The current state of practice of normothermic regional perfusion (NRP) has some parallels with the early days of donation after circulatory death (DCD) says John Edwards, Clinical Operations Administrator at the Gift of Life Donor Program in Philadelphia. “As NRP continues to emerge there are some similarities to the evolution of DCD donation. One of the early lessons we learned in DCD donation was significant variability in practice creates trust issues for our donor hospital partners and the public at large. We have to be cognizant there are some sensitivities surrounding NRP and take great care as we operationalize the technology.”
Edwards is serving on the planning committee for the Organ Donation and Transplantation Alliance’s (The Alliance) March 20-21, 2024 National Collaboration Forum on Developing National NRP Practices & Approaches. He will also present an update on the Association of Organ Procurement Organizations (AOPO) NRP Workgroup at the meeting. He says the goal of the forum is to develop consistencies around the practice of NRP.
Edwards also served on the planning committee for The Alliance’s 2023 Critical Issues Forum on NRP. “The work The Alliance does is exceptional,” he says. “The process by which they put the Philly meeting together was incredibly well done.”
Strong Administrator on Call Program is Critical
In reflecting on the Gift of Life Donor program, which is currently celebrating its 50th anniversary, he says there are several reasons for its long-term success.
“Our success speaks to the generosity of the community that we serve,” says Edwards. “It speaks to the collaboration that we have with our donor hospitals and the work that their teams put in. It’s a testament to the hard work and determination of our team. But people ask us all the time, ‘what would you attribute your success to over such a long period of time?’ And I would say it’s because we have an incredibly effective administrator on call program.”
As the clinical operations administrator, Edwards runs Gift of Life’s clinical operations in conjunction with Christine Radolovic, Chief Clinical Officer, but says he spends much of his time with the team’s nine administrators on call (AOCs) providing real time coaching and mentoring – but more importantly, accountability toward outcomes. “Our coordinators operate autonomously, independently, and sometimes in hostile environments. Our role as Administrators is to support them, inspire them, and set them up for success. We believe the administrator on call role is incredibly important in helping our team grow.”
On any given day, Gift of Life has 14 to 18 transplant coordinators, advanced practice coordinators or referral coordinators following upwards of 40 potential donor cases. It is common to be actively engaged in anywhere between 10 to 15 donors. “As an administrator, what I’m making sure is that we get on site and that we’re providing the best possible service that we can. We want to ensure the safety of these gifts for recovery and transplant and manage patients in a way to maximize their gift.”
Impact Practice and Donor Families
Edwards trained as a respiratory therapist and then obtained a nursing degree from West Chester University and worked as a cardiothoracic nurse for several years at Bryn Mawr Hospital. He joined Gift of Life in 1995 as a transplant coordinator and was the coordinator for Gift of Life’s first Donation after Circulatory Death (DCD) donor, 14-year-old Michael McVey – a donor who had a profound impact on Edwards, personally, as well as far-reaching implications toward wider adoption of DCD practices. DCD had been practically abandoned by the 1990s as brain death became the primary path to donation at most hospitals. McVey’s legacy went on to transform donation across the United States through his mother Susan McVey Dillon’s passionate advocacy. It is estimated that his legacy encompasses more than 44,000 lifesaving transplants nationwide as his case, which was shared by Gift of Life clinical experts at many other OPOs around the county, inspired a resurgence in DCD. Susan McVey Dillon also played an influential role on the faculty of the 2004 National Breakthrough Collaboratives – an initiative from which The Alliance was founded.
One of the things that has kept Edwards working in the world of organ donation and transplantation, he says, is the ability to impact its practice. “What I realized from Michael’s case is that you have a remarkable opportunity to impact practice. This is what I get passionate about. Transplantation is still relatively young since its inception and as someone who works with grieving families who have just tragically lost a loved one, you have the ability to impact practice.”
Edwards emphasizes that working with donor families has also kept him engaged. “The work with donor families is remarkable,” he says. “You meet someone at their worst possible moment, and you have the ability to help reframe the tragedy and create a legacy for their loved one. I’m blessed in working with these families and shepherding them through the process. If we’re compassionate, if we’re kind, if we’re communicative and we provide information, and if we instill confidence then most of the families will say yes to organ donation. My job is to help overcome the obstacles that’s preventing a family from saying yes.”
“Organ donation is not only science but it’s an art to work with families and gently shepherd them through the donation process. Then to work with intensivists, neurologists, neurosurgeons, traumatologists and bedside nurses and have them support an organ donor and do all the things that we ask for over the course of 24 hours in order to go to the operating room, it’s an art to manage this in a way to achieve a great outcome.”
In Awe of His Mentors
Edwards is quick to credit strong mentors for his long tenure at Gift of Life. “Probably for me, the most important reason that I have stayed is my connectivity to leadership,” he says. “I’ve been blessed that Rick Hasz, who’s the President and CEO, and Howard Nathan, Rick’s predecessor, have been my mentors. They are driven, they’re supportive, and they’re always laser focused on doing the right thing even if that right thing creates a bit of disruption. I’m in awe of the people in this field. To have these sorts of role models is a blessing.”
He says he may have had the skills of being positive, being a leader, communicating effectively and bringing people together, but he credits Nathan and Hasz with helping him sharpen his talents.
Influence of Father and Personal Interests
Edwards says he learned about being compassionate and the importance of communicating effectively from his father, who passed away in 2022. “There’s not a person who met my father who did not like him,” says Edwards. “He was a remarkable man; a blue-collar guy who worked on the shipping dock his whole life. But if there was a volunteer initiative, he was a part of it and he would give you the shirt off his back.”
He credits his father with his most valuable life lesson. “He said, ‘If you’re ever at a loss in a conversation, just ask people questions about themselves.”
Edwards has two sisters and a brother, and his mother was a homemaker when they were growing up. He says he has three amazing nephews and that his family is one of the most important aspects of his life. He grew up and still lives in Coatsville, PA, where he loves to play pickleball and where he’s been a volunteer firefighter since he was 16 with the East Brandywine Fire Company in nearby Downington, PA. He still responds to house fires and auto accidents with entrapment.
“I’m very fortunate that I’m part of a volunteer fire department with unbelievably skilled people,” says Edwards. “We have about 80 volunteers. And when I say we have skilled people, they’re as talented as anybody I’ve met in the OPO industry. They’re all about learning and performing the job the right way. Our team does an unbelievable job and provides unbelievably high-quality emergency services.”
Privilege of Working with Donor Families Fuels Him
“I believe the people in the organ donation and transplantation industry are people of strength and resilience and compassion and tenacity,” he says. “I’m incredibly proud of the people who are in this industry for the work that they do because it’s tireless work. To keep the energy and passion for this mission, it’s unbelievable.”
“To be involved in one of the most intimate moments of a family’s life and to have the ability to change the trajectory. that’s a gift,” he continues. “The privilege of shepherding families through donation is my fuel. Every time I want to do a better job with the next interaction that I have.”
