WHICH CRITERIA REALLY DECIDE WHO RECEIVES A DONATED ORGAN?
In 2015, 435 organ donors gave 1,241 Australians a new chance in life. In fact, the number of people donating organs in this country is now at a record high.
But waiting times for individuals desperate for an organ can be extremely long – anything from six months to four years, which sometimes can mean the difference between life and death.
So does your chance of receiving an organ increase the longer you’re on the waiting list? Not necessarily, because when speaking to seriously ill patients, some doctors are not completely honest. Alongside the ‘hard’ criteria that determine whether a donor organ is right for a patient, such as a person’s blood type and age, there are also numerous ‘soft’ criteria that play a crucial role in the allocation of organs.
For example, many of those affected do not realise that the ranking of patients on the transplant list is calculated anew for every donor organ that becomes available. This means a patient might be second on the list in one case, but right at the bottom in another, depending on blood type and specific circumstances.
But even if the dice are rolled in the patient’s favour, they will not automatically be selected for a transplant – far from it. In fact it doesn’t even mean they will get a new organ at all.
How can that be the case? In a nutshell: once the list of patients eligible for a kidney transplant has been whittled down to just two using the hard criteria, there’s a dilemma.
For the estimated 40,000 people waiting for a kidney in western Europe, it is a problem that occurs more frequently than many would believe. To select a patient for an organ in this instance, doctors must also take soft criteria into account. These are often based on subjective assessment. The doctors responsible must decide on an organ recipient using factors like lifestyle or likeliness to keep up with the gruelling anti-rejection drugs regime required after the transplant – and it’s a maddeningly difficult task.
In practice that might mean that a 47-year-old has a lower chance of being allocated a donor liver than a 17-year-old with a genetic condition who is otherwise healthy. For critics that’s a bitter pill to swallow: without objective criteria, they believe a red line is crossed. Patrick Mcmahon, a transplant coordinator, has even accused doctors of “playing God”.
“Why transplant medicine is not subject to certain disclosure obligations is a mystery to me.” PAOLO BAVASTRO, CARDIOLOGIST