Coordinating a transplant is one of the most exciting, frustrating, worrisome, and exhausting aspects of our job. For the last couple of years we have split call, meaning heart coordinators are only responsible for heart transplants and lung coordinators are only responsible for lung transplants. All offers are given to the coordinator on call. There is a coordinator on call 24 hours a day, 365 days a year. There are 6 lung coordinators and we take 5 days out of 30. There are 4 heart coordinators. They take every fourth weekend and one day during the week. We never know when the call can come in because death is unpredictable. Of all the lung offers we receive, only about 25% are usable organs. From those, many will be allocated to a candidate at another transplant center that is higher on the list than our candidate. The coordinator reviews the initial offer, if the donor does not meet any turn down criteria (such as cancer), and then we inform the OPO (organ procurement organization) that we may be interested in the organ(s) for one of our recipients. If the organ(s) is offered back to us, then we call and review donor information with the surgeon. If the surgeon feels the organs are suitable, we then discuss potential recipients. Candidates are discussed according blood group, score on the waiting list (status for heart patients), then size. We do not want to put an organ that is too big or too small in our possible recipient. Once we have accepted an organ and decided which patient to transplant, that is when the adrenaline really kicks in and the flurry of activity starts. Almost simultaneous we need to contact the OPO and let them know we have accepted the organ, contact IOPO (Indiana Organ Procurement Organization) if it is an out of state donor, A7N, and the patient. Calling the patient is one of the fun parts and has provided us with the best stories. We have been hung up on because or patient thought it was a prank, asked to call back tomorrow because they are sleeping, etc. It is one of the emotional parts, for those of you that have been transplanted you understand the overload of emotion. This is the call you have been waiting for and we can feel your emotion. Once we have asked you our questions, answered your questions, and given you instructions, we proceed with coordinating the rest of the team. We work with the surgeon and OPO to determine what would be the best time to go to surgery. Many things factor into the timing of surgery, distance, recipient needs, transplant centers from other parts of the country accepting organs, etc. We call our surgery coordinator so she can schedule the surgery and call in a team for the donor and the recipient surgery and coordinate the supplies needed for both. We call admitting to let them know we need a patient admitted, the pulmonologist for the patient, the critical care to let them know they will be receiving a patient after surgery, blood bank to put blood on hold for the surgery, HLA if a crossmatch is required, A7N nurse to give orders, and contact procurement surgeon. (After all of these phone calls you now know why we have an adrenaline rush). Once we have made all the contacts and surgery has been scheduled, we wait. Sometimes there is really not a wait (as evidenced by those of you that we have met in the lobby) or it takes forever (sorry to those of you that we have starved for nearly a day). Surgery and timing can be affected by many things: weather, donor family, donor stability, heart recipient, host hospital surgery schedule, etc. I am usually on pins and needles until I hear from the donor team that the lungs (or heart when I did those) look good and we are proceeding with the surgery. I usually feel like I have held my breath up until then. At that time I feel I begin praying without ceasing (prayers were included before, but with all the calls that are required it is frequently interrupted). I pray for the recipients, their family, and the donor’s family. I pray for the families that were so gracious to give at a time of sorrow. One of the worst parts of our jobs, outside of losing our patients that we have developed wonderful relationships with, is hearing the donor stories. During the surgery we usually get the opportunity to get a few catnaps. We try to update the recipient’s family every 1-2 hours until they are out of surgery. Once our patient has been transplanted we remove their name from the list. Then we either go to bed (if we are lucky) or go to work.