Although organ transplantation is the preeminent medical miracle of the last quarter of a century, Many Sleepless Nights is the first book to go beyond the headlines and describe the patients who have embraced this last chance to hold on to life, the intricate medical procedures that can save them, the surgeons and nurses who work in this emotionally charged world, and the ethics which complicate this “miracle” high-tech therapy.

Lee Gutkind was granted unconditional access to the world’s largest transplant center - the University of Pittsburgh’s Presbyterian-University and Children’s hospitals, where there is an organ transplant every eight hours, 365 days per year.  For four years he immersed himself in the frantic night-and-day world of transplantation, living side by side with transplant candidates and recipients, jetting though the night with organ procurement teams, monitoring patients with surgeons and nurses, observing in the operating room, participating in the ethical and psychosocial evaluations of prospective patients which help to determine who will receive scarce organs.

During his four years at Presbyterian and Children’s Hospitals, Gutkind established close relationships with many patients, and his portrayal of them, living and sometimes dying under unbelievable stress, is a moving and dramatic statement about the capacity of human beings to endure.

Many Sleepless Nights also outlines the history of organ transplantation and tells the story of the large and complex medical teams behind the operation.  It captures the tension of the search for viable organs; the pressure decisions about which patients, among many, will receive them; and the surgery itself.  Its vivid portrayal of the transplant pioneer Thomas Starzl -  a man obsessed with saving lives - shows how a major innovator in American medicine functions during days and nights of extreme pressure.