Most of us want to help — so why are organs still so scarce?
EveRy year up to 1,000 people die waiting for a transplant because there are no donors available, according to the British medical Association. Right now, 7,586 people in this country are on the waiting list. But most people in Britain say they would happily donate their organs after their death — they just don’t get round to making their wishes clear.
‘Around 90 per cent of people, when asked, say they would donate organs and tissue, but only 31 per cent are on the nHS organ Donor Register,’ explains Professor James neuberger, associate medical director at nHS Blood and Transplant.
‘Being on the register isn’t a requirement to be a donor because your next of kin can decide to donate your organs in the event of your death, but it makes it much easier for the nHS to establish a potential donor’s wishes and follow them.’
Why people don’t sign up has been put down to squeamishness, and widespread reluctance to face up to our own mortality.
‘There’s a superstitious idea that you are somehow tempting fate, and I suspect a lot is down to simple apathy,’ says Dr Paul gibbs, clinical director of transplantation at Addenbrookes Hospital in Cambridge, one of the largest transplant centres in the country.
The situation has become so desperate, groups such as the British medical Association are calling for a system in which everyone’s consent for donation is presumed, so people have to opt out if they don’t wish to do this.
Without clarity, doctors and next of kin are faced with a dilemma at a time which is already fraught with grief and overwhelming emotion. no wonder that in 45 per cent of cases where a patient is deemed to be suitable to donate organs, their families refuse to give consent.
‘There are many reasons, including the relatives simply not feeling able to make a decision at that time,’ says Dr gibbs.
‘They may not want their loved one to be taken away for organ removal so they can say their goodbyes. or they may not know what their loved one would have wanted.’
lynne Holt, transplant coordinator at the Freeman Hospital in newcastle, who deals with babies and adults who need heart and lung transplants, knows what a negative decision can mean.
In the past month, she has lost two babies who died before they could receive suitable organs. ‘you feel so helpless when you face parents who are desperately waiting for good news,’ she says.
even if someone has registered as an organ donor, if they haven’t told their family, this can be another obstacle. In theory, a donor family’s wishes cannot legally override the express wishes of the donor, but in practice, their wishes are usually followed even if they are technically breaking the law.
When the next of kin agree to organ donation, things proceed rapidly. The nHS Blood and Transplant agency coordinates efforts so that the donated organs can be matched with compatible recipients in the shortest possible time scale — hours, not days.
Doctors check that the organ is healthy and there is no evidence of HIv or other disease.
Although ethnicity is never taken into account, people from the same ethnic group are more likely to be a close match because their tissue type will tend to have more similarities.
Whether or not a potential donor is a smoker, or has health issues that stops them donating blood, does not mean the organs won’t be used. ‘We are keen to bust the myth that you have to be a perfect physical specimen,’ explains Professor neuberger.
GUIDelIneS
say that potential recipients should be told how the donor died, and if they pose any risk because of infection of malignancy.
As far as possible, every organ is used. And if a suitable Uk donor cannot be found, it is offered to patients in the rest of europe.
For many people, a transplant can restore them to full health.
lynne Holt is a trustee of Transplant Sport Uk, which organises sporting events for people who have received organ transplants. She says: ‘I don’t think people realise the difference that a transplant can make. This is not just about allowing someone to tie their shoelaces. This can mean a young person going from a wheelchair to running 100 metres in 11 seconds.’
She urges potential donors: ‘get on the register and carry an organ donor card. But most importantly, discuss your wishes with your nearest and dearest.
‘yes, it may never happen, but if it does, they need to know what you wanted. you can make a huge difference and give life to others even when your own life is over.’