Paediatric pioneer Luke Martindale

Paediatric pioneer Luke Martindale

An army jet, usually reserved for visiting dignitaries, made a mercy dash through the skies a bitter January night this year, speeding a dying young boy towards his last hope.

Luke Martindale lived with his family in a small village, some 10 miles outside Sligo, in North West Ireland. Initially Luke saw his local doctor on a Friday afternoon, feeling generally unwell and was advised to return to the surgery on the following Monday. However, by the Monday things had turned for the worse and young Luke was admitted to his local hospital in Sligo. It took just eight hours before medical staff decided that he needed to be transferred the 130 miles to Crumlin hospital in Dublin, which caters for acute emergencies. It was here that Luke was finally diagnosed with acute liver failure, kidney failure and a collapsed lung.

His condition had deteriorated to such a degree that his only hope was an emergency flight to King’s College London, another 372 miles away. As time was of the absolute essence the usual helicopter was not an option, it would simply take too long. The only option was a jet plane with the army coming to the rescue, offering to jet Luke, his acute medical team and Norma, Luke’s mum, to London.  Arriving at Stansted, Norma remembers how they were ‘blue lighted’ by two escort police bikes all the way to King’s College Hospital.

From the Friday night, when the first signs of illness became apparent, Luke had been moved through three hospitals, two countries and over 500 miles within 24 hours by the following Monday.

There was no doubt that Luke urgently needed a liver transplant. The call went out and various family members offered to be a living related donor for him. A procedure were relatives can be tested for a match, which results in them donating a part of their liver, (which then regrows) when a positive match is found.  But sadly no-one made a successful match, so with the clock ticking  dangerously fast, the search continued. But fate was with young Luke and a suitable liver was found by 6 am the morning.

As the surgical team gathered to perform the transplant it was discovered that Luke’s condition had deteriorated to the point that the surgery was no longer an option, he was just too sick. Norma and Michael, Luke’s mum and dad, were told that all the various attempts to stabilise Luke had failed and that he now had a less than 2% chance of survival. Into this nightmare came the news that doctors were prepared to try a new procedure with equipment that is so new and cutting edge in paediatric medicine that no certainty could be given as to whether it would help. As Luke had already been kept alive for the past 48 hours by a whole battery of machines, Michael and Norma agreed to let the medical team, led by Georg Auzinger try the new Ecmo (extracorporeal membrane oxygenation) machine. Despite concerns about moving such a critically sick patient, Luke was wheeled down and attached to the new machinery, which worked to support his failing lungs and heart sufficiently to enable the liver transplant to happen.  Dr Auzinger, the consultant who led the Ecmo team, said: “This could be hugely significant, and may extend the life of a number of people suffering from acute liver failure who deteriorate on the waiting list.”(1)

 

After two hours on this life saving device Luke was finally stable enough to undergo surgery for his liver transplant. Throughout the eight hour surgery his parents were updated regularly, letting them know how things were preceding.  After surgery, Luke was transferred to the paediatric intensive care unit and within three days Luke’s swelling and deep yellow/orange colour started to change. A team of more the 30 people had worked tirelessly to bring about this amazing change in condition and had managed to pull Luke back from the brink to the utter joy of this parents, siblings, family and friends. Norma’s gratitude to the medical team that looked after her son is immense, but also, more importantly the donor, whose generous decision to donate, made this all possible.

Luke remained on the ECMO machine which removes carbon dioxide and replenishes oxygen for another 11 days. But slowly he started to recover and was moved from Intensive Critical Care to the High Dependency unit and then finally on to the Rays of Sunshine ward. By the end of February, Luke was finally off all the support machines, including oxygen and by the beginning of March he was deemed well enough to be transferred back to the Crumlin Hospital in Dublin.

Talking with mum and dad at the end of their five week stay in the Camberwell House one very important aspect was having a ‘home from home’ so very close the hospital; it made a huge difference to the family. Being able to spend time in the House to recharge their batteries made their challenging journey possible and they are immensely grateful for this.  Another very vivid recollection for Michael was the terrible urgency of trying to get Luke’s passport issued while his son and wife were jetting over the ocean to an unknown future. Not knowing what the future held, being separated from his son at such a dire moment in his life and having to hold it all together and be organised enough to deal with all the bureaucracy and paperwork involved in getting a passport were etched into his memory.

But there were good moments as well, such as being supported by their local family priest, Brendan McCarthy, who came over to visit the family three times during their stay in London, which was especially memorable and significant for the family. The couple were also deeply touched by the number of family members who offered to be tested for the chance to become a living related donor for Luke.  Although being offered the chance to access the cutting edge technology to save Luke’s life during the family’s darkest moments, being part of that ground breaking moment in medicine was maybe the greatest high point of the whole journey; it returned their son to them.

After a stay in Crumlin hospital Luke finally able to return returned home as this final photo shows, and was soon well enough to return to school; luckily just in time to sit his end of year exam with the rest of his class mates. Although Luke continues to have regular check-ups, things continue well for him.

But maybe what stands out most in this family’s story is their quiet yet strong spirit, which was evident in so many ways, coping with the unfolding nightmare, the holding on and the staying strong, against all the odds. Also equally important was the fantastic outcome brought about by the dedicated medical team, who were prepared to push medical boundaries and the support of the Camberwell House and its caring team.

References

1. www.thetimes.co.uk/tto/health/article4509024.ece

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