Call to use Census to find donors

13 September 2005

By GAIL GOODGER and NZPA

People should be able to agree during the Census to donate organs for transplant, a Dunedin man says, amid revelations old or diseased organs are being used because of chronic shortages.

Jock Allison, who had a kidney transplant in July, said there was no better opportunity to contact every family in New Zealand than the Census in March.

Census packs could include donation information and questions about whether people wanted to donate.

The register of donors the Government had promised would only involve people who agreed to be donors on their driver's licence application, he said.

They would receive information and a consent form, including a clause about discussing it with their family. Some families had apparently refused to let organs be harvested, against the dead family member's wishes.

Mr Allison said waiting for people to return forms for the register would mean only a "slow dribble" joining and would probably be ineffective.

Doctors said at the weekend organs were being used which would have been turned down a decade ago, because fewer healthy young people were dying on the roads and about 400 people were waiting for organs.

But, doctors said they were careful to manage the risks.

Last year, donors' ages were between 14 months and 78 years. Four donors were 65 or older. The average age was 43.

Of the 40 donors, one had type 2 diabetes, nine had high blood pressure histories, 13 were smokers, three were former smokers and three had been exposed to hepatitis B. Organs were provided for 114 people.

Kidney and liver transplant programme director Stephen Munn said donors used to be young accident victims but were now "old fat people with strokes and hepatitis".

Potentially, the quality of organs was not as good, meaning recipients' life might not be as long or of as good quality.

In 1998, road accident victims made up 24% of all donors. In 2004, that had dropped to 17.5%.

Once, doctors would never have used organs from somebody with hepatitis C. Now, if a liver was only mildly damaged, it was used for patients with the disease because the new liver was still better than what they had.

Doctors also tried to immunise patients against hepatitis B, so they could get organs from donors with the disease.

Everyone agreed action was needed to improve donor rates, but attempts to boost numbers - including the proposed register - were unlikely to be enough, Mr Munn said.

Kidney transplant physician Ian Dittmer said the growing need to use marginal organs was a global problem. Doctors did biopsies of marginal kidneys to determine if they were usable.

Surgeons were pushing boundaries and in some cases might have gone too far. But other developments were positive; they could accept kidneys from children as young as two, he said.

Heart transplants appear to be less affected. Heart transplant unit cardiologist Peter Ruygrok said donors' average ages had remained fairly static from 1993 to 2004, at 30 to 35. But every case was different.

Organ Donation New Zealand donor co-ordinator Janice Langlands said while people could elect to be a donor, few could actually donate because few people died in the way necessary.

Donors needed to be brain dead but kept functioning on a ventilator until the organs were retrieved, she said.