Organs of more than half of potential deceased donors not transplanted 

Organs of more than half of potential deceased donors not transplanted 

An organ-donor card could help save lives after you have died, however surviving family members often object to transplants.

More than half of the deceased people identified as potential donors over a three-year period did not have their organs used in transplant procedures, new figures show.

Figures released under Freedom of Information laws show that between 2017 and 2019, 537 deceased people were referred to Organ Donation Transplant Ireland (ODTI), the HSE’s organ donation management system.

However, of those, 272 did not result in a donation. A lack of consent from the family of the deceased person prevented donations 100 times across the three-year period, while “medical contraindications” made up the remaining 172.

A spokeswoman for the HSE said corresponding figures for 2020 are not available, though there were 30% fewer transplants carried out that year as a result of the Covid-19 pandemic.

The donations that were made in 2019 resulted in 249 transplants. In 2018, there were 234 and in 2017, 260 transplants resulted from the donation of organs from deceased individuals.

An utter disgrace

Philip Watt, chief executive of Cystic Fibrosis Ireland, said it is “an utter disgrace” that the Human Tissue Bill, which was first proposed in 2009, has not yet been enacted.

The Bill provides for a soft opt-out system that would presume consent unless the deceased, while still alive, had specifically stated they do not want to donate organs.

There will be a “soft” element to the change, in which the next-of-kin is still consulted and, if they object, the donation does not proceed.

“At the minute, it’s left to the next-of-kin [to decide] and the next-of-kin are often in a state of shock, and people don’t easily discuss whether they want to be an organ donor or not. Ireland is probably the last country in Europe which is not following the opt-out system,” Mr Watt said.

However, Carol Moore, chief executive of the Irish Kidney Association, said another factor preventing increased transplants is the lack of adequate infrastructure and staff to carry out the procedures.

“One of the issues is the lack of ICU beds.

You have to have your ICU bed and if you don’t have that, you can’t do a transplant. And obviously, the lack of medical consultants. 

"The shortage of medical manpower is a problem area,” she said.

“You still need infrastructure. You can have the legislation, but [it won’t work] unless healthcare professionals are trained to approach people and say ‘we could use your loved one's organs’, because you’ve got to support people, you’ve got to have dedicated staff around that.” 

Approximately 550 people each year are on a waiting list for organ transplants, the majority of whom are seeking kidney transplants. On average, about 30 people die each year while waiting on a transplant.

Unmet need

Jim Egan, head of the ODTI, described the “unmet need” in the sector as substantial. However, he said transplants that occur after donation have to proceed safely.

“There are many circumstances where people generously offer their organs but for technical reasons due to the resuscitation, due to the circumstances in which the person has passed away, risks of infection, the team have to weigh up the risks of the process impacting on the outcome,” he explained.

Prof Egan said additional enhanced ICU beds focused on organ donation, as well as the passing of the Human Tissue Bill would increase the rate of organ donation in Ireland.

Health minister Stephen Donnelly has previously said he intends to bring the bill to Cabinet this year.

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