LAST YEAR saw the worst decline in organ donation on record. A 35 per cent drop meant there were just 58 deceased donors who provided organs for some 243 transplant operations, a significant reduction compared with 2009.
For those waiting for much-needed kidneys, hearts, liver and lungs, the figures represent a severe setback to their hopes of avoiding premature death. It means the Republic has dropped back to transplant activity levels not seen since 1989.
Although patients awaiting kidney transplants can fall back on dialysis to keep them alive, those with end stage cardiac, respiratory or liver failure are dependent on a suitable organ becoming available in a much shorter time-frame. With 38 liver transplants performed in 2010 compared to 64 in 2009 and heart transplantation in 2010 down from 11 to only three, many families have lost loved ones who might otherwise have had the chance of life-saving surgery.
There is no evidence the public has turned against the notion of organ donation. But a further analysis of the figures indicates a structural problem within the health system. Potential donor referrals dropped from 154 in 2009 to 120 last year, suggesting hospital staff are under such pressure they no longer have time to devote to the difficult process of discussing organ donation with distressed relatives.
In order to bring us in line with most of our European neighbours, it is estimated we need a network of at least 12 organ donation co-ordinators, based in the main acute hospitals. These skilled professionals offer support to both families and doctors when people with catastrophic head injuries are diagnosed as brain-stem dead and the question of possible organ donation arises. Such a network would also make it less likely that current inter-hospital differences in donor numbers would persist.
The Republic is also in breach of a European directive in not having a co-ordinated system of organ donation. We lack a clear legal framework for organ donation and transplantation and have failed to honour an obligation for each member state to have a national competent authority overseeing the process. And many of our neighbours also harvest organs from people who have a cardiac death in addition to those who are brain-stem dead. This is a valuable source of kidneys, pancreas, liver and lungs. By adopting this practice, we could expect to see deceased donations jump to 150 donors a year. The Health Service Executive must put in place a simple budget-neutral solution to this crisis without delay.