"Heartland" premiere, TNT, June 18, 10 p.m.
The premise: At St. Jude's Regional Transplant Center in Pittsburgh, transplant surgeon Nate Grant (Treat Williams) is having difficulty finding a heart that is the proper size and match for 14-year-old heart failure patient Leslie Walker. Grant's ex-wife Kate Armstrong (Kari Matchett) is the transplant coordinator, and she approaches the parent of a dying potential donor who turns her down. Walker's mother then attempts to overdose on her daughter's morphine so that her own heart can be used.
Armstrong finally finds a match, Sarah Evans, 24, who is dying from car accident injuries, and obtains consent from Sarah's father. During the transplant operation, however, the harvested heart becomes ischemic (doesn't get enough oxygen), and after the operation, Walker develops an irregular heartbeat, for which she's given mechanical support as well as anti-rejection drugs. Grant considers performing a new transplant, but Dr. Bart Jacobs, former chief of surgery, recommends Grant give the current heart "a chance to take."
Jacobs himself requires a lung transplant due to pulmonary fibrosis; he also suffers from hepatitis C. Grant (who will assume his mentor's position as chief) manages to find a lung through the computer-matching system UNOS (United Network for Organ Sharing), and transplants him as well. Jacobs was deemed a viable candidate for a lung even though his lung CT scan looked bad, because his arterial blood gases and pulmonary function tests were acceptable.
The medical questions: Are organs for transplant so difficult to come by? Does UNOS control the network for available organs? Are transplant coordinators (non-doctors) involved in obtaining donor consents? Would a patient awaiting heart transplant be treated with morphine? Can harvested hearts become easily ischemic as they are transitioned to the recipient, and would they then be treated with more anti-rejection drugs? Are hepatitis C patients routinely included on transplant lists?
The reality: Organs are very difficult to come by, according to UNOS. There are currently more than 96,000 patients on waiting lists, with more than 6,000 transplants and just more than 3,000 donors so far this year. Though UNOS oversees the national database of clinical transplant information, black market transplants (bought and sold organs) are increasingly popular.
And yes, coordinators are often neither physicians nor nurses, just as the show suggests.
