Donor statistics: The Republic faces a growing shortage of kidneys for transplantation despite having the third highest rate of organ donation in the world, the latest donor statistics show.
Addressing the 4th annual meeting of the Irish Transplant Society, national transplant co-ordinator Phyllis Cunningham said organ donation in the Republic remains at a consistent rate - some 89 people donated organs such as kidneys, liver and hearts in 2004 - but the waiting list is expanding.
"While we perform on average 150 kidney transplants a year using cadaver donations, there are more than 300 people waiting for a kidney at any given time," Ms Cunningham said.
"Up to the end of the 1990s we had sufficient kidneys for everyone on the waiting list but the numbers requiring transplantation have hugely increased in the last three to four years."
As a result of the shortfall, which is due to greater diagnosis of kidney disease, specialists at Beaumont Hospital, Dublin, are examining the possibility of performing more "live" transplants. This involves donation by a sibling or a parent/child and was more prevalent in the 1980s.
The renal transplant unit is looking at expanding donation from those who are "emotionally related" to the patient, such as a spouse or partner. However, greater "live" transplantation would require recruitment of additional transplant surgeons, donor co-ordinators and support staff. Expansion plans are being discussed by Beaumont and the Department of Health.
At 22.9 cadaver donors per million population (PMP), the Republic has one of the highest international organ donor rates. Spain, at 34.6 donors PMP, however, has transplant coordinators based at every hospital. Latvia, which boasts a rate of 30.9 pmp has a law of presumed consent, whereby a family must formally refuse permission for use of a relatives organs for them not to be offered for transplantation.
Forty hospitals in the State participate in organ donation. In 2004, Beaumont; Limerick Regional and Cork University Hospital supplied over half the 89 donors.
The main cause of death among donors was either head injury or brain haemorrhage. Between 2000 and 2004, 247 donor referrals were found to be medically unsuitable.
Elements of the donor's past medical history or the presence of severe infection at the time of death were among the reasons why donations had to be refused.
The National Organ Procurement Service, based at Beaumont, employs three transplant co-ordinators who offer a 24-hour on-call service for organ donor referrals. It has a reciprocal arrangement with UK transplant centres to whom they offer organs where no local recipients are available.
More than 40 livers are transplanted at St Vincent's hospital, Dublin, each year. Transplant surgeon Justin Geoghegan confirmed the first auxiliary liver transplant carried out in the State.
The procedure involved placing a lobe of a donor liver in the recipient which "bridges" the patient until such time as his own liver recovers.
Dr Jim Egan, chairman of the Irish Transplant Society said: "We are carrying out good volumes of work and applying research in a way that is improving the burden experienced by patients."
