Courtesy of Times Newspapers
Donor organ supplies low

Wednesday, 06 September 2006

• Tamaki and Districts Times

ORGAN donations nationally have slumped to near record lows, but the number of registered donors remains constant.

The discrepancy is a result of improved treatment for patients in hospital intensive care units (ICU) where fewer people are dying.

To be an organ donor, people must die from brain death while on an ICU ventilator.

According to Organ Donation New Zealand clinical director Dr Stephen Streat, the number of  brain deaths has significantly dropped in recent years due to improvements in road awareness and medical treatments.

“The number of road deaths has halved from 800 to 400 despite the fact the population has grown and the number of vehicles on the road has grown,” says Dr Streat.

 “Road deaths are a main cause of people dying from brain death.”

Spontaneous bleeding is another main cause of brain death and that rate is also declining, says Dr Streat.

“The net result of these declines means the number of people dying from brain death have also declined,” he says. “Inevitably this means the number of organ donors declines.”

About 40 per cent of the population are signed up as donors, a figure that’s been constant in recent years.

“It’s a very good thing that treatments have improved [to prevent brain deaths] if you are one of those people,” says Dr Streat.

 “The other side of the equation is results of transplantations are getting better. People who previously would not have been considered for a transplant are now being considered.

“The demand for an organ transplant is increasing while the supply is static or declining.”

The Australian and New Zealand Organ Donor Registry shows just 16 people have donated organs this year compared to 17 for the same time last year.

At the end of 2005, only 29 had donated organs, dropping New Zealand to an annual record low.

The counts equates to seven donors per million of population (pmp), on par with Costa Rica and Peru. Meanwhile, Spain has 35.1 pmp, USA 22.2 and Canada 12.8.

Organ donor campaigner and GiveLife NZ director Andy Tookey wants more residents to sign up to be donors.

“More people are dying while they wait [for an organ transplant],” says Mr Tookey.

 “It’s such a shame. If somebody is diagnosed with an incurable illness they make the most of the time they have left. What annoys me the most is when a transplant is 100 per cent curable and that cure is buried and cremated 100 times a day.”

Mr Tookey established GiveLife NZ after his six-week-old daughter was diagnosed in 2001 with a rare liver disease requiring life saving surgery. Now five, Katie battles the progressive disease, but will eventually need a liver transplant to survive.

Faced with the potential loss of his daughter, Mr Tookey started researching organ donation and discovered 40 per cent of patients pass away waiting for a donor despite its 95 per cent success rate.

He also discovered the difficulty in becoming an organ donor, thus kick-starting his campaign.

He says “red tape” bureaucracy needs to be cut and wants legislation passed disallowing families of organ donors the right to veto.

Under present rules, ICU doctors discuss the option of organ donation with family members of brain dead patients. Mr Tookey says some go against a person’s wish to donate, but Dr Streat disagrees.

“It’s rare that that situations occurs,” says Dr Streat. “It’s important you discuss your wishes with your family.

“They’re the ones who are around when you die. Most of the time if a person has indicated what they want to happen, the family will go along with that.”

An ICU audit revealed out of 104 potential organ donors, 39 signed up, 31 declined and 34 were not asked by doctors, says Mr Tookey.

“That’s a 66 per cent loss of possible donors,” says Mr Tookey. “Doctors already have the permission of the donor.

“Why do they need to ask for secondary permission from families? It’s the worst possible time, asking family for someone’s organs when they have just died.”

Organ donor waiting lists are difficult to calculate, as Dr Streat estimates up to 15 people are waiting for a new heart,lung or liver, six for a pancreas and “several hundred” for kidneys.