wuhan Union Hospital again and had a detailed examination.It was found that he had heart failure and the pacemaker could no longer work well enough on him.The only hope for him was a heart transplant.

Han suddenly burst into tears upon hearing that he could only survive by receiving a new heart.What’s more, his two-year old son had just been diagnosed with acute lymphocytic leukemia after being admitted to the hospital because of continuous fever.He ignored the doctor’s advice and decided to go home for conservative treatment, while using up all his savings as well as borrowed money for his son.

Han’s illness started to worsen in June of 2018.He had lost over 44 pounds and his skin was yellowing.His legs would become too weak to stand up on after walking several steps.He was referred to Union Hospital on December 3 because of his severe illness.The doctors said he needed a new heart immediately.

Hope From One Thousand Miles Away

It is typically very hard to find a heart donor for a transplant.Luckily, good news came from Liuzhou, Guangxi, on December 26, that there was a matched donor found through the China Organ Transplant Response System.

下午3时33分，器官转运箱被搬上车，准备送往协和医院The organ transport cooler was put in a special car at 3：33 pm and left for Union Hospital

In order to save Han’s life, Dr.Hu Xingjian, Hua Xiaoliang, and Sun Yongfeng, members of the Running Heart Guardians of Union Hospital, set out on the journey to get this life-saving heart back from Liuzhou with the necessary equipment.

Inside the ICU located on the 4th floor of the in-patient department of Liuzhou People’s Hospital, a brain-dead young man lied on a hospital bed.The three doctors were studying his medical record, treatment, and indexes of the body for preoperative assessment.The 22-year-old young man went to the hospital because of headaches in May 2017 and was diagnosed with a serious brain disease.The surgery didn’t work for him and his illness worsened day by day.On the morning of December 16, the young man, who was still lucid, said in tears that he would like to donate his organs to save other people.His parents consternated for a long time and finally decided to sign the Organ Donation Agreement.The young man was announced brain dead on December 25, and his heart, liver, kidneys, and other organs were all donated.

A Non-stop Journey

The heart removal surgery had been scheduled to start at 11 am on December 27, but it had to start an hour ahead because the liver had to be sent to Shanghai for another patient and there was only one flight from Liuzhou to Shanghai during the day, which was scheduled to take off at 12 am.

It was 9:30 am on the morning of December 27, all the medical physicians and staff stood beside the bed and paid silent tribute to the young man for three minutes.Half an hour later, the heart and liver were successfully removed and placed in the white organ transport cooler and sent to Wuhan and Shanghai respectively by doctors.

“The surgery has to be done within six hours after securing the heart so as to have the best effect,” Hu Xingjian said, “the longer the duration of cold ischemia of the organ, the lower the quality will be, and it will be harder to ensure the recipient’s prognostic effect.” The ischemia tolerance for a heart is around six hours, which means the heart for Han had to get to Wuhan Union Hospital before 4 pm on the same day so as to have the best possibility of success.

As it is quite far from Liuzhou to Wuhan, every minute counts.Hu Xingjian and his colleagues went to Liuzhou Bailian Airport immediately after picking up the heart.They also informed their team members in Union Hospital to prepare for the surgery.

The check-in staff at the airport heard about this and provided express service for the three doctors.The doctors boarded the plane with the organ transport cooler at 1:25 pm.

下午4时许，心脏被送到协和医院手术室 The heart was sent to the Operation Room of Union Hospital at around 4 pm

Successful Surgery

The flight arrived at Wuhan Tianhe Airport at 3:30 pm and the three doctors were led off the plane first.Hu Xingjian got in a special car waiting at the airport with the organ transport cooler and rushed to Union Hospital.

It was drizzling, but there was no serious traffic jam on the way to the hospital.

Hu Xingjian reported the location of the ambulance at 3:50 pm and the medical staff started to anesthetize Han.Eight minutes later, Hu Xingjian lugged the heart into the operation room.The heart was placed into Han’s chest cavity at 4:20 pm and it beat again at 4:52 pm.The surgery was completed at 7:10 pm.It was known that Han’s vital signs were stable now.

救心大战六小时

文/李晗 刘迅 王继亮 图/刘中灿

2018年12月27日，一场紧张的护心大战在相隔千里的中国中部城市武汉和南部城市柳州之间展开。一颗宝贵的心脏跨越这两座城市，让一个不幸逝去的生命，点亮了另一个岌岌可危的生命。

上午10时许，在广西柳州一位志愿捐献者遗体中取下的心脏，下午4时许就放进了武汉协和医院一位病人的胸腔，成功挽回了后者的生命。

完成这次生命接力的，是武汉协和医院心脏大血管外科的“护心跑男”团队。这里记录的是他们与生命赛跑的全过程。

下午3时30分，武汉天河机场派人引导器官转运箱出机场 A hostess from Wuhan Tianhe Airport facilitated the transport of the organ transport lunch cooler at 3：30 pm

湖北男子须换心保命

“我现在特别渴望活着，哪怕只有一丝希望，我都想试试。”27日上午，在武汉协和医院心脏大血管外科病房，49岁的韩先生躺在病床上，不停地咳嗽，声音嘶哑，想到下午即将开始的换心手术，他眼里满是期待。

韩先生常年在建筑工地打工。2013年1月，他不时咳嗽，爬楼梯就气喘，当时以为是感冒，但治了两个月不见好转，后检查发现心脏有问题，到武汉协和医院被确诊为扩心病。当时他的心脏已显著增大，心率最慢每分钟只有30次，泵血能力告急，安装起搏器后，呼吸困难等症状暂时缓解。

2015年年底，坏消息再次传来。韩先生病情突然加重，每天咳嗽不止，一躺下就喘不上气。武汉协和医院检查发现，他的心脏已经衰竭，起搏器逐渐失效，唯一的生机是做心脏移植手术。

得知要换心才能活下去，韩先生大哭了一场。祸不单行。偏偏就在两个月前，他两岁的小儿子连续高烧不退，被确诊为急性淋巴细胞疾病。他不顾医生劝说，决定回家保守治疗，将全家积蓄和借来的钱用于救孩子。

2018年6月起，韩先生病情再度加重，体重骤降40多斤，全身皮肤严重发黄，走几步路就累得站不起来。12月3日，他被紧急转到协和医院，病情危重，必须尽快换心脏。

生机来自千里外

心脏移植，供体十分紧缺，幸运的是，经过半个多月的等待，12月26日从广西柳州传来消息：通过全国器官移植分配与共享系统比对，当地有一颗配型成功的供体。

为挽救韩先生的生命，26日下午4时许，协和医院心脏大血管外科“护心跑男”团队的三名医生——胡行建、华晓亮和孙永丰，带着设备立即前往柳州，准备把这颗救命心脏护送回来。

在柳州市人民医院住院部4楼的ICU内，一名已经脑死亡的男青年躺在病床上，三位医生正详细了解他的治疗过程和身体各项指标，认真进行着术前评估。这名男青年22岁，和父母在南宁打工，2017年5月因头痛住院检查，被确诊患有严重脑部疾病，手术治疗无效，病情逐渐恶化。12月16日上午，尚处于清醒状态的他流泪表达了捐献器官、救治他人的意愿。经过激烈的思想斗争，痛苦的父母在器官捐献协议书上签了字。25日，青年被正式判定脑死亡。心脏、肝、肾等器官全部捐献救人。

护心奔跑不停蹄

取心脏的手术原定于27日上午11时进行，由于其肝脏要送往上海救治另一名肝移植患者，而当天从柳州飞往上海只有中午12时许的一趟航班，手术提前到10时开始。

27日上午9时30分，参与手术的医护人员静静站立在男青年病床两边，为他默哀3分钟。半个多小时后，心脏、肝脏被顺利摘出，分别装入白色的器官转运箱中，由医生分别送往武汉与上海。

“需要在6小时的黄金时间内完成手术，才能确保手术最佳效果。”胡行建告诉笔者，“器官离开人体后冷缺血时间越长，其质量就会越差，器官移植接受者的预后效果也越难保证。”心脏耐受缺血时间为6小时左右，也就是说，要确保韩先生移植手术效果最佳，必须在下午4时前将供心从千里之外的柳州送到武汉协和医院。

距离遥远，时间紧迫。取得心脏供体后，胡行建等三人迅速赶往柳州白莲机场，同时提前通知协和医院手术团队做好各项术前准备，确保无缝对接。

机场值机人员得知情况，迅速为“护心跑男”团队的三名医生办理了相关手续。下午1时25分，三名医生和装着宝贵心脏的器官转运箱，安全顺利地登上了飞机。

手术顺利完成

下午3时30分，飞机抵达武汉天河机场。“护心跑男”团队的三名医生被安排率先下机。胡行建带着器官转运箱上了早已等候在机场的专车，以最快的速度赶往协和医院。另外两名医生则去取行李。

天下着小雨，所幸一路未出现严重拥堵。

下午3时50分，离医院不远时，胡行建报告救护车所在位置，医护人员开始为韩先生进行术前麻醉；8分钟后，胡行建将心脏供体交到手术室同事手中……

下午3时58分，器官转运箱在医院门口被搬下车The organ transport cooler was taken out of the car at 3：58 pm in front of Union Hospital

下午4时20分，心脏供体植入韩先生胸腔；4时52分，心脏恢复跳动；7时10分，手术顺利结束。据了解，韩先生情况平稳。