Friends, Countrymen, Lend me your Ears... and your

Organs!

Given the opportunity, most people would like to leave some form of legacy before they die. But what happens if death occurs before they have a chance to act on this? Car­rying an organ donor card could be a last chance to have a positive impact on someone's life.

Organ donation in Ireland has a long, complicated and controversial history. A quick glance at Citizensinformation.ie will soon show you how un­clear the law is on the issue. From the retention of organs to the legality of children and the mentally ill donating, the law is "unclear", and this has been reflected in the numerous court cases and inquiries that have plagued our ju­dicial system and the country's coffers (Dunne Inquiry - take a bow). Muddier still is the legislation surrounding stem cell research and related avenues, such as the recent case of a UK family becoming the first to store their son’s umbilical cord tissue for potential use in the future against any disease he may develop. While storage of blood from the umbilical cord is common in the UK, this is a first for the tissue which allows the harvesting of the more useful stem cells. Ireland on the other hand lags far behind such initiatives, where the practice of even collecting stem cord blood continues to be outlawed, apart from private hospitals which then send the cells abroad.

Two types of organ donation are currently in operation in Ireland - living and deceased donations. Living donations are allowed for kidneys, tissues (like skin) and bone. Deceased donations include heart, lungs, liver, kidneys, pancreas and the eyes. A new phenomenon nicknamed ‘domino swap’ made headlines in the US recently. 6 individuals in need of a kidney each came to the John Hopkins Hospital in St. Louis with another healthy individual willing to donate who are not a match with their friend or loved one, but were with one of the other 5 individuals. The method ensured each person received a kidney, thus boosting the likelihood of someone donating in the first place. Ireland needs to follow such initiatives but is thus far failing to.

How much of a demand is there for organ donation in Ireland? There are currently over 600 people on the waiting list for organs, tough odds when on average 80 donations occur per year (resulting in about 250 overall donations). Demand clearly outstrips supply in a scenario where a single person donating can help up to 9 people. Irish Kidney Association (IKA) chief executive Mark Murphy highlights those on dialysis are increasing by over 16% every year. While the overwhelming majority of Irish transplants are kidney based, over 200 lives were saved in 2005 by organ donation.

There is no doubt deciding to donate your organs is a big decision. Ask yourself — would you donate a "spare" organ to a family member (such as a kidney)? Many would an­swer, hesitantly or otherwise, in the positive. How about a stranger you have never met? The opposite would be true here for the majority. Why should your quality of life suffer for somebody you never knew before, you might ask? I can understand and ap­preciate this. However, once you die this attitude should change. Bar reli­gious or medical reasons (such as infec­tion), I fail to see how anyone can selfishly refuse to donate organs for which they have no more use for, that could in fact save or improve another's life.

Often it is not selfishness that prevents organ donation, but the fact that those under a certain age simply don't dwell on their own mortality on a daily basis. They do not perceive the possibility that death may lie around the corner and many will not have thought seriously about the day they will die. There is nothing wrong with this: constantly dwelling on our demise is abnormal and interferes with enjoy­ing life. On the other hand, making an informed decision on organ donation, informing your next-of-kin of your wishes and carrying a donor card should be the responsibility of each of us. Imagine how difficult it is ap­proaching a grieving family and asking them for permission to remove the newly deceased's organs. If everyone is aware of your wishes, neither the fam­ily nor the medical team will have to go through this emotional minefield.

Unfortunately, the over­whelming demand for organs is not just down to the failure of ordinary people to think ahead. Firstly, inade­quate State funding is a huge issue. Take for instance the temporary closure of the ward in Beaumont Hospital in May 2006 for dual kidney and pancreas transplants. This was due to the one surgeon capable of doing both being on sick leave. Mr. Murphy adds that the State has never prop­erly funded the pancreatic transplant program. Another exam­ple is the agonizingly slow move away from sending people to the UK for transplants, as different options open up in Ireland. It is hard to believe that it was only May 2005 that the first lung transplant took place on Irish shores, after the opening of the lung trans­plant unit in March 2004. The State is obligated in its position of power to at­tract qualified individuals to this coun­try, and to provide proper transplant facilities and staff, rather than piggy­backing on foreign states like the UK. Such funding problems are not unique to this issue, and crop up in virtually every other area of our health service.

Secondly, the abuse of trust by hospitals in the organ retention scandals has caused some to shy away from con­sidering organ donation. Thirdly, peo­ple are living longer and healthier for the most part, in particular thanks to advances such as seat-belts and intensive care units to name but two. Obviously this is a good sign of quality of life in Ireland, but the downside is the negative impact on the num­ber of organs available at a given time.

Inevitably many of the or­gans that are given to the living regrettably come from the newly deceased. Their families must be com­mended for even thinking about allow­ing organ donation, regardless of whether they decide for or against it, as well as those doing the convincing and the actual operations. A brilliant idea by the IKA has been their lobbying for Ireland to follow Spain's lead, which has taken to hiring trained profession­als specifically and solely to seek out donor consent in every intensive care ward. Spain leads the EU in organ donation. Such a person could calmly explain at an appropriate time the benefits of donating, without pres­suring the family.