Moses deGraft-Johnson MD
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Moses deGraft-Johnson MD
When you think about someone getting their heart cut out, you probably think about horror movies. Or done-me-wrong love songs. But snipping out a person’s heart doesn’t necessarily make you mean spirited or low-down.

As a cardiovascular and thoracic surgeon, Moses deGraft-Johnson, MD, “procures” hearts—and lungs—with the best of intentions. With the University of Minnesota Medical Center as his home base, he travels the country, hopping off planes and into waiting ambulances that take off with their lights flashing and sirens blaring. They rush towards a local hospital, where an individual who has been declared brain dead, but who has been kept on life support, awaits.

DeGraft-Johnson goes in, changes into surgical scrubs and performs a brief, yet complicated procedure on the body, before returning to the ambulance, this time with a cooler by his side. Then he’s raced back to the airport with a special delivery for a sick patient whose days previously had been numbered.

“Oh boy! Nothing compares,” the doctor says of this role that places him squarely in the breach between life and death. “As one family cries for a lost loved one, another cries tears of joy for a family member who’s been saved.”

Today, more than 100,000 people are waiting for transplant surgeries, according to the official U.S. government website for organ and tissue donation. Nearly 28,000 transplant operations were performed in 2008. Each day, about 74 people receive an organ transplant, and about 17 people die waiting for one. The procedure is considered to be a last resort for patients in the final stages of illness, and only one in four people who need an organ is expected to get a transplant in time for it to save their lives.

As a medical student a decade or so back, deGraft-Johnson embarked on his current path during an anatomy class. He performed so well that he became the teacher’s assistant in the very course that he himself was taking. As he continued his studies, he began to see that while all doctors eventually fix floundering boats, surgeons patch torn sails instantly.

“With chronic illnesses, such as high blood pressure, you don’t really change a patient’s situation in that moment. You prescribe medication, they take it, and then you start to see a change,” he explains. “But if I’ve got someone who’s had multiple gunshot wounds, I do surgery on them, and the next day they’re talking to me, then I’ve saved their life.”

He experienced one of those stark turnarounds during the last year of a cardiothoracic fellowship, when he served on the trauma unit of a Queens, NY, hospital. That day he recalls that a patient with multiple gunshot wounds was left on the steps of the emergency room.

Working with the team, he helped to save the life of a young man who would go on to become a popular rapper. After the incident, deGraft-Johnson’s friends heard about his surgery on someone with an "inexpensive" name. His buddies laughed about the unusual name. “They were—who? What? A quarter? Twenty cents?” But it wasn’t long before the object of their humor—and deGraft Johnson’s emergency procedure—went on to fame and glory, with a huge dose of “street cred” for toughing out that blaze of bullets.

SILVER LININGS

The now famous performer pulled through, but many others facing major health crises do not. Those who elect to become donors, as indicated on a drivers’ license, or whose families contribute a loved one’s organs, set the process in motion. Recently, within a three day period, two high-profile organ donation cases made headlines: Actress Natasha Richardson, 45, died after what seemed a minor fall, and her family quietly donated her organs. Then the father of one of four Oakland police officers, tragically gunned down after a routine traffic stop, is reported to have kept his 41-year-old son, already declared brain dead, on life support until his organs could be harvested.

A liver, kidney and heart from slain cop John Hege is reported to have saved four men, and his donated tissue is expected to enhance the lives of up to 50 more, the California Transplant Donor Network reported.

While there’s no word on who received Richardson’s organs, a family friend told People magazine that the gesture “is very Natasha... At least by donating her organs something good could come out of [the tragedy].”

Organ donor advocate Andy Tookey says such high profile cases help the cause: “Celebrities and role models could dramatically increase the number of people who are prepared to be donors by their promotion of organ donation.”

Richardson and Hege became donors on opposite coasts, while deGraft-Johnson’s neck of the woods in recent years has been the Dakotas, Nebraska, Iowa, Wisconsin and Minnesota. They are part of the United Network for Organ Sharing (UNOS), a nonprofit organization that oversees a national database of potential recipients and their medical details to assign them a place on the registry. Where one lands on the list is based on degree of need, length of time on the list, type of transplant required, nearest transplant center and more.

When an organ becomes available, UNOS sends an alert message to all transplant centers within their network. That’s when his team logs onto their Intranet, accesses the deceased patients’ info, and makes the initial evaluation of the organs. They review the donor and recipient’s blood and tissue types, immune status, physical distance between donor and recipient, and so on.

If there isn’t a match for deGraft-Johnson’s team, or the patient is not immediately available, perhaps because they’re on vacation, UNOS keeps calling down the recipient list, until a match is made.

When his team decides to take an organ, “I leave Minnesota and go to wherever the organ is,” the surgeon says. “Once there, I go through all the paperwork and make sure my partner didn’t miss anything [in the initial assessment]. I go alone, or sometimes take a profusionist, who helps with organ preservation for transport.”

They want to know the donor’s medical history, the present illness, information on how they died, and what killed them, deGraft-Johnson says. Then there’s the physical inspection: “We do an echocardiogram, check the valves, do a heart catheterization, a cardiac angiogram, we check the blood vessels…”

If everything pans out, the heart must be stopped, or as he puts it “arrested,” so it can be procured. That’s when he puts a cross-clamp—a kinder, gentler type of wrench—over the aorta until it stops pumping out fluids. That way they can pour in a solution to cause “cardioplegia,” or temporary paralysis. With the heart stilled, the surgeon can cut it out of the body, store it in a cooler, and take it on to a new home.

Once the heart is sewn into a recipient, in a procedure called anastomosis, the cross-clamp is removed and the heart can get back to work.

“I’ve done tons of transplants,” deGraft-Johnson says, “but every time I see a heart start to beat again, it’s like the first time.”

NEATNESS COUNTS

“Every surgeon is not perfect, but when it comes to this level of skill there’s no room for error,” the doctor explains. “You’re not just cutting out a heart. There’s calculation that goes into it, there’s a certain technique that you have to perform. If you miss one of those steps, you can cause a heart to fail, and then it’s no good. Every single step that goes into the calculation must be precise. He notes that it costs a lot of money for a medical center to charter flights and coordinate all the moves.

“It’s a big production. You cannot be the reason the production didn’t take place. It’s like everything is set and ready to go, and the main actor loses his voice… In a $100 million dollar production, somebody’s going to be very upset.” It’s not cheap for the patient—or their insurer—either. He estimates the tab for getting a new heart at about $658,000.

Harvesting a good heart takes 20 minutes, and then they put in another 10 minutes to package it for travel. While his team must later be meticulous in placing this donor heart, precision is far less critical in getting rid of the heart it will replace: “You usually just whack it out,” he says. “You don’t have to be very fine about it. It takes about 10 minutes.”

DeGraft-Johnson’s team is understandably picky about the organs they procure, and take great care to ensure that a transplant will be successful. Aside from performing the exhaustive battery of tests, they have to make sure that an organ recipient is fit enough for major surgery. They also suggest that a patient stick close to home to avoid being out of network and getting passed over if the call comes that an organ is suddenly available.... continued in ABILITY Magazine

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ABILITY Magazine
Other articles in the Kristi Yamaguchi issue include DRLC — Seeking Global Human Rights: Headlines — The Accidental Advocate: Green Pages — Ready To Save Money?: Humor — You Don’t Know Jack!: Senator Harkin — Let’s Stop Workplace Abuses: Women’s Health — Give Your Ticker Some TLC: Ashley Fiolek Pt ii — More With The Teen Motocrosser: United Cerebral Palsy — My Child Without Limits: Scott Hamilton — On The Ice, In The Boardroom: Major League Baseball — Playing With A Disability: Sickle Cell Anemia — One Woman’s Story: Crossword Puzzle — Guess Your Best!: Events & Conferences; ABILITY's Crossword Puzzle; Events and Conferences...subscribe

More excerpts from the Kristi Yamaguchi issue:

Kristi Yamaguchi — Here Comes The Neighborhood

ABILITY House at Los Al — A Place Military Families Can Call Home

ABILITY Builds — New Accessible Homes

Moses deGraft Johnson, MD — Ace Of Hearts

Dancing with Sickle Cell Anemia

DRLC — Seeking Global Human Rights

HUMOR — You Don’t Know Jack!

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