Demand for transplant organs is exceeding supply

Dr Declan Grace was speaking to the ‘Journal’ as he confirmed the stark reality that, on average, around 15 people die in Northern Ireland every year while waiting on a transplant that never comes.

Dr Grace said: “The demand for organs exceeds supply in any given year. Although we have been making great strides in the last number of years in terms of donation, the number of recipients still tends to be greater.”

Dr. Grace said the “good news” that more people were living longer also meant there were more people needing organ transplants.

“There are more people living with complex medical problems, which is a tremendous thing,” he said.

“With advances in medical care over the years these people do well, where historically, 20 or 30 years ago they would have died. Conditions can be managed, but it is when they reach the end stage that the transplant becomes a necessity.

“For example if you have kidney failure you can live on dialysis for many years. It’s not particularly pleasant, they have a life but the quality of life is not like yours or mine. If they have a transplant the quality of life improves dramatically.”

In the past, he added, many of the organs donated came from younger people involved in trauma such as a road traffic collision, but this has declined as the message surrounding road safety has impacted over the years.

“This is clearly an excellent thing, but from a recipient point of view it means potentially fewer donors,” he said.

“Today the donor pool tends to be slightly older”, he added, “and if someone is older they are more likely to have their own medical issues and therefore there might be fewer organs that are donatable.”

Dr Grace said that when people reach that end stage, the Multi-Organ Transplant Teams across Britain come together to assess the situation with regards to past medical history and physiological condition of the potential donor and they also assess the patient waiting on the donor list and also tissue matching.

“There is a huge amount going on in the background,” Dr Grace said. “The process of referring people is very detailed and complicated.”

It also involves close liaison with the family of the potential donor.

Dr Grace said that this situation was greatly affected by whether or not close relatives have been told by their loved ones that they wished to donate their organs after they died.

“The reason that is so important is because when you are having end of life conversations you are not in a position to chat to the patient. If the next of kin knew what the patient wanted it makes it so much easier for them. If I or you had made the decision it kind of takes the responsibility off them.”

A team of specialist nurses, described by Dr Grace as ‘brilliant’, liaise with the family during what is a very traumatic time for them, and theyare on hand to discuss the practicalities, answer any questions they might have and provide any information they might require.

“I would urge people to ‘consider, discuss, register’. I would urge them to consider donation, discuss it with their family and also to register either electronically or by mail.

“It is very important people register as the nursing staff can then at the end of life go in a very positive way to the family. If that hasn’t happened, you are relaying on the family, the next of kin. You are relieving them of the burden of decision making.”

For every 10 families approached about donation in the UK, six are happy to go ahead with their loved one becoming a donor. “That is still 40% saying no,” Dr Grace said.

He said that in general, people in the Western Trust and across the North, and across the UK and Ireland were “very pro-donation”, with the last survey showing 84% in favour.

However only around 33% of those people had pre-registered, with only around half this figure again having discussed it with their family.”

“On average, each deceased donor has three to four organ recipients. That means three to four people can benefit,” he said.

Dr Grace added that he would be “absolutely thrilled” personally to know that he was able to donate when he was coming to the end of his own life.

“You can save multiple lives,” he said. “It transforms lives, it saves lives.”

There are currently across Britain and the North, 7,000 people on the national transplant waiting list.

Last year, more than 1,300 people tragically died whilst on the recipient waiting list or grew too ill to receive a transplant. The UK National Transplant Database includes the details of all donors and patients who are waiting for, or who have received, a transplant.

As well as maintaining the NHS Organ Donor Register, it also provides a 24-hour service for supporting donor families, as well as matching and allocating donated organs “in a fair and unbiased way, including the transport arrangements to get the organs to patients”.

Everyone can join the NHS Organ Donor Register, and this involves the expression of a wish to help others by donating organs for use in transplantation after death, and as a means of giving legal consent or authorisation for donation to take place.

People are also given the opportunity to join the Register when they are registering for a driving licence, registering at a GP surgery or registering for a European Health Insurance card.

By the end of March 2015 the NHS Organ Donor Register (ODR) held just under 21.1 million registrations.

In Northern Ireland, as of January 1 this year, there were 657,531 people on the Donor Register (36% of the population.

Anyone wishing to register to become a donor can do so on-line at www.organdonation.nhs.uk or telephone 03001232323.

Alternatively go to: www.organdonationni.info and follow the link.