Shortage of surgeons causing ‘transplant crisis’

A SHORTAGE of transplant surgeons and kidney donors is leading to an “accelerating crisis” within the service, the head of the National Organ Procurement Service warned yesterday.

Donal Hickey, director of transplantation services at Beaumont Hospital, said both issues had to be tackled head on.

“There are two crises in transplant at the moment - the lack of organs and of people to do the surgery.

“We have four transplant surgeons, we need eight for the size of our programme. Even if there is an increase in the number of donors, we don’t have the personnel to carry out the transplants.”

There are 305 people on the waiting list for kidney transplants.

Four years ago, the transplant rate kept pace with the waiting list so by the end of the year, more transplants (approximately 130-140) were carried out than names on the waiting list at the start of the year.

Mr Hickey said keeping patients on a waiting list was far more costly than carrying out surgery.

“It is one of the few areas where surgery is very cost effective. It can save €100,000 over five years by not having a patient on dialysis.”

Statistics from the Irish Kidney Association (IKA) show there was an 8% increase in the second-half of 2003 in patients requiring dialysis, putting the nationwide figure at 1,043 and increasing pressure on hospitals’ dialysis centres, “of which some are already at saturation point”, the IKA said.

The average waiting time for a kidney transplant has increased from nine months four years ago to 13 months. Thirty more people are waiting for a kidney and pancreas transplant.

The crisis will continue without additional transplant staff, Mr Hickey said.

“There are 28 posts vacant in the UK, and they haven’t got a single applicant. It’s largely down to the lifestyle - the very long hours. The shortage here is placing a huge burden on our staff and it has to be tackled.”

Plans are underway to tackle the donor shortage. Mr Hickey said it was “absolutely essential” that to start a “living related” donor programme, where family of the transplant patient sign up for donation.

Last year, there were no live donors in Ireland, and just one in 2002. In Scandinavia, half of all donors are living related with similar rates in the US.

Mr Hickey said our growing waiting list meant “we will never now match the demand with cadaveric (deceased) donors”.

He said despite the high mortality rate from road traffic accident victims in Ireland, approximately half were unsuitable donors either because of age, or health problems or because of immediate death.

The service hopes to appoint a living related organ donation co-ordinator early next year.

The Department of Health failed to comment on the plans for a living related donor programme or on the need for extra transplant surgeons.