Cornea Graft at Moorfields

[Liam O Donovan]

I was due to have a graft at Moorfields yesterday but it was cancelled at 8am.I now have a re-scheduled appt for Nov 08.

The Doctor in question had made two appts, one for 08th Sept 2008 and a second one in November in case the first one didnt happen. I would have thought the second one would have been booked for a week or two later.

Does anyone know why a lot of grafts seem to be cancelled at the last minute and does anyone know what the "short notice" waiting list is.

I am very grateful for the opportunity of a graft but I would like to know more as to how the transplant system works.

[Anne Klepacz]

Hi Liam
It's tough when you've psyched yourself up for something and then it doesn't happen, so you have my sympathies. I don't think it's true that a lot of graft operations are cancelled at the last minute - mine were done on the scheduled date, as were most of the other grafts I know about among KC Group members. But of course, cancellations can happen for all sorts of reasons. I guess one would be if there wasn't suitable donor material on the day (and I wonder if the fact that you were given 2 dates means there is a shortage at the moment?) Somebody on the surgical team could be off sick on the crucial day, or I guess sometimes there might be emergency operations taking priority (transplants are done for a variety of reasons, not just KC). But I do hope everything goes ahead in November for you.
Some hospitals don't book a definite date, but have people on 'standby' for when a donor cornea is available and call them in at short notice. It sounds as though that's the alternative that you're being offered. Obviously not everyone can drop everything at short notice to go for an op, but of course that's how most transplants for other organs work.
All the best
Anne

[Andrew MacLean]

I had my first graft 'bounced' for a week; I was there in the hospital when they came to tell me that there was a problem with the anesthetist, and could I manage to come back next week?

I was happy enough to come back a week later; I guess that anybody can be taken ill. Most ophthalmological procedures are carried out under local anesthetic, but in Glasgow grafts are always offered under general anesthesia. The rest of the day's schedule was not disrupted, but the two of us who were in for grafts just came back a week later.

All the best in November.

Andrew

[rosemary johnson]

Hi, and sorry to hear about the last-minute change of plans.
Who is your consultant? - booking two slots at once a couple of months apart is not one i've heard of before.
The ost probably explanation for a transplant being cancelled/postponed is that there isn't a donated cornea available - which is good enws in a way because it means someone didn't die eg. in road accident, to have donor organs taken from them.
I thought you'd normally be let know the previous evening if that was the case.
Also as I understand it, Moorfileds re-do all the tests on donor corneas - that is, they dont' rely on the testing done by the eye bank that the cornea is infection free, but test again when the cornea arrives at Moorfields. I suppose it is possible also that one of the tests failed and they decided the couldn't use the cornea ear-marked for you after all.
I've enver been involved in this system, but, as I understand it again, if you have a transplant cancelled one day, they might ask you if you can come in the next day - presumably, this is if they think there may be a suitable donated cornea available for you then, and there will be time to slot you into the theatre schedule.
Or the day after, or two days later.....
I'm guessing a bit here, but some of the tests will take some time to do. SO they may know, for example, that there is a cornea currently in the lab undergoing tests that could be yours tomorrow if it passes its tests, but its hasn't got the "all clear" yet.
I do also know that hospitals will pass donated corneas round if for some reason the operation they were intended for doesn't go ahead - maybe the person changes their mind, or they fail some of their tests..... so the hospital may know there is another cornea in a neighbouring hospital they can get even if there is not one today.
Of course, there are other reasons - maybe one of the key staff is ill, or there have been emergencies so the theatres are all busy, or even something like a machine failure or difficulties with the supply of drugs, or no beds in the ward (even if the op is due to be done as a day case, they'll allocate you a bed, just in case), or porbably lots of other things.
Hope everything goes smoothly on your new date.
Rosemary

[rosemary johnson]

PS to the above: if Moorfields tell you that the booked date is not possible and ask if you can come back the next day/2 days time.....
.... they'll do that up to a point, but after about a week, they'll say No More Standby and make another booking.
That is, they don't keep you on standby indefinitely, only for a few days after one appointment was cancelled.
for one thing, it would mess up everyone else too much! - and mess up the arrangements you made for the rest of your life.
You should have had this all explained at your pre-op appointment - did they not go through this?
Rosemary