Just in case you missed it last week (July 8 -14) was National Transplant Week in the UK. The theme this year centred on the need to call for more people to sign up with the National Organ Donor Register and once registered to communicate their wishes to their close family and friends. The idea is that should the worst happen and a donor was to die in hospital the family would have been fully aware of the donor's intentions and would not stand in the way of organ removal. Organs for transplant need to be removed and processed quickly if they are to be used to save or significantly enhance a patient's life.
The Organ Donor Register (ODR) wass launched in 1994. It contains names and address details of potential donors. To date there are close to 2 million registered donors who have indicated that they would like to donate their organs and other body tissues to save lives. Registeration was made simple by providing a form that one could fill whilst completing a Driver's Licence application. General Practice surgeries also offered simple registration facilities. These two methods remain the most popular ways for donors to get on the ODR but with new technology online and mobile phone registration are becoming widespread especially amongst younger donors.
Some random facts
Patients' waiting times (in days) for various organs: Liver 142; Lung 412; Kidney 1168; Heart ?
Did you know that you are far more likely to need an organ transplant than to be a donor?
An ageing population, an increase in diabetes and kidney disease and advances in transplant techniques all mean that we will see a steep increase in the number of transplants in the coming years.
Afro Caribbeans are 3 times as likely to suffer from kidney disease as the rest of the population.
S E Asians are more likely to suffer from heart disease than the reat of the general population and 4 times more likely to need heart and kidney transplants
Traditionally organs for transplant have come from Road Traffic Accident or brain haemorrhage patients who have died in hospital.
All major religions support organ donation.
The random questions
So there we have it. Organ donation is viewed positively and is supported by the vast majority of the population. After all what could be more valuable than giving someone the gift of life?
So all is fine in the transplant world, right? Well not according to Sally Johnson of NHS Blood and Transport. In an interview for Sky News she said that radical change is urgently needed if the country is to achieve its transplant objectives. As things currently stand a donor may be on the ODR but if at the time of death the relatives object to organ removal there is nothing to do but accept their wishes. In a cruel twist potentially life saving organs and tissues are buried or cremated even when the deceased was a donor on the ODR. Every year 1000 people in the UK die for lack of organs for transplant. That is 3 people every day. The NHSBT would like a change in legislation so that relatives would have no say if a donor was already on the ODR. Heated debate is inevitable. A more radical proposal by the NHS seeks to give registered donors priority should they require an organ transplant themselves. There is little chance of this being adopted seeing as transplants must be performed on the basis of need. The question, though needs to be asked. Is it fair that one is prepared to accept and organ transplant if they are not willing to give?
A few weeks ago the Welsh Government decided to introduce an “opt-out” policy for organ donation. In future it will be assumed that a deceased person is a potential organ donor unless they had specifically signed and opt out card. Another tricky one, no?
Finally, meet Joe*, a 29 year old Kenyan living in Catford, S.E London. 3 years ago Joe was diagnosed with kidney disease. The doctors explained that he had a rare autoimmune disorder that had caused his kidneys to fail. Joe has been on dialysis now for two and a half years. He visits the dialysis unit at the local hospital three times a week where he is connected to a dialysis machine that filters and purifies his blood. The process takes four hours to complete. In addition to the dialysis Joe must continue to take a variety of medications to control his immune system, his blood pressure and his cholesterol levels. He also takes powerful pain killers for gout which is common in kidney disease patients.
Joe has been told that the long term plan for his treatment must be for him to have a kidney transplant. By getting a donor kidney to replace his malfunctioning pair Joe would be able to come off the dialysis treatment and have every prospect of living a normal life. There has been a huge increase in the diagnosis of kidney disease and the demand for kidney transplants is on an all time high. Joe has been on the waiting list for a donor kidney since soon after his diagnosis. The estimated time on a waiting list for a kidney from a non-living donor is approximately three years.
Nine months ago Joe was visiting friends in the West End when he got a call to say that he should make his way to hospital immediately as a suitable donor organ had been found. He rushed about and got to the hospital to prepare for the life-changing operation. The team at the renal unit carried out a series of tests and after several hours told Joe that the operation would not be going ahead after all. The test results had come back positive for certain factors that would have meant that Joe's body would almost certainly have rejected the organ. People on transplant waiting lists go through several of these false dawns especially when theirs is a rare tissue type compared to that of the general population.
Two weeks before I met with Joe his doctors outlined yet another option which they thought he may like to investigate. They asked him to look into the possibility of obtaining a kidney from a living donor, most likely a close family member. Tests would still need to be done in order to assess the suitability of such a match but a living donor transplant usually means that the wait need not be so long. To date Joe has not made any decision on this most difficult proposition.
As the debates continue one thing we all agree on is the need to do more to increase the number of potential organ and body tissue donors. Have you registered with the ODR?