3804 Days

With 9.3 donors per one million inhabitants in 2017, the organ donors in Germany has fallen to a historical low. This fact was the reason to tell this story.

Gerd Kuck was 24 years old when he was diagnosed with heart muscle inflammation. He suddenly ran out of breath. The doctors told him he would not recover. Probably a delayed infection. In 2000, he suffered a heart attack. His then-wife, a nurse, reanimated him. From then on, he knew, he would need a new heart very soon.

His chances were bad from the beginning: He’s 1.96 meters, needs a particularly big heart. And because of his blood group 0 positive, he competes with many patients on the waiting list. Then, he became so weak that he almost died, in 2013, the doctors transplanted him an artificial heart.

He marries again, gets a little daughter, builds a house. In November 2017, at the age of 51, it becomes clear during an examination that the artificial heart won’t last long, only a donor heart can save him. Since then, he has been on the Transplant Association "Eurotransplant" on the High Urgency list. The doctors of Hannover Medical School sent him to the other patients waiting in a rehabilitation clinic in Bad Fallingbostel.

At the end of 2017, 703 patients in Germany were waiting for a heart. But, in the eight Eurotransplant countries, only 548 hearts were removed, of which 250 were in Germany. There, with the number of 9.3 donors per one million inhabitants in 2017, the willingness to donate is so low, that the membership in Eurotransplant is now under discussion. A „serious organ donation system“ is defined by at least ten donors per million inhabitants.

Gerd Kuck is getting weaker. August 21st, he gets an offer for a heart. When he was already being prepared for the transplant, in the induction room, the surgery was cancelled. The donor's heart was not good enough. On the 5th of September 2018, after 3804 days of waiting, he had a transplant. With success. On the 31st of October, he is allowed to return home and enters his new house for the first time. At the 28th of January, he started to work again.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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At 3 o'clock in the morning Gerd Kuck was called in for a possible heart transplant. He is waiting in a patient room of Hannover Medical School for the message whether the donor's heart is suitable for a transplant or not. After 16 hours of waiting the doctor told him that the heart was not good enough for a transplant.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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A helicopter flies from the hospital Bad Fallingbostel to the Hannover Medical School. There, a new heart is transplanted to a High Urgency listed patient. Gerd Kuck has met many people who have been transplanted before him.

© Patrick Junker & Jonathan Terlinden - Gerd Kuck is having coffee with other patients with heart disease. Many patients wait several months for a heart.
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Gerd Kuck is having coffee with other patients with heart disease. Many patients wait several months for a heart.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Gerd Kuck at a waterbed massage in the clinic Fallingbostel. He carries the artificial heart on his belt. Since 16th of November 2017, Gerd Kuck has been back at the High Urgency list for a donor’s heart. Gerd Kuck is not allowed to leave the clinic with the High Urgency status. He only sees his wife and daughter when they visit him at the weekend.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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At 3 o'clock in the morning Gerd Kuck was called in for a possible heart transplant. Gerd and Insa Kuck are waiting in a patient room of Hannover Medical School for the message whether the donor's heart is suitable for a transplant or not. After 16 hours of waiting the doctor told him that the heart was not good enough for a transplant.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Insa Kuck and Hannah Kuck (f.l.t.r.) after dinner. They do not know if Gerd will get a donor heart this time. In 2013, Gerd Kuck was waiting ten months for a donor's heart at the high urgency list. Due to a lack of donor organs, he was transplanted an artificial heart as a stopgap. Gerd Kuck has been waiting for a donor's heart since the beginning of November 2017. In the meantime, the new house of the Kuck family was finished. Gerd Kuck had no way to visit the house yet.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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The daughter of Gerd Kuck, Hannah Kuck reads before sleeping. Since 16th of November 2017, Gerd Kuck has been back at the High Urgency list for a donor’s heart. Hannah only has the opportunity to visit her father at the clinic Fallingbostel at the weekend. She does not know if her father will receive a suitable donor heart.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Organ removal. The surgeon Fabio Ius (center left) and medical assistant Stefan Rümke (center right) remove a donor's heart. There are two teams of the Hannover Medical School in the room and the staff of the clinic. The removed organs are then transplanted at Hannover Medical School. In order to ensure the privacy of the donor and the relatives, it is not allowed to mention the place and time of organ removal.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Organ removal. A heart is connected to the TransMedics Organ Care System after organ removal. The TransMedics system minimizes the damage to the transplanted heart. The machine overcomes the limitations of cold storage, using tubes to create its own blood circulation and keep the heart beating.

© Patrick Junker & Jonathan Terlinden - The surgeon Fabio Ius brings the donor heart for Gerd Kuck through the main entrance of Hannover Medical School.
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The surgeon Fabio Ius brings the donor heart for Gerd Kuck through the main entrance of Hannover Medical School.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Gerd Kuck is in the operating room and is being prepared for the heart transplant. On the left hip you can see the cable of the artificial heart, also called Driveline. At the 5th of September 2018, Gerd Kuck will be transplanted a donor heart at Hannover Medical School.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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At the 5th of September after 3804 days of waiting, Gerd Kuck had a transplant. Doctor W. Sommer and Prof. Dr. med. G. Warnecke transplant the donor heart at Gerd Kuck. The donor heart is in the chest and is stitched. At the 7th April of 2008, he was put on the waiting list for a donor's heart. In November 2017, he was placed on the high-urgency list for a donor's heart for the second time.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Two x-rays of Gerd Kuck. The left image was taken before the transplant, you can see above the defibrillator and below the artificial heart. On the right, the x-ray after transplantation shows the pacemaker.

© Patrick Junker & Jonathan Terlinden - In rehab Gerd Kuck is relaxing during a mudpack.
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In rehab Gerd Kuck is relaxing during a mudpack.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Gerd Kuck in rehab after his heart transplant. He has big scars from the heart transplant, the artificial heart and the stay in the intensive care unit. Gerd Kuck was transferred to the Schüchtermann-Klinik. Here he gets different uses to strengthen his body.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Four weeks after his heart transplant Gerd Kuck can already walk small distances with a rollator. To protect himself from infection, Gerd Kuck have to wear a breathing mask and protective clothing. Because of immunosuppressants, people are susceptible to germs after organ transplantation. About 85 per cent survive the first twelve months with donor's heart, 70 per cent still live after five years and 50 per cent live longer than ten years.

© Patrick Junker & Jonathan Terlinden - Gerd and Insa Kuck take a walk to pick up their daughter Hannah from school.
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Gerd and Insa Kuck take a walk to pick up their daughter Hannah from school.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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After nearly a year at the 31st of October, Gerd Kuck was allowed to return home. Gerd is sitting on the couch with his wife Insa. Insa has hardly decorated the apartment until now. She waited until Gerd was home again.

© Patrick Junker & Jonathan Terlinden - Image from the 3804 Days photography project
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Since the 28th January 2019, Gerd Kuck is back at work at a health insurance. He now works in a single office to protect himself from germs.

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