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Column: We have to do much more to increase organ transplant rates

The Seanad has made the correct decision not to annul a Statutory Instrument on organ donation and transplantation – but much improvement is still needed in the area, writes Senator Colm Burke.

Senator Colm Burke

AFTER CONSIDERABLE DISCUSSION on organ donation and transplantation in the Seanad earlier this week, ultimately the correct decision was taken not to annul Statutory Instrument No 325 of 2012 European Union (Quality and Safety of Human Organs Intended for Transplantation), which implements EU Directive 2010/53/EU.

The EU Directive was drafted on the basis of establishing common quality and safety criteria, to cover the entire chain from donation to transplantation, primarily to enhance safety mechanism providing better outcomes for organ donors and recipients.  The Directive will also allow for the safe exchange of organs between Member States.  The requirement on the State and the designate bodies to maintain these quality and safety standards will, following defeat of the motion, remain in force.

During the course of the debate, however, deficiencies in the current infrastructure of organ donation and transplantation were highlighted by all sides.

No progress in increasing level of organ transplants

There has been no real progress in increasing the level of organ transplants over the last ten years.  In 2000, there were 150 people waiting for kidney transplants.  By 2010, the figure had reached over 650, representing a 333 per cent increase in real terms.

The failure to affect any significant increase in organ donation and transplantation rates has created a tremendous strain on hospital budgets and resources, and unacceptable system for patients and their families.  In 2010 the single highest ranked procedure for day patient attendances at acute public hospitals was haemodialysis, accounting for one fifth of all day case attendances.

Each kidney transplantation in addition to giving the recipient the opportunity to live a normal life amounts to a saving of €750,000.00 to the taxpayer during the life time of the recipient.

Every effort must now to move the debate forward in order to address the deficiencies in the system, increase organ donations and transplantations, while optimising outcomes for recipients and living donors.

The need for donor co-ordinators

The HSE is currently working on the assignment of donor co-ordinators. Currently we have five transplant co-ordinators all based in Beaumont hospital in Dublin. In comparison authorities in Northern Ireland, over a five year period, have put in place 27 transplant co-ordinators resulting in an 81 per cent increase in organ donation.

It will be essential that additional staff are recruited to deliver the services; similarly to the stagnation in the number of transplant procedures, there has been no real increase in the number of consultants with the ability to carry out transplants in the past decade.

The Department of Health has recently initiated a public consultation process on the issue of consent to organ donation, inviting interested parties to submit their views on the introduction of an opt-out system. Consent and further issues relating to post-mortems, research and anatomical examination will be addressed in the Human Tissue Bill, the heads of which are currently being drafted by the Department of Health.

A comprehensive awareness campaign is required

In drafting this legislation the Department of Health has committed to engaging with patient representative organisations like the Irish Donor Network, clinicians and other interested parties to inform the legislative process.

The Department of Health has on several occasions emphasised its desire to make organ donation the norm, so as to increase the number of organs available for transplantation.

Coupled with infrastructure and service improvements, rates of donation must be encouraged for living and deceased donors. We need to put in place a comprehensive awareness campaign and adopt the same approach as that of the Road Safety Authority where a high profile person was used to sell the importance of road safety.

Former Derry star and well-known GAA pundit Joe Brolly has, in a very short period of time, already raised the importance of organ donation. It is a person of that calibre that is required in order to create the awareness of the importance of being an organ donor.

Expenses incurred by living donors

In addition a procedure must be established to discharge the out of pocket expenses incurred by living donors. I have no doubt that this is not a priority in considering donation but it is practical mechanism of supporting those who have made that commitment.  In the UK the sum of £5,000 sterling is paid in order to cover loss of earnings, travel and miscellaneous expenses.

While the recall of the Seanad focused the debate on organ donation and transplantation, and highlighted failures in the current infrastructure, annulment of the EU Directive, particularly the failure on the part of the opposition to present an alternative, would have done nothing to achieve a better outcome.

In remaining part of the common framework mechanism established by the EU Directive, and working to address the deficiencies in the current infrastructure, there is a huge potential to increase organ availability and an opportunity to share experience and expertise amongst Member States.

Senator Colm Burke is the Fine Gael Spokesperson on Health

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Senator Colm Burke

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