Corby D'Amico, cardiac transplant coordinator at Emory University Hospital in Atlanta, listens to the heartbeat of transplant patient Rickey Kuykendall during a six-month checkup. Kuykendall received a heart transplant six years ago.

There are 1,571 patients on the waiting list for an organ transplant in Georgia. Some have been waiting for months, others for years. When the right organ finally becomes available, it's a transplant coordinator who makes the call that will change someone's life.

It often seems like a miracle to the patient. To Meg Jeffrey, RN, BSN, CCTC, kidney and pancreas transplant coordinator at Emory University Hospital, it's just one part of her multi-faceted job. She calls it ?virtual bedside nursing."

"You have an hour to make contact with the patient and be sure that nothing has changed medically [that would] disqualify him as a candidate," Jeffrey said. "You have to be able to assess the situation without seeing what is going on.

"I've had to call small-town police officers and get them to knock on someone's door. I've brought patients in by helicopter, in the middle of hurricanes or ice storms, and once I called a woman with a car load of kids [who was] almost to Disneyland. I felt like the Grinch that stole Christmas, but for a new kidney and a chance to get off dialysis - she turned around and drove immediately back to Atlanta."

Locating the patient is only the first of many calls. The coordinator must arrange for admission and pre-operative testing, notify the operating room and transplant unit staff, coordinate with the blood bank and tissue sampling lab, talk to the surgeons who are procuring the organ and the pharmacist, social worker and chaplain. It takes a team of specialists working with Emory's transplant program to make miracles happen.

"Transplant coordinator is not a job for someone who can't deal with the unexpected, unpredictable hours or multi-tasking," Jeffrey said. "But the rewards are tremendous. I've seen patients, many I've known for a long time, go back to leading productive lives, working, traveling - doing all the things we take for granted."

Jeffrey has been working with transplant patients since the early '80s when the field was small, new and even more exciting than now. She's seen it grow by leaps and bounds, but believes that many professionals still don't understand her role.

"It's not a common enough specialty for them to teach in nursing school," said Corby D'Amico, RN, MN, cardiac transplant coordinator at Emory University Hospital. "You have to have expertise in your field (kidney, heart, lung, etc.) and then there's a lot of on-the-job training. It's a fairly steep learning curve for patients and clinicians."

Meg Jeffrey, kidney and pancreas transplant coordinator at Emory University Hospital, teaches a class to prospective transplant patients.“The rewards are tremendous,” she said. “I’ve seen patients, many I’ve known for a long time, go back to leading productive lives, working, traveling — doing all the things we take for granted.”

D'Amico fell into the role by working on a coronary care unit and treating patients waiting for transplants. Pictures of many of those patients - some 10 years or more out from surgery - decorate her bulletin board.

"The beauty of being a coordinator is that you see patients and their families in the most trying, unhealthy time of their lives," she said. "You help them through the process and then you follow their progress afterward. It's a real privilege as a nurse to be a part of their lives and make sure that all the pieces that need to happen get done."

Long before the actual transplant, the coordinator is educating patients and their families about the challenges and costs.

"Transplant is not a cure," D'Amico said. "It's a treatment that comes with its own set of issues that revolve around the immunosuppressive drugs that a patient must take for the rest of his life to prevent organ rejection."

Success rates have increased, as have the length of recipients' lives. Coordinators work with patients to teach them what to expect, and may schedule tests they need to get ready and stay ready for a transplant so that they won't miss an opportunity
when it comes.

"When someone loses the function of his kidneys and has to go on dialysis, he usually loses his job, lifestyle and insurance as well. That's a lot of loss," Jeffrey said. "Sometimes the financing is just as challenging as the medical aspects of transplant, and there's a lot of paperwork.We try to empower patients with the education and resources that will help them see the light at
the end of the tunnel."

Jeffrey has volunteered with the Georgia Transplant Foundation since it was started in 1992 by Tommy Smith, a kidney recipient she knew.

Heart transplant coordinators, like D'Amico, see their patients post-surgery in ICU and, later, in the transplant outpatient clinic. After surgery, she helps coordinate a discharge plan that will include follow-up care, medication and dealing with the psychological aspects of recovery.

If all goes well, a heart transplant patient is off the breathing machine in eight hours, and up and walking within 24 hours.

"Our goal is to have them able to care for themselves by day seven," D'Amico said. "Most are very emotional and grateful to the donor and the staff after a transplant. But they deal in different ways with the idea that someone had to die for them to
live."

Staff psychiatrists and social workers help patients work through those issues.

In the transplant outpatient clinic, D'Amico examines patients, reviews their medications and apprises the attending physician of any problems. "We're having greater success with transplants, largely because the post-operative medications are better and we're getting better at using them and managing the symptoms," D'Amico said.

While working with patients is the most rewarding part of D'Amico's job, the position also comes with opportunities for research and community outreach.For two years, she served as an outreach coordinator to educate physicians and the community about transplant patients and helped to write a manual on the management of end-stage heart failure.

"There's always something new to learn with this job and it often seems like there's not enough time in the day," Jeffrey said. "Sometimes you work all day and then if you're on call you may work through the night, but we don't complain, because the surgeons often have to travel to procure the organ and then operate the next day."

One of the best things about the job is working with a dedicated, supportive team. There are about 150 doctors, nurses and other professionals connected with the Emory Transplant Center.

Both Jeffrey and D'Amico love the diversity and autonomy of being a transplant coordinator. They like knowing their patients
well, sometimes over the span of years.

"And there's no doubt that we're helping to change lives," D'Amico said.