Live donors the key to organ shortage

13 September 2005

By NIKKI MACDONALD

An increase in live donors offers the most promising answer to the chronic organ shortage, surgeons say.

The Dominion Post reported yesterday that the donor shortage, and the changing profile of donors, was forcing surgeons and patients to accept old or diseased organs they would have turned down a decade ago.

New Zealand has one of the lowest donor rates in the world. But, contrary to popular belief, that did not mean there were thousands of potential donors dying every year whose families did not consent to organ donation, donor coordinator Janice Langlands said.

"There are natural limitations – people have to die of a catastrophic event. That is much more significant than the issue of consent."

Australia had invested much more in education in an attempt to improve donor rates, but had only a slightly higher rate, she said.

Only Spain, Portugal, Italy and Ireland had managed to increase their donor rates in the past decade, in some cases with draconian measures unlikely to be accepted in New Zealand.

There was no quick fix to the donor shortage, but making sure family knew of your wishes was a good start to improving consent rates, she said. "I still think people need to consider it while they are alive and well, and tell their families about it."

Heart transplant unit cardiologist Peter Ruygrok agreed that the best way to improve consent rates was for every New Zealander to think about organ donation and tell their families their decision.

The question was often too difficult to process at the time of the catastrophic incident that took their loved one's life, but families would remember back to that conversation.

However, even increased awareness is likely to have a limited effect on donor rates. Kidney and liver transplant programme medical director Stephen Munn said the best option for improving rates was to raise the number of live donors.

However, that had its own difficulties as several possible donors had to be worked up to find a satisfactory one. In one recent case, doctors went through 13 donors to find a good match, he said.

All those involved in the organ donor process, including the intensive care doctors who have to ask families for permission to harvest organs, oppose making an individual's choice binding