Take a closer look at a career in transplant surgery

July 27, 2015

There is no such thing as a ‘routine’ transplant procedure. Transplant surgery is almost always complex and speed is of essence. Making it even more complex are the ethical and technical challenges involved. Organs have to be harvested from deceased donors and transported carefully and quickly to the OR where the transplant surgery will be done. More importantly, with the wait list far outnumbering the number of donor organs available, you may be faced with the job of having to prioritise patients. Challenges aside, what makes this such an appealing specialty, is the thought that you will be giving people with no hope a second lease on life. If you are committed, analytical, interested in immunology and attracted to “big” surgery involving complex, lengthy operations this could be the ideal specialty for you.

What a working week looks like as a transplant surgeon

As a transplant surgeon, you will be involved in every aspect of patient care and handling, from before the transplant till the time the patient is discharged and even long after.

Pre-surgery assessment

For a transplant surgeon, a large part of the pre-surgery responsibility involves assessing new patients who are being referred for consideration on to the waiting list as well as performing regular reviews of those already on the list. These assessments and reviews help determine if the patient is fit enough to undergo transplant surgery. They also determine if the advantages of the transplantation outweigh the risk. Multidisciplinary team meetings are often held to discuss patients on the waiting list and make decisions regarding patients with chronically deteriorating health.

On-call duties

Transplant surgeons are almost always on call. This is because, once brain death has been confirmed and consent has been obtained for organ donation, there are several formalities and procedures to be completed before the surgery can take place and everything has to be done quickly and efficiently for a successful outcome.

The most important tasks at this time are ensuring that the organ on offer is suitable for use and matching the organ with a suitable recipient. Organ suitability is determined by checking the donor’s age, weight, blood group, medical history, organ function and circumstances surrounding the death. Choosing a suitable recipient is the last task before the surgery can be performed but choosing one person from a long wait list is also the most emotionally wrenching task for any surgeon in this specialty. If there is one aspect that differentiates transplant surgery from any other surgery, it is having to make this choice.

Follow up duties

The success of a transplant depends on how well the recipient’s body accepts the donor organ. Keeping a watch on the patient is particularly crucial in the early stages after the operation. During this time, transplant surgeons do regular follow ups with the recipients, screening for side effects, organ rejection and other complications. As the patient’s health stabilises, follow up care is then taken over by other members of the team.