Wits transplant team shows way to boost organ donors

Transplant co-ordinators in Johannesburg have successfully increased donor numbers after revising the way they communicate with families and medical staff after a potential donor has died.

An SA Medical Journal article, published by members of the Wits Transplant Unit team from the Donald Gordon Medical Centre, shows an increase in donations to the organisation from 25% to 73% in the last 18 months.

They created a handbook for other donation centres to use in the hope of increasing the organ pool so patients in need could receive life-saving transplants.

According to the Organ Donor Foundation, there are about 4,300 people waiting for a life-saving organ or tissue transplants in SA, but only 0.2% of South Africans are registered organ donors.

And of the 0.2%, only a fraction will donate their organs.

In 2016, the Wits Transplant Unit was in a state of crisis.

The unit is the largest solidorgan transplant unit in SubSaharan Africa, but donations were low.

The unit only performs kidney and liver transplants but co-ordinates other donations.

The team decided to go

There are about 4,300 people waiting for organ or tissue transplants

back to the drawing board to improve procurement.

They came up with a model with two phases, the first being speaking to hospital staff to increase their referral rate, and the other being to convert the referral rate into consent by families for donation.

Marlize de Jager, a transplant co-ordinator and co-author of the article, is tasked with building relationships and educating staff at hospitals on the donation process.

She also works directly with donor families to get consent to retrieve organs.

“We found a lot of potential donors had fallen through the cracks. But now we have had increased referrals, which have led to increased consent and increased donations.

“Some of the nurses were also not aware of how much of the body we could retrieve.

“Some nurses did not know we could retrieve skin.”

Some of the families she meets have never even heard of organ donation.

“Most families don’t have the discussion before something tragic happens.

“Timing and words used are really important. It is important the family understands what the process is, to be able to make an informed decision.

“It is also important we respect the family’s wishes.

“If they say no, then we respect that. We don’t want to cause friction within families.”

The logistics around one donation could require up to 60 phone calls to co-ordinate the process, De Jager said.

Stella de Kock, 43, is a Pretoria patient who has been on the kidney transplant list for seven years.

She was diagnosed with end-stage kidney disease at the age of 35, when she went to the doctor to complain about pain in her foot.

She learnt she had 8% kidney function, and has been on dialysis ever since.

“I like to tell people that I haven’t peed in five years.

“It sounds shocking, but everything I drink stays inside.

“Five years ago I started haemodialysis, which I do three times a week to subtract toxins from my blood, which kidneys would normally do.”

De Kock’s condition means she cannot have fulltime employment and cannot travel to places far from dialysis centres.

“I would love a kidney, but the waiting list is around eight years.”–